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

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: Atrius Imaging Appropriateness (Lumbar MRI)

Draft as of 2026-07-24

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<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="atrius-imaging-appropriateness"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/StructureDefinition/cdshooksserviceplandefinition|4.0.1"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>See <code>Library/AtriusImagingAppropriateness</code> for gating expressions and ValueSets.</p></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-cdsHooksEndpoint">
    <valueUri
              value="https://cds.atrius.in/cds-services/atrius-imaging-appropriateness"/>
  </extension>
  <url
       value="https://atrius.in/fhir/r4/atrius-in/PlanDefinition/atrius-imaging-appropriateness"/>
  <identifier>
    <use value="official"/>
    <value value="atrius-imaging-appropriateness"/>
  </identifier>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:1.3.6.1.4.1.66219.1.34.3"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="AtriusImagingAppropriateness"/>
  <title value="Imaging Appropriateness (Lumbar MRI)"/>
  <type>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
      <code value="eca-rule"/>
    </coding>
  </type>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2026-07-24T19:16:12+05:30"/>
  <publisher value="Atrius"/>
  <contact>
    <name value="Atrius"/>
    <telecom>
      <system value="url"/>
      <value value="https://atrius.in"/>
    </telecom>
  </contact>
  <description
               value="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 value="documentation"/>
    <display value="ACR Appropriateness Criteria — Low Back Pain"/>
    <url value="https://acsearch.acr.org/docs/69483/Narrative/"/>
    <document>
      <url value="https://acsearch.acr.org/docs/69483/Narrative/"/>
    </document>
  </relatedArtifact>
  <library
           value="https://atrius.in/fhir/r4/atrius-in/Library/AtriusImagingAppropriateness|0.1.0"/>
  <action id="atrius-imaging-appropriateness-root">
    <title value="Imaging Appropriateness (Lumbar MRI)"/>
    <description value="Early lumbar MRI selected without red flags."/>
    <trigger>
      <type value="named-event"/>
      <name value="order-select"/>
    </trigger>
    <condition>
      <kind value="applicability"/>
      <expression>
        <language value="text/cql"/>
        <expression value="Early Lumbar MRI Without Red Flags"/>
      </expression>
    </condition>
    <input>
      <type value="Patient"/>
      <profile
               value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-patient|0.1.0"/>
    </input>
    <input>
      <type value="Condition"/>
      <profile
               value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-encounter-diagnosis|0.1.0"/>
      <profile
               value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-problems-health-concerns|0.1.0"/>
    </input>
    <input>
      <type value="ServiceRequest"/>
      <profile
               value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-servicerequest|0.1.0"/>
    </input>
    <groupingBehavior value="logical-group"/>
    <action id="lumbar-mri-early">
      <title value="Early lumbar MRI: imaging likely not indicated yet"/>
      <description
                   value="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 value="urgent"/>
      <documentation>
        <type value="documentation"/>
        <display value="ACR Appropriateness Criteria — Low Back Pain"/>
        <url value="https://acsearch.acr.org/docs/69483/Narrative/"/>
        <document>
          <url value="https://acsearch.acr.org/docs/69483/Narrative/"/>
        </document>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <language value="text/cql"/>
          <expression value="Early Lumbar MRI Without Red Flags"/>
        </expression>
      </condition>
      <groupingBehavior value="logical-group"/>
      <selectionBehavior value="at-most-one"/>
      <action id="lumbar-xr-instead">
        <title value="Order plain lumbar spine X-ray instead"/>
        <priority value="urgent"/>
        <definitionCanonical
                             value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-xr-lumbar-spine|0.1.0"/>
      </action>
    </action>
  </action>
</PlanDefinition>