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

: Heart Failure Admission Protocol

Draft as of 2026-07-14

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@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 sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/PlanDefinition/hf-admission-protocol> a fhir:PlanDefinition ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "hf-admission-protocol"] ;
  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><b>Heart Failure Admission Protocol</b> (<code>clinical-protocol</code>). See <code>Library/AtriusHFAdmission</code> for applicability expressions and <code>Questionnaire/hf-admission-eligibility</code> for the ED gate.</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/hf-admission-protocol" ]
  ] ;
  fhir:PlanDefinition.url [ fhir:value "https://atrius.in/fhir/r4/atrius-in/PlanDefinition/hf-admission-protocol"] ;
  fhir:PlanDefinition.identifier [
     fhir:index -1 ;
     fhir:Identifier.use [ fhir:value "official" ] ;
     fhir:Identifier.system [ fhir:value "https://atrius.in/fhir/sid/cds-service" ] ;
     fhir:Identifier.value [ fhir:value "hf-admission-protocol" ]
  ], [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:1.3.6.1.4.1.66219.1.34.8" ]
  ] ;
  fhir:PlanDefinition.version [ fhir:value "0.1.0"] ;
  fhir:PlanDefinition.name [ fhir:value "AtriusHFAdmissionProtocol"] ;
  fhir:PlanDefinition.title [ fhir:value "Heart Failure Admission Protocol"] ;
  fhir:PlanDefinition.subtitle [ fhir:value "ED / inpatient admission pathway for acute decompensated HF"] ;
  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 "clinical-protocol" ]
     ]
  ] ;
  fhir:PlanDefinition.status [ fhir:value "draft"] ;
  fhir:PlanDefinition.experimental [ fhir:value "true"^^xsd:boolean] ;
  fhir:PlanDefinition.subjectCodeableConcept [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ] ;
       fhir:Coding.code [ fhir:value "Patient" ]
     ]
  ] ;
  fhir:PlanDefinition.date [ fhir:value "2026-07-14"^^xsd:date] ;
  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 "Person with active heart failure on the chart at encounter start: confirm ED eligibility features, then propose daily weight monitoring, sodium-restricted diet, IV furosemide, and an admission BNP when none resulted in the last 24 hours."] ;
  fhir:PlanDefinition.useContext [
     fhir:index -1 ;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ] ;
       fhir:Coding.code [ fhir:value "venue" ]
     ] ;
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ActCode" ] ;
         fhir:Coding.code [ fhir:value "EMER" ] ;
         fhir:Coding.display [ fhir:value "emergency" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ] ;
       fhir:Coding.code [ fhir:value "venue" ]
     ] ;
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ActCode" ] ;
         fhir:Coding.code [ fhir:value "IMP" ] ;
         fhir:Coding.display [ fhir:value "inpatient encounter" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ] ;
       fhir:Coding.code [ fhir:value "focus" ]
     ] ;
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         a sct:84114007 ;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ;
         fhir:Coding.code [ fhir:value "84114007" ] ;
         fhir:Coding.display [ fhir:value "Heart failure (disorder)" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ] ;
       fhir:Coding.code [ fhir:value "venue" ]
     ] ;
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-RoleCode" ] ;
         fhir:Coding.code [ fhir:value "ICU" ] ;
         fhir:Coding.display [ fhir:value "Intensive care unit" ]
       ]
     ]
  ] ;
  fhir:PlanDefinition.purpose [ fhir:value "Standardize safe initial management of acute decompensated heart failure at admission, aligned with AHA/ACC/HFSA guidance, while avoiding redundant natriuretic peptide draws."] ;
  fhir:PlanDefinition.usage [ fhir:value "Invoke on encounter-start (ED or inpatient). Complete the eligibility questionnaire when the working diagnosis is acute HF, then review and place the proposed admission actions."] ;
  fhir:PlanDefinition.copyright [ fhir:value "© Atrius. Pathway structure is illustrative; institutions must adapt dosing and local formulary."] ;
  fhir:PlanDefinition.approvalDate [ fhir:value "2026-07-14"^^xsd:date] ;
  fhir:PlanDefinition.lastReviewDate [ fhir:value "2026-07-14"^^xsd:date] ;
