Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide
1.0.0 - ci-build
Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "PrimaryScreeningDecision_eve-fhxbrcarisk_uspstf_only",
"type" : "collection",
"entry" : [
{
"fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/175",
"resource" : {
"resourceType" : "CarePlan",
"id" : "175",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"CarePlan_175\"> </a><p class=\"res-header-id\"><b>Generated Narrative: CarePlan 175</b></p><a name=\"175\"> </a><a name=\"hc175\"> </a><a name=\"175-en-US\"> </a><p><b>instantiatesCanonical</b>: <a href=\"PlanDefinition-PrimaryScreeningDecision.html\">Primary Screening Decision</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>created</b>: 2024-12-10 00:00:00+0000</p><h3>Activities</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Reference</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-PrimaryScreeningDecision_eve-fhxbrcarisk_uspstf_only.html#RequestGroup_176\">Bundle: type = collection</a></td></tr></table></div>"
},
"instantiatesCanonical" : [
🔗 "http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/PrimaryScreeningDecision"
],
"status" : "draft",
"intent" : "proposal",
"subject" : {
"reference" : "Patient/defaultPatient",
"display" : "Jane Doe"
},
"created" : "2024-12-10T00:00:00.0Z",
"activity" : [
{
"reference" : {
"reference" : "RequestGroup/176"
}
}
]
}
},
{
"fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/176",
"resource" : {
"resourceType" : "RequestGroup",
"id" : "176",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RequestGroup_176\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RequestGroup 176</b></p><a name=\"176\"> </a><a name=\"hc176\"> </a><a name=\"176-en-US\"> </a><p><b>instantiatesCanonical</b>: <a href=\"PlanDefinition-PrimaryScreeningDecision.html\">Primary Screening Decision</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>CompellingFamilyHistory</blockquote><p><b>title</b>: Perform lifetime risk assessment</p><p><b>description</b>: Consider performing assessment of lifetime risk, as defined by models largely dependent on family history.\n\nIf estimated lifetime risk is >20%, based on informal assessment or assessment using validated risk model, then patient is eligible for annual screening mammogram starting at age 30 and supplemental screening with annual screening MRI. Otherwise, patient can be offered annual screening mammogram starting at age 40.\n\nValidated tools include BRCAPRO, Claus, BOADICEA [Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm], and Tyrer-Cuzick.</p><p><b>code</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system lifetimeriskassessment}\">Perform lifetime risk assessment</span></p><h3>Documentations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Label</b></td><td><b>Display</b></td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>ACS</td><td>American Cancer Society Recommendations for the Early Detection of Breast Cancer</td><td><a href=\"https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html\">https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html</a></td></tr></table><p><b>resource</b>: <a href=\"Bundle-PrimaryScreeningDecision_eve-fhxbrcarisk_uspstf_only.html#ServiceRequest_177\">Bundle: type = collection</a></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>USPSTFRecommendation</blockquote><p><b>Recommendation Flag Extension</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system overdue}\">Overdue</span></p><p><b>title</b>: Biennial screening mammo starting age 40</p><p><b>description</b>: Biennial screening mammogram starting at age 40</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 24606-6}\">MG Breast Screening</span></p><h3>Documentations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Label</b></td><td><b>Display</b></td><td><b>Citation</b></td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>USPSTF</td><td>Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement</td><td><div><p>US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024.</p>\n</div></td><td><a href=\"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening\">https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening</a></td></tr></table><p><b>timing</b>: Events: 2021-01-01 , Once per 2 years</p><p><b>resource</b>: <a href=\"Bundle-PrimaryScreeningDecision_eve-fhxbrcarisk_uspstf_only.html#ServiceRequest_178\">Bundle: type = collection</a></p></blockquote></div>"
},
"instantiatesCanonical" : [
🔗 "http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/PrimaryScreeningDecision"
],
"status" : "draft",
"intent" : "proposal",
"subject" : {
"reference" : "Patient/defaultPatient",
"display" : "Jane Doe"
},
"action" : [
{
"id" : "CompellingFamilyHistory",
