{

"resourceType": "PlanDefinition",
"id": "KDN5",
"text": {
  "status": "additional",
  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <table style=\"width: 100%;\">\n        <tr>\n          <td>\n              <!-- link to NCCN image -->\n            <div style=\"width: 200px; height: 100px; vertical-align: top;\">National Comprehensive Cancer Network</div>\n          </td>\n          <td>\n            <h3>Chemotherapy Order Template</h3>\n            <h1>Kidney Cancer</h1>\n            <h2>Gemcitabine/CARBOplatin</h2>\n          </td>\n          <td style=\"text-align: right; vertical-align: top;\">KDN5</td>\n        </tr>\n      </table>\n      <table style=\"width: 100%; border-top: 1px solid; border-bottom: 1px solid;\">\n        <tr>\n          <td style=\"width: 33%; border-right: 1px solid; vertical-align: top\">\n            <h4>INDICATION:</h4>\n            <p>Metastatic or Relapsed – Collecting Duct/Medullary Subtypes</p>\n          </td>\n          <td style=\"width: 34%; border-right: 1px solid; vertical-align: top\">\n            <h4>REFERENCES:</h4>\n            <ol>\n              <li><a href=\"http://www.example.org/professionals/physician_gls/PDF/kidney.pdf\">NCCN Guidelines® for Kidney Cancer. V.3.2015.</a></li>\n              <li><a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=%22The+Journal+of+urology%22%5BJour%5D+AND+1698%5Bpage%5D+AND+2007%5Bpdat%5D+AND+Oudard+S%5Bauthor%5D\">Oudard S, et al. <em>J Urol</em>. 2007;177(5):1698-702.</a><sup>\n                  <a href=\"http://www.example.org/OrderTemplates/PDF/appendix_E.pdf\">a</a></sup>\n              </li>\n            </ol>\n          </td>\n          <td style=\"width: 33%; vertical-align: top\">\n            <h4>NCCN SUPPORTIVE CARE:</h4>\n            <ol>\n              <li>\n                <i>Emetic Risk:</i>\n                <table>\n                  <tr>\n                    <td>Day 1</td>\n                    <td>Moderate</td>\n                  </tr>\n                  <tr>\n                    <td>Day 8</td>\n                    <td>Low</td>\n                  </tr>\n                </table>\n              </li>\n              <li>\n                <i>Fever Neutropenia Risk:</i><br/>\n                Refer to <a href=\"http://www.example.org/professionals/physician_gls/PDF/myeloid_growth.pdf\">NCCN Guidelines for Myeloid Growth Factors. V.2.2014</a>\n              </li>\n            </ol>\n          </td>\n        </tr>\n      </table>\n        <!-- same as the regimen section of the Composition resource only this version is without the style guide notes -->\n      <h4>CHEMOTHERAPY REGIMEN</h4>\n      <p>\n        <i>21-day cycle for 6 cycles</i>\n      </p>\n      <ul>\n        <li>Gemcitabine 1250 mg/m<sup>2</sup> IV over 30 minutes on Days 1 and 8</li>\n        <li>CARBOplatin AUC 5 IV over 30 minutes on Day 1</li>\n      </ul>\n    </div>"
},
"contained": [
  {
    "resourceType": "ActivityDefinition",
    "id": "1111",
    "status": "draft",
    "productCodeableConcept": {
      "coding": [
        {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "12574",
          "display": "gemcitabine"
        }
      ],
      "text": "gemcitabine"
    },
    "dosage": [
      {
        "text": "1250 mg/m² IV over 30 minutes",
        "timing": {
          "repeat": {
            "duration": 30,
            "durationUnit": "min"
          }
        },
        "route": {
          "text": "IV"
        },
        "doseQuantity": {
          "value": 1250,
          "unit": "mg/m²"
        }
      }
    ]
  },
  {
    "resourceType": "ActivityDefinition",
    "id": "2222",
    "status": "draft",
    "productCodeableConcept": {
      "coding": [
        {
          "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code": "40048",
          "display": "Carboplatin"
        }
      ],
      "text": "CARBOplatin"
    },
    "dosage": [
      {
        "text": "AUC 5 IV over 30 minutes",
        "timing": {
          "repeat": {
            "duration": 30,
            "durationUnit": "min"
          }
        },
        "route": {
          "text": "IV"
        },
        "doseQuantity": {
          "extension": [
            {
              "url": "http://example.org/fhir/AUC-dose",
              "valueInteger": 5
            }
          ]
        }
      }
    ]
  }
],
"identifier": [
  {
    "system": "http://example.org/ordertemplates",
    "value": "KDN5"
  }
],
"version": "1",
"title": "Gemcitabine/CARBOplatin",
"type": {
  "text": "Chemotherapy Order Template"
},
"status": "draft",
"experimental": true,
"publisher": "National Comprehensive Cancer Network, Inc.",
"approvalDate": "2016-07-27",
