Package | IdHIE.0v |
Resource Type | Questionnaire |
Id | saiful |
FHIR Version | R4 |
Source | https://simplifier.net/resolve?scope=IdHIE.0v@0.0.1&canonical=http://fhir.hie.moh.gov.my/Questionnaire/saiful-my-core |
URL | http://fhir.hie.moh.gov.my/Questionnaire/saiful-my-core |
Status | active |
Date | 2023-03-30T22:48:32.9749675+00:00 |
Name | Saiful |
Title | Malaysia National Health Screening |
No resources found
No resources found
No narrative content found in resource
{ "resourceType": "Questionnaire", "id": "saiful", "meta": { "source": "http://provider.hie.moh.gov.my", "profile": [ "http://hl7.org/fhir/StructureDefinition/Questionnaire" ] }, "url": "http://fhir.hie.moh.gov.my/Questionnaire/saiful-my-core", "name": "Saiful", "title": "Malaysia National Health Screening", "status": "active", "experimental": true, "date": "2023-03-30T22:48:32.9749675+00:00", "item": [ { "linkId": "1", "text": "User Demographic", "type": "reference", "required": false }, { "linkId": "2", "text": "Assessments", "type": "group", "required": false, "item": [ { "linkId": "2.1", "text": "Does the patient have any family history?", "type": "boolean", "required": false, "item": [ { "linkId": "2.1.1", "text": "If yes:", "type": "reference", "required": false } ] }, { "linkId": "2.2", "text": "Does the patient have any medical history?", "type": "reference", "required": false } ] }, { "linkId": "3", "text": "Mental Health Assessments", "type": "reference", "required": false }, { "linkId": "4", "text": "Lifestyle Health Assessment", "type": "group", "required": false, "item": [ { "linkId": "4.1", "text": "Alcohol consumption", "type": "reference", "required": false }, { "linkId": "4.2", "text": "Smoking Status", "type": "reference", "required": false } ] }, { "linkId": "5", "text": "Clinical Parameters", "type": "group", "required": false, "item": [ { "linkId": "5.1", "code": [ { "system": "http://loinc.org", "code": "8302-2", "display": "Anthropometry: Height" } ], "text": "Anthropometry: Height", "type": "reference", "required": false }, { "linkId": "5.2", "code": [ { "system": "http://loinc.org", "code": "8306-3", "display": "Anthropometry: Weight" } ], "text": "Anthropometry: Weight", "type": "reference", "required": false }, { "linkId": "5.3", "code": [ { "system": "http://loinc.org", "code": "8280-0", "display": "Anthropometry: Waistline" } ], "text": "Anthropometry: Waistline", "type": "reference", "required": false }, { "linkId": "5.4", "code": [ { "system": "http://loinc.org", "code": "39156-5", "display": "BMI" } ], "text": "BMI Outcome", "type": "reference", "required": false }, { "linkId": "5.6", "code": [ { "system": "http://loinc.org", "code": "8480-6", "display": "Vital Signs: Blood Pressure (systolic)" } ], "text": "Vital Signs: Blood Pressure (systolic)", "type": "reference", "required": false }, { "linkId": "5.7", "code": [ { "system": "http://loinc.org", "code": "8462-4", "display": "Vital Signs: Blood Pressure (diastolic)" } ], "text": "Vital Signs: Blood Pressure (diastolic)", "type": "reference", "required": false }, { "linkId": "5.8", "code": [ { "system": "http://loinc.org", "code": "8867-4", "display": "Vital Signs: Pulse Rate" } ], "text": "Vital Signs: Pulse Rate", "type": "reference", "required": false }, { "linkId": "5.09", "text": "Point of Care Testing: Blood Glucose", "type": "group", "required": false, "item": [ { "linkId": "5.09.1", "code": [ { "system": "http://snomed.info/sct", "code": "271062006", "display": "Fasting" } ], "text": "Fasting", "type": "reference", "required": false }, { "linkId": "5.09.2", "code": [ { "system": "http://snomed.info/sct", "code": "271061004", "display": "Random" } ], "text": "Random", "type": "reference", "required": false } ] }, { "linkId": "5.10", "code": [ { "system": "http://loinc.org", "code": "57698-3", "display": "Lipid panel - Serum or Plasma" } ], "text": "Point of Care Testing: Blood Cholesterol", "type": "reference", "required": false } ] }, { "linkId": "6", "text": "Advanced Health Screening (Optional)", "type": "group", "required": false, "item": [ { "linkId": "6.1", "text": "Cardiovascular", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Chest Pain" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Ankle Swelling" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Shortness of breath" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Intermittent claudication" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Orthopnoea" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Cough with or without sputum" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Palpitation" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "08", "display": "Nocturnal dyspnoea" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "09", "display": "Haemoptysis" } } ] }, { "linkId": "6.2", "text": "Gastrointestinal", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abdominal pain" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Nausea and/or vomiting" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Bowel pattern and any changes" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Dyspepsia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Degree of appetide" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Cough with or without sputum" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Dysphagia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "08", "display": "Weight loss or gain" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "09", "display": "Haemoptyis" } } ] }, { "linkId": "6.3", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "6.3", "display": "Genitourinary" } ], "text": "Genitourinary", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Haematuria" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Dysuria" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Menstual irregularity - women" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Nocturia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Frequency" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Urethral discharge - men" } } ] }, { "linkId": "6.4", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "6.4", "display": "Locomotor" } ], "text": "Locomotor", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Joint pain" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Change in mobility" } } ] }, { "linkId": "6.5", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "6.5", "display": "Neurological" } ], "text": "Neurological", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Seizures" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Eyesight" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Transient loss of function (vision, speech, sight)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Collapses" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Hearing" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Paresthesia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Dizziness" } } ] }, { "linkId": "6.6", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "6.6", "display": "ENT Symptoms" } ], "text": "ENT Symptoms", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Hearing loss/tinnitus" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Epistaxis" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Snoring" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Otalgia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Dysphonia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Trismus" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Facial pain" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "08", "display": "Dysphagia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "09", "display": "Neck swelling" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "10", "display": "Persistent nasal discharge" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "11", "display": "Odynophagia" } } ] }, { "linkId": "6.7", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "6.7", "display": "Dermatology" } ], "text": "Dermatology", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Rashes" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Skin color changes" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Ulcers" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Skin lesions" } } ] } ] }, { "linkId": "7", "text": "Advanced Systemic Examination (Optional)", "type": "group", "required": false, "item": [ { "linkId": "7.