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
<Bundle xmlns="http://hl7.org/fhir">
<id
value="SpecialPopulations_eve-fhxbrcarisk_eve-acs_act-performriskassessment"/>
<type value="collection"/>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/537"/>
<resource>
<CarePlan>
<id value="537"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="CarePlan_537"> </a><p class="res-header-id"><b>Generated Narrative: CarePlan 537</b></p><a name="537"> </a><a name="hc537"> </a><a name="537-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-SpecialPopulations.html">Special Populations</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-SpecialPopulations_eve-fhxbrcarisk_eve-acs_act-performriskassessment.html#RequestGroup_538">Bundle: type = collection</a></td></tr></table></div>
</text>
<instantiatesCanonical
value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-SpecialPopulations"/>
<status value="draft"/>
<intent value="proposal"/>
<subject>
<reference value="Patient/defaultPatient"/>
<display value="Jane Doe"/>
</subject>
<created value="2024-12-10T00:00:00.0Z"/>
<activity>
<reference>
<reference value="RequestGroup/538"/>
</reference>
</activity>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/538"/>
<resource>
<RequestGroup>
<id value="538"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="RequestGroup_538"> </a><p class="res-header-id"><b>Generated Narrative: RequestGroup 538</b></p><a name="538"> </a><a name="hc538"> </a><a name="538-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-SpecialPopulations.html">Special Populations</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.
If 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.
Validated 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-SpecialPopulations_eve-fhxbrcarisk_eve-acs_act-performriskassessment.html#ServiceRequest_539">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>
</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-SpecialPopulations_eve-fhxbrcarisk_eve-acs_act-performriskassessment.html#ServiceRequest_540">Bundle: type = collection</a></p></blockquote></div>
</text>
<instantiatesCanonical
value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-SpecialPopulations"/>
<status value="draft"/>
<intent value="proposal"/>
<subject>
<reference value="Patient/defaultPatient"/>
<display value="Jane Doe"/>
</subject>
<action id="CompellingFamilyHistory">
<title value="Perform lifetime risk assessment"/>
<description
value="Consider performing assessment of lifetime risk, as defined by models largely dependent on family history.
If 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.
Validated tools include BRCAPRO, Claus, BOADICEA [Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm], and Tyrer-Cuzick."/>
<code>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
<code value="lifetimeriskassessment"/>
<display value="Perform lifetime risk assessment"/>
</coding>
</code>
<documentation>
<type value="citation"/>
<label value="ACS"/>
<display
value="American Cancer Society Recommendations for the Early Detection of Breast Cancer"/>
<url
value="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"/>
</documentation>
<resource>
<reference value="ServiceRequest/539"/>
</resource>
</action>
<action id="USPSTFRecommendation">
<extension
url="http://cancerscreeningcds.github.io/bcsm-cds/StructureDefinition/csm-recommendation-flag">
<valueCodeableConcept>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system"/>
<code value="overdue"/>
<display value="Overdue"/>
</coding>
</valueCodeableConcept>
</extension>
<title value="Biennial screening mammo starting age 40"/>
<description
value="Biennial screening mammogram starting at age 40"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="24606-6"/>
<display value="MG Breast Screening"/>
</coding>
</code>
<documentation>
<type value="citation"/>
<label value="USPSTF"/>
<display
value="Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement"/>
<citation
value="US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024."/>
<url
value="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"/>
</documentation>
<timingTiming>
<event value="2021-01-01"/>
<repeat>
<boundsPeriod>
<start value="2021-01-01"/>
</boundsPeriod>
<frequency value="1"/>
<period value="2"/>
<periodUnit value="a"/>
</repeat>
</timingTiming>
<resource>
<reference value="ServiceRequest/540"/>
</resource>
</action>
</RequestGroup>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/539"/>
<resource>
<ServiceRequest>
<id value="539"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_539"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 539</b></p><a name="539"> </a><a name="hc539"> </a><a name="539-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>
</text>
<basedOn>🔗
<reference
value="http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"/>
</basedOn>
<status value="option"/>
<intent value="proposal"/>
<code>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
<code value="lifetimeriskassessment"/>
<display value="Perform lifetime risk assessment"/>
</coding>
</code>
<subject>
<reference value="Patient/defaultPatient"/>
<display value="Jane Doe"/>
</subject>
<reasonCode>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"/>
<code value="fhxbreastcarisk"/>
<display value="Compelling family history of breast cancer"/>
</coding>
</reasonCode>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/540"/>
<resource>
<ServiceRequest>
<id value="540"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_540"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 540</b></p><a name="540"> </a><a name="hc540"> </a><a name="540-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>
</text>
<basedOn>🔗
<reference
value="http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"/>
</basedOn>
<status value="option"/>
<intent value="proposal"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="24606-6"/>
<display value="MG Breast Screening"/>
</coding>
</code>
<subject>
<reference value="Patient/defaultPatient"/>
<display value="Jane Doe"/>
</subject>
<occurrenceDateTime value="2021-01-01"/>
<reasonCode>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"/>
<code value="USPSTFaveragerisk"/>
<display value="USPSTF average risk"/>
</coding>
</reasonCode>
</ServiceRequest>
</resource>
</entry>
</Bundle>