ATTACHMENT 16 - Opioid ChronicPain Doc Template_Terminology Svc Request_V1.2_20180607.xlsx

XLSX spreadsheet 229 KB Posted Aug 13, 2020

Attached to: R405--Clinical Decision Support CO: Matthew Klempay CS: Sharif Shabaz Ra-El
Solicitation number: 36C77620R0015
Issued by: Department of Veterans Affairs Technology Acquisition Center Austin

About this file

Written by GovTribe AI · Dec 29, 2023

This pre-solicitation notice announces an upcoming request for proposal for Clinical Decision Support Services. The Department of Veterans Affairs intends to award multiple indefinite delivery indefinite quantity contracts to small businesses for subject matter expertise, policy guidance, and strategic recommendations regarding clinical decision support standards implementation for VA IT systems. The NAICS code is 541611 with a small business size standard of $16.5 million. The ordering period will be ten years with an effective period of fifteen years. Interested parties should monitor FEDBIZOPPS and the VA Vendor Portal on or around August 11, 2018 for the full solicitation. All questions must be submitted in writing to the contracting officer and specialist by the specified dates. Only Federal Business Opportunities and the VA Vendor Portal should be used for any amendments.

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Other files

File	Type	Posted
36C77620R0015 0005.docx	DOCX document	Sep 11, 2020
ATTACHMENT I - QASP.docx	DOCX document	Aug 26, 2020
36C77620R0015 0004.docx	DOCX document	Aug 26, 2020
CONTRACTOR QUESTIONS CDS IDIQ RFP KBS responses_20200825.xlsx	XLSX spreadsheet	Aug 25, 2020
36C77620R0015 0003.docx	DOCX document	Aug 25, 2020
ATTACHMENT 11 CDS IDIQ TASK ORDER 1 PRICE SCHEDULE.xlsx	XLSX spreadsheet	Aug 24, 2020
ATTACHMENT 3 CDS_IDIQ_TO2_PWS.docx	DOCX document	Aug 24, 2020
ATTACHMENT 1 PWS CDS IDIQ_FINAL.docx	DOCX document	Aug 24, 2020
ATTACHMENT 10 IDIQ PRICE SCHEDULE.xlsx	XLSX spreadsheet	Aug 24, 2020
36C77620R0015 0002.docx	DOCX document	Aug 24, 2020
CONTRACTOR QUESTIONS CDS IDIQ RFP_KBS responses_20200824.xlsx	XLSX spreadsheet	Aug 24, 2020
ATTACHMENT H - BOE-SampleTask.xlsx	XLSX spreadsheet	Aug 24, 2020
ATTACHMENT 12 CDS IDIQ TASK ORDER 2 PRICE SCHEDULE.xlsx	XLSX spreadsheet	Aug 24, 2020
AMENDMENT 002.docx	DOCX document	Aug 24, 2020
ATTACHMENT 12 - CDS IDIQ - TASK ORDER 2 PRICE SCHEDULE v2.xlsx	XLSX spreadsheet	Aug 18, 2020
36C77620R0015 0001_1.docx	DOCX document	Aug 18, 2020
ATTACHMENT 11 - CDS IDIQ - TASK ORDER 1 PRICE SCHEDULE v2.xlsx	XLSX spreadsheet	Aug 18, 2020
ATTACHMENT F - Sample Conceptual Structure for Documentation Template.docx	DOCX document	Aug 13, 2020
ATTACHMENT 2 - CDS_IDIQ_TO1_PWS.docx	DOCX document	Aug 13, 2020
ATTACHMENT 6 - TMS User Request.doc	DOC document	Aug 13, 2020
ATTACHMENT 29 - Opiod Non Cancer Pain Mgt Order Set_KNART XML_2018-06-25.pdf	PDF	Aug 13, 2020
ATTACHMENT 4 - QASP_CDS IDIQ 02.docx	DOCX document	Aug 13, 2020
ATTACHMENT 10 - IDIQ PRICE SCHEDULE.xlsx	XLSX spreadsheet	Aug 13, 2020
ATTACHMENT 19 - Suicide Risk (Suicidality)_CDS Content White Paper_2019-01-02.pdf	PDF	Aug 13, 2020
ATTACHMENT 25 - Opioid NonCancer Pain Mgt Order Set Conceptual Structure_2018-05-28.pdf	PDF	Aug 13, 2020
ATTACHMENT 17 - SuicideRisk Assessment Doc Template KNART_Terminology Svc Request_V1.4_20180425.xlsx	XLSX spreadsheet	Aug 13, 2020
ATTACHMENT C - Sample conceptual Structure for ECA Rule.docx	DOCX document	Aug 13, 2020
ATTACHMENT 14 - Opiod Chronic Pain_OrderSet_ Terminology Svc Request_V1.1_20180524.xlsx	XLSX spreadsheet	Aug 13, 2020
ATTACHMENT 24 - Opioid Non Cancer Pain Mgt_CDS Content White Paper_2018-12-18.pdf	PDF	Aug 13, 2020
ATTACHMENT 28 - Suicide Risk Order Set KNART XML_2018-06-21.pdf	PDF	Aug 13, 2020
ATTACHMENT B - Process for Requesting New Terminology Artifacts.docx	DOCX document	Aug 13, 2020
ATTACHMENT 26 - Opiod Non Cancer Pain Assmt Doc Template KNART XML_2018-06-21.pdf	PDF	Aug 13, 2020
ATTACHMENT 7 - Contractor Personnel Change Form.doc	DOC document	Aug 13, 2020
ATTACHMENT 5 - Travel Authorization Request 02.docx	DOCX document	Aug 13, 2020
ATTACHMENT 30 - Suicide Risk Doc Template KNART XML_2018-06-21.pdf	PDF	Aug 13, 2020
ATTACHMENT E - Screenshots of Example Order Set Complexity.docx	DOCX document	Aug 13, 2020
ATTACHMENT 1 - PWS - CDS IDIQ - FINAL_plus kbs edits to section 6.docx	DOCX document	Aug 13, 2020
ATTACHMENT 12 - CDS IDIQ - TASK ORDER 2 PRICE SCHEDULE.xlsx	XLSX spreadsheet	Aug 13, 2020
ATTACHMENT 3 - CDS_IDIQ_TO2_PWS.docx	DOCX document	Aug 13, 2020
ATTACHMENT 22 - Mental Health Positive Suicide Risk Screening.pdf	PDF	Aug 13, 2020
ATTACHMENT 8 - Contractor Staff Roster.doc	DOC document	Aug 13, 2020
ATTACHMENT 21 - Mental Health Suicide Risk Assessment.pdf	PDF	Aug 13, 2020
ATTACHMENT 20 - Suicide Risk_Order Set_KNART Conceptual Structure_2018-06-21.pdf	PDF	Aug 13, 2020
ATTACHMENT 27 - Opiod Use Non Cancer Pain_OTTR-STORM Query_Doc Templt KNART XML_2018-06-21.pdf	PDF	Aug 13, 2020
ATTACHMENT G- Business Associate Agreement.doc	DOC document	Aug 13, 2020
ATTACHMENT 11 - CDS IDIQ - TASK ORDER 1 PRICE SCHEDULE .xlsx	XLSX spreadsheet	Aug 13, 2020
ATTACHMENT 18 - Opioid NonCancer Pain OTRR-STORM Doc Templt_Concept Structure_2018-06-06.pdf	PDF	Aug 13, 2020
ATTACHMENT D - Sample Conceptual Structure for Partial Order Set.docx	DOCX document	Aug 13, 2020
ATTACHMENT 9 - Labor Categories and Descriptions v2.xlsx	XLSX spreadsheet	Aug 13, 2020
ATTACHMENT 23 - Opiod NonCancer Pain Mgt Assmt Doc Templt_Concept Structure_2018-06-07.pdf	PDF	Aug 13, 2020

