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