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="er-acute-breathlessness-pathway"/>
<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/AtriusEDAcuteBreathlessness</code> for CQL expression definitions.</p></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-cdsHooksEndpoint">
<valueUri
value="https://cds.atrius.in/cds-services/er-acute-breathlessness-pathway"/>
</extension>
<url
value="https://atrius.in/fhir/r4/atrius-in/PlanDefinition/er-acute-breathlessness-pathway"/>
<identifier>
<use value="official"/>
<value value="er-acute-breathlessness-pathway"/>
</identifier>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:1.3.6.1.4.1.66219.1.34.12"/>
</identifier>
<version value="0.1.0"/>
<name value="EDAcuteBreathlessnessPathway"/>
<title value="Emergency Department Acute Breathlessness Pathway"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="clinical-protocol"/>
</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="Person presenting to the emergency department with acute breathlessness: danger-sign review, airway rescue when indicated, parallel stabilization (access, monitoring, imaging, labs), working etiology classification, then branch-specific management."/>
<library
value="https://atrius.in/fhir/r4/atrius-in/Library/AtriusEDAcuteBreathlessness|0.1.4"/>
<action id="er-acute-breathlessness-pathway-root">
<title value="ED Acute Breathlessness Pathway"/>
<description
value="Active ED encounter with dyspnea / acute breathlessness chief complaint."/>
<trigger>
<type value="named-event"/>
<name value="encounter-start"/>
</trigger>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="In Scope"/>
</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="Encounter"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-encounter|0.1.0"/>
</input>
<input>
<type value="Condition"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-encounter-diagnosis|0.1.0"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-problems-health-concerns|0.1.0"/>
</input>
<input>
<type value="Observation"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-observation|0.1.0"/>
</input>
<input>
<type value="QuestionnaireResponse"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-questionnaireresponse|0.1.0"/>
</input>
<input>
<type value="ServiceRequest"/>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-servicerequest|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="danger-signs-review">
<title value="Review Danger Signs"/>
<description
value="Confirm whether any danger sign mandates immediate airway and ventilation escalation."/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/Questionnaire/er-acute-breathlessness-danger-signs|0.2.0"/>
</action>
<action id="airway-rescue">
<title value="Airway Rescue"/>
<description
value="Senior help, NIV preparation, and intubation readiness when danger signs are present."/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Airway Endangered"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="all"/>
<action id="airway-call-senior">
<title value="Call senior / ICU"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-airway-call-senior|0.1.0"/>
</action>
<action id="airway-prepare-niv">
<title value="Prepare NIV"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-prepare-niv|0.1.0"/>
</action>
<action id="airway-prepare-intubation">
<title value="Prepare intubation (RSI)"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-prepare-intubation|0.1.0"/>
</action>
</action>
<action id="parallel-stabilization">
<title value="Parallel Stabilization"/>
<description
value="IV access, oxygen, imaging, and baseline labs while etiology is evaluated."/>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="all"/>
<action id="stabilize-iv-access">
<title value="IV access"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-iv-access|0.1.0"/>
</action>
<action id="stabilize-oxygen">
<title value="Start supplemental oxygen"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-supplemental-oxygen|0.1.0"/>
</action>
<action id="stabilize-cxr">
<title value="Chest radiograph"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-cxr|0.1.0"/>
</action>
<action id="stabilize-ecg">
<title value="12-lead ECG"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-ecg-12-lead|0.1.0"/>
</action>
<action id="stabilize-bmp">
<title value="Basic metabolic panel"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-bmp|0.1.0"/>
</action>
<action id="stabilize-lactate">
<title value="Lactate"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-lactate|0.1.0"/>
</action>
<action id="stabilize-troponin">
<title value="Cardiac troponin"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-troponin-cardiac|0.2.0"/>
</action>
<action id="stabilize-bnp">
<title value="BNP / NT-proBNP"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-bnp|0.1.0"/>
</action>
</action>
<action id="capture-classification">
<title value="Record Working Classification"/>
<description
value="Clinician selects working etiology after danger-sign review and initial stabilization."/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/Questionnaire/er-acute-breathlessness-classification|0.2.0"/>
</action>
<action id="breathlessness-classification">
<title value="Apply Pathway Branch"/>
<description
value="Cardiogenic/HF; COPD/asthma; PE; pneumonia; pneumothorax; upper airway; other."/>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="exactly-one"/>
<action id="branch-cardiogenic">
<title value="Cardiogenic pulmonary edema / acute HF"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression
value="Classification Is Cardiogenic Pulmonary Edema"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="cardiogenic-guidance">
<title value="Cardiogenic workup guidance"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-branch-cardiogenic|0.1.0"/>
</action>
<action id="cardiogenic-niv">
<title value="Prepare NIV (flash edema)"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-prepare-niv|0.1.0"/>
</action>
<action id="cardiogenic-furosemide">
<title value="IV furosemide"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-furosemide|0.1.0"/>
</action>
<action id="cardiogenic-bnp">
<title value="BNP / NT-proBNP"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-bnp|0.1.0"/>