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TSR Submission Details

Version	The version of this TSR template	1.0
Submitted on	Date TSR was submitted to terminology team.	6/1/18
Submitted by	Person who submitted the TSR	Joey Coyle
Referenced KNART identifier	The KNART that is the source of the request	O34
Model version	The anf model version	urn:solor.io:anf-model:1.0
Reviewed on	Date TSR was reviewed by CDS content team
Reviewed by	Person who reviewed the TSR
Rejected on	Date TSR was rejected by terminology team
Rejected by	Person on terminology team that rejected the TSR
Item(s) rejected	Columns rejected
Rejection reason	Reason for rejection
TERMINOLOGY TEAM
Intake Assessment Date	6/1/18
Assessed by	Deb Konicek
Final review by	Kirsten Haake
Completed date
Returned to JIRA date

Standards used	Name	Version
Lab Orders	SNOMED CT	United States Edition 20180301
Radiology Orders	SNOMED CT	United States Edition 20180301
Other Procedure Orders	SNOMED CT	United States Edition 20180301
Medication (Generic)	SNOMED CT	United States Edition 20180301
Medication (Specified)	RXNorm SCD Codes	7-May-18
Medication Classes	SNOMED CT	United States Edition 20180301

UUID Generator	Version 4 UUID Generator
KBS Terminology Team Disclaimer:

This TSR was completed to the best of our knowledge, based on the concept model, the current understanding of the Informatics Architecture Analysis Normal Form guidance and the information given with the instance requests. No assumptions were made.

https://www.uuidgenerator.net/version4 Performance Instance Request Type Textual Representation Complete Blood Count Comprehensive Metabolic Panel HbA1c of X % Toxicology Screen 25-hydroxyvitamin D of X Patient Age of X Years Patient Gender of Maile Patient Gender of Female Neuropathic pain Somatic pain Back Pain Lower Back Pain Middle Back Pain

Upper Back Pain

Neck Pain

Joint Pain

Knee Pain

Hip Pain

Shoulder Pain

Abdominal Pain

Pain aggrevated by cold weather

Pain aggrevated by change in climate

Pain aggrevated by diabetes

Pain aggrevated by hormone imbalance

Pain aggrevated by infectious disease

Pain aggrevated by inflammatory process

Pain aggrevated by mental health related problems

Pain aggrevated by anxiety

Pain aggrevated by depression

Pain aggrevated by military sexual trauma

Pain aggrevated by post-traumatic stress disorder

Pain aggrevated by movement

Pain aggrevated by poor nutrition

Pain aggrevated by poor sleep

Pain aggrevated by prolonged sitting

Pain aggrevated by prolonged standing

Risky behaviors related to opiod use

Concurrent use with opiods of other substances that increase risk (e.g., alcohol, cannabis)

History of Early refills of opiods

Multiple prescribers

Use of opioids for sleep

Use of opioids for stress

Use of opioids in a manner other than prescribed

Use of opioids not prescribed to patient

Stress

Structural Imbalance

Current Alcohol Use

Former Alcohol Use

Current Legal Recreational Cannabis use

Former Legal Recreational Cannabis use

Current Illicit Recreational Cannabis use

Former Illicit Recreational Cannabis use

Current Medical Cannabis use

Former Medical Cannabis use

Current Illicit Drug Use

Former Illicit Drug Use

Current Tobacco user

Former Tobacco user

History of Toxic Exposure

Pain alleviated by lying down

Pain alleviated by rest

Pain alleviated by heat

Pain alleviated by ice

Medium Energy Level

High Energy Level

X Hours of sleep per night

Early Awakening

Early Awakening caused by pain

Early Awakening caused by Nightmares

Early Awakening caused by Restless leg syndrome

Uses continuous positive airway pressure (CPAP)