"lastReviewDate": "2016-07-27",
"useContext": [
  {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
        "valueString": "A"
      }
    ],
    "code": {
      "system": "http://example.org/fhir/CodeSystem/indications",
      "code": "treamentSetting-or-diseaseStatus"
    },
    "valueCodeableConcept": {
      "text": "Metastatic"
    }
  },
  {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
        "valueString": "A"
      }
    ],
    "code": {
      "system": "http://example.org/fhir/CodeSystem/indications",
      "code": "disease-or-histology"
    },
    "valueCodeableConcept": {
      "text": "Collecting Duct/Medullary Subtypes"
    }
  },
  {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
        "valueString": "A"
      }
    ],
    "code": {
      "system": "http://hl7.org/fhir/usage-context-type",
      "code": "focus"
    },
    "valueCodeableConcept": {
      "text": "Kidney Cancer"
    }
  },
  {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
        "valueString": "B"
      }
    ],
    "code": {
      "system": "http://example.org/fhir/CodeSystem/indications",
      "code": "treatmentSetting-or-diseaseStatus"
    },
    "valueCodeableConcept": {
      "text": "Relapsed"
    }
  },
  {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
        "valueString": "B"
      }
    ],
    "code": {
      "system": "http://example.org/fhir/CodeSystem/indications",
      "code": "disease-or-histology"
    },
    "valueCodeableConcept": {
      "text": "Collecting Duct/Medullary Subtypes"
    }
  },
  {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
        "valueString": "B"
      }
    ],
    "code": {
      "system": "http://hl7.org/fhir/usage-context-type",
      "code": "focus"
    },
    "valueCodeableConcept": {
      "text": "Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"
    }
  }
],
"contributor": [
  {
    "type": "author",
    "name": "Lee Surprenant"
  }
],
"copyright": "All rights reserved.",
"relatedArtifact": [
  {
    "type": "derived-from",
    "display": "NCCN Guidelines for Kidney Cancer. V.2.2016",
    "url": "http://www.example.org/professionals/physician_gls/PDF/kidney.pdf"
  },
  {
    "type": "citation",
    "_type": {
      "extension": [
        {
          "url": "http://example.org/fhir/regimenReferenceType",
          "valueCode": "a"
        }
      ]
    },
    "citation": "Oudard S, et al. J Urol. 2007;177(5):1698-702",
    "url": "http://www.ncbi.nlm.nih.gov/pubmed/17437788"
  }
],
"action": [
  {
    "selectionBehavior": "exactly-one",
    "action": [
      {
        "selectionBehavior": "all",
        "action": [
          {
            "groupingBehavior": "sentence-group",
            "selectionBehavior": "exactly-one",
            "action": [
              {
                "id": "cycle-definition-1",
                "textEquivalent": "21-day cycle for 6 cycles",
                "timingTiming": {
                  "repeat": {
                    "count": 6,
                    "duration": 21,
                    "durationUnit": "d"
                  }
                },
                "action": [
                  {
                    "id": "action-1",
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
                        "extension": [
                          {
                            "url": "day",
                            "valueInteger": 1
                          },
                          {
                            "url": "day",
                            "valueInteger": 8
                          }
                        ]
                      }
                    ],
                    "textEquivalent": "Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8",
                    "definition": {
                      "reference": "#1111"
                    }
                  },
                  {
                    "id": "action-2",
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
                        "extension": [
                          {
                            "url": "day",
                            "valueInteger": 1
                          }
                        ]
                      }
                    ],
                    "textEquivalent": "CARBOplatin AUC 5 IV over 30 minutes on Day 1",
                    "relatedAction": [
                      {
                        "actionId": "action-1",
                        "relationship": "concurrent-with-start"
                      }
                    ],
                    "definition": {
                      "reference": "#2222"
                    }
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  }
]

}