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="DecisionToScreen_act-sdmcontinuelifexp__end-decisionspecialpop"/>
<type value="collection"/>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/291"/>
<resource>
<CarePlan>
<id value="291"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="CarePlan_291"> </a><p class="res-header-id"><b>Generated Narrative: CarePlan 291</b></p><a name="291"> </a><a name="hc291"> </a><a name="291-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-DecisionToScreen.html">Decision to Screen</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-DecisionToScreen_act-sdmcontinuelifexp__end-decisionspecialpop.html#RequestGroup_292">Bundle: type = collection</a></td></tr></table></div>
</text>
<instantiatesCanonical
value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-DecisionToScreen"/>
<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/292"/>
</reference>
</activity>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/292"/>
<resource>
<RequestGroup>
<id value="292"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="RequestGroup_292"> </a><p class="res-header-id"><b>Generated Narrative: RequestGroup 292</b></p><a name="292"> </a><a name="hc292"> </a><a name="292-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-DecisionToScreen.html">Decision to Screen</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>SDMContinueScreeningLifeExp</blockquote><p><b>title</b>: Shared decision making to continue screening based on life expectancy</p><p><b>description</b>: Decision to continue screening mammography in cases of limited life expectancy should be based on shared decision-making.
ACS advises that women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or more.
Life expectancy is generally defined as having greater than a 50% probability of surviving 10 years. A validated tool such as www.eprognosis.com can help guide decision making.</p><p><b>code</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system sdmcontinue}">Shared decision making to continue 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>ACS</td><td>Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society</td><td><div><p>Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, Morris E, Pisano E, Schnall M, Sener S, Smith RA, Warner E, Yaffe M, Andrews KS, Russell CA; American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89.</p>
</div></td><td><a href="https://jamanetwork.com/journals/jama/fullarticle/2463262">https://jamanetwork.com/journals/jama/fullarticle/2463262</a></td></tr></table><p><b>resource</b>: <a href="Bundle-DecisionToScreen_act-sdmcontinuelifexp__end-decisionspecialpop.html#CommunicationRequest_293">Bundle: type = collection</a></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>ACSMammoHighRisk</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>: Annual screening mammogram starting age 30</p><p><b>description</b>: An annual screening mammogram starting at age 30 is recommended.
Women who are at higher than average risk for breast cancer based on certain risk factors should get a mammogram every year, typically starting at age 30.</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>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>timing</b>: Events: 2011-01-01 , Once per 1 year</p><p><b>resource</b>: <a href="Bundle-DecisionToScreen_act-sdmcontinuelifexp__end-decisionspecialpop.html#ServiceRequest_294">Bundle: type = collection</a></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>ACSMriHighRisk</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>: Annual screening MRI starting age 30</p><p><b>description</b>: An annual screening MRI starting at age 30 is recommended.
Women who are at higher than average risk for breast cancer based on certain risk factors should get a breast MRI every year, typically starting at age 30.</p><p><b>code</b>: <span title="Codes:{http://loinc.org 30794-2}">MR Breast</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>ACS</td><td>American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography</td><td><div><p>Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA. 2015;314(15):1599–1614.</p>
</div></td><td><a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75">https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75</a></td></tr></table><p><b>timing</b>: Events: 2011-01-01 , Once per 1 year</p><p><b>resource</b>: <a href="Bundle-DecisionToScreen_act-sdmcontinuelifexp__end-decisionspecialpop.html#ServiceRequest_295">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-DecisionToScreen_act-sdmcontinuelifexp__end-decisionspecialpop.html#ServiceRequest_296">Bundle: type = collection</a></p></blockquote></div>
</text>
<instantiatesCanonical
value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-DecisionToScreen"/>
<status value="draft"/>
<intent value="proposal"/>
<subject>
<reference value="Patient/defaultPatient"/>
<display value="Jane Doe"/>
</subject>
<action id="SDMContinueScreeningLifeExp">
<title
value="Shared decision making to continue screening based on life expectancy"/>
<description
value="Decision to continue screening mammography in cases of limited life expectancy should be based on shared decision-making.
ACS advises that women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or more.