Anxiety

Depression

Thoughts of sucidality

Thoughts of homicidality

Informed consent for opioid therapy

Plan of Movement

Plan of Stretching

Plan of Nutrition

Plan Sleep and Rest

Plan Stress resilience

Plan Social connection

Plan Physical Therapy

Plan of accupuncture

Plan of Tai Chi

Plan of Yoga

Plan of Mindfulness

Plan of Meditation

Plan of Guided imagery

Plan of hynotherapy

Plan of biofeedback

Plan disease state education

Plan Lifestyle counseling

Plan Lifestyle education

Plan Psychotherapy

Plan Cognitive behavioral therapy

Plan Acceptance and commitment therapy

Plan Substance use disorder interventions

Plan Tobacco cessation interventions

Plan of Non-opioid pain medication

Plan of Opioid pain medication

Plan Management/prevention of opioid-induced constipation

Plan Overdose education and naloxone distribution

Plan Medication monitoring/diagnostic evaluation

Plan Manage adverse drug reaction related to pain medication

statementId

UUID

unique id for this item

statementType

LogicalExpression

the kind of statement, request, performance

398166005 |Performed (qualifier value)|

METADATA: model fit comments

not codable

VA CDS Team IR Review Rating

1. Perfect fit of model and terminology with the use case.

2. Meets the use case within the constraints of the model.

3. Some specificity of the use case is lost, secondary to limitations of terminology modeling.

4. There are significant errors that require correction.	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	1	2	1	1	1	1			1	1	1	1	1
	VA CDS Team Reviewer Initials			CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS	CS		CS		CS

subjectOfInformation LogicalExpression relationship such as 'mother', 'brother', 'sibling', 'relative', 'donor' 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record 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|Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)| 410604004 |Subject of record (person)|

	topic	LogicalExpression		26604007 \|Complete blood count (procedure)\|	1411000205104 \|Comprehensive metabolic panel (procedure)\|	43396009 \|Hemoglobin A1c measurement (procedure)\|	314076009 \|Toxicology screening test (procedure)\|	447678008 \|Measurement of 25-hydroxyergocalciferol (procedure)\|	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[105726004 \|Age AND/OR growth finding (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[248153007 \|Male (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[248152002 \|Female (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[247398009 \|Neuropathic pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[48429009 \|Somatic pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[161891005 \|Backache (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[279039007 \|Low back pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[279038004 \|Thoracic back pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[161896000 \|Complaining of upper back ache (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[81680005 \|Neck pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[57676002 \|Joint pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[30989003 \|Knee pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[49218002 \|Hip pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[45326000 \|Shoulder pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[21522001 \|Abdominal pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[200c9d89-dee9-4f0e-903f-53f77fbf5bd6 \|Pain aggravated by cold weather (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[e583ef45-eddb-4028-bb7b-73171c6734b9 \|Pain aggravated by change in climate (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[88004a00-3b67-408b-8737-fe0cce58ddcf \|Pain aggravated by diabetes (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6be254c4-4309-4d3c-8a79-53d9bd184bcb \|Pain aggravated by hormone imbalance (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[972638ea-cc75-48f2-a881-16358a798848 \|Pain aggravated by infectious disease (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[d57ab696-0ec2-479a-be85-9fb7ee17655f \|Pain aggravated by inflammatory process (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[d415a2fc-d8ff-47a2-949b-37193db38df4 \|Pain aggravated by mental health problems (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[2957a442-7e93-4eeb-9527-c7042c2cba0f \|Pain aggravated by anxiety (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6ae3b455-5b3d-44b4-aa25-b9ed03dea815 \|Pain aggravated by depression (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[bf8ceb54-0a74-46f1-a43e-646b3587d564 \|Pain aggravated by sexual trauma during military service (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[34c30e9b-a621-44ad-8d13-6806f4c7a7f3 \|Pain aggravated by post-traumatic stress disorder (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6833f7dd-cd16-4987-8320-db07729a89df \|Pain aggravated by movement (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[061d5677-0600-4b60-98b0-e4a0c5fd3a84 \|Pain aggravated by poor nutrition (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[594d0a01-ed45-4021-86dc-4b3c1f826113 \|Pain aggravated by poor sleep (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[ec406ab7-1200-4ef4-b31e-062896495a4a \|Pain aggravated by prolonged sitting (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[d1bdabcd-d0e8-45da-b4ad-d9159049d824 \|Pain aggravated by prolonged standing (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[427346002 \|Risk prone health behavior (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[228372006 \|Poly-drug misuser (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[1a0ef3fa-4e70-4a84-bedf-706396899f63 \|Obtains early refills of opioid prescriptions (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6d75b166-20b5-4fe5-98a0-d38ec561d5fa \|Uses multiple prescribers (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[b71c0528-33ce-499b-aef8-b095f8c2900e \|Uses opioids to support sleep (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[e5530930-acc3-4778-943d-a7def9476607 \|Uses opioids for stress relief (finding)]			[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[73595000 \|Stress (finding)]		[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[219006 \|Current drinker of alcohol (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[82581004 \|Ex-drinker (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[36358673-9d77-4c7a-987b-441f8f5da653 \|User of legal recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[7804d280-befe-4ba7-9387-86019285144f \|Ex-user of legal recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[31760619-c4c2-4d6c-aa46-4a2d8e7733cd \|User of illicit recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[7516f2f5-8171-4d6d-af28-fbb0994b6b4c \|Ex-user of illicit recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[ac23a526-dc71-4264-b359-61f2b5ab7a1b \|User of medical marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6eec41c4-15b3-4d7c-b731-d7b126690f47 \|Ex-user of medical marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[307052004 \|Illicit drug use (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[b1c03656-6306-47d6-8ee6-a80227b99e4a \|Ex-user of illicit drugs (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[110483000 \|Tobacco user (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[702975009 \|Ex-tobacco user (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[75478009 \|Poisoning (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[172f1507-d6f0-4c48-bd1e-95dd477754d6 \|Pain relief by lying down (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[427935006 \|Pain relief by rest (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[79ede33a-45a2-46f9-a3be-94bb384e747a \|Pain relief by application of heat (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[3c4d6355-2e1d-4a9a-b8e7-0bc90204209a \|Pain relief by application of ice (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[e49cc42c-afa0-4f52-9b1b-6509d31b68bc \|Pain relief by elevation of limb (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[ad5e2961-02f1-40dd-aafb-82821f6ac985 \|Pain relief by movement (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[796908f2-6b92-435f-a098-c648fdb36029 \|Pain relief by integrative health therapy (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[3e7f9703-bd6a-42da-b727-be43f988876e \|Pain relief by cognitive behavioral approach (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[301331008 \|Finding of body mass index (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[163020007 \|On examination - blood pressure reading (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[163030003 \|On examination - Systolic blood pressure reading (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[163031004 \|On examination - Diastolic blood pressure reading (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[301283003 \|Finding of rate of respiration (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[301113001 \|Finding of heart rate (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[609328004 \|Allergic disposition (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[62014003 \|Adverse reaction caused by drug (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[242253008 \|Overdose of opiate (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]-

