ATTACHMENT 29 - Opiod Non Cancer Pain Mgt Order Set_KNART XML_2018-06-25.pdf

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KNART Validation Report"/> 58 </resource> 59 </resources> 60 </relatedResource> 61 </relatedResources> 63 <supportingEvidence> 64 <evidence> 65 <resources> 66 <resource> 67 <identifiers> 68 <identifier root="https://doi.org" extension=

"10.1037/ser0000099" identifierName="DOI"/> 69 <identifier root="LocalDocBook" extension="e1" identifierName="Oliva 2017"/> 70 </identifiers> 71 <title value="Development and applications of the Veterans

Health Administration's Stratification Tool for Opioid Risk Mitigation (STORM) to improve opioid safety and prevent overdose and suicide"/>

72 <location value="https://doi.org/10.1037/ser0000099"/> 73 <citation 74 value="Oliva EM, Bowe T, Tavakoli S, et al. Development and applications of the Veterans Health Administration's Stratification Tool for Opioid Risk Mitigation (STORM) to improve opioid safety and prevent overdose and suicide.

Psychol Serv. 2017;14(1):34-49."

75 /> 76 </resource> 77 </resources> 78 </evidence> 79 <evidence> 80 <resources> 81 <resource> 82 <identifiers> 83 <identifier root="LocalDocBook" extension="e2" identifierName="Trafton 2017a"/> 84 </identifiers> 85 <title 86 value="Opioid risk stratification and mitigation tool:

supporting targeted efforts to encourage and track use of recommended strategies for prevention of adverse events in patients with opioid prescriptions or opioid use disorders"/>

87 <citation 88 value="J. Trafton. Opioid risk stratification and mitigation tool: supporting targeted efforts to encourage and track use of recommended strategies for prevention of adverse events in patients with opioid prescriptions or opioid use disorders (AAPM December 2015 panel presentation for clearance2"

89 /> 90 </resource> 91 </resources> 92 </evidence> 93 <evidence> 94 <resources> 95 <resource> 96 <identifiers> 97 <identifier root="LocalDocBook" extension="e3" identifierName="Sanders 2017"/> 98 </identifiers> 99 <title value="Opioid Therapy Risk Report patient details"/>

100 <citation 101 value="Opioid Therapy Risk Report patient details (Office of Health Informatics - Opioid KNARTs Harmonization Project

- OTRR Screenshots 20171222.docx; email communication and materials provided by William J. Sanders, December 22, 2017)."

102 /> 103 </resource> 104 </resources> 105 </evidence> 106 <evidence> 107 <resources> 108 <resource> 109 <identifiers> 110 <identifier root="LocalDocBook" extension="e4" identifierName="Robeck 2017a"/> 111 </identifiers> 112 <title value="PBM CPPO pain PhARMD template"/> 113 <citation value="PBM CPPO pain PhARMD template: frequently asked questions (PBM PAIN PhARMD TEMPLATE FAQ DOCUMENT2.pptx;

materials provided by Ilene R. Robeck, November 27, 2017"/>

114 </resource> 115 </resources> 116 </evidence> 117 <evidence> 118 <resources> 119 <resource> 120 <identifiers> 121 <identifier root="LocalDocBook" extension="e5" identifierName="Robeck 2017b"/> 122 </identifiers> 123 <title value="PBM PhARMD pain documentation template version 1"/> 124 <citation value="PBM PhARMD pain documentation template version

1: installation instructions, 28AUG2017 (PhARMD Pain Mgmt Note Template_Install Screenshots_28AUG2017.pptx; materials provided by Ilene R. Robeck, November 27, 2017)."

125 /> 126 </resource> 127 </resources> 128 </evidence> 129 <evidence> 130 <resources> 131 <resource> 132 <identifiers> 133 <identifier root="LocalDocBook" extension="e6" identifierName="Trafton 2017b"/> 134 </identifiers> 135 <title value="STORM: Patient Detail Dashboard: Stratification

Tool for Opioid Risk Mitigation"/> 136 <citation value="STORM: Patient Detail Dashboard:

Stratification Tool for Opioid Risk Mitigation (STORMde-idedscreenshot.png; materials provided by Jodie Trafton, December 12, 2017)."/>

137 </resource> 138 </resources>

139 </evidence> 140 <evidence> 141 <resources> 142 <resource> 143 <identifiers> 144 <identifier root="https://doi.org" extension=

"10.1093/pm/pnx203" identifierName="DOI"/> 145 <identifier root="LocalDocBook" extension="e7" identifierName="Rosenberg 2017"/> 146 </identifiers> 147 <title value="Opioid Therapy for Chronic Pain: Overview of the

2017 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline."/>

148 <location value="https://www.ncbi.nlm.nih.gov/pubmed/29025128"/> 149 <citation value="Rosenberg JM, Bilka BM, Wilson SM, Spevak C.

Opioid Therapy for Chronic Pain: Overview of the 2017 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline. Pain Med. 2017 Sep 1"/>

150 </resource> 151 </resources> 152 </evidence> 153 <evidence> 154 <resources> 155 <resource> 156 <identifiers> 157 <identifier root="https://www.va.gov" extension=

"vhapublications/ViewPublication.asp?pub_ID=3283"/> 158 <identifier root="LocalDocBook" extension="e8" identifierName="VA 2016"/> 159 </identifiers> 160 <title value="Querying State Prescription Drug Monitoring

Programs (PDMP)"/> 161 <location value=

"https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=32 83"/>

162 <citation 163 value="U.S. Department of Veterans Affairs; Veterans Health

Administration. Querying State Prescription Drug Monitoring Programs (PDMP). VHA Directive 1306. VHA Publications website.