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.1", "display": "General Appearance" } ], "text": "General Appearance", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.1.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.1.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Ill-looking" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Dehydrated" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Cachexic" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Abnormal gait" } } ] } ] }, { "linkId": "7.2", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.2", "display": "Hands and Arms:" } ], "text": "Hands and Arms:", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.2.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.2.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Clubbing" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Koilonychia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Leuchonychia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Palmar erythema" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Dupuytren’s contracture" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Cyanosis" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Tremors" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "08", "display": "Finger Clubbing" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "09", "display": "Spider Naevi" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "10", "display": "Bruising" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "11", "display": "Muscle wasting" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "12", "display": "Scratch Marks" } } ] } ] }, { "linkId": "7.3", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.3", "display": "Head, Ears, Eyes, Nose and Throat" } ], "text": "Head, Ears, Eyes, Nose and Throat", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.3.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.3.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Bleeding" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Discharges" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Abnormal Breath" } } ] } ] }, { "linkId": "7.4", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.4", "display": "Eyes:" } ], "text": "Eyes:", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.4.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.4.1", "display": "If Abnormal (Conjuntival):" } ], "text": "If Abnormal (Conjuntival):", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "display": "Pallor" } } ] }, { "linkId": "7.4.2", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.4.2", "display": "If Abnormal (Sclera):" } ], "text": "If Abnormal (Sclera):", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Jaundice" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Iritis" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Hemorrhage" } } ] }, { "linkId": "7.4.3", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.4.3", "display": "If Abnormal (Cornea):" } ], "text": "If Abnormal (Cornea):", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Kaiser Fleischer’s ring (Wilson Disease)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Xanthelasma" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Protruded eyeballs" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Periorbital edema" } } ] } ] }, { "linkId": "7.5", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.5", "display": "Fundoscopy" } ], "text": "Fundoscopy", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.5.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.5.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Absence of red reflex" } } ] }, { "linkId": "7.5.2", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.5.2", "display": "Optic Disc" } ], "text": "Optic Disc", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Swollen" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Pale" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Cup-Disc Ratio > 0.5" } } ] }, { "linkId": "7.5.3", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.5.3", "display": "Retina" } ], "text": "Retina", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Arteriolar narrowing" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Arteriovenous nicking" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Cotton-wool spots" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Exudates" } } ] }, { "linkId": "7.5.4", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.5.4", "display": "Macula" } ], "text": "Macula", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Exudates" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Pigmented" } } ] } ] }, { "linkId": "7.6", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.6", "display": "Snellen Eye Chart Score:" } ], "text": "Snellen Eye Chart Score:", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.6.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.6.1", "display": "If Abnormal (Right Eye):" } ], "text": "If Abnormal (Right Eye):", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "60/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "36/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "24/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "18/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "12/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "9/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "6/6" } } ] }, { "linkId": "7.6.2", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.6.2", "display": "If Abnormal (Left Eye):" } ], "text": "If Abnormal (Left Eye):", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "60/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "36/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "24/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "18/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "12/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "9/6" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "6/6" } } ] } ] }, { "linkId": "7.7", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.7", "display": "Lips:" } ], "text": "Lips:", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.7.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.7.1", "display": "If Abnormal (Lips):" } ], "text": "If Abnormal (Lips):", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Angular Stomatitis" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Ulceritis" } } ] }, { "linkId": "7.7.2", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.7.2", "display": "If Abnormal (Gums)" } ], "text": "If Abnormal (Gums)", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Gingivitis" } } ] } ] }, { "linkId": "7.8", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.8", "display": "Tongue:" } ], "text": "Tongue:", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.8.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.8.