->(363702006 |Has focus (attribute))->[185265000 |Seen in emergency clinic (finding)]-

->(42752001 \|Due to (attribute))->[5602001 \|Opioid abuse (disorder)]	[32485007 \|Hospital admission (procedure)]
->(363702006 \|Has focus (attribute))->[5602001 \|Opioid abuse (disorder)]	91251008 \|Physical therapy procedure (regime/therapy)\|	44868003 \|Acupuncture (procedure)\|	229223006 \|Participation in Tai Chi (regime/therapy)\|	229224000 \|Participation in yoga (regime/therapy)\|	05257e84-e247-4f2e-bb83-dccd395d56a8 \|Mindfulness therapy (procedure)\|	386365008 \|Meditation facilitation (procedure)\|	228565006 \|Imagery technique (regime/therapy)\|	19997007 \|Hypnotherapy (regime/therapy)\|	28150003 \|Biofeedback procedure (regime/therapy)\|	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]-

->(363702006 |Has focus (attribute))->[301325005 |Finding of general energy (finding)]- ->(363714003 |Interprets (attribute))->[359755007 |Energy / stamina (observable entity)]- (363713009 |Has interpretation (attribute))->[62482003 |Low (qualifier value)] [a997cc03-3e99-40eb-833a-6374c7750a3a |Observation procedure (procedure)]- ->(363702006 |Has focus (attribute))->[301325005 |Finding of general energy (finding)]- ->(363714003 |Interprets (attribute))->[359755007 |Energy / stamina (observable entity)]- (363713009 |Has interpretation (attribute))->[1fb50fd0-c49f-4a2b-b4e1-df6699a4cc10 |Medium (qualifier value)] [a997cc03-3e99-40eb-833a-6374c7750a3a |Observation procedure (procedure)]- ->(363702006 |Has focus (attribute))->[301325005 |Finding of general energy (finding)]- ->(363714003 |Interprets (attribute))->[359755007 |Energy / stamina (observable entity)]-

(363713009 \|Has interpretation (attribute))->[75540009 \|High (qualifier value)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[118190003 \|Sleep finding (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[67062000 \|Terminal insomnia (disorder)]		[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]-

->(42752001 |Due to (attribute))->[32914008 |Restless legs (disorder)];

47545007 |Continuous positive airway pressure ventilation treatment (regime/therapy)|

[a997cc03-3e99-40eb-833a-6374c7750a3a |Observation procedure (procedure)]

->(363702006 |Has focus (attribute))->[197480006 |Anxiety disorder (disorder)]

[a997cc03-3e99-40eb-833a-6374c7750a3a |Observation procedure (procedure)]

->(363702006 |Has focus (attribute))->[35489007 |Depressive disorder (disorder)]

[a997cc03-3e99-40eb-833a-6374c7750a3a |Observation procedure (procedure)]

->(363702006 |Has focus (attribute))->[6471006 |Suicidal thoughts (finding)]

[a997cc03-3e99-40eb-833a-6374c7750a3a |Observation procedure (procedure)]

->(363702006 |Has focus (attribute))->[225450009 |Homicidal thoughts (finding)]

[182771004 |Informed consent for procedure (procedure)]

->(363702006 |Has focus (attribute))->[726582005 |Opiate therapy (procedure)]