  fhir:PlanDefinition.effectivePeriod [
     fhir:Period.start [ fhir:value "2026-07-14"^^xsd:date ]
  ] ;
  fhir:PlanDefinition.topic [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/definition-topic" ] ;
       fhir:Coding.code [ fhir:value "treatment" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       a sct:84114007 ;
       fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ;
       fhir:Coding.code [ fhir:value "84114007" ] ;
       fhir:Coding.display [ fhir:value "Heart failure (disorder)" ]
     ]
  ] ;
  fhir:PlanDefinition.author [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "Atrius Cardiology / Clinical Reasoning" ]
  ] ;
  fhir:PlanDefinition.editor [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "Atrius Clinical Reasoning" ]
  ] ;
  fhir:PlanDefinition.relatedArtifact [
     fhir:index -1 ;
     fhir:RelatedArtifact.type [ fhir:value "documentation" ] ;
     fhir:RelatedArtifact.display [ fhir:value "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" ] ;
     fhir:RelatedArtifact.citation [ fhir:value "Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Circulation." ] ;
     fhir:RelatedArtifact.url [ fhir:value "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063" ] ;
     fhir:RelatedArtifact.document [
       fhir:Attachment.url [ fhir:value "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ] ;
     fhir:RelatedArtifact.display [ fhir:value "HF admission ED eligibility questionnaire" ] ;
     fhir:RelatedArtifact.resource [
       fhir:value "https://atrius.in/fhir/r4/atrius-in/Questionnaire/hf-admission-eligibility|0.1.0" ;
       fhir:link <https://atrius.in/fhir/r4/atrius-in/Questionnaire/hf-admission-eligibility|0.1.0>
     ]
  ], [
     fhir:index -1 ;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ] ;
     fhir:RelatedArtifact.display [ fhir:value "Atrius HF admission CQL library" ] ;
     fhir:RelatedArtifact.resource [
       fhir:value "https://atrius.in/fhir/r4/atrius-in/Library/AtriusHFAdmission|0.1.0" ;
       fhir:link <https://atrius.in/fhir/r4/atrius-in/Library/AtriusHFAdmission|0.1.0>
     ]
  ] ;
  fhir:PlanDefinition.library [
     fhir:value "https://atrius.in/fhir/r4/atrius-in/Library/AtriusHFAdmission|0.1.0" ;
     fhir:index -1 ;
     fhir:link <https://atrius.in/fhir/r4/atrius-in/Library/AtriusHFAdmission|0.1.0>
  ] ;
  fhir:PlanDefinition.goal [
     fhir:index -1 ;
     fhir:Element.id [ fhir:value "euvolemia" ] ;
     fhir:PlanDefinition.goal.category [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/goal-category" ] ;
         fhir:Coding.code [ fhir:value "safety" ]
       ]
     ] ;
     fhir:PlanDefinition.goal.description [
       fhir:CodeableConcept.text [ fhir:value "Relieve congestion and maintain clinical euvolemia during the admission" ]
     ] ;
     fhir:PlanDefinition.goal.priority [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/goal-priority" ] ;
         fhir:Coding.code [ fhir:value "high-priority" ] ;
         fhir:Coding.display [ fhir:value "High Priority" ]
       ]
     ] ;
     fhir:PlanDefinition.goal.addresses [
       fhir:index -1 ;
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         a sct:84114007 ;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ;
         fhir:Coding.code [ fhir:value "84114007" ] ;
         fhir:Coding.display [ fhir:value "Heart failure (disorder)" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Element.id [ fhir:value "daily-weight-trend" ] ;
     fhir:PlanDefinition.goal.category [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/goal-category" ] ;
         fhir:Coding.code [ fhir:value "nursing" ]
       ]
     ] ;
     fhir:PlanDefinition.goal.description [
       fhir:CodeableConcept.text [ fhir:value "Document reliable daily weights (same scale, before breakfast) to guide diuresis" ]
     ] ;
     fhir:PlanDefinition.goal.priority [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/goal-priority" ] ;
         fhir:Coding.code [ fhir:value "medium-priority" ] ;
         fhir:Coding.display [ fhir:value "Medium Priority" ]
       ]
     ]
  ] ;
  fhir:PlanDefinition.action [
     fhir:index -1 ;
     fhir:Element.id [ fhir:value "hf-admission-root" ] ;
     fhir:PlanDefinition.action.prefix [ fhir:value "1" ] ;
     fhir:PlanDefinition.action.title [ fhir:value "Heart Failure Admission Protocol" ] ;
