1. Clinical Workflow Questions
How do I use order sets when planning care?
How does care plans identify what protocol it’s adhering to?
How can I use best practices or clinical practice guidelines while planning care?
How do I close-the-loop?
How do I know a request or an order has been satisfied?
How does an event or a result point to the order that authorized it?
How do I know who the patient care team members are?

2. Protocol/Template/orderSets
First Line Monotherapy Metformin HCL 500 mg
…..
description: Metformin HCl 500 MG Oral Tablet; TAKE one TABLET Twice daily with meals; 60 tablet; 2 refills
purpose: Defines a guideline supported prescription for the treatment of DM Type II
usage: This activity definition is used as part of Diabetes Mellitus, Type 2, Adult +MU care guides
approvalDate: 04/28/2017
lastReviewDate: 05/04/2017
effectivePeriod: 05/04/ > 05/04/2018
ActivityDefinition
Alternative Monotherapy Glimepiride 1 MG Oral
…..
description: Glimepiride 1 MG Oral Tablet; one TABLET QD WITH BREAKFAST.; Qty: 30; Tablet; Days Supply: 30; Refill: 2
purpose: Defines a guideline supported prescription for the treatment of DM Type II
usage: This activity definition is used as part of Diabetes Mellitus, Type 2, Adult +MU care guides
approvalDate: 04/28/2017
lastReviewDate: 05/04/2017
effectivePeriod: 05/04/ > 05/04/2018
ActivityDefinition library
Protocol/Template/orderSets
PlanDefinition
e.g. DM Type II
definition
basedOn
Patient specific
Care Plan
HealthConcern
identifies
addresses
HealthGoal
fulfils
Activity Request
e.g. ProcedureRequest
initiates
Activity Event – uses action resources
e.g. Procedure

3. actionDefintion (group)
ActivityDefinition
PlanDefinition
actionDefintion (group)
First Line Monotherapy Metformin HCL 500 mg
…..
description: Metformin HCl 500 MG Oral Tablet; TAKE one TABLET Twice daily with meals; 60 tablet; 2 refills
purpose: Defines a guideline supported prescription for the treatment of DM Type II
usage: This activity definition is used as part of Diabetes Mellitus, Type 2, Adult +MU care guides
approvalDate: 04/28/2017
lastReviewDate: 05/04/2017
effectivePeriod: 05/04/ > 05/04/2018
ActivityDefinition library
Protocol/Template/orderSets
PlanDefinition
e.g. DM Type II
definition
Patient specific
basedOn
Care Plan
Diet Recommendation – follow a 1500 calories diabetic diet
…..
description: Diabetes diet, specified calories; Follow a diabetic diet with 1500 calories.
purpose: Defines a guideline supported patient instructions for the treatment of DM Type II
usage: This activity definition is used as part of Diabetes Mellitus, Type 2, Adult +MU care guides
approvalDate: 04/28/2017
lastReviewDate: 05/04/2017
effectivePeriod: 05/04/ > 05/04/ …..
HealthConcern
identifies
addresses
HealthGoal
Activity Request
e.g. ProcedureRequest
fulfils
initiates
Activity Event – uses action resources
e.g. Procedure

4. Plan & Activity Definitions
PlanDefinition
PlanDefinition maps to CarePlan and/or request group
PlanDefinition Actions are activities, i.e. ActivityDefinition
PlanDefinition aggregate activity definitions so they are implementable, i.e. library of activity definitions
ActivityDefinition
ActivityDefinition referenced from PlanDefinition
ActivityDefinition.kind uses request type resources
ActivityDefinition, i.e. definition of an activity
Actions are generated from the activityDefinition so they are used in a CarePlan
ActivityDefinitions can be based on best practices, CPG

5. Care Team Members
How can I use PlanDefintion to derive care team members?
PlanDefinition.action.definition reference activityDefinition
ActivityDefinition.participant.type defines the practitioner | patient |relatedPerson
This person can be included in the care team
planDefinition need linkage to care team at 1) entire definition level (for coordination purposes) as well as support of teams in team and 2) at the activity level – where individuals that have accountability and responsibility