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 |
{
"resourceType" : "PlanDefinition",
"id" : "er-chest-pain-pathway",
"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/AtriusERChestPainPathway</code> for CQL expression definitions.</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-cdsHooksEndpoint",
"valueUri" : "https://cds.atrius.in/cds-services/er-chest-pain-pathway"
}
],
"url" : "https://atrius.in/fhir/r4/atrius-in/PlanDefinition/er-chest-pain-pathway",
"identifier" : [
{
"use" : "official",
"value" : "er-chest-pain-pathway"
},
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:1.3.6.1.4.1.66219.1.34.7"
}
],
"version" : "0.1.0",
"name" : "ERChestPainPathway",
"title" : "Emergency Department Chest Pain Pathway",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
"code" : "clinical-protocol"
}
]
},
"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" : "Person presenting to the emergency department with chest pain: initial clinical assessment, classification into ACS / other cardiac / non-cardiac / other causes, then branch-specific management. ACS branch includes ECG, troponin, aspirin, and cardiology consult.",
"library" : [
"https://atrius.in/fhir/r4/atrius-in/Library/AtriusERChestPainPathway|0.4.2"
],
"action" : [
{
"id" : "er-chest-pain-pathway-root",
"title" : "ER Chest Pain Pathway",
"description" : "Active ED encounter with chest pain chief complaint.",
"trigger" : [
{
"type" : "named-event",
"name" : "encounter-start"
}
],
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "In Scope"
}
}
],
"input" : [
{
"type" : "Patient",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-patient|0.1.0"
]
},
{
"type" : "Encounter",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-encounter|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" : "Observation",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-observation|0.1.0"
]
},
{
"type" : "QuestionnaireResponse",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-questionnaireresponse|0.1.0"
]
},
{
"type" : "ServiceRequest",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-servicerequest|0.1.0"
]
},
{
"type" : "MedicationRequest",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-medicationrequest|0.1.0"
]
},
{
"type" : "DiagnosticReport",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-diagnosticreport-note|0.1.0"
]
},
{
"type" : "MedicationAdministration",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-medicationadministration|0.1.0"
]
}
],
"groupingBehavior" : "logical-group",
"action" : [
{
"id" : "initial-clinical-assessment",
"title" : "Initial Clinical Assessment",
"description" : "History, examination, vitals; obtain ECG when ACS suspected.",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-initial-assessment|0.1.0"
},
{
"id" : "capture-classification",
"title" : "Record Working Classification",
"description" : "Clinician selects working chest pain etiology after initial assessment.",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/Questionnaire/er-chest-pain-classification|0.2.0"
},
{
"id" : "chest-pain-classification",
"title" : "Apply Pathway Branch",
"description" : "ACS; other cardiac (aortic dissection, pericarditis); non-cardiac pulmonary (pneumothorax, pleurisy/pneumonia); other (musculoskeletal, heartburn).",
"groupingBehavior" : "logical-group",
"selectionBehavior" : "exactly-one",
"action" : [
{
"id" : "branch-acs",
"title" : "Acute Coronary Syndrome",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is ACS"
}
}
],
"groupingBehavior" : "logical-group",
"action" : [
{
"id" : "acs-ecg",
"title" : "12-lead ECG",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-ecg-12-lead|0.1.0"
},
{
"id" : "acs-troponin",
"title" : "Cardiac troponin",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-troponin-cardiac|0.2.0"
},
{
"id" : "acs-aspirin",
"title" : "Aspirin",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-aspirin|0.2.0"
},
{
"id" : "acs-cardiology-consult",
"title" : "Cardiology consult",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-referral-cardiology|0.1.0"
},
{
"id" : "acs-troponin-elevated",
"title" : "Elevated troponin — repeat sampling",
"description" : "Initial troponin above pathway threshold; order repeat troponin per ACS protocol.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is ACS and Troponin Elevated"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-troponin-cardiac|0.2.0"
},
{
"id" : "acs-troponin-not-elevated",
"title" : "Initial troponin not elevated",
"description" : "Continue ACS rule-out and serial sampling per protocol.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is ACS and Troponin Not Elevated"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-acs-troponin-normal-guidance|0.1.0"
},
{
"id" : "acs-ecg-stemi",
"title" : "STEMI on ECG — activate cath lab",
"description" : "ST-segment elevation on 12-lead ECG; urgent reperfusion pathway.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is ACS and ECG Shows STEMI"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-acs-stemi-cath-lab|0.1.0"
},
{
"id" : "acs-ecg-no-stemi",
"title" : "ECG without STEMI",
"description" : "ECG reviewed without ST elevation; continue ACS work-up.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is ACS and ECG Without STEMI"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-acs-ecg-no-stemi-guidance|0.1.0"
}
]
},
{
"id" : "branch-aortic-dissection",
"title" : "Aortic Dissection",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is Aortic Dissection"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-branch-aortic-dissection|0.1.0"
},
{
"id" : "branch-pericarditis",
"title" : "Pericarditis",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is Pericarditis"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-branch-pericarditis|0.1.0"
},
{
"id" : "branch-pneumothorax",
"title" : "Pneumothorax",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is Pneumothorax"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-branch-pneumothorax|0.1.0"
},
{
"id" : "branch-pleurisy-pneumonia",
"title" : "Pleurisy / Pneumonia",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is Pleurisy Or Pneumonia"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-branch-pleurisy-pneumonia|0.1.0"
},
{
"id" : "branch-musculoskeletal",
"title" : "Musculoskeletal Chest Pain",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is Musculoskeletal"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-branch-musculoskeletal|0.1.0"
},
{
"id" : "branch-heartburn",
"title" : "Heartburn / GERD",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "Classification Is Heartburn"
}
}
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-chest-pain-branch-heartburn|0.1.0"
}
]
}
]
}
]
}