229064008 |Movement therapy (regime/therapy)|

229070002 |Stretching exercises (regime/therapy)|

386373004 |Nutrition therapy (regime/therapy)|

225206006 |Sleep and rest interventions (procedure)|

226060000 |Stress management (procedure)|

38256005 |Social network therapy (regime/therapy)|

91251008 |Physical therapy procedure (regime/therapy)|

44868003 |Acupuncture (procedure)|

229223006 |Participation in Tai Chi (regime/therapy)|

229224000 |Participation in yoga (regime/therapy)|

05257e84-e247-4f2e-bb83-dccd395d56a8 |Mindfulness therapy (procedure)|

386365008 |Meditation facilitation (procedure)|

228565006 |Imagery technique (regime/therapy)|

19997007 |Hypnotherapy (regime/therapy)|

28150003 |Biofeedback procedure (regime/therapy)|

84635008 |Disease process or condition education (procedure)|

715756009 |Lifestyle adjustment training (procedure)|

313204009 |Lifestyle education (procedure)|

75516001 |Psychotherapy (regime/therapy)|

304891004 |Cognitive - behavior therapy (regime/therapy)|

aada5366-f841-4015-9c6a-5dd1a22a8ee3 |Acceptance and commitment therapy (regime/therapy)|

424407005 |Substance use cessation education, guidance, and counseling (procedure)|

702388001 |Tobacco use cessation education (procedure)|

[416118004 |Administration (procedure)]

->(260686004 |Method (attribute))->[129445006 |Administration - action (qualifier value)] ->(363701004 |Direct substance (attribute))->[322208004 |Non-opioid analgesics (product)] [416118004 |Administration (procedure)] ->(260686004 |Method (attribute))->[129445006 |Administration - action (qualifier value)] ->(363701004 |Direct substance (attribute))->[404642006 |Substance with opioid receptor agonist mechanism of action (substance)] [169443000 |Preventive procedure (procedure)]- ->(363702006 |Has focus (attribute))->[14760008 |Constipation (disorder)]- ->(246075003 |Causative agent (attribute))->[404642006 |Substance with opioid receptor agonist mechanism of action (substance)]; 718021000 |Education about take home naloxone for opiate overdose intervention (procedure)| 395170001 |Medication monitoring (regime/therapy)| [363259005 |Patient management procedure (procedure)] ->(363702006 |Has focus (attribute))->[292040004 |Analgesic adverse reaction (disorder)]

unstructured	String	related to opioid use	opiods and other substances that increase risk (e.g., alcohol, cannabis)	e.g. mindfulness	e.g., meeting with friends, music
unstructured	String

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

timing.lowerBound

float

timing.upperBound

float

inf

timing.includeLowerBound

boolean

TRUE

timing.includeLowerBound

boolean

TRUE

FALSE

timing.resolution

float (optional)

timing.measureSemantic

Logical Expression

ISO 8601 prior to statement time

purpose

Logical Expression

[277132007 |Therapeutic procedure (procedure)]

->(363702006 |Has focus (attribute))->[22253000 |Pain (finding)]

purpose	Logical Expression
purpose	Logical Expression

result.lowerBound

float

Lower value of range

result.upperBound

float

Upper value of range

result.includeLowerBound

boolean

true or false

TRUE

result.includeUpperBound

boolean

true or false

TRUE

result.resolution

float (optional)

value of precision

result.measureSemantic

LogicalExpression

unit of measure

118582008 |Percent (property) (qualifier value)|

258806002 |Nanogram/milliliter (qualifier value)|

258707000 |year (qualifier value)|

258896009 |Kilogram/square meter (qualifier value)|

259018001 |Millimeter of mercury (qualifier value)|

258984001 |Breaths/minute (qualifier value)|

258983007 |Beats/minute (qualifier value)|

229788003 |hours/day (qualifier value)|

Below use healthRisk for ObservationResults and use status for InterventionResults

result.healthRisk

LogicalExpression (optional)

result.status

LogicalExpression

397943006 |Planned (qualifier value)|

Request

Instance Request	Type	Textual Representation
statementId	UUID	unique id for this item
statementType	LogicalExpression	the kind of statement, request, performance
METADATA: model fit comments
VA CDS Team IR Review Rating		1. Perfect fit of model and terminology with the use case.

2. Meets the use case within the constraints of the model.

3. Some specificity of the use case is lost, secondary to limitations of terminology modeling.

4. There are significant errors that require correction.

VA CDS Team Reviewer Initials subjectOfInformation LogicalExpression relationship such as 'mother', 'brother', 'sibling', 'relative', 'donor' topic LogicalExpression

unstructured	String
unstructured	String

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

timing.lowerBound	float
timing.upperBound	float
timing.includeLowerBound	boolean
timing.includeLowerBound	boolean
timing.resolution	float (optional)
timing.measureSemantic	Logical Expression
purpose	Logical Expression
purpose	Logical Expression
purpose	Logical Expression

requestedResult.lowerBound	float	Lower value of range
requestedResult.upperBound	float	Upper value of range
requestedResult.includeLowerBound	boolean	true or false
requestedResult.includeUpperBound	boolean	true or false
requestedResult.resolution	float (optional)	value of precision
requestedResult.measureSemantic	LogicalExpression	unit of measure
Below use healthRisk for ObservationResults and use status for InterventionResults
requestedResult.healthRisk	LogicalExpression (optional)
requestedResult.status	LogicalExpression

conditionalTrigger.semantic	LogicalExpression
conditionalTrigger.statementId	UUID

conditionalTrigger.semantic	LogicalExpression
conditionalTrigger.statementId	UUID

conditionalTrigger.semantic	LogicalExpression
conditionalTrigger.statementId	UUID