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID =3283. Published October 19, 2016. Accessed February 8, 2018"

164 /> 165 </resource> 166 </resources> 167 </evidence> 168 <evidence> 169 <resources> 170 <resource> 171 <identifiers> 172 <identifier root="https://www.va.gov" extension=

"vhapublications/ViewPublication.asp?pub_ID=3005"/> 173 <identifier root="LocalDocBook" extension="e9" identifierName="VA 2014"/> 174 </identifiers> 175 <title value="Informed Consent for Long-Term Opioid Therapy for

Pain"/> 176 <location value=

"https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=30 05"/>

177 <citation 178 value="U.S. Department of Veterans Affairs; Veterans Health

Administration. Informed Consent for Long-Term Opioid Therapy for Pain. VHA Directive 1005. VHA Publications website.

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID =3005. Published May 6, 2014. Accessed February 8, 2018."

179 /> 180 </resource> 181 </resources> 182 </evidence> 183 <evidence> 184 <resources> 185 <resource> 186 <identifiers> 187 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "fda/fdaDrugXsl.cfm?setid=0d75b27f-496e-495d-b788-0dd3c0f5a32 f"/>

188 <identifier root="LocalDocBook" extension="e10" identifierName="NLM 2016a"/>

189 </identifiers> 190 <title value="BENGAY GREASELESS PAIN RELIEVING- menthol, unspecified form and methyl salicylate cream"/> 191 <location value=

"https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=0 d75b27f-496e-495d-b788-0dd3c0f5a32f"/>

192 <citation 193 value="U.S. National Library of Medicine. BENGAY GREASELESS

PAIN RELIEVING- menthol, unspecified form and methyl salicylate cream [Johnson and Johnson Consumer Inc.].

DailyMed website.

https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?seti d=0d75b27f-496e-495d-b788-0dd3c0f5a32f. Revised April 2016"

194 /> 195 </resource> 196 </resources> 197 </evidence> 198 <evidence> 199 <resources> 200 <resource> 201 <identifiers> 202 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "drugInfo.cfm?setid=7c31736c-edaa-4390-a2fb-eab2fd495f7d"/>

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204 </identifiers> 205 <title value="CAPSAICIN ARTHRITIS PAIN RELIEF CREAM-capsaicin cream"/> 206 <location value=

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207 <citation 208 value="U.S. National Library of Medicine. CAPSAICIN

ARTHRITIS PAIN RELIEF CREAM-capsaicin cream [McCure Health Solutions Inc.]. DailyMed website.

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c31 736c-edaa-4390-a2fb-eab2fd495f7d. Revised April 2015."

209 /> 210 </resource> 211 </resources> 212 </evidence> 213 <evidence> 214 <resources> 215 <resource> 216 <identifiers> 217 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "drugInfo.cfm?setid=27d813ea-7798-09cb-734b-b970d7248f1f"/>

218 <identifier root="LocalDocBook" extension="e12" identifierName="NLM 2017a"/>

219 </identifiers> 220 <title value="CELECOXIB - celecoxib capsule [Jubilant Cadista

Pharmaceuticals Inc.]."/> 221 <location value=

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222 <citation 223 value="U.S. National Library of Medicine. CELECOXIB -celecoxib capsule [Jubilant Cadista Pharmaceuticals Inc.].

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https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=27d8 13ea-7798-09cb-734b-b970d7248f1f. Revised April 2017."

224 /> 225 </resource> 226 </resources> 227 </evidence> 228 <evidence> 229 <resources> 230 <resource> 231 <identifiers> 232 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "dailymed/drugInfo.cfm?setid=f64b68a5-d6d2-4e92-87e7-90af04c1 f9db"/>

233 <identifier root="LocalDocBook" extension="e13" identifierName="NLM 2017b"/>

234 </identifiers> 235 <title value="DICLOFENAC SODIUM-diclofenac gel"/> 236 <location value=

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237 <citation 238 value="U.S. National Library of Medicine. DICLOFENAC

SODIUM-diclofenac gel [Amneal Pharmaceuticals LLC].

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https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f64b 68a5-d6d2-4e92-87e7-90af04c1f9db. Revised January 2017"

239 /> 240 </resource> 241 </resources> 242 </evidence> 243 <evidence> 244 <resources> 245 <resource> 246 <identifiers> 247 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "drugInfo.cfm?setid=24731405-219c-79b4-ecf0-7d5fbfda94ba"/>

248 <identifier root="LocalDocBook" extension="e14" identifierName="NLM 2016b"/>

249 </identifiers> 250 <title value="IBU-ibuprofen tablet"/> 251 <location value=

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252 <citation 253 value="U.S. National Library of Medicine. IBU-ibuprofen tablet [Dr. Reddy's Laboratories Limited]. DailyMed website.

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2473 1405-219c-79b4-ecf0-7d5fbfda94ba. Revised October 2016."

254 /> 255 </resource> 256 </resources> 257 </evidence> 258 <evidence> 259 <resources> 260 <resource> 261 <identifiers>

262 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "drugInfo.cfm?setid=f1c40164-4626-4290-9012-c00e33420a33"/>

263 <identifier root="LocalDocBook" extension="e15" identifierName="NLM 2015b"/>

264 </identifiers> 265 <title value="LIDODERM-lidocaine patch [Endo Pharmaceuticals, Inc.]."/> 266 <location value=

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267 <citation 268 value="U.S. National Library of Medicine.

LIDODERM-lidocaine patch [Endo Pharmaceuticals, Inc.].

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https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f1c4 0164-4626-4290-9012-c00e33420a33. Revised January 2015."

