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
| Draft as of 2026-07-24 |
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/PlanDefinition/atrius-renal-dosing> a fhir:PlanDefinition ;
fhir:nodeRole fhir:treeRoot ;
fhir:Resource.id [ fhir:value "atrius-renal-dosing"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/StructureDefinition/cdshooksserviceplandefinition|4.0.1" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/StructureDefinition/cdshooksserviceplandefinition|4.0.1>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ] ;
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>See <code>Library/AtriusRenalDosing</code> for eGFR bands and dose text definitions.</p></div>"
] ;
fhir:DomainResource.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-cdsHooksEndpoint" ] ;
fhir:Extension.valueUri [ fhir:value "https://cds.atrius.in/cds-services/atrius-renal-dosing" ]
] ;
fhir:PlanDefinition.url [ fhir:value "https://atrius.in/fhir/r4/atrius-in/PlanDefinition/atrius-renal-dosing"] ;
fhir:PlanDefinition.identifier [
fhir:index -1 ;
fhir:Identifier.use [ fhir:value "official" ] ;
fhir:Identifier.value [ fhir:value "atrius-renal-dosing" ]
], [
fhir:index -1 ;
fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
fhir:Identifier.value [ fhir:value "urn:oid:1.3.6.1.4.1.66219.1.34.5" ]
] ;
fhir:PlanDefinition.version [ fhir:value "0.1.0"] ;
fhir:PlanDefinition.name [ fhir:value "AtriusRenalDosing"] ;
fhir:PlanDefinition.title [ fhir:value "Renal Dosing Check"] ;
fhir:PlanDefinition.type [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/plan-definition-type" ] ;
fhir:Coding.code [ fhir:value "eca-rule" ]
]
] ;
fhir:PlanDefinition.status [ fhir:value "draft"] ;
fhir:PlanDefinition.experimental [ fhir:value "true"^^xsd:boolean] ;
fhir:PlanDefinition.date [ fhir:value "2026-07-24T19:16:12+05:30"^^xsd:dateTime] ;
fhir:PlanDefinition.publisher [ fhir:value "Atrius"] ;
fhir:PlanDefinition.contact [
fhir:index -1 ;
fhir:ContactDetail.name [ fhir:value "Atrius" ] ;
fhir:ContactDetail.telecom [
fhir:index -1 ;
fhir:ContactPoint.system [ fhir:value "url" ] ;
fhir:ContactPoint.value [ fhir:value "https://atrius.in" ]
]
] ;
fhir:PlanDefinition.description [ fhir:value "At order signing, compare draft metformin and gabapentin orders against the most recent eGFR (last 12 months): metformin is contraindicated below eGFR 30 and dose-limited at 30-45; gabapentin is dose-banded below 60. Replacement orders carry the renally-adjusted dose via dynamicValue."] ;
fhir:PlanDefinition.relatedArtifact [
fhir:index -1 ;
fhir:RelatedArtifact.type [ fhir:value "documentation" ] ;
fhir:RelatedArtifact.display [ fhir:value "KDIGO CKD guideline — medication dosing in kidney disease" ] ;
fhir:RelatedArtifact.url [ fhir:value "https://kdigo.org/guidelines/ckd-evaluation-and-management/" ] ;
fhir:RelatedArtifact.document [
fhir:Attachment.url [ fhir:value "https://kdigo.org/guidelines/ckd-evaluation-and-management/" ]
]
] ;
fhir:PlanDefinition.library [
fhir:value "https://atrius.in/fhir/r4/atrius-in/Library/AtriusRenalDosing|0.1.0" ;
fhir:index -1 ;
fhir:link <https://atrius.in/fhir/r4/atrius-in/Library/AtriusRenalDosing|0.1.0>
] ;
fhir:PlanDefinition.action [
fhir:index -1 ;
fhir:Element.id [ fhir:value "atrius-renal-dosing-root" ] ;
fhir:PlanDefinition.action.title [ fhir:value "Renal Dosing Check" ] ;
fhir:PlanDefinition.action.description [ fhir:value "A draft order needs renal dose adjustment." ] ;
fhir:PlanDefinition.action.trigger [
fhir:index -1 ;
fhir:TriggerDefinition.type [ fhir:value "named-event" ] ;
fhir:TriggerDefinition.name [ fhir:value "order-sign" ]
] ;
fhir:PlanDefinition.action.condition [
fhir:index -1 ;
fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ] ;
fhir:PlanDefinition.action.condition.expression [
fhir:Expression.language [ fhir:value "text/cql" ] ;
fhir:Expression.expression [ fhir:value "Renal Dose Adjustment Needed" ]
]
] ;
fhir:PlanDefinition.action.input [
