FHIR IG analytics| Package | ca.on.oh-eforms |
| Resource Type | Questionnaire |
| Id | dr_garvey_chilopora_.json |
| FHIR Version | R4 |
| Source | https://simplifier.net/resolve?scope=ca.on.oh-eforms@1.0.0-ballot5&canonical=http://ontariohealth.ca/legacy/Questionnaire/dr-garvey-chilopora- |
| URL | http://ontariohealth.ca/legacy/Questionnaire/dr-garvey-chilopora- |
| Version | 0 |
| Status | active |
| Title | Dr. Chilopora eReferral Form [FINAL MAY 2022] |
| Realm | ca |
No resources found
No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "dr-garvey-chilopora-",
"contained": [
{
"resourceType": "Library",
"id": "liquid",
"status": "active",
"type": {
"coding": [
{
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/library-types",
"code": "qr-narrative-liquid"
}
]
},
"description": "HTML with embedded [FHIRPath Liquid](https://confluence.hl7.org/spaces/FHIR/pages/66938964/FHIR+Liquid+Profile) that is intended to be executed against QuestionnaireResponses based on this Questionnaire.",
"content": [
{
"contentType": "text/html",
"data": 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"
}
]
}
],
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm",
"valueCoding": {
"system": "http://hl7.org/fhir/version-algorithm",
"code": "semver"
}
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode",
"valueCode": "random"
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext",
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "patient"
}
},
{
"url": "type",
"valueCode": "Patient"
}
]
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "query-ptLatestVal.ht",
"language": "application/x-fhir-query",
"expression": "Observation?patient={{%patient.id}}&code=http%3A//loinc.org|8302-2&status=final,ammended&_sort=-date&_count=1"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptLatestVal.ht",
"language": "text/fhirpath",
"expression": "%`query-ptLatestVal.ht`.entry.resource.ofType(Observation).first().value.where(code='cm').value.toString()"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "query-ips",
"language": "application/x-fhir-query",
"expression": "Bundle?composition.patient={{%patient.id}}&composition.code=http%3A//loinc.org|60591-5&composition.status=final,ammended&_sort=-composition.date&_count=1"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptCpp.soc",
"language": "text/fhirpath",
"expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='29762-2')).text.div"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "query-ptLatestVal.wt",
"language": "application/x-fhir-query",
"expression": "Observation?patient={{%patient.id}}&code=http%3A//loinc.org|29463-7&status=final,ammended&_sort=-date&_count=1"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptLatestVal.wt",
"language": "text/fhirpath",
"expression": "%`query-ptLatestVal.wt`.entry.resource.ofType(Observation).first().value.where(code='kg').value.toString()"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptCpp.allg",
"language": "text/fhirpath",
"expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='48765-2')).text.div"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptCpp.pmhx",
"language": "text/fhirpath",
"expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='47519-4')).text.div"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptCpp.prob",
"language": "text/fhirpath",
"expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='11450-4')).text.div"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptCpp.rx",
"language": "text/fhirpath",
"expression": "%`query-ips`.entry.resource.first().section.where(code.coding.exists(code='http%3A//loinc.org' and code='46264-8')).text.div"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "query-ptCpp.fhx",
"language": "application/x-fhir-query",
"expression": "Observation?patient={{%patient.id}}&code=http%3A//loinc.org|10157-6&status=final,ammended&_sort=-date&_count=1"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "var-ptCpp.fhx",
"language": "text/fhirpath",
"expression": "%`query-ptCpp.fhx`.entry.resource.ofType(Observation).first().value"
}
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/sdc-responseRenderingLiquid",
"valueReference": {
"reference": "#liquid"
}
}
],
"url": "http://ontariohealth.ca/legacy/Questionnaire/dr-garvey-chilopora-",
"version": "0",
"title": "Dr. Chilopora eReferral Form [FINAL MAY 2022]",
"status": "active",
"experimental": false,
"subjectType": [
"Patient"
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "background-color:grey;border-style:solid;"
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info",
"extension": [
{
"url": "style",
"valueString": "font-weight:bold;text-decoration:underline;"
}
]
}
],
"linkId": "questionnaire",
"type": "group",
"item": [
{
"linkId": "item47143865",
"text": "* Indicates a required field",
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "font-weight:bold;"
}
]
},
"type": "display"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "background-color:white;border-style:solid;"
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info",
"extension": [
{
"url": "listSeparator",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString": "<br/>"
}
]
}
}
]
}
],
"linkId": "section47163071",
"text": "Patient Information",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%`var-ptLatestVal.ht`"
}
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
{
"url": "text",
"valueString": "Height (cm):"
}
]
}
],
"linkId": "item29578021",
"text": "Height (cm):",
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString": "Height (cm):<br/>"
}
]
},
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%`var-ptLatestVal.wt`"
}
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
{
"url": "text",
"valueString": "Weight (kg): "
}
]
}
],
"linkId": "item67890802",
"text": "Weight (kg):",
"_text": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString": "Weight (kg): <br/>"
}
]
},
"type": "string"
},
{
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"language": "text/fhirpath",
"expression": "item.where(linkId='prob').answer.exists()"
}
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
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"expression": "%`var-ptCpp.prob`"
}
}
],
"linkId": "prob",
"type": "text",
"enableBehavior": "all"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
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"expression": "%resource.repeat(item).where(linkId='prob').answer.empty()"
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}
],
"linkId": "section61677093",
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"item": [
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"linkId": "item4613718",
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},
"type": "display"
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{
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{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"code": "check-box"
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]
}
}
],
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"text": "High blood pressure",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
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]
}
}
],
"linkId": "item18948376",