269 /> 270 </resource> 271 </resources> 272 </evidence> 273 <evidence> 274 <resources> 275 <resource> 276 <identifiers> 277 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "drugInfo.cfm?setid=68848217-03c9-4377-9be6-6f567e629129"/>

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279 </identifiers> 280 <title value="NAPROSYN-naproxen tablet; EC-NAPROSYN-naproxen tablet, delayed release; NAPROSYN-naproxen suspension;

ANAPROX-naproxen sodium tablet; ANAPROX DS-naproxen sodium tablet"/>

281 <location value= "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6884821 7-03c9-4377-9be6-6f567e629129"/>

282 <citation 283 value="U.S. National Library of Medicine. NAPROSYN-naproxen tablet; EC-NAPROSYN-naproxen tablet, delayed release;

NAPROSYN-naproxen suspension; ANAPROX-naproxen sodium tablet; ANAPROX DS-naproxen sodium tablet [Genentech, Inc.]. DailyMed website.

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6884 8217-03c9-4377-9be6-6f567e629129. Revised January 2018."

284 /> 285 </resource> 286 </resources> 287 </evidence> 288 <evidence> 289 <resources> 290 <resource> 291 <identifiers> 292 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "drugInfo.cfm?setid=45eb33f0-71e2-11d5-e054-00144ff88e88"/>

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294 </identifiers> 295 <title value="REDICARE IBUPROFEN- ibuprofen 200mg tablet, film coated [Redicare LLC]"/> 296 <location value=

"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=45eb33f 0-71e2-11d5-e054-00144ff88e88"/>

297 <citation 298 value="U.S. National Library of Medicine. REDICARE

IBUPROFEN- ibuprofen 200mg tablet, film coated [Redicare LLC]. DailyMed website.

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=45eb 33f0-71e2-11d5-e054-00144ff88e88. Revised January 2017."

299 /> 300 </resource> 301 </resources> 302 </evidence> 303 <evidence> 304 <resources> 305 <resource> 306 <identifiers> 307 <identifier root="https://dailymed.nlm.nih.gov/dailymed" extension= "drugInfo.cfm?setid=1622f694-4d63-4c56-8737-fae31f0ecfb7"/>

308 <identifier root="LocalDocBook" extension="e18" identifierName="NLM 2016c"/>

309 </identifiers> 310 <title value="REDICARE IBUPROFEN- ibuprofen 200mg tablet, film coated"/> 311 <location value=

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312 <citation 313 value="U.S. National Library of Medicine. REDICARE

IBUPROFEN- ibuprofen 200mg tablet, film coated [McNeil Consumer Healthcare Division]. DailyMed Website.

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1622 f694-4d63-4c56-8737-fae31f0ecfb7. Revised October 2016."

314 /> 315 </resource> 316 </resources> 317 </evidence> 318 </supportingEvidence> 320 <applicability> 321 <coverage> 322 <focus value="TargetUser"/> 323 <description value="Primary Care Provider (PCP)"/> 324 <value code="453231000124104 |Primary care provider (occupation)|" codeSystem="SNOMED CT"/> 325 </coverage> 326 <coverage> 327 <focus value="PatientAgeGroup"/> 328 <description value="Adult"/> 329 <value code="133936004 |Adult (person)|" codeSystem="SNOMED CT"/> 330 </coverage> 331 <coverage> 332 <focus value="WorkflowSetting"/> 333 <description value="Primary Care"/> 334 </coverage> 335 <coverage> 336 <focus value="ClinicalVenue"/> 337 <description value="Outpatient"/> 338 <value code="33022008 |Hospital-based outpatient department

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Center, VA Palo Alto Health Care System, Menlo Park, CA"/> 392 </affiliation> 393 </contributor> 394 <role value="Author"/> 395 </contribution> 396 <contribution> 397 <contributor xsi:type="Person"> 398 <name> 399 <dt:part type="GIV" value="Friedhelm"/> 400 <dt:part type="FAM" value="Sandbrink"/> 401 <dt:part type="TITLE" value="Acting Director of Pain Management

Program Office"/> 402 </name> 403 <affiliation> 404 <name value="Acting Director of Pain Management Program Office, Department of VA, Washington, DC"/> 405 </affiliation> 406 </contributor> 407 <role value="Author"/> 408 </contribution> 409 <contribution> 410 <contributor xsi:type="Person"> 411 <name> 412 <dt:part type="GIV" value="Elizabeth"/>

413 <dt:part type="FAM" value="Oliva"/> 414 <dt:part type="TITLE" value="OEND Coordinator"/> 415 </name> 416 <affiliation> 417 <name value="VA National Opioid Overdose Education and Naloxone

Distribution (OEND) Coordinator, VA Palo Alto Health Care System, Menlo Park, CA"/>

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428 </name> 429 <affiliation> 430 <name value="Research Health Science Specialist, VA Palo Alto

Health Care System, Menlo Park, CA"/> 431 </affiliation> 432 </contributor> 433 <role value="Author"/> 434 </contribution> 435 <contribution> 436 <contributor xsi:type="Person"> 437 <name> 438 <dt:part type="GIV" value="Kendall"/> 439 <dt:part type="FAM" value="Browne"/> 440 <dt:part type="TITLE" value="Clinical Psychologist"/> 441 </name> 442 <affiliation> 443 <name value="Clinical Psychologist, Seattle Puget Sound Health