priority Logical Expression

repetition.periodStart.lowerBound	float
repetition.periodStart.upperBound	float
repetition.periodStart.includeLowerBound	boolean
repetition.periodStart.includeUpperBound	boolean
repetition.periodStart.resolution	float (optional)
repetition.periodStart.measureSemantic	Logical Expression
repetition.periodDuration.lowerBound	float
repetition.periodDuration.upperBound	float
repetition.periodDuration.includeLowerBound	boolean
repetition.periodDuration.includeUpperBound	boolean
repetition.periodDuration.resolution	float (optional)
repetition.periodDuration.measureSemantic	Logical Expression
repetition.eventFrequency.lowerBound	float
repetition.eventFrequency.upperBound	float
repetition.eventFrequency.includeLowerBound	boolean
repetition.eventFrequency.includeUpperBound	boolean
repetition.eventFrequency.resolution	float (optional)
repetition.eventFrequency.measureSemantic	Logical Expression
repetition.eventSeparation.lowerBound	float
repetition.eventSeparation.upperBound	float
repetition.eventSeparation.includeLowerBound	boolean
repetition.eventSeparation.includeUpperBound	boolean
repetition.eventSeparation.resolution	float (optional)
repetition.eventSeparation.measureSemantic	Logical Expression
repetition.eventDuration.lowerBound	float
repetition.eventDuration.upperBound	float
repetition.eventDuration.includeLowerBound	boolean
repetition.eventDuration.includeUpperBound	boolean
repetition.eventDuration.resolution	float (optional)
repetition.eventDuration.measureSemantic	Logical Expression

repetition.periodStart.lowerBound	float
repetition.periodStart.upperBound	float
repetition.periodStart.includeLowerBound	boolean
repetition.periodStart.includeUpperBound	boolean
repetition.periodStart.resolution	float (optional)
repetition.periodStart.measureSemantic	Logical Expression
repetition.periodDuration.lowerBound	float
repetition.periodDuration.upperBound	float
repetition.periodDuration.includeLowerBound	boolean
repetition.periodDuration.includeUpperBound	boolean
repetition.periodDuration.resolution	float (optional)
repetition.periodDuration.measureSemantic	Logical Expression
repetition.eventFrequency.lowerBound	float
repetition.eventFrequency.upperBound	float
repetition.eventFrequency.includeLowerBound	boolean
repetition.eventFrequency.includeUpperBound	boolean
repetition.eventFrequency.resolution	float (optional)
repetition.eventFrequency.measureSemantic	Logical Expression
repetition.eventSeparation.lowerBound	float
repetition.eventSeparation.upperBound	float
repetition.eventSeparation.includeLowerBound	boolean
repetition.eventSeparation.includeUpperBound	boolean
repetition.eventSeparation.resolution	float (optional)
repetition.eventSeparation.measureSemantic	Logical Expression
repetition.eventDuration.lowerBound	float
repetition.eventDuration.upperBound	float
repetition.eventDuration.includeLowerBound	boolean
repetition.eventDuration.includeUpperBound	boolean
repetition.eventDuration.resolution	float (optional)
repetition.eventDuration.measureSemantic	Logical Expression

repetition.periodStart.lowerBound	float
repetition.periodStart.upperBound	float
repetition.periodStart.includeLowerBound	boolean
repetition.periodStart.includeUpperBound	boolean
repetition.periodStart.resolution	float (optional)
repetition.periodStart.measureSemantic	Logical Expression
repetition.periodDuration.lowerBound	float
repetition.periodDuration.upperBound	float
repetition.periodDuration.includeLowerBound	boolean
repetition.periodDuration.includeUpperBound	boolean
repetition.periodDuration.resolution	float (optional)
repetition.periodDuration.measureSemantic	Logical Expression
repetition.eventFrequency.lowerBound	float
repetition.eventFrequency.upperBound	float
repetition.eventFrequency.includeLowerBound	boolean
repetition.eventFrequency.includeUpperBound	boolean
repetition.eventFrequency.resolution	float (optional)
repetition.eventFrequency.measureSemantic	Logical Expression
repetition.eventSeparation.lowerBound	float
repetition.eventSeparation.upperBound	float
repetition.eventSeparation.includeLowerBound	boolean
repetition.eventSeparation.includeUpperBound	boolean
repetition.eventSeparation.resolution	float (optional)
repetition.eventSeparation.measureSemantic	Logical Expression
repetition.eventDuration.lowerBound	float
repetition.eventDuration.upperBound	float
repetition.eventDuration.includeLowerBound	boolean
repetition.eventDuration.includeUpperBound	boolean
repetition.eventDuration.resolution	float (optional)
repetition.eventDuration.measureSemantic	Logical Expression

Unstructured

Instance Request	Type	Textual Representation
statementId	UUID	unique id for this item
statementType	LogicalExpression	the kind of statement, request, performance
METADATA: model fit
METADATA: model fit comments

subjectOfInformation LogicalExpression relationship such as 'mother', 'brother', 'sibling', 'relative', 'donor' topic LogicalExpression

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

statementAssociation.semantic	LogicalExpression
statementAssociation.statementId	UUID

timing.lowerBound	float
timing.upperBound	float
timing.includeLowerBound	boolean
timing.includeLowerBound	boolean
timing.resolution	float (optional)
timing.measureSemantic	Logical Expression
purpose	Logical Expression
purpose	Logical Expression
purpose	Logical Expression