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Atrophic" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "glossitis" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Thrush" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Leukoplakia" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Tonsils" } } ] } ] }, { "linkId": "7.9", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.9", "display": "Neck" } ], "text": "Neck", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.9.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.9.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Lymphadenopathy" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Neck mass" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Skin lesion" } } ] } ] }, { "linkId": "7.10", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.10", "display": "Cardiorespiratory Examination" } ], "text": "Cardiorespiratory Examination", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.10.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.10.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Chest deformities" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Raised JVP" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Tracheal Deviation" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Displaced apex beat" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Peripheal edema" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Breath sound (Reduce air entry/Crepitations/Rhonci)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Heart sound (Murmur/Additional Heart Sound)" } } ] } ] }, { "linkId": "7.11", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.11", "display": "Abdominal Examination" } ], "text": "Abdominal Examination", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.11.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.11.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Scars" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Distension" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Prominent Veins" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Striae" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Bruises" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Pigmentation" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Visible Peristalsis" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "08", "display": "Mass" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "09", "display": "Bowel Sound (Reduce/Absence/Hyperactive)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "10", "display": "Bruits" } } ] } ] }, { "linkId": "7.12", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.12", "display": "Genital Examination" } ], "text": "Genital Examination", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.12.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.12.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Skin lesion" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Bleeding" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Discharges" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Anal fissure" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Anal fistula" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "External hemorrhoid, Prolapse (Uterovaginal (F)/ Rectal)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "07", "display": "Stools (Melena/Hematochezia)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "08", "display": "Mass" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "09", "display": "Enlarged Prostate" } } ] } ] }, { "linkId": "7.13", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.13", "display": "Musculoskeletal Examination" } ], "text": "Musculoskeletal Examination", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.13.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.13.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Muscle wasting" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Swelling" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Skin changes" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Scars" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Deformities" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Range of movement" } } ] } ] }, { "linkId": "7.14", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.14", "display": "Neurological Examination" } ], "text": "Neurological Examination", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Normal" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Abnormal" } } ], "item": [ { "linkId": "7.14.1", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "7.14.1", "display": "If Abnormal:" } ], "text": "If Abnormal:", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Muscle Tone (Hypertonia/Hypotonia)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Muscle Power (Score from 0-5)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Reflexes (Hyperreflex/Hyporeflex)" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Babinski (Present/Absent)" } } ] } ] } ] }, { "linkId": "8", "text": "Further Investigations", "type": "group", "required": false, "item": [ { "linkId": "8.1", "code": [ { "system": "http://hl7.org/fhir/StructureDefinition/Questionnaire", "code": "8.1", "display": "Urine dipstick" } ], "text": "Urine dipstick", "type": "string", "required": false }, { "linkId": "8.2", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "8.2", "display": "Urine FEME" } ], "text": "Urine FEME", "type": "string", "required": false }, { "linkId": "8.3", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "8.3", "display": "ECG" } ], "text": "ECG", "type": "string", "required": false }, { "linkId": "8.4", "code": [ { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "8.4", "display": "Haemoglobin" } ], "text": "Haemoglobin", "type": "string", "required": false } ] }, { "linkId": "9", "text": "Diagnosis", "type": "group", "required": false, "item": [ { "linkId": "9.1", "text": "Normal Healthy individual?", "type": "choice", "required": false, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "00", "display": "Yes" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "No" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "At risk" } } ] }, { "linkId": "9.2", "text": "Diagnosis", "type": "reference", "required": false, "repeats": true } ] }, { "linkId": "10", "text": "Management", "type": "group", "required": false, "item": [ { "linkId": "10.1", "text": "General management", "type": "choice", "required": false, "repeats": true, "answerOption": [ { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "01", "display": "Dietary advice" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "02", "display": "Smoking cessation" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "03", "display": "Physiotherapy" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "04", "display": "Physical activity advice" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "05", "display": "Alcohol cessation" } }, { "valueCoding": { "system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core", "code": "06", "display": "Referral" } } ] }, { "linkId": "10.2", "text": "Doctor’s notes", "type": "text", "required": false }, { "linkId": "10.3", "text": "Prescription", "type": "group", "required": false, "item": [ { "linkId": "10.3.1", "text": "Any medication prescribed?", "type": "reference", "required": false, "repeats": true } ] } ] }, { "linkId": "11", "text": "Verified by", "type": "group", "required": false, "item": [ { "linkId": "11.1", "text": "Officer incharge", "type": "string", "required": false }, { "linkId": "11.2", "text": "Registration Number/ IC number", "type": "string", "required": false } ] } ] }