Care System, Seattle, WA"/> 444 </affiliation> 445 </contributor> 446 <role value="Author"/> 447 </contribution> 448 <contribution> 449 <contributor xsi:type="Person"> 450 <name> 451 <dt:part type="GIV" value="Alicia"/> 452 <dt:part type="FAM" value="Heapy"/> 453 <dt:part type="TITLE" value="Mental Health"/> 454 </name> 455 <affiliation> 456 <name value="Mental Health, VA New England Healthcare System, West Haven, CT"/> 457 </affiliation> 458 </contributor> 459 <role value="Author"/> 460 </contribution> 461 <contribution> 462 <contributor xsi:type="Person"> 463 <name> 464 <dt:part type="GIV" value="Karen"/> 465 <dt:part type="FAM" value="Drexler"/> 466 <dt:part type="TITLE" value="National Mental Health Program

Director"/> 467 </name> 468 <affiliation> 469 <name value="National Mental Health Program Director, Substance

Use Disorders, VA Central Office, Atlanta, GA"/> 470 </affiliation> 471 </contributor>

472 <role value="Author"/> 473 </contribution> 474 <contribution> 475 <contributor xsi:type="Person"> 476 <name> 477 <dt:part type="GIV" value="Andrew"/> 478 <dt:part type="FAM" value="Saxon"/> 479 <dt:part type="TITLE" value="Physician"/> 480 </name> 481 <affiliation> 482 <name value="Physician, Seattle Health Care System, Seattle, WA"

483 </affiliation> 484 </contributor> 485 <role value="Author"/> 486 </contribution> 487 <contribution> 488 <contributor xsi:type="Person"> 489 <name> 490 <dt:part type="GIV" value="Melissa"/> 491 <dt:part type="FAM" value="Christopher"/> 492 <dt:part type="TITLE" value="National Director"/> 493 </name> 494 <affiliation> 495 <name value="National Director, Academic Detailing VACO

Pharmacy Benefits Management (PBM), Mission Valley Annex VISN 22, San Diego, CA"/>

496 </affiliation> 497 </contributor> 498 <role value="Author"/> 499 </contribution> 500 <contribution> 501 <contributor xsi:type="Person"> 502 <name> 503 <dt:part type="GIV" value="Daina"/> 504 <dt:part type="FAM" value="Wells"/> 505 </name> 506 <affiliation> 507 <name value="United States"/> 508 </affiliation> 509 </contributor> 510 <role value="Author"/> 511 </contribution> 512 <contribution> 513 <contributor xsi:type="Person"> 514 <name> 515 <dt:part type="GIV" value="Lucille"/> 516 <dt:part type="FAM" value="Burgo"/> 517 <dt:part type="TITLE" value="Firm Chief, Primary Care"/> 518 </name> 519 <affiliation> 520 <name value="Firm Chief, Primary Care, VA New England

Healthcare System, West Haven, CT"/> 521 </affiliation> 522 </contributor> 523 <role value="Author"/> 524 </contribution> 525 <contribution> 526 <contributor xsi:type="Person"> 527 <name> 528 <dt:part type="GIV" value="Julianne"/> 529 <dt:part type="FAM" value="Himstreet"/> 530 <dt:part type="TITLE" value="Pharmacist"/> 531 </name> 532 <affiliation> 533 <name value="Pharmacist, Eugene, OR"/> 534 </affiliation>

535 </contributor> 536 <role value="Author"/> 537 </contribution> 538 </contributions> 539 <publishers> 540 <publisher xsi:type="Organization"> 541 <name value="Department of Veterans Affairs"/> 542 </publisher> 543 </publishers> 545 <usageTerms> 546 <rightsDeclaration> 547 <assertedRights 548 value="Copyright 2018 B3 Group, Inc.

549 NOTICE OF GOVERNMENT COPYRIGHT LICENSE AND UNLIMITED RIGHTS LICENSE

550 Licensed under the Apache License, Version 2.0 (the

&quot;License&quot;); you may not use this file except in compliance with the License.

551 You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0

552 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.

553 Portions of this content are derivative works from content produced by Cognitive Medical Systems, Inc. licensed under the Apache License, Version 2.0.

554 Additional portions of this content are derivative works from content contributed by Motive Medical Intelligence Inc., under Creative Commons Attribution-ShareAlike 4.0.

555 Contributions from 2013-2018 were performed either by US Government employees, or under US Veterans Health Administration contracts.

556 US Veterans Health Administration contributions by government employees are work of the U.S. Government and are not subject to copyright protection in the United States. Portions contributed by government employees are USGovWork (17USC §105). Not subject to copyright.

557 See: https://www.usa.gov/government-works 558 Contribution by contractors to the US Veterans Health

Administration during this period are contractually contributed under the Apache License, Version 2.0 and US Government sponsorship is acknowledged under Contract VA118-16-D-1008, Task Order

VA11817F10080007."/>

559 <rightsHolder xsi:type="Organization"> 560 <addresses> 561 <address> 562 <dt:part type="AL" value="10156 Tapestry Ct"/> 563 <dt:part type="ADL" value=""/> 564 <dt:part type="CTY" value="Fairfax"/> 565 <dt:part type="STA" value="VA"/> 566 <dt:part type="ZIP" value="22032"/> 567 </address> 568 </addresses> 569 <name value="B3 Group, Inc."/> 570 </rightsHolder> 571 </rightsDeclaration> 572 <rightsDeclaration> 573 <assertedRights 574 value="Copyright 2018 Cognitive Medical Systems, Inc.

575 Licensed under the Apache License, Version 2.0 (the

&quot;License&quot;); you may not use this file except in compliance with the License.

576 You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0

577 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS

IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.

