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Resource Questionnaire/FHIR Server from package cinc.fhir.ig#current (78 ms)

Package cinc.fhir.ig
Type Questionnaire
Id Id
FHIR Version R4
Source https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire-SecondaryProphylaxisHealthAssessmentQuestionnaire.html
Url https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/SecondaryProphylaxisHealthAssessmentQuestionnaire
Version 1.0.0
Status draft
Date 2023-11-10
Name SecondaryProphylaxisHealthAssessmentQuestionnaire
Title Secondary Prophylaxis Health Assessment Questionnaire
Experimental False
Realm nz
Authority national
Description Gathers information about patient health at a secondary prophylaxis medication appointment
Purpose Gathers information about patient health at a secondary prophylaxis medication appointment

Resources that use this resource

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Resources that this resource uses

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Narrative

Note: links and images are rebased to the (stated) source

Structure
LinkIdTextCardinalityTypeDescription & Constraintsdoco
.. SecondaryProphylaxisHealthAssessmentQuestionnaireGathers information about patient health at a secondary prophylaxis medication appointmentQuestionnairehttps://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/SecondaryProphylaxisHealthAssessmentQuestionnaire#1.0.0
... page1page1. Please complete this questionnaire at the secondary prophylaxis appointment to assess a rheumatic fever patient's health.0..1display
... ReasonsInjectionOverdue2). Reason(s) injection was give late? (multiple choice)1..*choiceOptions: 10 options
... OverdueInjectionOtherDetail3). Other details for late injection (enter text)1..1text
... OtherPainManagementToolsUsed11). Pain management tools used? (multiple choice)1..*choiceOptions: 7 options
... PainManagementOtherDetails11.1). Details of other pain management (enter text)1..1textEnable When: OtherPainManagementToolsUsed = Other
... PostInjectionConcern12). Post injection concern or possible reaction identified?1..1booleanInitial Value: boolean = false
... PostInjectionConcernDetails12.1). If Yes, Record Details, Symptoms, Actions Taken and Follow-Up Plan (enter text)1..1textEnable When: PostInjectionConcern = true
... AnyOtherConcerns13). Were There Any Other Concerns or Issues Identified During the Visit?1..1booleanInitial Value: boolean = false
... OtherConcernsDetail13.1). If yes, describe details, actions taken, and follow-up planned (enter text)1..1textEnable When: AnyOtherConcerns = true
... HealthEducationTopicsDiscussed14). Health education topics discussed? (multiple choice)1..*choiceOptions: 10 options
... HealthEducationOtherDetail14.1). Enter details of other health education topic discussed (enter text)1..1textEnable When: HealthEducationTopicsDiscussed = Other
... RecentOrUpcomingAppointments15). Any recent or upcoming follow-up appointments?1..1boolean
... RecentOrUpcomingAppointmentsDetails15.1). Enter details and dates of any recent or upcoming follow-up appointments (enter text)1..1textEnable When: RecentOrUpcomingAppointments = true
... PlanForNextMedicationAppointment16). Comments for the next appointment (enter text)1..1text

doco Documentation for this format

Option Sets

Answer options for ReasonsInjectionOverdue

  • Previously Care On-Hold
  • Unable to Contact Patient
  • Patient Not Available on the Day
  • Patient Declined Treatment
  • INR Too High
  • Patient Lost to Follow-Up
  • Service Delayed To Follow-Up
  • Service Unavailable on the Day
  • Service Error
  • Other

Answer options for OtherPainManagementToolsUsed

  • Ice pack
  • Buzzy bee
  • Numbing cream (Emla)
  • Numbing spray
  • Distraction
  • Very slow injection
  • Other

Answer options for HealthEducationTopicsDiscussed

  • Secondary prophylaxis
  • Sore Throat Management
  • Skin Infection Management
  • Dental Health
  • Endocarditis Prophylaxis
  • Nutrition
  • Physical Activity
  • Healthy Home Environments
  • Sexual Health
  • Other