     fhir:PlanDefinition.action.description [ fhir:value "Active heart failure condition on the chart; run eligibility then admission management." ] ;
     fhir:PlanDefinition.action.priority [ fhir:value "urgent" ] ;
     fhir:PlanDefinition.action.code [
       fhir:index -1 ;
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         a sct:84114007 ;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ;
         fhir:Coding.code [ fhir:value "84114007" ] ;
         fhir:Coding.display [ fhir:value "Heart failure (disorder)" ]
       ]
     ] ;
     fhir:PlanDefinition.action.goalId [
       fhir:value "euvolemia" ;
       fhir:index -1
     ], [
       fhir:value "daily-weight-trend" ;
       fhir:index -1
     ] ;
     fhir:PlanDefinition.action.trigger [
       fhir:index -1 ;
       fhir:TriggerDefinition.type [ fhir:value "named-event" ] ;
       fhir:TriggerDefinition.name [ fhir:value "encounter-start" ]
     ] ;
     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 "HF Admission Applicable" ]
       ]
     ] ;
     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 "Condition" ] ;
       fhir:DataRequirement.profile [
         fhir:value "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-encounter-diagnosis|0.1.0" ;
         fhir:index -1 ;
         fhir:link <https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-encounter-diagnosis|0.1.0>
       ], [
         fhir:value "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-problems-health-concerns|0.1.0" ;
         fhir:index -1 ;
         fhir:link <https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-problems-health-concerns|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 "Encounter" ] ;
       fhir:DataRequirement.profile [
         fhir:value "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-encounter|0.1.0" ;
         fhir:index -1 ;
         fhir:link <https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-encounter|0.1.0>
       ]
     ], [
       fhir:index -1 ;
       fhir:DataRequirement.type [ fhir:value "QuestionnaireResponse" ] ;
       fhir:DataRequirement.profile [
         fhir:value "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-questionnaireresponse|0.1.0" ;
         fhir:index -1 ;
         fhir:link <https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-questionnaireresponse|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.selectionBehavior [ fhir:value "all" ] ;
     fhir:PlanDefinition.action.requiredBehavior [ fhir:value "must-unless-documented" ] ;
     fhir:PlanDefinition.action.cardinalityBehavior [ fhir:value "single" ] ;
     fhir:PlanDefinition.action.action [
       fhir:index -1 ;
       fhir:Element.id [ fhir:value "hf-admission-eligibility" ] ;
       fhir:PlanDefinition.action.prefix [ fhir:value "1.1" ] ;
       fhir:PlanDefinition.action.title [ fhir:value "Confirm ED eligibility" ] ;
       fhir:PlanDefinition.action.description [ fhir:value "Confirm dyspnea/congestion features and that the working diagnosis is acute decompensated heart failure before placing the admission bundle." ] ;
       fhir:PlanDefinition.action.priority [ fhir:value "urgent" ] ;
       fhir:PlanDefinition.action.definitionCanonical [
         fhir:value "https://atrius.in/fhir/r4/atrius-in/Questionnaire/hf-admission-eligibility|0.1.0" ;
         fhir:link <https://atrius.in/fhir/r4/atrius-in/Questionnaire/hf-admission-eligibility|0.1.0>
       ]
     ], [
       fhir:index -1 ;
       fhir:Element.id [ fhir:value "hf-admission-bundle" ] ;
       fhir:PlanDefinition.action.prefix [ fhir:value "1.2" ] ;
       fhir:PlanDefinition.action.title [ fhir:value "HF admission bundle" ] ;
       fhir:PlanDefinition.action.description [ fhir:value "Daily weights, sodium restriction, and IV diuresis for decompensated heart failure. Place all elements together unless contraindicated." ] ;
       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 "2022 AHA/ACC/HFSA heart failure guideline" ] ;
         fhir:RelatedArtifact.url [ fhir:value "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063" ] ;
         fhir:RelatedArtifact.document [
           fhir:Attachment.url [ fhir:value "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063" ]
         ]
       ] ;
       fhir:PlanDefinition.action.goalId [
         fhir:value "euvolemia" ;
         fhir:index -1
       ], [
         fhir:value "daily-weight-trend" ;