578 This and related content produced by Cognitive Medical Systems, Inc. licensed under the Apache License, Version 2.0 is available at: https://bitbucket.org/cogmedsys/hl7-kas-examples

579 Additional portions of this content are derivative works from content contributed by Motive Medical Intelligence Inc., under Creative Commons Attribution-ShareAlike 4.0.

https://bitbucket.org/cogmedsys/kas-source-material

580 Contributions from 2013-2018 were performed either by US Government employees, or under US Veterans Health Administration contracts.

581 US Veterans Health Administration contributions by government employees are work of the U.S. Government and are not subject to copyright protection in the United States. Portions contributed by government employees are USGovWork (17USC §105). Not subject to copyright. See: https://www.usa.gov/government-works

582 Contribution by contractors to the US Veterans Health Administration during this period are contractually contributed under the Apache License, Version 2.0 and US Government sponsorship is acknowledged under Contract VA118-16-D-1008-0007."/>

583 <rightsHolder xsi:type="Organization"> 584 <addresses> 585 <address> 586 <dt:part type="AL" value="9444 Waples Street"/> 587 <dt:part type="ADL" value="Suite 300"/> 588 <dt:part type="CTY" value="San Diego"/> 589 <dt:part type="STA" value="CA"/> 590 <dt:part type="ZIP" value="92121"/> 591 </address> 592 </addresses> 593 <name value="Cognitive Medical Systems, Inc."/> 594 </rightsHolder> 595 </rightsDeclaration> 596 </usageTerms> 597 </metadata> 598 <externalData> 599 <codesystem name="SNOMED CT" id="2.16.840.1.113883.6.96" version="United States

Edition 20180301"/> 600 </externalData> 601 <actionGroup> 602 <subElements> 603 <actionGroup> 604 <title value="Medications"/> 605 <description value="Oral Medications"/> 606 <subElements> 607 <actionGroup> 608 <behaviors> 609 <behavior xsi:type="GroupSelectionBehavior" value="Any"/> 610 </behaviors> 611 <subElements> 612 <simpleAction xsi:type="CreateAction"> 613 <textEquivalent value="Ibuprofen 200 mg tablet oral every 4 to 6 hours as needed for pain 100 tablets 2 refills"/>

614 <actionSentence xsi:type="elm:Instance" classType= "anf:ClinicalStatement">

615 <elm:element name="statementType"> 616 <elm:value xsi:type="elm:Code" code="385644000

|Requested (qualifier value)|" display= "Precoordinated Expression">

617 <elm:system name="SNOMED CT"/> 618 </elm:value> 619 </elm:element> 620 <elm:element name="topic"> 621 <elm:value xsi:type="elm:Code" 622 code="[416118004 |Administration (procedure)]

623 ->(260686004 |Method (attribute))->[129445006 |Administration -action (qualifier value)]

624 ->(363701004 |Direct substance (attribute))->[Rx;310965 Ibuprofen 200 MG Oral Tablet]

625 ->(410675002 |Route of administration (attribute))->[26643006 |Oral route (qualifier value)]"

626 display="Postcoordinated Expression"> 627 <elm:system name="SNOMED CT"/> 628 </elm:value> 629 </elm:element> 630 <elm:element name="unstructured[0]"> 631 <elm:value xsi:type="elm:Literal" valueType=

"String" value="100 tablets 2 refills"/> 632 </elm:element> 633 <elm:element name="unstructured[1]"> 634 <elm:value xsi:type="elm:Literal" valueType=

"String" value="as needed"/> 635 </elm:element> 636 <elm:element name="purpose[0]"> 637 <elm:value xsi:type="elm:Code" code="[277132007

|Therapeutic procedure (procedure)] 638 ->(363702006 |Has focus

(attribute))->[22253000 |Pain (finding)]" 639 display="Postcoordinated Expression"> 640 <elm:system name="SNOMED CT"/> 641 </elm:value> 642 </elm:element> 643 <elm:element name="requestedResult.lowerBound"> 644 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 645 </elm:element> 646 <elm:element name="requestedResult.upperBound"> 647 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 648 </elm:element> 649 <elm:element name=

"requestedResult.includeLowerBound"> 650 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 651 </elm:element> 652 <elm:element name=

"requestedResult.includeUpperBound"> 653 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 654 </elm:element> 655 <elm:element name="requestedResult.measureSemantic"> 656 <elm:value xsi:type="elm:Code" code="421026006

|Oral tablet (qualifier value)|" display= "Precoordinated Expression">

657 <elm:system name="SNOMED CT"/> 658 </elm:value> 659 </elm:element> 660 <elm:element name=

"repetition[0].periodDuration.lowerBound"> 661 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 662 </elm:element> 663 <elm:element name=

"repetition[0].periodDuration.upperBound"> 664 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="75"/> 665 </elm:element> 666 <elm:element name=

"repetition[0].periodDuration.includeLowerBound">

667 <elm:value xsi:type="elm:Literal" valueType= "Boolean" value="true"/>

668 </elm:element> 669 <elm:element name=

"repetition[0].periodDuration.includeUpperBound"> 670 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 671 </elm:element> 672 <elm:element name=

"repetition[0].periodDuration.measureSemantic"> 673 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

674 <elm:system name="SNOMED CT"/> 675 </elm:value> 676 </elm:element> 677 <elm:element name=

"repetition[0].eventFrequency.lowerBound"> 678 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="4"/> 679 </elm:element> 680 <elm:element name=

"repetition[0].eventFrequency.upperBound"> 681 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="6"/> 682 </elm:element> 683 <elm:element name=

"repetition[0].eventFrequency.includeLowerBound"> 684 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 685 </elm:element> 686 <elm:element name=

"repetition[0].eventFrequency.includeUpperBound"> 687 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 688 </elm:element> 689 <elm:element name=