Source

{
  "resourceType" : "Questionnaire",
  "id" : "SecondaryProphylaxisHealthAssessmentQuestionnaire",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkId for the item\">LinkId</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the itemcan appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> SecondaryProphylaxisHealthAssessmentQuestionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Gathers information about patient health at a secondary prophylaxis medication appointment</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/SecondaryProphylaxisHealthAssessmentQuestionnaire#1.0.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.page1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Display\" class=\"hierarchy\"/> page1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">page1. Please complete this questionnaire at the secondary prophylaxis appointment to assess a rheumatic fever patient's health.</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display\">display</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.ReasonsInjectionOverdue\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> ReasonsInjectionOverdue</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">2). Reason(s) injection was give late? (multiple choice)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.ReasonsInjectionOverdue\">10 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.OverdueInjectionOtherDetail\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Text\" class=\"hierarchy\"/> OverdueInjectionOtherDetail</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">3). Other details for late injection (enter text)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.OtherPainManagementToolsUsed\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> OtherPainManagementToolsUsed</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">11). Pain management tools used? (multiple choice)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.OtherPainManagementToolsUsed\">7 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PainManagementOtherDetails\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Text\" class=\"hierarchy\"/> PainManagementOtherDetails</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">11.1). Details of other pain management (enter text)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.OtherPainManagementToolsUsed\">OtherPainManagementToolsUsed</a> = Other</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PostInjectionConcern\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Boolean\" class=\"hierarchy\"/> PostInjectionConcern</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">12). Post injection concern or possible reaction identified?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Initial Value: boolean = false</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PostInjectionConcernDetails\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Text\" class=\"hierarchy\"/> PostInjectionConcernDetails</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">12.1). If Yes, Record Details, Symptoms, Actions Taken and Follow-Up Plan (enter text)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.PostInjectionConcern\">PostInjectionConcern</a> = true</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.AnyOtherConcerns\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Boolean\" class=\"hierarchy\"/> AnyOtherConcerns</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">13). Were There Any Other Concerns or Issues Identified During the Visit?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Initial Value: boolean = false</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.OtherConcernsDetail\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Text\" class=\"hierarchy\"/> OtherConcernsDetail</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">13.1). If yes, describe details, actions taken, and follow-up planned (enter text)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.AnyOtherConcerns\">AnyOtherConcerns</a> = true</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.HealthEducationTopicsDiscussed\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Coding\" class=\"hierarchy\"/> HealthEducationTopicsDiscussed</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">14). Health education topics discussed? (multiple choice)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.HealthEducationTopicsDiscussed\">10 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.HealthEducationOtherDetail\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Text\" class=\"hierarchy\"/> HealthEducationOtherDetail</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">14.1). Enter details of other health education topic discussed (enter text)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.HealthEducationTopicsDiscussed\">HealthEducationTopicsDiscussed</a> = Other</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.RecentOrUpcomingAppointments\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Boolean\" class=\"hierarchy\"/> RecentOrUpcomingAppointments</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">15). Any recent or upcoming follow-up appointments?