Examples
The Lung Cancer Diagnosis Pathway from Ontario Health is modeled using a FHIR PlanDefinition. This umbrella instance holds sub PlanDefinitions that correspond to the scores and outcomes of the Low-Dose chest CT scan. Theses decision points determine the path a patient will follow as they progress through the pathway map.
An exmaple of the overarching PlanDefinition - An Example of a PlanDefinition
PlanDefinition.identifier[0].system[0] | http://someIdentifier.com |
PlanDefinition.identifier[0].value[0] | LungDiagnosis_PD |
PlanDefinition.name[0] | LungCancerDiagnosis |
PlanDefinition.title[0] | Lung Cancer Diagnosis |
PlanDefinition.type[0].coding[0].code[0] | workflow-definition |
PlanDefinition.status[0] | active |
PlanDefinition.action[0].title[0] | LDCT Lung |
PlanDefinition.action[0].trigger[0].type[0] | data-added |
PlanDefinition.action[0].trigger[0].data[0].type[0] | Observation |
PlanDefinition.action[0].trigger[0].data[0].codeFilter[0].code[0].system[0] | http://snomed.org |
PlanDefinition.action[0].trigger[0].data[0].codeFilter[0].code[0].code[0] | 66857006 |
PlanDefinition.action[0].trigger[0].data[0].codeFilter[0].code[0].display[0] | Hemoptysis |
PlanDefinition.action[0].condition[0].kind[0] | start |
PlanDefinition.action[0].condition[0].expression[0].expression[0] | START EXP TO BE FILLED IN |
PlanDefinition.action[0].condition[1].kind[0] | stop |
PlanDefinition.action[0].condition[1].expression[0].expression[0] | STOP EXP TO BE FILLED IN |
PlanDefinition.action[0].definition[0] | ActivityDefinition/LDCTLungActDef1 |
PlanDefinition.action[1].title[0] | Lung Rads 1 |
PlanDefinition.action[1].trigger[0].type[0] | data-added |
PlanDefinition.action[1].trigger[0].data[0].type[0] | Observation |
PlanDefinition.action[1].trigger[0].data[0].codeFilter[0].code[0].system[0] | http://snomed.org |
PlanDefinition.action[1].trigger[0].data[0].codeFilter[0].code[0].code[0] | 16334891000119106 |
PlanDefinition.action[1].trigger[0].data[0].codeFilter[0].code[0].display[0] | Low dose computed tomography of chest without contrast (procedure) |
PlanDefinition.action[1].condition[0].kind[0] | start |
PlanDefinition.action[1].condition[0].expression[0].language[0] | application/x-fhir-query |
PlanDefinition.action[1].condition[0].expression[0].expression[0] | /Observation?subject:Patient/{id}/&value-concept=http://radlex.org|RID50136 |
PlanDefinition.action[1].condition[1].kind[0] | stop |
PlanDefinition.action[1].condition[1].expression[0].language[0] | text/cql |
PlanDefinition.action[1].condition[1].expression[0].expression[0] | TO BE FILLED IN - 5 years of follow up |
PlanDefinition.action[1].definition[0] | PlanDefinition/LungDiagnosis_PD1 |
PlanDefinition.action[2].title[0] | Lung Rads 2 |
PlanDefinition.action[2].trigger[0].type[0] | data-added |
PlanDefinition.action[2].trigger[0].data[0].type[0] | Observation |
PlanDefinition.action[2].trigger[0].data[0].codeFilter[0].code[0].system[0] | http://snomed.org |
PlanDefinition.action[2].trigger[0].data[0].codeFilter[0].code[0].code[0] | 16334891000119106 |
PlanDefinition.action[2].trigger[0].data[0].codeFilter[0].code[0].display[0] | Low dose computed tomography of chest without contrast (procedure) |
PlanDefinition.action[2].condition[0].kind[0] | start |
PlanDefinition.action[2].condition[0].expression[0].language[0] | application/x-fhir-query |
PlanDefinition.action[2].condition[0].expression[0].expression[0] | /Observation?subject:Patient/{id}/&value-concept=http://radlex.org|RID50137 |
PlanDefinition.action[2].condition[1].kind[0] | stop |
PlanDefinition.action[2].condition[1].expression[0].language[0] | text/cql |
PlanDefinition.action[2].condition[1].expression[0].expression[0] | Low Dose Chest CT Within 5 Years |
PlanDefinition.action[2].definition[0] | PlanDefinition/LungDiagnosis_PD2 |
PlanDefinition.action[3].title[0] | Lung Rads 3 |
PlanDefinition.action[3].trigger[0].type[0] | data-added |
PlanDefinition.action[3].trigger[0].data[0].type[0] | Observation |
PlanDefinition.action[3].trigger[0].data[0].codeFilter[0].code[0].system[0] | http://snomed.org |
PlanDefinition.action[3].trigger[0].data[0].codeFilter[0].code[0].code[0] | 16334891000119106 |
PlanDefinition.action[3].trigger[0].data[0].codeFilter[0].code[0].display[0] | Low dose computed tomography of chest without contrast (procedure) |
PlanDefinition.action[3].condition[0].kind[0] | start |
PlanDefinition.action[3].condition[0].expression[0].language[0] | application/x-fhir-query |
