Colorectal Cancer Screening and Management (CRCSM) Clinical Decision Support (CDS) Implementation Guide
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: HighLevel_HollyHereditary - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="HighLevel_HollyHereditary"/>
  <type value="collection"/>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/crcsm-cds/CarePlan/36"/>
    <resource>
      <CarePlan>
        <id value="36"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="CarePlan_36"> </a><p class="res-header-id"><b>Generated Narrative: CarePlan 36</b></p><a name="36"> </a><a name="hc36"> </a><a name="36-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-HighLevel.html">High Level Flow</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href="Bundle-HollyHereditary.html#Patient_HollyHereditary">Holly Hereditary</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-HighLevel_HollyHereditary.html#RequestGroup_37">Bundle: type = collection</a></td></tr></table></div>
        </text>
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                               value="http://cancerscreeningcds.github.io/crcsm-cds/PlanDefinition/HighLevel"/>
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          <reference value="Patient/HollyHereditary"/>
          <display value="Holly Hereditary"/>
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        <created value="2024-12-10T00:00:00.0Z"/>
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    <fullUrl
             value="http://cancerscreeningcds.github.io/crcsm-cds/RequestGroup/37"/>
    <resource>
      <RequestGroup>
        <id value="37"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="RequestGroup_37"> </a><p class="res-header-id"><b>Generated Narrative: RequestGroup 37</b></p><a name="37"> </a><a name="hc37"> </a><a name="37-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-HighLevel.html">High Level Flow</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href="Bundle-HollyHereditary.html#Patient_HollyHereditary">Holly Hereditary</a></p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>39</blockquote><p><b>title</b>: Primary Screening Decision</p><p><b>description</b>: Primary Screening Decision pathway.</p><p><b>resource</b>: <a href="Bundle-HighLevel_HollyHereditary.html#CarePlan_40">Bundle: type = collection</a></p></blockquote></div>
        </text>
        <instantiatesCanonical
                               value="http://cancerscreeningcds.github.io/crcsm-cds/PlanDefinition/HighLevel"/>
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          <reference value="Patient/HollyHereditary"/>
          <display value="Holly Hereditary"/>
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          <title value="Primary Screening Decision"/>
          <description value="Primary Screening Decision pathway."/>
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    <fullUrl
             value="http://cancerscreeningcds.github.io/crcsm-cds/CarePlan/40"/>
    <resource>
      <CarePlan>
        <id value="40"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="CarePlan_40"> </a><p class="res-header-id"><b>Generated Narrative: CarePlan 40</b></p><a name="40"> </a><a name="hc40"> </a><a name="40-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-PrimaryScreeningDecision.html">Primary Screening Decision</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href="Bundle-HollyHereditary.html#Patient_HollyHereditary">Holly Hereditary</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-HighLevel_HollyHereditary.html#RequestGroup_41">Bundle: type = collection</a></td></tr></table></div>
        </text>
        <instantiatesCanonical
                               value="http://cancerscreeningcds.github.io/crcsm-cds/PlanDefinition/PrimaryScreeningDecision"/>
        <status value="option"/>
        <intent value="proposal"/>
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          <reference value="Patient/HollyHereditary"/>
          <display value="Holly Hereditary"/>
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        <created value="2024-12-10T00:00:00.0Z"/>
        <activity>
          <reference>
            <reference value="RequestGroup/41"/>
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  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/crcsm-cds/RequestGroup/41"/>
    <resource>
      <RequestGroup>
        <id value="41"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="RequestGroup_41"> </a><p class="res-header-id"><b>Generated Narrative: RequestGroup 41</b></p><a name="41"> </a><a name="hc41"> </a><a name="41-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-HollyHereditary.html#Patient_HollyHereditary">Holly Hereditary</a></p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>HereditarySyndromesSurveillance</blockquote><p><b>title</b>: Colorectal cancer surveillance per specialist recommendations</p><p><b>description</b>: Refer to GI specialist for colorectal cancer (and possibly additional cancers) surveillance recommendations.

Patients with a hereditary cancer syndrome require specialized management and colonoscopy surveillance for colorectal cancer (as well as additional surveillance for other cancers). Recommendations on when to start surveillance and surveillance intervals vary according to the syndrome.</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></tr><tr><td style="display: none">*</td><td>Citation</td><td>ACG Hereditary Syndromes (2015)</td><td>ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes</td><td><div><p>Syngal, S., et al. (2015). ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes. American Journal of Gastroenterology 110(2):p 223-262. https://doi.org/10.1038/ajg.2014.435</p>
</div></td></tr></table><p><b>resource</b>: <a href="Bundle-HighLevel_HollyHereditary.html#ServiceRequest_42">Bundle: type = collection</a></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>HistoryPolypsIncreasedRisk</blockquote><p><b>title</b>: Post-polypectomy surveillance</p><p><b>description</b>: Follow endoscopist-recommended interval. </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></tr><tr><td style="display: none">*</td><td>Citation</td><td>USMSTF Follow-Up After Colonoscopy and Polypectomy (2020)</td><td>Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer</td><td><div><p>Gupta, S., et al. (2020). Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 158(4), 1131–1153.e5. https://doi.org/10.1053/j.gastro.2019.10.026</p>
</div></td></tr></table><p><b>resource</b>: <a href="Bundle-HighLevel_HollyHereditary.html#ServiceRequest_43">Bundle: type = collection</a></p></blockquote></div>
        </text>
        <instantiatesCanonical
                               value="http://cancerscreeningcds.github.io/crcsm-cds/PlanDefinition/PrimaryScreeningDecision"/>
        <status value="draft"/>
        <intent value="proposal"/>
        <subject>
          <reference value="Patient/HollyHereditary"/>
          <display value="Holly Hereditary"/>
        </subject>
        <action id="HereditarySyndromesSurveillance">
          <title
                 value="Colorectal cancer surveillance per specialist recommendations"/>
          <description
                       value="Refer to GI specialist for colorectal cancer (and possibly additional cancers) surveillance recommendations.