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.RecentOrUpcomingAppointmentsDetails\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Text\" class=\"hierarchy\"/> RecentOrUpcomingAppointmentsDetails</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">15.1). Enter details and dates of any recent or upcoming follow-up appointments (enter text)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.RecentOrUpcomingAppointments\">RecentOrUpcomingAppointments</a> = true</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.PlanForNextMedicationAppointment\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Text\" class=\"hierarchy\"/> PlanForNextMedicationAppointment</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">16). Comments for the next appointment (enter text)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name=\"opt-item.ReasonsInjectionOverdue\"> </a><p><b>Answer options for ReasonsInjectionOverdue</b></p><ul><li style=\"font-size: 11px\">Previously Care On-Hold</li><li style=\"font-size: 11px\">Unable to Contact Patient</li><li style=\"font-size: 11px\">Patient Not Available on the Day</li><li style=\"font-size: 11px\">Patient Declined Treatment</li><li style=\"font-size: 11px\">INR Too High</li><li style=\"font-size: 11px\">Patient Lost to Follow-Up</li><li style=\"font-size: 11px\">Service Delayed To Follow-Up</li><li style=\"font-size: 11px\">Service Unavailable on the Day</li><li style=\"font-size: 11px\">Service Error</li><li style=\"font-size: 11px\">Other</li></ul><a name=\"opt-item.OtherPainManagementToolsUsed\"> </a><p><b>Answer options for OtherPainManagementToolsUsed</b></p><ul><li style=\"font-size: 11px\">Ice pack</li><li style=\"font-size: 11px\">Buzzy bee</li><li style=\"font-size: 11px\">Numbing cream (Emla)</li><li style=\"font-size: 11px\">Numbing spray</li><li style=\"font-size: 11px\">Distraction</li><li style=\"font-size: 11px\">Very slow injection</li><li style=\"font-size: 11px\">Other</li></ul><a name=\"opt-item.HealthEducationTopicsDiscussed\"> </a><p><b>Answer options for HealthEducationTopicsDiscussed</b></p><ul><li style=\"font-size: 11px\">Secondary prophylaxis</li><li style=\"font-size: 11px\">Sore Throat Management</li><li style=\"font-size: 11px\">Skin Infection Management</li><li style=\"font-size: 11px\">Dental Health</li><li style=\"font-size: 11px\">Endocarditis Prophylaxis</li><li style=\"font-size: 11px\">Nutrition</li><li style=\"font-size: 11px\">Physical Activity</li><li style=\"font-size: 11px\">Healthy Home Environments</li><li style=\"font-size: 11px\">Sexual Health</li><li style=\"font-size: 11px\">Other</li></ul></div>"
  },
  "url" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/SecondaryProphylaxisHealthAssessmentQuestionnaire",
  "identifier" : [
    {
      "use" : "official",
      "value" : "SecondaryProphylaxisHealthAssessmentQuestionnaire",
      "period" : {
        "start" : "2023-10-16"
      }
    }
  ],
  "version" : "1.0.0",
  "name" : "SecondaryProphylaxisHealthAssessmentQuestionnaire",
  "title" : "Secondary Prophylaxis Health Assessment Questionnaire",
  "status" : "draft",
  "experimental" : false,
  "subjectType" : [
    "Patient"
  ],
  "date" : "2023-11-10",
  "publisher" : "Te Whatu Ora",
  "contact" : [
    {
      "name" : "Te Whatu Ora",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.tewhatuora.govt.nz/"
        }
      ]
    },
    {
      "name" : "David Grainger",
      "telecom" : [
        {
          "system" : "email",
          "value" : "david.grainger@middleware.co.nz",
          "use" : "work"
        }
      ]
    }
  ],
  "description" : "Gathers information about patient health at a secondary prophylaxis medication appointment",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "NZ",
          "display" : "New Zealand"
        }
      ]
    }
  ],
  "purpose" : "Gathers information about patient health at a secondary prophylaxis medication appointment",
  "item" : [
    {
      "linkId" : "page1",
      "prefix" : "page1",
      "text" : "Please complete this questionnaire at the secondary prophylaxis appointment to assess a rheumatic fever patient's health.",
      "type" : "display"
    },
    {
      "linkId" : "ReasonsInjectionOverdue",
      "prefix" : "2)",
      "text" : "Reason(s) injection was give late? (multiple choice)",
      "type" : "choice",
      "required" : true,
      "repeats" : true,
      "answerOption" : [
        {
          "valueString" : "Previously Care On-Hold"
        },
        {
          "valueString" : "Unable to Contact Patient"
        },
        {
          "valueString" : "Patient Not Available on the Day"
        },
        {
          "valueString" : "Patient Declined Treatment"
        },
        {
          "valueString" : "INR Too High"
        },
        {
          "valueString" : "Patient Lost to Follow-Up"
        },
        {