PlanDefinition.action[3].condition[0].expression[0].expression[0] | /Observation?subject:Patient/{id}/&value-concept=http://radlex.org|RID50138 |
PlanDefinition.action[3].definition[0] | PlanDefinition/LungDiagnosis_PD3 |
PlanDefinition.action[4].title[0] | Lung Rads 4A |
PlanDefinition.action[4].trigger[0].type[0] | data-added |
PlanDefinition.action[4].trigger[0].data[0].type[0] | Observation |
PlanDefinition.action[4].trigger[0].data[0].codeFilter[0].code[0].system[0] | http://snomed.org |
PlanDefinition.action[4].trigger[0].data[0].codeFilter[0].code[0].code[0] | 16334891000119106 |
PlanDefinition.action[4].trigger[0].data[0].codeFilter[0].code[0].display[0] | Low dose computed tomography of chest without contrast (procedure) |
PlanDefinition.action[4].condition[0].kind[0] | start |
PlanDefinition.action[4].condition[0].expression[0].language[0] | application/x-fhir-query |
PlanDefinition.action[4].condition[0].expression[0].expression[0] | /Observation?subject:Patient/{id}/&value-concept=http://radlex.org|RID50139 |
PlanDefinition.action[4].definition[0] | PlanDefinition/LungDiagnosis_PD4A |
PlanDefinition.action[5].title[0] | Lung Rads 4B |
PlanDefinition.action[5].trigger[0].type[0] | data-added |
PlanDefinition.action[5].trigger[0].data[0].type[0] | Observation |
PlanDefinition.action[5].trigger[0].data[0].codeFilter[0].code[0].system[0] | http://snomed.org |
PlanDefinition.action[5].trigger[0].data[0].codeFilter[0].code[0].code[0] | 16334891000119106 |
PlanDefinition.action[5].trigger[0].data[0].codeFilter[0].code[0].display[0] | Low dose computed tomography of chest without contrast (procedure) |
PlanDefinition.action[5].condition[0].kind[0] | start |
PlanDefinition.action[5].condition[0].expression[0].language[0] | application/x-fhir-query |
PlanDefinition.action[5].condition[0].expression[0].expression[0] | /Observation?subject:Patient/{id}/&value-concept=http://radlex.org|RID50140 |
PlanDefinition.action[5].definition[0] | PlanDefinition/LungDiagnosis_PD4B |
PlanDefinition.action[6].title[0] | Lung Rads 4X |
PlanDefinition.action[6].trigger[0].type[0] | data-added |
PlanDefinition.action[6].trigger[0].data[0].type[0] | Observation |
PlanDefinition.action[6].trigger[0].data[0].codeFilter[0].code[0].system[0] | http://snomed.org |
PlanDefinition.action[6].trigger[0].data[0].codeFilter[0].code[0].code[0] | 16334891000119106 |
PlanDefinition.action[6].trigger[0].data[0].codeFilter[0].code[0].display[0] | Low dose computed tomography of chest without contrast (procedure) |
PlanDefinition.action[6].condition[0].kind[0] | start |
PlanDefinition.action[6].condition[0].expression[0].language[0] | application/x-fhir-query |
PlanDefinition.action[6].condition[0].expression[0].expression[0] | /Observation?subject:Patient/{id}/&value-concept=http://radlex.org|RID50141 |
PlanDefinition.action[6].definition[0] | PlanDefinition/LungDiagnosis_PD4X |
The corresponding decision points are represented as sub PlanDefinitions
Lung RADS-1 - 12 month follow up - An Example of a PlanDefinition
Lung RADS-3 - 6 month follow up - An Example of a PlanDefinition
Lung RADS-4A - 3 month follow up - An Example of a PlanDefinition
Each PlanDefinition is associated with one or ore actions. The triggering of the Low dose computed tomography is achieved when the symptom that is associated with triggering the PlanDefinition is added using the action.trigger.type="data-added".
The action.definitionCanonical is path to the ActivityDefinition that will produce the service request for the procedure. The ActivityDefinition.kind denotes the expected resource as a result of the $apply operation.
ActivityDefinition.identifier[0].system[0] | http://someIdentifier.com |
ActivityDefinition.identifier[0].value[0] | LDCTLungActDef1 |
ActivityDefinition.status[0] | active |
ActivityDefinition.relatedArtifact[0].type[0] | composed-of |
ActivityDefinition.relatedArtifact[0].display[0] | CCO LDCT Lung Radiology Reporting Template |
ActivityDefinition.relatedArtifact[0].url[0] | https://somehospital.on.ca/SDC/LDCT_Lung1 |
ActivityDefinition.kind[0] | ServiceRequest |
ActivityDefinition.code[0].coding[0].system[0] | http://snomed.org/ |
ActivityDefinition.code[0].coding[0].code[0] | 16334891000119106 |
ActivityDefinition.code[0].coding[0].display[0] | Low dose computed tomography of chest without contrast (procedure) |
Service request for chest CT - An Example of a ServiceRequest