</action>
<action id="cardiogenic-echo">
<title value="Transthoracic echocardiogram"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-echo-transthoracic|0.1.0"/>
</action>
<action id="cardiogenic-daily-weight">
<title value="Daily weight"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-daily-weight|0.1.0"/>
</action>
<action id="cardiogenic-cardiology">
<title value="Cardiology consult"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-referral-cardiology|0.1.0"/>
</action>
</action>
<action id="branch-copd-asthma">
<title value="COPD / asthma exacerbation"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Classification Is COPD Asthma Exacerbation"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="copd-guidance">
<title value="COPD / asthma workup guidance"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-branch-copd-asthma|0.1.0"/>
</action>
<action id="copd-salbutamol">
<title value="Salbutamol nebulizer"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-salbutamol-nebulizer|0.1.0"/>
</action>
<action id="copd-prednisolone">
<title value="Prednisolone"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-prednisolone|0.1.0"/>
</action>
<action id="copd-peak-flow">
<title value="Peak expiratory flow"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-peak-flow|0.1.0"/>
</action>
<action id="copd-pulmonology">
<title value="Pulmonology consult"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-referral-pulmonology|0.1.0"/>
</action>
</action>
<action id="branch-pe">
<title value="Pulmonary embolism"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Classification Is Pulmonary Embolism"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="pe-guidance">
<title value="PE workup guidance"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-branch-pe|0.1.0"/>
</action>
<action id="pe-d-dimer">
<title value="D-dimer"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-d-dimer|0.1.0"/>
</action>
<action id="pe-ct-chest">
<title value="CT chest (PE protocol)"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-ct-chest|0.1.0"/>
</action>
<action id="pe-enoxaparin">
<title value="Enoxaparin (therapeutic LMWH)"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-enoxaparin|0.1.0"/>
</action>
<action id="pe-general-medicine">
<title value="General medicine consult"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-referral-general-medicine|0.1.0"/>
</action>
</action>
<action id="branch-pneumonia">
<title value="Pneumonia / infection"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Classification Is Pneumonia"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="pneumonia-guidance">
<title value="Pneumonia workup guidance"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-branch-pneumonia|0.1.0"/>
</action>
<action id="pneumonia-cbc">
<title value="Complete blood count"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-cbc|0.1.0"/>
</action>
<action id="pneumonia-blood-culture">
<title value="Blood culture"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-blood-culture|0.1.0"/>
</action>
<action id="pneumonia-ceftriaxone">
<title value="Ceftriaxone"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-ceftriaxone|0.1.0"/>
</action>
<action id="pneumonia-azithromycin">
<title value="Azithromycin"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-azithromycin|0.1.0"/>
</action>
<action id="pneumonia-general-medicine">
<title value="General medicine consult"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-referral-general-medicine|0.1.0"/>
</action>
</action>
<action id="branch-pneumothorax">
<title value="Pneumothorax"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Classification Is Pneumothorax"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="pneumothorax-guidance">
<title value="Pneumothorax workup guidance"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-branch-pneumothorax|0.1.0"/>
</action>
<action id="pneumothorax-cxr">
<title value="Chest X-ray"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-rad-cxr|0.1.0"/>
</action>
<action id="pneumothorax-chest-drain">
<title value="Prepare chest drain / needle decompression"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-prepare-chest-drain|0.1.0"/>
</action>
<action id="pneumothorax-senior">
<title value="Call senior / ICU"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-airway-call-senior|0.1.0"/>
</action>
</action>
<action id="branch-upper-airway">
<title value="Upper airway obstruction"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Classification Is Upper Airway Obstruction"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="upper-airway-guidance">
<title value="Upper airway workup guidance"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-branch-upper-airway|0.1.0"/>
</action>
<action id="upper-airway-senior">
<title value="Call senior / ICU"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-airway-call-senior|0.1.0"/>
</action>
<action id="upper-airway-ent">
<title value="ENT consult"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-referral-ent|0.1.0"/>
</action>
<action id="upper-airway-rsi">
<title value="Prepare intubation (RSI)"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-prepare-intubation|0.1.0"/>
</action>
</action>
<action id="branch-other">
<title value="Other / unclear"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql"/>
<expression value="Classification Is Other Unclear"/>
</expression>
</condition>
<groupingBehavior value="logical-group"/>
<action id="other-guidance">
<title value="Other / unclear workup guidance"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/er-breathlessness-branch-other|0.1.0"/>
</action>
<action id="other-assessment">
<title value="Clinical reassessment"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-clinical-assessment|0.1.0"/>
</action>
<action id="other-cbc">
<title value="Complete blood count"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-cbc|0.1.0"/>
</action>
<action id="other-general-medicine">
<title value="General medicine consult"/>
<definitionCanonical
value="https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-referral-general-medicine|0.1.0"/>
</action>
</action>
</action>
</action>
</PlanDefinition>