         fhir:index -1
       ] ;
       fhir:PlanDefinition.action.groupingBehavior [ fhir:value "logical-group" ] ;
       fhir:PlanDefinition.action.selectionBehavior [ fhir:value "all" ] ;
       fhir:PlanDefinition.action.requiredBehavior [ fhir:value "must-unless-documented" ] ;
       fhir:PlanDefinition.action.action [
         fhir:index -1 ;
         fhir:Element.id [ fhir:value "hf-daily-weight" ] ;
         fhir:PlanDefinition.action.title [ fhir:value "Daily weight (same scale, before breakfast)" ] ;
         fhir:PlanDefinition.action.description [ fhir:value "Nursing task: morning weight on the same scale to trend volume status." ] ;
         fhir:PlanDefinition.action.goalId [
           fhir:value "daily-weight-trend" ;
           fhir:index -1
         ] ;
         fhir:PlanDefinition.action.definitionCanonical [
           fhir:value "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-daily-weight|0.1.0" ;
           fhir:link <https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-daily-weight|0.1.0>
         ]
       ], [
         fhir:index -1 ;
         fhir:Element.id [ fhir:value "hf-low-sodium-diet" ] ;
         fhir:PlanDefinition.action.title [ fhir:value "Sodium-restricted diet (< 2 g/day)" ] ;
         fhir:PlanDefinition.action.description [ fhir:value "Dietary order supporting congestion management." ] ;
         fhir:PlanDefinition.action.definitionCanonical [
           fhir:value "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-low-sodium-diet|0.1.0" ;
           fhir:link <https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-low-sodium-diet|0.1.0>
         ]
       ], [
         fhir:index -1 ;
         fhir:Element.id [ fhir:value "hf-furosemide" ] ;
         fhir:PlanDefinition.action.title [ fhir:value "Furosemide IV" ] ;
         fhir:PlanDefinition.action.description [ fhir:value "Initial IV loop diuretic for decongestion; adjust to prior outpatient dose and renal function." ] ;
         fhir:PlanDefinition.action.priority [ fhir:value "urgent" ] ;
         fhir:PlanDefinition.action.goalId [
           fhir:value "euvolemia" ;
           fhir:index -1
         ] ;
         fhir:PlanDefinition.action.definitionCanonical [
           fhir:value "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-furosemide|0.1.0" ;
           fhir:link <https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-furosemide|0.1.0>
         ]
       ]
     ], [
       fhir:index -1 ;
       fhir:Element.id [ fhir:value "hf-admission-bnp" ] ;
       fhir:PlanDefinition.action.prefix [ fhir:value "1.3" ] ;
       fhir:PlanDefinition.action.title [ fhir:value "Baseline natriuretic peptide" ] ;
       fhir:PlanDefinition.action.description [ fhir:value "No BNP or NT-proBNP resulted in the last 24 hours; draw an admission baseline." ] ;
       fhir:PlanDefinition.action.documentation [
         fhir:index -1 ;
         fhir:RelatedArtifact.type [ fhir:value "documentation" ] ;
         fhir:RelatedArtifact.display [ fhir:value "2022 AHA/ACC/HFSA heart failure guideline" ] ;
         fhir:RelatedArtifact.url [ fhir:value "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063" ] ;
         fhir:RelatedArtifact.document [
           fhir:Attachment.url [ fhir:value "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063" ]
         ]
       ] ;
       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 "No Recent BNP" ]
         ]
       ] ;
       fhir:PlanDefinition.action.groupingBehavior [ fhir:value "logical-group" ] ;
       fhir:PlanDefinition.action.selectionBehavior [ fhir:value "all" ] ;
       fhir:PlanDefinition.action.action [
         fhir:index -1 ;
         fhir:Element.id [ fhir:value "hf-bnp-order" ] ;
         fhir:PlanDefinition.action.title [ fhir:value "BNP on admission" ] ;
         fhir:PlanDefinition.action.description [ fhir:value "Admission natriuretic peptide for diagnosis support and trajectory." ] ;
         fhir:PlanDefinition.action.definitionCanonical [
           fhir:value "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-bnp|0.1.0" ;
           fhir:link <https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-bnp|0.1.0>
         ]
       ]
     ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/PlanDefinition/hf-admission-protocol.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/PlanDefinition/hf-admission-protocol.ttl> .