"repetition[0].eventFrequency.measureSemantic"> 690 <elm:value xsi:type="elm:Code" code="258702006

|hour (qualifier value)|" display= "Precoordinated Expression">

691 <elm:system name="SNOMED CT"/> 692 </elm:value> 693 </elm:element> 694 </actionSentence> 695 </simpleAction> 696 <simpleAction xsi:type="CreateAction"> 697 <textEquivalent value="Naproxen 250 mg tablet oral 2 times daily as needed for pain 100 tablets 2 refills"/> 698 <actionSentence xsi:type="elm:Instance" classType=

"anf:ClinicalStatement"> 699 <elm:element name="statementType"> 700 <elm:value xsi:type="elm:Code" code="385644000

|Requested (qualifier value)|" display= "Precoordinated Expression">

701 <elm:system name="SNOMED CT"/> 702 </elm:value> 703 </elm:element> 704 <elm:element name="topic"> 705 <elm:value xsi:type="elm:Code" 706 code="[416118004 |Administration (procedure)] 707 ->(260686004 |Method

(attribute))->[129445006 |Administration -action (qualifier value)]

708 ->(363701004 |Direct substance (attribute))->[Rx;198013 Naproxen 250 MG Oral Tablet]

709 ->(410675002 |Route of administration (attribute))->[26643006 |Oral route (qualifier value)]"

710 display="Postcoordinated Expression"> 711 <elm:system name="SNOMED CT"/> 712 </elm:value> 713 </elm:element> 714 <elm:element name="unstructured[0]"> 715 <elm:value xsi:type="elm:Literal" valueType=

"String" value="100 tablets 2 refills"/> 716 </elm:element> 717 <elm:element name="unstructured[1]"> 718 <elm:value xsi:type="elm:Literal" valueType=

"String" value="as needed"/> 719 </elm:element> 720 <elm:element name="purpose[0]"> 721 <elm:value xsi:type="elm:Code" code="[277132007

|Therapeutic procedure (procedure)] 722 ->(363702006 |Has focus

(attribute))->[22253000 |Pain (finding)]" 723 display="Postcoordinated Expression"> 724 <elm:system name="SNOMED CT"/> 725 </elm:value> 726 </elm:element> 727 <elm:element name="requestedResult.lowerBound"> 728 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 729 </elm:element> 730 <elm:element name="requestedResult.upperBound"> 731 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 732 </elm:element> 733 <elm:element name=

"requestedResult.includeLowerBound"> 734 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 735 </elm:element> 736 <elm:element name=

"requestedResult.includeUpperBound"> 737 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 738 </elm:element> 739 <elm:element name="requestedResult.measureSemantic"> 740 <elm:value xsi:type="elm:Code" code="421026006

|Oral tablet (qualifier value)|" display= "Precoordinated Expression">

741 <elm:system name="SNOMED CT"/> 742 </elm:value> 743 </elm:element> 744 <elm:element name=

"repetition[0].periodDuration.lowerBound"> 745 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 746 </elm:element> 747 <elm:element name=

"repetition[0].periodDuration.upperBound"> 748 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="150"/> 749 </elm:element> 750 <elm:element name=

"repetition[0].periodDuration.includeLowerBound"> 751 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 752 </elm:element> 753 <elm:element name=

"repetition[0].periodDuration.includeUpperBound"> 754 <elm:value xsi:type="elm:Literal" valueType=

755 </elm:element> 756 <elm:element name=

"repetition[0].periodDuration.measureSemantic"> 757 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

758 <elm:system name="SNOMED CT"/> 759 </elm:value> 760 </elm:element> 761 <elm:element name=

"repetition[0].eventFrequency.lowerBound"> 762 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="2"/> 763 </elm:element> 764 <elm:element name=

"repetition[0].eventFrequency.upperBound"> 765 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="2"/> 766 </elm:element> 767 <elm:element name=

"repetition[0].eventFrequency.includeLowerBound"> 768 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 769 </elm:element> 770 <elm:element name=

"repetition[0].eventFrequency.includeUpperBound"> 771 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 772 </elm:element> 773 <elm:element name=

"repetition[0].eventFrequency.measureSemantic"> 774 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

775 <elm:system name="SNOMED CT"/> 776 </elm:value> 777 </elm:element> 778 </actionSentence> 779 </simpleAction> 780 <simpleAction xsi:type="CreateAction"> 781 <textEquivalent value="Acetaminophen 325 mg tablet oral

2 tablets every 6 hours as needed for pain; may increase dose frequency to 2 tablets every 4 hours; do not take more than 10 tablets per day 100 tablets 2 refills"/>

782 <actionSentence xsi:type="elm:Instance" classType= "anf:ClinicalStatement">

783 <elm:element name="statementType"> 784 <elm:value xsi:type="elm:Code" code="385644000

|Requested (qualifier value)|" display= "Precoordinated Expression">

785 <elm:system name="SNOMED CT"/> 786 </elm:value> 787 </elm:element> 788 <elm:element name="topic"> 789 <elm:value xsi:type="elm:Code" 790 code="[416118004 |Administration (procedure)] 791 ->(260686004 |Method

(attribute))->[129445006 |Administration -action (qualifier value)]

792 ->(363701004 |Direct substance (attribute))->[Rx;313782 Acetaminophen 325 MG Oral Tablet]

793 ->(410675002 |Route of administration (attribute))->[26643006 |Oral route (qualifier value)]"

794 display="Postcoordinated Expression"> 795 <elm:system name="SNOMED CT"/> 796 </elm:value> 797 </elm:element> 798 <elm:element name="unstructured[0]"> 799 <elm:value xsi:type="elm:Literal" valueType=