fhir:index -1 ;
fhir:DataRequirement.type [ fhir:value "Patient" ] ;
fhir:DataRequirement.profile [
fhir:value "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-patient|0.1.0" ;
fhir:index -1 ;
fhir:link <https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-patient|0.1.0>
]
], [
fhir:index -1 ;
fhir:DataRequirement.type [ fhir:value "Observation" ] ;
fhir:DataRequirement.profile [
fhir:value "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-observation|0.1.0" ;
fhir:index -1 ;
fhir:link <https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-observation|0.1.0>
]
], [
fhir:index -1 ;
fhir:DataRequirement.type [ fhir:value "MedicationRequest" ] ;
fhir:DataRequirement.profile [
fhir:value "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-medicationrequest|0.1.0" ;
fhir:index -1 ;
fhir:link <https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-medicationrequest|0.1.0>
]
] ;
fhir:PlanDefinition.action.groupingBehavior [ fhir:value "logical-group" ] ;
fhir:PlanDefinition.action.action [
fhir:index -1 ;
fhir:Element.id [ fhir:value "renal-metformin-contraindicated" ] ;
fhir:PlanDefinition.action.title [ fhir:value "Metformin contraindicated: eGFR below 30" ] ;
fhir:PlanDefinition.action.description [ fhir:value "The latest eGFR is below 30 mL/min/1.73m². Metformin is contraindicated (lactic acidosis risk) — do not sign; choose an alternative antihyperglycemic agent." ] ;
fhir:PlanDefinition.action.priority [ fhir:value "stat" ] ;
fhir:PlanDefinition.action.documentation [
fhir:index -1 ;
fhir:RelatedArtifact.type [ fhir:value "documentation" ] ;
fhir:RelatedArtifact.display [ fhir:value "FDA — metformin use in renal impairment" ] ;
fhir:RelatedArtifact.url [ fhir:value "https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-revises-warnings-regarding-use-diabetes-medicine-metformin-certain" ] ;
fhir:RelatedArtifact.document [
fhir:Attachment.url [ fhir:value "https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-revises-warnings-regarding-use-diabetes-medicine-metformin-certain" ]
]
] ;
fhir:PlanDefinition.action.condition [
fhir:index -1 ;
fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ] ;
fhir:PlanDefinition.action.condition.expression [
fhir:Expression.language [ fhir:value "text/cql" ] ;
fhir:Expression.expression [ fhir:value "Metformin Contraindicated" ]
]
] ;
fhir:PlanDefinition.action.groupingBehavior [ fhir:value "logical-group" ] ;
fhir:PlanDefinition.action.selectionBehavior [ fhir:value "at-most-one" ] ;
fhir:PlanDefinition.action.action [
fhir:index -1 ;
fhir:Element.id [ fhir:value "renal-metformin-contraindicated-review" ] ;
fhir:PlanDefinition.action.title [ fhir:value "Clinician review — select alternative agent" ] ;
fhir:PlanDefinition.action.priority [ fhir:value "stat" ] ;
fhir:PlanDefinition.action.definitionCanonical [
fhir:value "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-clinical-assessment|0.1.0" ;
fhir:link <https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-clinical-assessment|0.1.0>
]
]
], [
fhir:index -1 ;
fhir:Element.id [ fhir:value "renal-metformin-reduce" ] ;
fhir:PlanDefinition.action.title [ fhir:value "Metformin: reduce dose for eGFR 30-45" ] ;
fhir:PlanDefinition.action.description [ fhir:value "The latest eGFR is 30-45 mL/min/1.73m². Limit metformin to 1000 mg/day and recheck renal function in 3 months." ] ;
fhir:PlanDefinition.action.priority [ fhir:value "urgent" ] ;
fhir:PlanDefinition.action.documentation [
fhir:index -1 ;
fhir:RelatedArtifact.type [ fhir:value "documentation" ] ;
fhir:RelatedArtifact.display [ fhir:value "FDA — metformin use in renal impairment" ] ;
fhir:RelatedArtifact.url [ fhir:value "https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-revises-warnings-regarding-use-diabetes-medicine-metformin-certain" ] ;
fhir:RelatedArtifact.document [
fhir:Attachment.url [ fhir:value "https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-revises-warnings-regarding-use-diabetes-medicine-metformin-certain" ]