"title" : "Perform lifetime risk assessment",
"description" : "Consider performing assessment of lifetime risk, as defined by models largely dependent on family history.\n\nIf estimated lifetime risk is >20%, based on informal assessment or assessment using validated risk model, then patient is eligible for annual screening mammogram starting at age 30 and supplemental screening with annual screening MRI. Otherwise, patient can be offered annual screening mammogram starting at age 40.\n\nValidated tools include BRCAPRO, Claus, BOADICEA [Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm], and Tyrer-Cuzick.",
"code" : [
{
"coding" : [
{
"system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system",
"code" : "lifetimeriskassessment",
"display" : "Perform lifetime risk assessment"
}
]
}
],
"documentation" : [
{
"type" : "citation",
"label" : "ACS",
"display" : "American Cancer Society Recommendations for the Early Detection of Breast Cancer",
"url" : "https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html"
}
],
"resource" : {
"reference" : "ServiceRequest/177"
}
},
{
"id" : "USPSTFRecommendation",
"extension" : [
{
"url" : "http://cancerscreeningcds.github.io/bcsm-cds/StructureDefinition/csm-recommendation-flag",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system",
"code" : "overdue",
"display" : "Overdue"
}
]
}
}
],
"title" : "Biennial screening mammo starting age 40",
"description" : "Biennial screening mammogram starting at age 40",
"code" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "24606-6",
"display" : "MG Breast Screening"
}
]
}
],
"documentation" : [
{
"type" : "citation",
"label" : "USPSTF",
"display" : "Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement",
"citation" : "US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024.",
"url" : "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"
}
],
"timingTiming" : {
"event" : [
"2021-01-01"
],
"repeat" : {
"boundsPeriod" : {
"start" : "2021-01-01"
},
"frequency" : 1,
"period" : 2,
"periodUnit" : "a"
}
},
"resource" : {
"reference" : "ServiceRequest/178"
}
}
]
}
},
{
"fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/177",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "177",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_177\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 177</b></p><a name=\"177\"> </a><a name=\"hc177\"> </a><a name=\"177-en-US\"> </a><p><b>basedOn</b>: <a href=\"ActivityDefinition-BreastCancerScreeningServiceRequest.html\">Breast Cancer Screening Service Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system lifetimeriskassessment}\">Perform lifetime risk assessment</span></p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>reasonCode</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system fhxbreastcarisk}\">Compelling family history of breast cancer</span></p></div>"
},
"basedOn" : [
{
🔗 "reference" : "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"
}
],
"status" : "option",
"intent" : "proposal",
"code" : {
"coding" : [
{
"system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system",
"code" : "lifetimeriskassessment",
"display" : "Perform lifetime risk assessment"
}
]
},
"subject" : {
"reference" : "Patient/defaultPatient",
"display" : "Jane Doe"
},
"reasonCode" : [
{
"coding" : [
{
"system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system",
"code" : "fhxbreastcarisk",
"display" : "Compelling family history of breast cancer"
}
]
}
]
}
},
{
"fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/178",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "178",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_178\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 178</b></p><a name=\"178\"> </a><a name=\"hc178\"> </a><a name=\"178-en-US\"> </a><p><b>basedOn</b>: <a href=\"ActivityDefinition-BreastCancerScreeningServiceRequest.html\">Breast Cancer Screening Service Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 24606-6}\">MG Breast Screening</span></p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>occurrence</b>: 2021-01-01</p><p><b>reasonCode</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system USPSTFaveragerisk}\">USPSTF average risk</span></p></div>"
},
"basedOn" : [
{
🔗 "reference" : "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"
}
],
"status" : "option",
"intent" : "proposal",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "24606-6",
"display" : "MG Breast Screening"
}
]
},
"subject" : {
"reference" : "Patient/defaultPatient",
"display" : "Jane Doe"
},
"occurrenceDateTime" : "2021-01-01",
"reasonCode" : [
{
"coding" : [
{
"system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system",
"code" : "USPSTFaveragerisk",
"display" : "USPSTF average risk"
}
]
}
]
}
}
]
}