Patients with a hereditary cancer syndrome require specialized management and colonoscopy surveillance for colorectal cancer (as well as additional surveillance for other cancers). Recommendations on when to start surveillance and surveillance intervals vary according to the syndrome."/>
          <documentation>
            <type value="citation"/>
            <label value="ACG Hereditary Syndromes (2015)"/>
            <display
                     value="ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes"/>
            <citation
                      value="Syngal, S., et al. (2015). ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes. American Journal of Gastroenterology 110(2):p 223-262. https://doi.org/10.1038/ajg.2014.435"/>
          </documentation>
          <resource>
            <reference value="ServiceRequest/42"/>
          </resource>
        </action>
        <action id="HistoryPolypsIncreasedRisk">
          <title value="Post-polypectomy surveillance"/>
          <description value="Follow endoscopist-recommended interval. "/>
          <documentation>
            <type value="citation"/>
            <label
                   value="USMSTF Follow-Up After Colonoscopy and Polypectomy (2020)"/>
            <display
                     value="Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer"/>
            <citation
                      value="Gupta, S., et al. (2020). Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 158(4), 1131–1153.e5. https://doi.org/10.1053/j.gastro.2019.10.026"/>
          </documentation>
          <resource>
            <reference value="ServiceRequest/43"/>
          </resource>
        </action>
      </RequestGroup>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/crcsm-cds/ServiceRequest/42"/>
    <resource>
      <ServiceRequest>
        <id value="42"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_42"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 42</b></p><a name="42"> </a><a name="hc42"> </a><a name="42-en-US"> </a><p><b>basedOn</b>: <a href="ActivityDefinition-ColorectalCancerScreeningServiceRequest.html">Colorectal 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://snomed.info/sct 452071000124102}">Surveillance for colorectal cancer (regime/therapy)</span></p><p><b>subject</b>: <a href="Bundle-HollyHereditary.html#Patient_HollyHereditary">Holly Hereditary</a></p><p><b>reasonCode</b>: <span title="Codes:{http://snomed.info/sct 699346009}">Hereditary cancer-predisposing syndrome (disorder)</span></p></div>
        </text>
        <basedOn>🔗 
          <reference
                     value="http://cancerscreeningcds.github.io/crcsm-cds/ActivityDefinition/ColorectalCancerScreeningServiceRequest"/>
        </basedOn>
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        <intent value="proposal"/>
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            <display
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        <subject>
          <reference value="Patient/HollyHereditary"/>
          <display value="Holly Hereditary"/>
        </subject>
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            <system value="http://snomed.info/sct"/>
            <code value="699346009"/>
            <display
                     value="Hereditary cancer-predisposing syndrome (disorder)"/>
          </coding>
        </reasonCode>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://cancerscreeningcds.github.io/crcsm-cds/ServiceRequest/43"/>
    <resource>
      <ServiceRequest>
        <id value="43"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_43"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 43</b></p><a name="43"> </a><a name="hc43"> </a><a name="43-en-US"> </a><p><b>basedOn</b>: <a href="ActivityDefinition-ColorectalCancerScreeningServiceRequest.html">Colorectal 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/crcsm-cds/CodeSystem/plan-definition-action-code-system increasedriskscreening}">Increased risk screening for colorectal cancer</span></p><p><b>subject</b>: <a href="Bundle-HollyHereditary.html#Patient_HollyHereditary">Holly Hereditary</a></p><p><b>reasonCode</b>: <span title="Codes:{http://cancerscreeningcds.github.io/crcsm-cds/CodeSystem/plan-definition-action-reason-code-system historyofprecancerouspolyps}">History of potentially precancerous polyps</span></p></div>
        </text>
        <basedOn>🔗 
          <reference
                     value="http://cancerscreeningcds.github.io/crcsm-cds/ActivityDefinition/ColorectalCancerScreeningServiceRequest"/>
        </basedOn>
        <status value="option"/>
        <intent value="proposal"/>
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          <coding>
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                    value="http://cancerscreeningcds.github.io/crcsm-cds/CodeSystem/plan-definition-action-code-system"/>
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            <display value="Increased risk screening for colorectal cancer"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/HollyHereditary"/>
          <display value="Holly Hereditary"/>
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        <reasonCode>
          <coding>
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                    value="http://cancerscreeningcds.github.io/crcsm-cds/CodeSystem/plan-definition-action-reason-code-system"/>
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            <display value="History of potentially precancerous polyps"/>
          </coding>
        </reasonCode>
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</Bundle>