Atrius India Core FHIR Implementation Guide
0.1.0 - ci-build

Atrius India Core FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Atrius Imaging Appropriateness (Lumbar MRI)

Draft as of 2026-07-24

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{
  "resourceType" : "PlanDefinition",
  "id" : "atrius-imaging-appropriateness",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/StructureDefinition/cdshooksserviceplandefinition|4.0.1"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>See <code>Library/AtriusImagingAppropriateness</code> for gating expressions and ValueSets.</p></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-cdsHooksEndpoint",
      "valueUri" : "https://cds.atrius.in/cds-services/atrius-imaging-appropriateness"
    }
  ],
  "url" : "https://atrius.in/fhir/r4/atrius-in/PlanDefinition/atrius-imaging-appropriateness",
  "identifier" : [
    {
      "use" : "official",
      "value" : "atrius-imaging-appropriateness"
    },
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:1.3.6.1.4.1.66219.1.34.3"
    }
  ],
  "version" : "0.1.0",
  "name" : "AtriusImagingAppropriateness",
  "title" : "Imaging Appropriateness (Lumbar MRI)",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule"
      }
    ]
  },
  "status" : "draft",
  "experimental" : true,
  "date" : "2026-07-24T19:16:12+05:30",
  "publisher" : "Atrius",
  "contact" : [
    {
      "name" : "Atrius",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://atrius.in"
        }
      ]
    }
  ],
  "description" : "When a lumbar spine MRI is selected for a patient whose low back pain began within 6 weeks and who has no red-flag condition (cauda equina, malignancy), advise conservative therapy first and propose a plain lumbar radiograph when imaging is required.",
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "display" : "ACR Appropriateness Criteria — Low Back Pain",
      "url" : "https://acsearch.acr.org/docs/69483/Narrative/",
      "document" : {
        "url" : "https://acsearch.acr.org/docs/69483/Narrative/"
      }
    }
  ],
  "library" : [
    🔗 "https://atrius.in/fhir/r4/atrius-in/Library/AtriusImagingAppropriateness|0.1.0"
  ],
  "action" : [
    {
      "id" : "atrius-imaging-appropriateness-root",
      "title" : "Imaging Appropriateness (Lumbar MRI)",
      "description" : "Early lumbar MRI selected without red flags.",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "order-select"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Early Lumbar MRI Without Red Flags"
          }
        }
      ],
      "input" : [
        {
          "type" : "Patient",
          "profile" : [
            🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-patient|0.1.0"
          ]
        },
        {
          "type" : "Condition",
          "profile" : [
            🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-encounter-diagnosis|0.1.0"🔗 ,
            "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-problems-health-concerns|0.1.0"
          ]
        },
        {
          "type" : "ServiceRequest",
          "profile" : [
            🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-servicerequest|0.1.0"
          ]
        }
      ],
      "groupingBehavior" : "logical-group",
      "action" : [
        {
          "id" : "lumbar-mri-early",
          "title" : "Early lumbar MRI: imaging likely not indicated yet",
          "description" : "Low back pain of less than 6 weeks without red flags: imaging does not improve outcomes. Prefer conservative therapy (activity modification, analgesia, physiotherapy) and reassess; if imaging is clinically required, start with plain radiographs.",
          "priority" : "urgent",
          "documentation" : [
            {
              "type" : "documentation",
              "display" : "ACR Appropriateness Criteria — Low Back Pain",
              "url" : "https://acsearch.acr.org/docs/69483/Narrative/",
              "document" : {
                "url" : "https://acsearch.acr.org/docs/69483/Narrative/"
              }
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Early Lumbar MRI Without Red Flags"
              }
            }
          ],
          "groupingBehavior" : "logical-group",
          "selectionBehavior" : "at-most-one",
          "action" : [
            {
              "id" : "lumbar-xr-instead",
              "title" : "Order plain lumbar spine X-ray instead",
              "priority" : "urgent",
              "definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-xr-lumbar-spine|0.1.0"
            }
          ]
        }
      ]
    }
  ]
}