"String" value="100 tablets 2 refills"/> 800 </elm:element> 801 <elm:element name="unstructured[1]"> 802 <elm:value xsi:type="elm:Literal" valueType=

"String" value="as needed; may increase dose frequency to 2 tablets every 4 hours; do not take more than 10 tablets per day"/>

803 </elm:element> 804 <elm:element name="purpose[0]"> 805 <elm:value xsi:type="elm:Code" code="[277132007

|Therapeutic procedure (procedure)] 806 ->(363702006 |Has focus

(attribute))->[22253000 |Pain (finding)]" 807 display="Postcoordinated Expression"> 808 <elm:system name="SNOMED CT"/> 809 </elm:value> 810 </elm:element> 811 <elm:element name="requestedResult.lowerBound"> 812 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="2"/> 813 </elm:element> 814 <elm:element name="requestedResult.upperBound"> 815 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="2"/> 816 </elm:element> 817 <elm:element name=

"requestedResult.includeLowerBound"> 818 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 819 </elm:element> 820 <elm:element name=

"requestedResult.includeUpperBound"> 821 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 822 </elm:element> 823 <elm:element name="requestedResult.measureSemantic"> 824 <elm:value xsi:type="elm:Code" code="421026006

|Oral tablet (qualifier value)|" display= "Precoordinated Expression">

825 <elm:system name="SNOMED CT"/> 826 </elm:value> 827 </elm:element> 828 <elm:element name=

"repetition[0].periodDuration.lowerBound"> 829 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 830 </elm:element> 831 <elm:element name=

"repetition[0].periodDuration.upperBound"> 832 <elm:value xsi:type="elm:Literal" valueType=

"Decimal" value="37.5"/> 833 </elm:element> 834 <elm:element name=

"repetition[0].periodDuration.includeLowerBound"> 835 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 836 </elm:element> 837 <elm:element name=

"repetition[0].periodDuration.includeUpperBound"> 838 <elm:value xsi:type="elm:Literal" valueType=

839 </elm:element> 840 <elm:element name=

"repetition[0].periodDuration.measureSemantic"> 841 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

842 <elm:system name="SNOMED CT"/> 843 </elm:value> 844 </elm:element> 845 <elm:element name=

"repetition[0].eventFrequency.lowerBound"> 846 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="4"/> 847 </elm:element> 848 <elm:element name=

"repetition[0].eventFrequency.upperBound"> 849 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="4"/> 850 </elm:element> 851 <elm:element name=

"repetition[0].eventFrequency.includeLowerBound"> 852 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 853 </elm:element> 854 <elm:element name=

"repetition[0].eventFrequency.includeUpperBound"> 855 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 856 </elm:element> 857 <elm:element name=

"repetition[0].eventFrequency.measureSemantic"> 858 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

859 <elm:system name="SNOMED CT"/> 860 </elm:value> 861 </elm:element> 862 </actionSentence> 863 </simpleAction> 864 <simpleAction xsi:type="CreateAction"> 865 <textEquivalent value="Celecoxib 100 mg capsule oral 2 times a day 60 capsules 2 refills"/> 866 <actionSentence xsi:type="elm:Instance" classType=

"anf:ClinicalStatement"> 867 <elm:element name="statementType"> 868 <elm:value xsi:type="elm:Code" code="385644000

|Requested (qualifier value)|" display= "Precoordinated Expression">

869 <elm:system name="SNOMED CT"/> 870 </elm:value> 871 </elm:element> 872 <elm:element name="topic"> 873 <elm:value xsi:type="elm:Code" 874 code="[416118004 |Administration (procedure)] 875 ->(260686004 |Method

(attribute))->[129445006 |Administration -action (qualifier value)]

876 ->(363701004 |Direct substance (attribute))->[Rx;205322 celecoxib 100 MG Oral Capsule]

877 ->(410675002 |Route of administration (attribute))->[26643006 |Oral route (qualifier value)]"

878 display="Postcoordinated Expression"> 879 <elm:system name="SNOMED CT"/> 880 </elm:value> 881 </elm:element>

882 <elm:element name="unstructured[0]"> 883 <elm:value xsi:type="elm:Literal" valueType=

"String" value="60 capsules 2 refills"/> 884 </elm:element> 885 <elm:element name="requestedResult.lowerBound"> 886 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 887 </elm:element> 888 <elm:element name="requestedResult.upperBound"> 889 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 890 </elm:element> 891 <elm:element name=

"requestedResult.includeLowerBound"> 892 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 893 </elm:element> 894 <elm:element name=

"requestedResult.includeUpperBound"> 895 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 896 </elm:element> 897 <elm:element name="requestedResult.measureSemantic"> 898 <elm:value xsi:type="elm:Code" code="420692007

|Conventional release oral capsule (dose form)|" display="Precoordinated Expression">

899 <elm:system name="SNOMED CT"/> 900 </elm:value> 901 </elm:element> 902 <elm:element name=

"repetition[0].periodDuration.lowerBound"> 903 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="90"/> 904 </elm:element> 905 <elm:element name=

"repetition[0].periodDuration.upperBound"> 906 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="90"/> 907 </elm:element> 908 <elm:element name=

"repetition[0].periodDuration.includeLowerBound"> 909 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 910 </elm:element> 911 <elm:element name=

"repetition[0].periodDuration.includeUpperBound"> 912 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 913 </elm:element> 914 <elm:element name=

"repetition[0].periodDuration.measureSemantic"> 915 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