"text": "Diabetes",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
}
]
}
}
],
"linkId": "item35434575",
"text": "Blood clots in lungs/legs",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
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]
}
}
],
"linkId": "item69273958",
"text": "Migraine headaches",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
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]
}
}
],
"linkId": "item47066864",
"text": "Liver disease/hepatitis",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"code": "check-box"
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]
}
}
],
"linkId": "item75358255",
"text": "Osteoporosis",
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},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
}
]
}
}
],
"linkId": "item41631847",
"text": "Infertility",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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}
}
],
"linkId": "item18292760",
"text": "Cancer",
"type": "boolean"
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{
"extension": [
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
{
"url": "answerStyle",
"valueString": "font-weight:bold;color:#AA0000;"
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}
],
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"answerBoolean": true
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],
"enableBehavior": "all",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"coding": [
{
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"code": "check-box"
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]
}
}
],
"linkId": "item77134898",
"text": "Thyroid problems",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
}
]
}
}
],
"linkId": "item880791",
"text": "Asthma",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
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]
}
}
],
"linkId": "item72238932",
"text": "Anxiety/ Depression",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
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]
}
}
],
"linkId": "item37884318",
"text": "Incontinence (urine/stool)",
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},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
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"code": "check-box"
}
]
}
}
],
"linkId": "item41904126",
"text": "Constipation",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
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]
}
}
],
"linkId": "item51470870",
"text": "Frequent bladder infections",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
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]
}
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
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"url": "enableWhenExpression",
"valueExpression": {
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"language": "text/fhirpath",
"expression": "false"
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}
]
}
],
"linkId": "item15815594",
"text": "Other",
"type": "boolean"
},
{
"extension": [
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
{
"url": "text",
"valueString": "Other: {{answer}}"
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]
}
],
"linkId": "item78475900",
"text": "Specify:",
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"operator": "=",
"answerBoolean": true
}
],
"enableBehavior": "all",
"required": true
}
]
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "background-color:white;border-style:solid;"
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info",
"extension": [
{
"url": "style",
"valueString": "font-weight:bold;text-decoration:underline;"
}
]
}
],
"linkId": "i_nmedications_n",
"text": "Medications",
"type": "group",
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{
"extension": [
{
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"valueExpression": {
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"expression": "%`var-ptCpp.rx`"
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}
],
"linkId": "rx",
"type": "text"
}
]
},
{
"extension": [
{
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"valueString": "background-color:white;border-style:solid;"
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{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info",
"extension": [
{
"url": "style",
"valueString": "font-weight:bold;"
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{
"url": "answerStyle",
"valueString": "font-weight:bold;color:#AA0000;"
}
]
}
],
"linkId": "allergies",
"text": "Allergies",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%`var-ptCpp.allg`"
}
}
],
"linkId": "allg",
"type": "text"
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "background-color:white;border-style:solid;"
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info",
"extension": [
{
"url": "style",
"valueString": "font-weight:bold;"
}
]
}
],
"linkId": "i_npast_medical_histo",
"text": "Past Medical History",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
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"expression": "%`var-ptCpp.pmhx`"
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}
],
"linkId": "pmhx",
"type": "text"
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "background-color:white;border-style:solid;"
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{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info",
"extension": [
{
"url": "style",
"valueString": "font-weight:bold;"
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{
"url": "lastSeparator",
"_valueString": {
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{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
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]
}
},
{
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"valueBoolean": false
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]
}
],
"linkId": "section68506771",
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"type": "group",
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{
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{
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"expression": "item.where(linkId='fhx').answer.exists()"
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},
{
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"expression": "%`var-ptCpp.fhx`"
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}
],
"linkId": "fhx",
"type": "text",
"enableBehavior": "all"
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{
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}
],
"linkId": "section48519309",
"type": "group",
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{
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"text": "Select all that apply:",
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"valueString": "font-style:italic;"
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]
},
"type": "display"
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{
"extension": [
{
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"valueCodeableConcept": {
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{
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"code": "check-box"
