<?xml version=“1.0” encoding=“UTF-8”?> <ActivityDefinition xmlns=“hl7.org/fhir”>

<id value="citalopramPrescription"/>
<meta>
  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta>
<contained>
  <Medication>
    <id value="citalopramMedication"/>
    <code>
      <coding>
        <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
        <code value="200371"/>
      </coding>
      <text value="citalopram"/>
    </code>
      <form>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="385055001"/>
          <display value="Tablet dose form"/>
        </coding>
        <text value="Tablet dose form"/>
      </form>
      <ingredient>
        <itemReference>
          <reference value="#citalopramSubstance"/>
        </itemReference>
        <strength>
          <numerator>
            <value value="20"/>
            <unit value="mg"/>
          </numerator>
          <denominator>
            <value value="1"/>
            <unit value="{tbl}"/>
          </denominator>
        </strength>
      </ingredient>
  </Medication>
</contained>
<contained>
  <Substance>
    <id value="citalopramSubstance"/>
    <code>
      <coding>
        <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
        <code value="2556"/>
      </coding>
      <text value="citalopram"/>
    </code>
  </Substance>
</contained>
<url value="http://motivemi.com/artifacts/ActivityDefinition/citalopramPrescription"/>
<identifier>
  <use value="official"/>
  <system value="http://motivemi.com"/>
  <value value="citalopramPrescription"/>
</identifier>
<version value="1.0.0"/>
<name value="CitalopramPrescription"/>
<title value="Citalopram Prescription"/>
      <status value="active"/>
      <experimental value="true"/>
<date value="2015-08-15"/>
<publisher value="Motive Medical Intelligence"/>
<contact>
  <telecom>
    <system value="phone"/>
    <value value="415-362-4007"/>
    <use value="work"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="info@motivemi.com"/>
    <use value="work"/>
  </telecom>
</contact>
<description value="Citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills"/>
<useContext>
  <code>
    <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
    <code value="age"/>
  </code>
  <valueCodeableConcept>
    <coding>
      <system value="https://meshb.nlm.nih.gov"/>
      <code value="D000328"/>
      <display value="Adult"/>
    </coding>
  </valueCodeableConcept>
</useContext>
<useContext>
  <code>
    <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
    <code value="focus"/>
  </code>
  <valueCodeableConcept>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="87512008"/>
      <display value="Mild major depression"/>
    </coding>
  </valueCodeableConcept>
</useContext>
<useContext>
  <code>
    <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
    <code value="focus"/>
  </code>
  <valueCodeableConcept>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="40379007"/>
      <display value="Major depression, recurrent, mild"/>
    </coding>
  </valueCodeableConcept>
</useContext>
<useContext>
  <code>
    <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
    <code value="focus"/>
  </code>
  <valueCodeableConcept>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="225444004"/>
      <display value="At risk for suicide (finding)"/>
    </coding>
  </valueCodeableConcept>
</useContext>
<useContext>
  <code>
    <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
    <code value="focus"/>
  </code>
  <valueCodeableConcept>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="306206005"/>
      <display value="Referral to service (procedure)"/>
    </coding>
  </valueCodeableConcept>
</useContext>
<useContext>
  <code>
    <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
    <code value="user"/>
  </code>
  <valueCodeableConcept>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="309343006"/>
      <display value="Physician"/>
    </coding>
  </valueCodeableConcept>
</useContext>
<useContext>
  <code>
    <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
    <code value="venue"/>
  </code>
  <valueCodeableConcept>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="440655000"/>
      <display value="Outpatient environment"/>
    </coding>
  </valueCodeableConcept>
</useContext>
<jurisdiction>
  <coding>
    <system value="urn:iso:std:iso:3166"/>
    <code value="US"/>
  </coding>
</jurisdiction>
<purpose value="Defines a guideline supported prescription for the treatment of depressive disorders"/>
<usage value="This activity definition is used as part of various suicide risk order sets"/>
<copyright value="© Copyright 2016 Motive Medical Intelligence. All rights reserved."/>
<approvalDate value="2016-03-12"/>
<lastReviewDate value="2016-08-15"/>
<effectivePeriod>
  <start value="2016-01-01"/>
  <end value="2017-12-31"/>
</effectivePeriod>
<topic>
  <text value="Mental Health Treatment"/>
</topic>
<author>
  <name value="Motive Medical Intelligence"/>
  <telecom>
        <system value="phone"/>
        <value value="415-362-4007"/>
        <use value="work"/>
  </telecom>
  <telecom>
        <system value="email"/>
        <value value="info@motivemi.com"/>
        <use value="work"/>
  </telecom>
</author>
  <relatedArtifact>
    <type value="citation"/>
    <display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>
    <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
      </relatedArtifact>
      <relatedArtifact>
    <type value="composed-of"/>
    <resource value="#citalopramMedication"/>
      </relatedArtifact>
      <kind value="MedicationRequest"/>
      <productReference>
              <reference value="#citalopramMedication"/>
      </productReference>
      <dosage>
              <text value="1 tablet oral 1 time daily"/>
              <timing>
                      <repeat>
                              <frequency value="1"/>
                              <period value="1"/>
                              <periodUnit value="d"/>
                      </repeat>
              </timing>
              <route>
                      <coding>
                              <code value="26643006"/>
                              <display value="Oral route (qualifier value)"/>
                      </coding>
                      <text value="Oral route (qualifier value)"/>
              </route>
        <doseAndRate>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
              <code value="ordered"/>
              <display value="Ordered"/>
            </coding>
          </type>
          <doseQuantity>
            <value value="1"/>
            <unit value="{tbl}"/>
          </doseQuantity>
        </doseAndRate>
      </dosage>
      <dynamicValue>
              <path value="dispenseRequest.numberOfRepeatsAllowed"/>
              <expression>
                      <description value="dispenseRequest.numberOfRepeatsAllowed is three (3)"/>
                      <language value="text/cql"/>
                      <expression value="3"/>
              </expression>
      </dynamicValue>
      <dynamicValue>
              <path value="dispenseRequest.quantity"/>
              <expression>
                      <description value="dispenseRequest.quantity is thirty (30) tablets"/>
                      <language value="text/cql"/>
                      <expression value="30 '{tbl}'"/>
              </expression>
      </dynamicValue>

</ActivityDefinition>