unstructuredText String Free Text

Concepts

Issues

	Tab	Opened by	Instance Request	Issue	Reply	Status
	Performance	Kirsten Haake	25-hydroxyvitamin D of X	units not specified nmol/L or ng/mL?	Joey: Let's go with ng/mL
6/6/2018 Kirsten: Used 258806002 \|Nanogram/milliliter (qualifier value)\|	Closed
	Performance		Middle Back Pain	Location needs clarification: does this mean thoracic spine? Or thoracolumbar spine?	Julia Skapik: Middle upper and lower are not directly correlated to location in the way you suggest; however, I would use: upper: cervical and thoracic, middle: thoracic: lower: lumbar. technically as you point out most back pain is musculoskeletal and not spinalso if there are concepts for middle upper and lower i would use those but if not, do what you can	Closed
	Performance		Upper Back Pain	Location needs clarification: does this mean thoracic or cervical spine?	as above	Closed
	Performance	Kirsten Haake	Risky behaviors related to opiod use	IR is quite ambiguous. Used 427346002 \|Risk prone health behavior (finding) and entered the opioid use in unstructured, because I don't want to create a subtype of this for a drug (combinatorial explosion).	Joey: OK	Closed
	Performance	Kirsten Haake	Concurrent use with opiods of other substances that increase risk (e.g., alcohol, cannabis)	Used 228372006 \|Poly-drug misuser (finding). I think this is the best we can do here, otherwise it would be "not codable".	Joey: OK	Closed
	Performance	Kirsten Haake	Use of opioids in a manner other than prescribed	not codable	Joey: OK	Closed
	Performance	Kirsten Haake	Use of opioids not prescribed to patient	not codable	Joey: OK	Closed
	Performance		Structural Imbalance	Clarification/definition?	Julia Skapik: no idea what's meant here unless it's a preexisting orthopedic malformation or trauma (could go with that reasonably (one leg longer, s/p crush fracture as examples)
6/6/2018 Kirsten: Since it seems to be unknown what this means it is not codable.	Closed
	Performance		Early awakening	2 duplicate concepts	Joey: OK	Closed
	Performance		Plan of Movement and Stretching	Created 2 separate IR
Plan of Movement and Plan of Stretching	Joey: OK	Closed
	Performance		Plan Lifestyle counseling and education	Created 2 separate IR
Plan Lifestyle counseling and Plan Lifestyle education	Joey: OK	Closed
	Performance		Plan Acceptance and commitment therapy	Clarification/definition? If these are indeed 2 different IR, acceptance and commitment to what?
	Julia Skapik : This should just be one thing
6/6/2018 Kirsten: Created new concept.	Closed
	Performance		Plan Substance use disorder interventions	Need clarification, there is a broad group of interventions ( e.g. screening, counseling, education, referrals, etc.); propose: 408933008 \|Substance abuse prevention (procedure)\|	Julia Skapik : Is there a grouper for these? I would use that if possible. If not want referrals, counseling and education
6/6/2018 Kirsten: Used 424407005 \|Substance use cessation education, guidance, and counseling (procedure)\|	Closed
	Performance		Plan Tobacco cessation interventions	Similar issue as above; available: 702388001 \|Tobacco use cessation education (procedure)\|	Joey: OK
6/6/2018 Kirsten: Used 702388001 \|Tobacco use cessation education (procedure)\|	Closed
	Performance		Plan Medication monitoring/diagnostic evaluation	Clarification/definition of "diagnostic evaluation"?	Julia Skapik : this is two things separately not sure why they are lumped
6/6/2018 Kirsten: Still no definition of "diagnostic evaluation". Coded Medication monitoring only	Closed
	Performance	catherine staes	Back Pain	currently it is coded to 'backache' which I don't believe is the same as backpain.	6/7/2018 Kirsten: To SCT, it is the same. The "Backache" concept has a synonum "Back pain".	Closed
	Performance	catherine staes

Middle Back Pain issue

what is meant by the word 'issue'. Is it supposed to be different than the other IRs that simply indicate 'pain'?	6/7/2018 Kirsten: Sorry. That word was just not deleted by me after discussing an "issue" with this IR with Deb.	Closed
Performance	catherine staes	Pain aggrevated by cold weather	is it really necessary to create all the postcoordinated expressions for all the aggravations? You can't just use 'has focus' pain' and specify 'due to'? See an example of this in column CB	6/7/2018 Kirsten: I have been thinking about this, too. But "Pain due to….X" is not the same as pain that is already present and is aggravated by something. Those are semantically not equivalent.

6/7/18- catheirne: I see what you mean. I agree.	Closed
	Performance	catherine staes	Former Legal Recreational Cannabis use	wouldn't you do the 'history of' model?

And same for all the other 'former' IR s	6/7/2018 Kirsten: "History of X" means that it was present in the past and can also still be present in the present. "Former" is equivalent to "Ex…."	Closed
	Performance	catherine staes	Pain alleviated by Cognitive behavioral approaches (e.g., meeting with friends, music)	B consistent - see BQ and BR. Add the unstructured text.	6/7/2018 Kirsten: added the unstructured text	Closed
	Performance	catherine staes	Blood Pressure	remove X elements	6/7/2018 Kirsten: removed	Closed
	Performance	catherine staes	History of opiod related hospital admission	I think the focus should be 'hospital admission' not 'seen in ward'. The admission could be to the ICU or elsewhere, so needs not be specific to a ward.	6/7/2018 Kirsten: changed modeling	Closed
	Performance	catherine staes	Low Energy Level
	wouldn't the 3 energy levels have an observation focus of energy level, and the status or value is low medium or high?	6/7/2018 Kirsten: changed modeling	Closed
	Performance	catherine staes	Plan of Opioid pain medication	can you put 'pain managemtn in the purpose element?	6/7/2018 Kirsten: Assuming you mean "pain medication". Added the purpose.

6/7/18- I had it wrong. You were right with the original. I was thinking it needed to say why it was being given (for pain management). But, you had already said for pain below and it actally said 'pain medication' not 'pain management'. please remove the unstructured text.