          "valueString" : "Service Delayed To Follow-Up"
        },
        {
          "valueString" : "Service Unavailable on the Day"
        },
        {
          "valueString" : "Service Error"
        },
        {
          "valueString" : "Other"
        }
      ]
    },
    {
      "linkId" : "OverdueInjectionOtherDetail",
      "prefix" : "3)",
      "text" : "Other details for late injection (enter text)",
      "type" : "text",
      "required" : true
    },
    {
      "linkId" : "OtherPainManagementToolsUsed",
      "prefix" : "11)",
      "text" : "Pain management tools used? (multiple choice)",
      "type" : "choice",
      "required" : true,
      "repeats" : true,
      "answerOption" : [
        {
          "valueString" : "Ice pack"
        },
        {
          "valueString" : "Buzzy bee"
        },
        {
          "valueString" : "Numbing cream (Emla)"
        },
        {
          "valueString" : "Numbing spray"
        },
        {
          "valueString" : "Distraction"
        },
        {
          "valueString" : "Very slow injection"
        },
        {
          "valueString" : "Other"
        }
      ]
    },
    {
      "linkId" : "PainManagementOtherDetails",
      "prefix" : "11.1)",
      "text" : "Details of other pain management (enter text)",
      "type" : "text",
      "enableWhen" : [
        {
          "question" : "OtherPainManagementToolsUsed",
          "operator" : "=",
          "answerString" : "Other"
        }
      ],
      "required" : true
    },
    {
      "linkId" : "PostInjectionConcern",
      "prefix" : "12)",
      "text" : "Post injection concern or possible reaction identified?",
      "type" : "boolean",
      "required" : true,
      "initial" : [
        {
          "valueBoolean" : false
        }
      ]
    },
    {
      "linkId" : "PostInjectionConcernDetails",
      "prefix" : "12.1)",
      "text" : "If Yes, Record Details, Symptoms, Actions Taken and Follow-Up Plan (enter text)",
      "type" : "text",
      "enableWhen" : [
        {
          "question" : "PostInjectionConcern",
          "operator" : "=",
          "answerBoolean" : true
        }
      ],
      "required" : true
    },
    {
      "linkId" : "AnyOtherConcerns",
      "prefix" : "13)",
      "text" : "Were There Any Other Concerns or Issues Identified During the Visit?",
      "type" : "boolean",
      "required" : true,
      "initial" : [
        {
          "valueBoolean" : false
        }
      ]
    },
    {
      "linkId" : "OtherConcernsDetail",
      "prefix" : "13.1)",
      "text" : "If yes, describe details, actions taken, and follow-up planned (enter text)",
      "type" : "text",
      "enableWhen" : [
        {
          "question" : "AnyOtherConcerns",
          "operator" : "=",
          "answerBoolean" : true
        }
      ],
      "required" : true
    },
    {
      "linkId" : "HealthEducationTopicsDiscussed",
      "prefix" : "14)",
      "text" : "Health education topics discussed? (multiple choice)",
      "type" : "choice",
      "required" : true,
      "repeats" : true,
      "answerOption" : [
        {
          "valueString" : "Secondary prophylaxis"
        },
        {
          "valueString" : "Sore Throat Management"
        },
        {
          "valueString" : "Skin Infection Management"
        },
        {
          "valueString" : "Dental Health"
        },
        {
          "valueString" : "Endocarditis Prophylaxis"
        },
        {
          "valueString" : "Nutrition"
        },
        {
          "valueString" : "Physical Activity"
        },
        {
          "valueString" : "Healthy Home Environments"
        },
        {
          "valueString" : "Sexual Health"
        },
        {
          "valueString" : "Other"
        }
      ]
    },
    {
      "linkId" : "HealthEducationOtherDetail",
      "prefix" : "14.1)",
      "text" : "Enter details of other health education topic discussed (enter text)",
      "type" : "text",
      "enableWhen" : [
        {
          "question" : "HealthEducationTopicsDiscussed",
          "operator" : "=",
          "answerString" : "Other"
        }
      ],
      "required" : true
    },
    {
      "linkId" : "RecentOrUpcomingAppointments",
      "prefix" : "15)",
      "text" : "Any recent or upcoming follow-up appointments?",
      "type" : "boolean",
      "required" : true
    },
    {
      "linkId" : "RecentOrUpcomingAppointmentsDetails",
      "prefix" : "15.1)",
      "text" : "Enter details and dates of any recent or upcoming follow-up appointments (enter text)",
      "type" : "text",
      "enableWhen" : [
        {
          "question" : "RecentOrUpcomingAppointments",
          "operator" : "=",
          "answerBoolean" : true
        }
      ],
      "required" : true
    },
    {
      "linkId" : "PlanForNextMedicationAppointment",
      "prefix" : "16)",
      "text" : "Comments for the next appointment (enter text)",
      "type" : "text",
      "required" : true
    }
  ]
}

XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.