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

<id value="KDN5"/>
<meta>
  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta>

<!--  regimen entries represented using contained ActivityDefinition resources (with extensions)  -->
<contained>
  <ActivityDefinition>
    <id value="1111"/>
    <status value="draft"/>
    <productCodeableConcept>
      <coding>
        <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
        <code value="12574"/>
        <display value="gemcitabine"/>
      </coding>
      <text value="gemcitabine"/>
    </productCodeableConcept>
    <dosage>
      <text value="1250 mg/m² IV over 30 minutes"/>
      <timing>
        <repeat>
          <duration value="30"/>
          <durationUnit value="min"/>
        </repeat>
      </timing>
      <route>
        <text value="IV"/>
      </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="1250"/>
          <unit value="mg/m²"/>
        </doseQuantity>
      </doseAndRate>
    </dosage>
  </ActivityDefinition>
</contained>
<contained>
  <ActivityDefinition>
    <id value="2222"/>
    <status value="draft"/>
    <productCodeableConcept>
      <coding>
        <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
        <code value="40048"/>
        <display value="Carboplatin"/>
      </coding>
      <text value="CARBOplatin"/>
    </productCodeableConcept>
    <dosage>
      <text value="AUC 5 IV over 30 minutes"/>
      <timing>
        <repeat>
          <duration value="30"/>
          <durationUnit value="min"/>
        </repeat>
      </timing>
      <route>
        <text value="IV"/>
      </route>
      <doseAndRate>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
            <code value="ordered"/>
            <display value="Ordered"/>
          </coding>
        </type>
        <doseQuantity>
          <!--  AUC as dose unit or as an extension?  -->
          <extension url="http://example.org/fhir/AUC-dose">
            <valueInteger value="5"/>
          </extension>
          <!--  <value value="5" />
        <unit value="AUC" />
        <system value="http://snomed.info/sct" />
        <code value="413573002" />  -->
        </doseQuantity>
      </doseAndRate>

    </dosage>
  </ActivityDefinition>
</contained>

<identifier>
  <system value="http://example.org/ordertemplates"/>
  <value value="KDN5"/>
</identifier>
<version value="1"/>
<title value="Gemcitabine/CARBOplatin"/>
<type>
  <text value="Chemotherapy Order Template"/>
</type>
<status value="draft"/>
<experimental value="true"/>
<publisher value="National Comprehensive Cancer Network, Inc."/>
<!--  Indications  -->
      <useContext>
              <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
                      <valueString value="A"/>
              </extension>
              <code>
                      <system value="http://example.org/fhir/CodeSystem/indications"/>
                      <code value="treamentSetting-or-diseaseStatus"/>
              </code>
              <valueCodeableConcept>
                      <text value="Metastatic"/>
              </valueCodeableConcept>
      </useContext>
      <useContext>
              <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
                      <valueString value="A"/>
              </extension>
              <code>
                      <system value="http://example.org/fhir/CodeSystem/indications"/>
                      <code value="disease-or-histology"/>
              </code>
              <valueCodeableConcept>
                      <text value="Collecting Duct/Medullary Subtypes"/>
              </valueCodeableConcept>
      </useContext>
      <useContext>
              <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
                      <valueString value="A"/>
              </extension>
              <code>
                      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
                      <code value="focus"/>
              </code>
              <valueCodeableConcept>
                      <text value="Kidney Cancer"/>
              </valueCodeableConcept>
      </useContext>
      <useContext>
              <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
                      <valueString value="B"/>
              </extension>
              <code>
                      <system value="http://example.org/fhir/CodeSystem/indications"/>
                      <code value="treatmentSetting-or-diseaseStatus"/>
              </code>
              <valueCodeableConcept>
                      <text value="Relapsed"/>
              </valueCodeableConcept>
      </useContext>
      <useContext>
              <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
                      <valueString value="B"/>
              </extension>
              <code>
                      <system value="http://example.org/fhir/CodeSystem/indications"/>
                      <code value="disease-or-histology"/>
              </code>
              <valueCodeableConcept>
                      <text value="Collecting Duct/Medullary Subtypes"/>
              </valueCodeableConcept>
      </useContext>
      <useContext>
              <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
                      <valueString value="B"/>
              </extension>
              <code>
                      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
                      <code value="focus"/>
              </code>
              <valueCodeableConcept>
                      <text value="Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"/>
              </valueCodeableConcept>
      </useContext>
<copyright value="All rights reserved."/>
<approvalDate value="2016-07-27"/>
<lastReviewDate value="2016-07-27"/>
<author>
  <name value="Lee Surprenant"/>
</author>
<!--  list of references for the order template  -->
<relatedArtifact>
  <type value="derived-from"/>
  <display value="NCCN Guidelines for Kidney Cancer. V.2.2016"/>
  <url value="http://www.example.org/professionals/physician_gls/PDF/kidney.pdf"/>
</relatedArtifact>
<relatedArtifact>
  <type value="citation">
    <extension url="http://example.org/fhir/regimenReferenceType">
      <valueCode value="a"/>
    </extension>
  </type>
  <citation value="Oudard S, et al. J Urol. 2007;177(5):1698-702"/>
  <url value="http://www.ncbi.nlm.nih.gov/pubmed/17437788"/>
</relatedArtifact>

<action>
  <!--  list of regimen options. in this case only one  -->
  <selectionBehavior value="exactly-one"/>
  <action>
    <!--  list of regimen parts. in this case only one  -->
    <selectionBehavior value="all"/>
    <action>
      <!--  list of cycle definitions. in this case only one  -->
      <groupingBehavior value="sentence-group"/>
      <selectionBehavior value="exactly-one"/>
      <action id="cycle-definition-1">
        <textEquivalent value="21-day cycle for 6 cycles"/>

        <timingTiming>
          <repeat>
            <count value="6"/>
            <duration value="21"/>
            <durationUnit value="d"/>
          </repeat>
        </timingTiming>

        <!--  list of regimen entry references for this regimen part  -->
        <!--  references would duplicated in each cycle definition option
        (see http://build.fhir.org/codesystem-action-grouping-behavior.html#sentence-group) -->
        <action id="action-1">
          <extension url="http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle">
            <extension url="day">
              <valueInteger value="1"/>
            </extension>
            <extension url="day">
              <valueInteger value="8"/>
            </extension>
          </extension>
          <textEquivalent value="Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8"/>
          <definitionCanonical value="#1111"/>
        </action>
        <action id="action-2">
          <extension url="http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle">
            <extension url="day">
              <valueInteger value="1"/>
            </extension>
          </extension>
          <textEquivalent value="CARBOplatin AUC 5 IV over 30 minutes on Day 1"/>
          <relatedAction>
            <actionId value="action-1"/>
            <relationship value="concurrent-with-start"/>
          </relatedAction>
          <definitionCanonical value="#2222"/>
        </action> <!--  end of regimen entries  -->
      </action> <!--  end of cycle definitions  -->
    </action> <!--  end of regimen parts  -->
  </action> <!--  end of regimen options  -->
</action>

</PlanDefinition>