6/7/2018 Kirsten: Removed.	Closed
	Performance	catherine staes	Plan Management/prevention of opioid-induced constipation
	add the statement type	6/7/2018 Kirsten: added statement type	Closed

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Aug 14, 2020.

	topic	LogicalExpression		26604007 \|Complete blood count (procedure)\|	1411000205104 \|Comprehensive metabolic panel (procedure)\|	43396009 \|Hemoglobin A1c measurement (procedure)\|	314076009 \|Toxicology screening test (procedure)\|	447678008 \|Measurement of 25-hydroxyergocalciferol (procedure)\|	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[105726004 \|Age AND/OR growth finding (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[248153007 \|Male (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[248152002 \|Female (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[247398009 \|Neuropathic pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[48429009 \|Somatic pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[161891005 \|Backache (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[279039007 \|Low back pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[279038004 \|Thoracic back pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[161896000 \|Complaining of upper back ache (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[81680005 \|Neck pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[57676002 \|Joint pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[30989003 \|Knee pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[49218002 \|Hip pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[45326000 \|Shoulder pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[21522001 \|Abdominal pain (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[200c9d89-dee9-4f0e-903f-53f77fbf5bd6 \|Pain aggravated by cold weather (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[e583ef45-eddb-4028-bb7b-73171c6734b9 \|Pain aggravated by change in climate (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[88004a00-3b67-408b-8737-fe0cce58ddcf \|Pain aggravated by diabetes (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6be254c4-4309-4d3c-8a79-53d9bd184bcb \|Pain aggravated by hormone imbalance (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[972638ea-cc75-48f2-a881-16358a798848 \|Pain aggravated by infectious disease (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[d57ab696-0ec2-479a-be85-9fb7ee17655f \|Pain aggravated by inflammatory process (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[d415a2fc-d8ff-47a2-949b-37193db38df4 \|Pain aggravated by mental health problems (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[2957a442-7e93-4eeb-9527-c7042c2cba0f \|Pain aggravated by anxiety (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6ae3b455-5b3d-44b4-aa25-b9ed03dea815 \|Pain aggravated by depression (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[bf8ceb54-0a74-46f1-a43e-646b3587d564 \|Pain aggravated by sexual trauma during military service (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[34c30e9b-a621-44ad-8d13-6806f4c7a7f3 \|Pain aggravated by post-traumatic stress disorder (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6833f7dd-cd16-4987-8320-db07729a89df \|Pain aggravated by movement (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[061d5677-0600-4b60-98b0-e4a0c5fd3a84 \|Pain aggravated by poor nutrition (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[594d0a01-ed45-4021-86dc-4b3c1f826113 \|Pain aggravated by poor sleep (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[ec406ab7-1200-4ef4-b31e-062896495a4a \|Pain aggravated by prolonged sitting (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[d1bdabcd-d0e8-45da-b4ad-d9159049d824 \|Pain aggravated by prolonged standing (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[427346002 \|Risk prone health behavior (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[228372006 \|Poly-drug misuser (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[1a0ef3fa-4e70-4a84-bedf-706396899f63 \|Obtains early refills of opioid prescriptions (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6d75b166-20b5-4fe5-98a0-d38ec561d5fa \|Uses multiple prescribers (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[b71c0528-33ce-499b-aef8-b095f8c2900e \|Uses opioids to support sleep (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[e5530930-acc3-4778-943d-a7def9476607 \|Uses opioids for stress relief (finding)]			[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[73595000 \|Stress (finding)]		[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[219006 \|Current drinker of alcohol (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[82581004 \|Ex-drinker (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[36358673-9d77-4c7a-987b-441f8f5da653 \|User of legal recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[7804d280-befe-4ba7-9387-86019285144f \|Ex-user of legal recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[31760619-c4c2-4d6c-aa46-4a2d8e7733cd \|User of illicit recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[7516f2f5-8171-4d6d-af28-fbb0994b6b4c \|Ex-user of illicit recreational marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[ac23a526-dc71-4264-b359-61f2b5ab7a1b \|User of medical marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[6eec41c4-15b3-4d7c-b731-d7b126690f47 \|Ex-user of medical marijuana (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[307052004 \|Illicit drug use (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[b1c03656-6306-47d6-8ee6-a80227b99e4a \|Ex-user of illicit drugs (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[110483000 \|Tobacco user (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[702975009 \|Ex-tobacco user (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[75478009 \|Poisoning (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[172f1507-d6f0-4c48-bd1e-95dd477754d6 \|Pain relief by lying down (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[427935006 \|Pain relief by rest (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[79ede33a-45a2-46f9-a3be-94bb384e747a \|Pain relief by application of heat (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[3c4d6355-2e1d-4a9a-b8e7-0bc90204209a \|Pain relief by application of ice (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[e49cc42c-afa0-4f52-9b1b-6509d31b68bc \|Pain relief by elevation of limb (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[ad5e2961-02f1-40dd-aafb-82821f6ac985 \|Pain relief by movement (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[796908f2-6b92-435f-a098-c648fdb36029 \|Pain relief by integrative health therapy (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[3e7f9703-bd6a-42da-b727-be43f988876e \|Pain relief by cognitive behavioral approach (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[301331008 \|Finding of body mass index (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[163020007 \|On examination - blood pressure reading (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[163030003 \|On examination - Systolic blood pressure reading (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[163031004 \|On examination - Diastolic blood pressure reading (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[301283003 \|Finding of rate of respiration (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[301113001 \|Finding of heart rate (finding)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[609328004 \|Allergic disposition (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[62014003 \|Adverse reaction caused by drug (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]
->(363702006 \|Has focus (attribute))->[242253008 \|Overdose of opiate (disorder)]	[a997cc03-3e99-40eb-833a-6374c7750a3a \|Observation procedure (procedure)]-