]
] ;
fhir:PlanDefinition.action.condition [
fhir:index -1 ;
fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ] ;
fhir:PlanDefinition.action.condition.expression [
fhir:Expression.language [ fhir:value "text/cql" ] ;
fhir:Expression.expression [ fhir:value "Metformin Dose Limited" ]
]
] ;
fhir:PlanDefinition.action.groupingBehavior [ fhir:value "logical-group" ] ;
fhir:PlanDefinition.action.selectionBehavior [ fhir:value "at-most-one" ] ;
fhir:PlanDefinition.action.action [
fhir:index -1 ;
fhir:Element.id [ fhir:value "renal-metformin-reduced-order" ] ;
fhir:PlanDefinition.action.title [ fhir:value "Metformin at renally-adjusted dose (max 1000 mg/day)" ] ;
fhir:PlanDefinition.action.priority [ fhir:value "urgent" ] ;
fhir:PlanDefinition.action.definitionCanonical [
fhir:value "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-metformin|0.1.0" ;
fhir:link <https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-metformin|0.1.0>
] ;
fhir:PlanDefinition.action.dynamicValue [
fhir:index -1 ;
fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "dosageInstruction[0].text" ] ;
fhir:PlanDefinition.action.dynamicValue.expression [
fhir:Expression.language [ fhir:value "text/cql" ] ;
fhir:Expression.expression [ fhir:value "Metformin Reduced Dose Text" ]
]
]
]
], [
fhir:index -1 ;
fhir:Element.id [ fhir:value "renal-gabapentin-adjust" ] ;
fhir:PlanDefinition.action.title [ fhir:value "Gabapentin: renal dose adjustment" ] ;
fhir:PlanDefinition.action.description [ fhir:value "Gabapentin is entirely renally cleared and the latest eGFR is below 60 mL/min/1.73m². Use the eGFR-banded dose on the suggested replacement order." ] ;
fhir:PlanDefinition.action.priority [ fhir:value "urgent" ] ;
fhir:PlanDefinition.action.documentation [
fhir:index -1 ;
fhir:RelatedArtifact.type [ fhir:value "documentation" ] ;
fhir:RelatedArtifact.display [ fhir:value "KDIGO CKD guideline — medication dosing in kidney disease" ] ;
fhir:RelatedArtifact.url [ fhir:value "https://kdigo.org/guidelines/ckd-evaluation-and-management/" ] ;
fhir:RelatedArtifact.document [
fhir:Attachment.url [ fhir:value "https://kdigo.org/guidelines/ckd-evaluation-and-management/" ]
]
] ;
fhir:PlanDefinition.action.condition [
fhir:index -1 ;
fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ] ;
fhir:PlanDefinition.action.condition.expression [
fhir:Expression.language [ fhir:value "text/cql" ] ;
fhir:Expression.expression [ fhir:value "Gabapentin Dose Adjustment Needed" ]
]
] ;
fhir:PlanDefinition.action.groupingBehavior [ fhir:value "logical-group" ] ;
fhir:PlanDefinition.action.selectionBehavior [ fhir:value "at-most-one" ] ;
fhir:PlanDefinition.action.action [
fhir:index -1 ;
fhir:Element.id [ fhir:value "renal-gabapentin-adjusted-order" ] ;
fhir:PlanDefinition.action.title [ fhir:value "Gabapentin at renally-adjusted dose" ] ;
fhir:PlanDefinition.action.priority [ fhir:value "urgent" ] ;
fhir:PlanDefinition.action.definitionCanonical [
fhir:value "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-gabapentin|0.1.0" ;
fhir:link <https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-gabapentin|0.1.0>
] ;
fhir:PlanDefinition.action.dynamicValue [
fhir:index -1 ;
fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "dosageInstruction[0].text" ] ;
fhir:PlanDefinition.action.dynamicValue.expression [
fhir:Expression.language [ fhir:value "text/cql" ] ;
fhir:Expression.expression [ fhir:value "Gabapentin Adjusted Dose Text" ]
]
]
]
]
] .
# - ontology header ------------------------------------------------------------
<http://hl7.org/fhir/PlanDefinition/atrius-renal-dosing.ttl> a owl:Ontology ;
owl:imports fhir:fhir.ttl ;
owl:versionIRI <http://build.fhir.org/PlanDefinition/atrius-renal-dosing.ttl> .
IG © 2026+ Atrius.
Package atrius.fhir.r4.india#0.1.0 based on FHIR 4.0.1.
Generated
2026-07-24
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