{
  "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"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}