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]
}
}
],
"linkId": "item65894204",
"text": "High blood pressure",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
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"code": "check-box"
}
]
}
}
],
"linkId": "item82516489",
"text": "Heart Disease/Stroke",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
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"code": "check-box"
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]
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}
],
"linkId": "item30885585",
"text": "Diabetes",
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},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
}
]
}
}
],
"linkId": "item4088333",
"text": "Bad reaction to anesthetic",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
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"code": "check-box"
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]
}
}
],
"linkId": "item37784990",
"text": "Breast Cancer",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "check-box"
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]
}
}
],
"linkId": "item53504294",
"text": "Uterine Cancer",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
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"code": "check-box"
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]
}
}
],
"linkId": "item4801402",
"text": "Ovarian Cancer",
"type": "boolean"
},
{
"extension": [
{
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"valueCodeableConcept": {
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"code": "check-box"
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]
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}
],
"linkId": "item75842905",
"text": "Colon/Bowel Cancer",
"type": "boolean"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
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]
}
},
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
{
"url": "enableWhenExpression",
"valueExpression": {
"description": "false",
"language": "text/fhirpath",
"expression": "false"
}
}
]
}
],
"linkId": "item22994219",
"text": "Other Cancer(s)",
"type": "boolean"
},
{
"extension": [
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
{
"url": "text",
"valueString": "Other Cancer(s): {{answer}}"
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]
}
],
"linkId": "item29254997",
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"answerBoolean": true
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],
"enableBehavior": "all",
"required": true
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]
}
]
},
{
"extension": [
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"valueString": "background-color:white;border-style:solid;"
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{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/group-note-info",
"extension": [
{
"url": "style",
"valueString": "font-weight:bold;"
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]
}
],
"linkId": "i_nsocial_history_n",
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{
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{
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],
"linkId": "soc",
"type": "text",
"enableBehavior": "all"
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{
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},
{
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"extension": [
{
"url": "style",
"valueString": "font-weight:bold;text-decoration:underline;"
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{
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}
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],
"linkId": "section64573544",
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]
}
}
],
"linkId": "item57834583",
"text": "Smoker:",
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"answerOption": [
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"valueCoding": {
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{
"url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
"valueDecimal": 1
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],
"system": "http://ontariohealth.ca/legacy/CodeSystem/dr-garvey-chilopora-_item57834583",
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"display": "No"
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},
{
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"valueDecimal": 2
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],
"system": "http://ontariohealth.ca/legacy/CodeSystem/dr-garvey-chilopora-_item57834583",
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"display": "Yes"
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},
{
"valueCoding": {
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"url": "http://hl7.org/fhir/StructureDefinition/itemWeight",
"valueDecimal": 3
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],
"system": "http://ontariohealth.ca/legacy/CodeSystem/dr-garvey-chilopora-_item57834583",
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"display": "Ex-Smoker"
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}
]
},
{
"linkId": "item10529961",
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"code": "Yes",
"display": "Yes"
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}
],
"enableBehavior": "all"
},
{
"linkId": "item44127211",
"text": "Number of cigarettes per day:",
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"enableWhen": [
{
"question": "item57834583",
"operator": "=",
"answerCoding": {
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"code": "Yes",
"display": "Yes"
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}
],
"enableBehavior": "all"
},
{
"linkId": "item41506070",
"text": "Quit date:",
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"question": "item57834583",
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"answerCoding": {
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}
],
"enableBehavior": "all"
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{
"linkId": "item151992",
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{
"valueCoding": {
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"display": "Yes"
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{
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"code": "N",
"display": "No"
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}
]
},
{
"linkId": "item94627251",
"text": "Number of drinks per week on average:",
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{
"question": "item151992",
"operator": "=",
"answerCoding": {
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"code": "Y",
"display": "Yes"
}
}
],
"enableBehavior": "all"
},
{
"extension": [
{
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/question-note-info",
"extension": [
{
"url": "answerStyle",
"valueString": "font-weight:bold;color:#A6A900;"
}
]
}
],
"linkId": "item93764222",
"text": "Uses recreational and/or street drugs:",
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"answerOption": [
{
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/v2-0532",
"code": "Y",
"display": "Yes"
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