Atrius India Core FHIR Implementation Guide
0.1.0 - ci-build
Atrius India Core FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft as of 2026-08-30 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="atrius-ddi-check"/>
<meta>
<profile
value="http://hl7.org/fhir/StructureDefinition/cdshooksserviceplandefinition|4.0.1"/>
</meta>
<language value="en"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p>See <code>Library/AtriusDrugInteractions</code> for pair definitions and drug-class ValueSets.</p></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-cdsHooksEndpoint">
<valueUri value="https://cds.atrius.in/cds-services/atrius-ddi-check"/>
</extension>
<url
value="https://atrius.in/fhir/r4/atrius-in/PlanDefinition/atrius-ddi-check"/>
<identifier>
<use value="official"/>
<value value="atrius-ddi-check"/>
</identifier>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:1.3.6.1.4.1.66219.1.34.2"/>
</identifier>
<version value="0.1.0"/>
<name value="AtriusDdiCheck"/>
<title value="Drug-Drug Interaction Check"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="eca-rule"/>
</coding>
</type>
<status value="draft"/>
<experimental value="true"/>
<date value="2026-08-30T18:15:29+05:30"/>
<publisher value="Atrius"/>
<contact>
<name value="Atrius"/>
<telecom>
<system value="url"/>
<value value="https://atrius.in"/>
</telecom>
</contact>
<description
value="Interruptive alerts at order signing when a draft medication order interacts with an active prescription: statin + CYP3A4-inhibiting macrolide (rhabdomyolysis), warfarin + NSAID (bleeding), ACE inhibitor + potassium-sparing diuretic (hyperkalemia). Cards propose safer alternatives or monitoring."/>
<library
value="https://atrius.in/fhir/r4/atrius-in/Library/AtriusDrugInteractions|0.1.0"/>
<action id="atrius-ddi-check-root">
<title value="Drug-Drug Interaction Check"/>
<description
value="A draft order interacts with an active prescription."/>
<trigger>
<type value="named-event"/>
<name value="order-sign"/>
</trigger>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Has Drug Interaction"/>
</expression>
</condition>
<input>
<type value="Patient"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-patient|0.1.0"/>
</input>
<input>
<type value="MedicationRequest"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-medicationrequest|0.1.0"/>
</input>
<groupingBehavior value="logical-group"/>
<action id="ddi-statin-macrolide">
<title value="Statin + macrolide: rhabdomyolysis risk"/>
<description
value="Clarithromycin and erythromycin inhibit CYP3A4 and raise statin exposure, risking myopathy and rhabdomyolysis. Consider azithromycin (minimal CYP3A4 inhibition) or hold the statin for the antibiotic course."/>
<priority value="stat"/>
<documentation>
<type value="documentation"/>
<display value="AHA statement — statin drug interactions"/>
<url
value="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000456"/>
<document>
<url
value="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000456"/>
</document>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Statin Macrolide Interaction"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action id="ddi-statin-macrolide-azithromycin">
<title value="Switch to azithromycin (no CYP3A4 interaction)"/>
<priority value="stat"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-azithromycin|0.1.0"/>
</action>
</action>
<action id="ddi-warfarin-nsaid">
<title value="Warfarin + NSAID: bleeding risk"/>
<description
value="NSAIDs potentiate warfarin and independently injure gastric mucosa, sharply raising GI bleeding risk. Prefer paracetamol for analgesia; if an NSAID is unavoidable, add gastroprotection and increase INR monitoring."/>
<priority value="stat"/>
<documentation>
<type value="documentation"/>
<display value="Warfarin drug interactions (StatPearls)"/>
<url value="https://www.ncbi.nlm.nih.gov/books/NBK470313/"/>
<document>
<url value="https://www.ncbi.nlm.nih.gov/books/NBK470313/"/>
</document>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Warfarin NSAID Interaction"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action id="ddi-warfarin-nsaid-paracetamol">
<title value="Use paracetamol for analgesia instead"/>
<priority value="stat"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-paracetamol|0.1.0"/>
</action>
</action>
<action id="ddi-acei-k-sparing">
<title
value="ACE inhibitor + potassium-sparing diuretic: hyperkalemia risk"/>
<description
value="Combined ACE inhibitor and potassium-sparing diuretic therapy risks hyperkalemia, particularly with renal impairment. If co-prescription is intended, check baseline and follow-up potassium and renal function."/>
<priority value="urgent"/>
<documentation>
<type value="documentation"/>
<display
value="UK Kidney Association — acute hyperkalaemia guideline"/>
<url
value="https://ukkidney.org/health-professionals/guidelines/treatment-acute-hyperkalaemia-adults"/>
<document>
<url
value="https://ukkidney.org/health-professionals/guidelines/treatment-acute-hyperkalaemia-adults"/>
</document>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression
value="ACE Inhibitor Potassium Sparing Diuretic Interaction"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="ddi-acei-k-sparing-bmp">
<title value="Order potassium and renal function (BMP)"/>
<priority value="urgent"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-bmp|0.1.0"/>
</action>
</action>
</action>
</PlanDefinition>