Life expectancy is generally defined as having greater than a 50% probability of surviving 10 years. A validated tool such as www.eprognosis.com can help guide decision making."/>
<code>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
<code value="sdmcontinue"/>
<display value="Shared decision making to continue screening"/>
</coding>
</code>
<documentation>
<type value="citation"/>
<label value="ACS"/>
<display
value="Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society"/>
<citation
value="Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, Morris E, Pisano E, Schnall M, Sener S, Smith RA, Warner E, Yaffe M, Andrews KS, Russell CA; American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89."/>
<url
value="https://jamanetwork.com/journals/jama/fullarticle/2463262"/>
</documentation>
<resource>
<reference value="CommunicationRequest/293"/>
</resource>
</action>
<action id="ACSMammoHighRisk">
<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="Annual screening mammogram starting age 30"/>
<description
value="An annual screening mammogram starting at age 30 is recommended.
Women who are at higher than average risk for breast cancer based on certain risk factors should get a mammogram every year, typically starting at age 30."/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="24606-6"/>
<display value="MG Breast Screening"/>
</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>
<timingTiming>
<event value="2011-01-01"/>
<repeat>
<boundsPeriod>
<start value="2011-01-01"/>
</boundsPeriod>
<frequency value="1"/>
<period value="1"/>
<periodUnit value="a"/>
</repeat>
</timingTiming>
<resource>
<reference value="ServiceRequest/294"/>
</resource>
</action>
<action id="ACSMriHighRisk">
<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="Annual screening MRI starting age 30"/>
<description
value="An annual screening MRI starting at age 30 is recommended.
Women who are at higher than average risk for breast cancer based on certain risk factors should get a breast MRI every year, typically starting at age 30."/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="30794-2"/>
<display value="MR Breast"/>
</coding>
</code>
<documentation>
<type value="citation"/>
<label value="ACS"/>
<display
value="American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography"/>
<citation
value="Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA. 2015;314(15):1599–1614."/>
<url
value="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75"/>
</documentation>
<timingTiming>
<event value="2011-01-01"/>
<repeat>
<boundsPeriod>
<start value="2011-01-01"/>
</boundsPeriod>
<frequency value="1"/>
<period value="1"/>
<periodUnit value="a"/>
</repeat>
</timingTiming>
<resource>
<reference value="ServiceRequest/295"/>
</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/296"/>
</resource>
</action>
</RequestGroup>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/CommunicationRequest/293"/>
<resource>
<CommunicationRequest>
<id value="293"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="CommunicationRequest_293"> </a><p class="res-header-id"><b>Generated Narrative: CommunicationRequest 293</b></p><a name="293"> </a><a name="hc293"> </a><a name="293-en-US"> </a><p><b>basedOn</b>: <a href="ActivityDefinition-CommunicateSDMContinueScreening.html">Communicate Shared Decision Making to Continue Screening</a></p><p><b>status</b>: option</p><p><b>subject</b>: <a href="Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient">Jane Doe</a></p><h3>Payloads</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Content[x]</b></td></tr><tr><td style="display: none">*</td><td>Shared decision making to continue screening</td></tr></table><p><b>reasonCode</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system lifeexp}">Reduced life expectancy indicator</span></p></div>
</text>
<basedOn>🔗
<reference
value="http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateSDMContinueScreening"/>
</basedOn>
<status value="option"/>
<subject>
<reference value="Patient/defaultPatient"/>
<display value="Jane Doe"/>
</subject>
<payload>
<contentString
value="Shared decision making to continue screening"/>
</payload>
<reasonCode>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"/>
<code value="lifeexp"/>
<display value="Reduced life expectancy indicator"/>
</coding>
</reasonCode>
</CommunicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/294"/>
<resource>
<ServiceRequest>
<id value="294"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_294"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 294</b></p><a name="294"> </a><a name="hc294"> </a><a name="294-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>: 2011-01-01</p><p><b>reasonCode</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system highlifetimerisk}">High lifetime 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="2011-01-01"/>
<reasonCode>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"/>
<code value="highlifetimerisk"/>
<display value="High lifetime risk"/>
</coding>
</reasonCode>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/295"/>
<resource>
<ServiceRequest>
<id value="295"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_295"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 295</b></p><a name="295"> </a><a name="hc295"> </a><a name="295-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 30794-2}">MR Breast</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>: 2011-01-01</p><p><b>reasonCode</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system highlifetimerisk}">High lifetime 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="30794-2"/>
<display value="MR Breast"/>
</coding>
</code>
<subject>
<reference value="Patient/defaultPatient"/>
<display value="Jane Doe"/>
</subject>
<occurrenceDateTime value="2011-01-01"/>
<reasonCode>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"/>
<code value="highlifetimerisk"/>
<display value="High lifetime risk"/>
</coding>
</reasonCode>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/296"/>
<resource>
<ServiceRequest>
<id value="296"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_296"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 296</b></p><a name="296"> </a><a name="hc296"> </a><a name="296-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>