916 <elm:system name="SNOMED CT"/> 917 </elm:value> 918 </elm:element> 919 <elm:element name=

"repetition[0].eventFrequency.lowerBound"> 920 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="2"/> 921 </elm:element> 922 <elm:element name=

"repetition[0].eventFrequency.upperBound"> 923 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="2"/> 924 </elm:element>

925 <elm:element name= "repetition[0].eventFrequency.includeLowerBound">

926 <elm:value xsi:type="elm:Literal" valueType= "Boolean" value="true"/>

927 </elm:element> 928 <elm:element name=

"repetition[0].eventFrequency.includeUpperBound"> 929 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 930 </elm:element> 931 <elm:element name=

"repetition[0].eventFrequency.measureSemantic"> 932 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

933 <elm:system name="SNOMED CT"/> 934 </elm:value> 935 </elm:element> 936 </actionSentence> 937 </simpleAction> 938 </subElements> 939 </actionGroup> 940 <actionGroup> 941 <behaviors> 942 <behavior xsi:type="GroupSelectionBehavior" value="Any"/> 943 </behaviors> 944 <title value="The following orders may be considered for patients who tolerate lower doses but whose pain control remains inadequate on lower doses"/>

945 <subElements> 946 <simpleAction xsi:type="CreateAction"> 947 <textEquivalent value="Ibuprofen 400 mg tablet oral every 4 to 6 hours as needed for pain 100 tablets 2 refills"/>

948 <actionSentence xsi:type="elm:Instance" classType= "anf:ClinicalStatement">

949 <elm:element name="statementType"> 950 <elm:value xsi:type="elm:Code" code="385644000

|Requested (qualifier value)|" display= "Precoordinated Expression">

951 <elm:system name="SNOMED CT"/> 952 </elm:value> 953 </elm:element> 954 <elm:element name="topic"> 955 <elm:value xsi:type="elm:Code" 956 code="[416118004 |Administration (procedure)] 957 ->(260686004 |Method

(attribute))->[129445006 |Administration -action (qualifier value)]

958 ->(363701004 |Direct substance (attribute))->[Rx;197805 Ibuprofen 400 MG Oral Tablet]

959 ->(410675002 |Route of administration (attribute))->[26643006 |Oral route (qualifier value)]"

960 display="Postcoordinated Expression"> 961 <elm:system name="SNOMED CT"/> 962 </elm:value> 963 </elm:element> 964 <elm:element name="unstructured[0]"> 965 <elm:value xsi:type="elm:Literal" valueType=

"String" value="100 tablets 2 refills"/> 966 </elm:element> 967 <elm:element name="unstructured[1]"> 968 <elm:value xsi:type="elm:Literal" valueType=

"String" value="as needed"/> 969 </elm:element>

970 <elm:element name="purpose[0]"> 971 <elm:value xsi:type="elm:Code" code="[277132007

|Therapeutic procedure (procedure)] 972 ->(363702006 |Has focus

(attribute))->[22253000 |Pain (finding)]" 973 display="Postcoordinated Expression"> 974 <elm:system name="SNOMED CT"/> 975 </elm:value> 976 </elm:element> 977 <elm:element name="requestedResult.lowerBound"> 978 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 979 </elm:element> 980 <elm:element name="requestedResult.upperBound"> 981 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 982 </elm:element> 983 <elm:element name=

"requestedResult.includeLowerBound"> 984 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 985 </elm:element> 986 <elm:element name=

"requestedResult.includeUpperBound"> 987 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 988 </elm:element> 989 <elm:element name="requestedResult.measureSemantic"> 990 <elm:value xsi:type="elm:Code" code="421026006

|Oral tablet (qualifier value)|" display= "Precoordinated Expression">

991 <elm:system name="SNOMED CT"/> 992 </elm:value> 993 </elm:element> 994 <elm:element name=

"repetition[0].periodDuration.lowerBound"> 995 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="1"/> 996 </elm:element> 997 <elm:element name=

"repetition[0].periodDuration.upperBound"> 998 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="75"/> 999 </elm:element>

1000 <elm:element name= "repetition[0].periodDuration.includeLowerBound">

1001 <elm:value xsi:type="elm:Literal" valueType= "Boolean" value="true"/>

1002 </elm:element> 1003 <elm:element name=

"repetition[0].periodDuration.includeUpperBound"> 1004 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 1005 </elm:element> 1006 <elm:element name=

"repetition[0].periodDuration.measureSemantic"> 1007 <elm:value xsi:type="elm:Code" code="258703001

|day (qualifier value)|" display= "Precoordinated Expression">

1008 <elm:system name="SNOMED CT"/> 1009 </elm:value> 1010 </elm:element> 1011 <elm:element name=

"repetition[0].eventFrequency.lowerBound"> 1012 <elm:value xsi:type="elm:Literal" valueType=

"Integer" value="4"/> 1013 </elm:element>

1014 <elm:element name= "repetition[0].eventFrequency.upperBound">

1015 <elm:value xsi:type="elm:Literal" valueType= "Integer" value="6"/>

1016 </elm:element> 1017 <elm:element name=

"repetition[0].eventFrequency.includeLowerBound"> 1018 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 1019 </elm:element> 1020 <elm:element name=

"repetition[0].eventFrequency.includeUpperBound"> 1021 <elm:value xsi:type="elm:Literal" valueType=

"Boolean" value="true"/> 1022 </elm:element> 1023 <elm:element name=

"repetition[0].eventFrequency.measureSemantic"> 1024 <elm:value xsi:type="elm:Code" code="258702006

|hour (qualifier value)|" display= "Precoordinated Expression">

1025 1026 1027 1028 1029 1030 …