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Packageca.on.oh.setp.iar.dev
Resource TypeQuestionnaire
IdQuestionnaire-iar-preliminary-prescreener-v.2.0.0-oh.json
FHIR VersionR4
Sourcehttps://simplifier.net/resolve?scope=ca.on.oh.setp.iar.dev@1.0.0-ballot1-dev&canonical=http://ontariohealth.ca/fhir/iar/Questionnaire/oh-interrai-preliminary-screener-primary-community-care-settings
URLhttp://ontariohealth.ca/fhir/iar/Questionnaire/oh-interrai-preliminary-screener-primary-community-care-settings
Version1.0.0_OH
Statusactive
Date2026-02-01T21:47:22.96+00:00
TitleinterRAI™ Preliminary Screener for Primary and Community Care Settings (PS) 1.0.0_OH
Realmca
Authorityhl7
DescriptionThis assessment is the interRAI™ Preliminary Screener for Primary and Community Care Settings (PS) version 1.0_OH. The core content of the assessment was developed by interRAI with modifications from Ontario Health. The FHIR artifact is maintained and published by Ontario Health.

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Source1

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  "version": "1.0.0_OH",
  "title": "interRAI™ Preliminary Screener for Primary and Community Care Settings (PS) 1.0.0_OH",
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  "approvalDate": "2026-01-09",
  "effectivePeriod": {
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  },
  "subjectType": [
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      "display": "interRAI Preliminary Screener"
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      "text": "Section A: Identification Information",
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              "text": "Jr/Sr",
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              "linkId": "A2b",
              "text": "Gender Identity",
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          ],
          "linkId": "A3",
          "text": "Birthdate",
          "prefix": "3."
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        {
          "linkId": "A4",
          "text": "Numeric identifiers",
          "prefix": "4.",
          "type": "group",
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              "type": "text",
              "linkId": "A4c",
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        {
          "linkId": "A5",
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              "linkId": "A5a",
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            {
              "type": "string",
              "linkId": "A5b",
              "text": "Postal Code of usual living arrangement",
              "prefix": "b."
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        {
          "type": "text",
          "linkId": "A6",
          "text": "Facility/Agency Identifier",
          "prefix": "6."
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          "linkId": "A7",
          "text": "Primary Language",
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          "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/languages"
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          "linkId": "A8",
          "text": "Interpreter Need",
          "prefix": "8.",
          "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no"
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        {
          "type": "text",
          "linkId": "A9",
          "text": "Reasons for Referral",
          "prefix": "9."
        },
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          "type": "date",
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          ],
          "linkId": "A10",
          "text": "Assessment Rerference Date",
          "prefix": "10."
        },
        {
          "linkId": "A11",
          "text": "Indigenous Identity",
          "prefix": "11.",
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              "linkId": "A11a",
              "text": "First Nations",
              "prefix": "a.",
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            },
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              "type": "choice",
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              ],
              "linkId": "A11b",
              "text": "Metis",
              "prefix": "b.",
              "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/indigenous-identity"
            },
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              ],
              "linkId": "A11c",
              "text": "Inuit",
              "prefix": "c.",
              "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/indigenous-identity"
            }
          ]
        },
        {
          "type": "choice",
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            }
          ],
          "linkId": "A12",
          "text": "Ethnicty and Race",
          "prefix": "12.",
          "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/ethnicity-race"
        },
        {
          "type": "text",
          "linkId": "Anote",
          "maxLength": 4000,
          "text": "Notes"
        }
      ]
    },
    {
      "linkId": "B",
      "text": "Section B: Screener",
      "type": "group",
      "_text": {
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          ],
          "linkId": "B1",
          "text": "Cognitive Skills for Daily Decision Making",
          "prefix": "1.",
          "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-daily-decision-making2"
        },
        {
          "linkId": "B2",
          "text": "ADL Self Performance",
          "prefix": "2.",
          "type": "group",
          "item": [
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              "type": "choice",
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              ],
              "linkId": "B2a",
              "text": "Bathing",
              "prefix": "a.",
              "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/adl-self-performance"
            },
            {
              "type": "choice",
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                }
              ],
              "linkId": "B2b",
              "text": "Personal Hygiene",
              "prefix": "b.",
              "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/adl-self-performance"
            },
            {
              "type": "choice",
              "extension": [
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                  }
                }
              ],
              "linkId": "B2c",
              "text": "Dressing Lower Body",
              "prefix": "c.",
              "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/adl-self-performance"
            },
            {
              "type": "choice",
              "extension": [
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              ],
              "linkId": "B2d",
              "text": "Locomotion",
              "prefix": "d.",
              "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/adl-self-performance"
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        },
        {
          "type": "choice",
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          ],
          "linkId": "B3",
          "text": "Dyspnea (Shortness of Breath)",
          "prefix": "3.",
          "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/dyspnea"
        },
        {
          "type": "choice",
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          "linkId": "B4",
          "text": "Self Reported Health - In general, how would you rate your health?",
          "prefix": "4.",
          "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/self-reported-health"
        },
        {
          "linkId": "B5",
          "text": "Instablity of Conditions",
          "prefix": "5.",
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              "linkId": "B5a",
              "text": "Conditions/diseases make cognitive, ADL, mood, or behaviour patterns unstable (fluctuating, precarious, or deteriorating)",
              "prefix": "a.",
              "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no"
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              ],
              "linkId": "B5b",
              "text": "Experiencing an acute episode, or a flare-up of a recurrent or chronic problem",
              "prefix": "b.",
              "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no"
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          "linkId": "B6",
          "text": "Self-Reported Mood",
          "prefix": "6.",
          "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no-or-na-could-not-respond"
        },
        {
          "linkId": "B7",
          "text": "Informal Helper Status",
          "prefix": "7.",
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              ],
              "linkId": "B7a",
              "text": "Primary informal helper expresses feelings of distress, anger, or depression",
              "prefix": "a.",
              "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no"
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              "type": "choice",
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              ],
              "linkId": "B7b",
              "text": "Family or close friends report feeling overwhelmed by person’s illness",
              "prefix": "b.",
              "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no"
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          ]
        },
        {
          "type": "text",
          "linkId": "Bnote",
          "maxLength": 4000,
          "text": "Notes"
        }
      ]
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    {
      "linkId": "C",
      "text": "Section C: Summary",
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              "valueDecimal": 1
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
              "valueDecimal": 6
            }
          ],
          "linkId": "C1",
          "text": "Assessment Urgeny Algorithm",
          "prefix": "1."
        },
        {
          "type": "choice",
          "extension": [
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              }
            }
          ],
          "linkId": "C2",
          "text": "InterRAI CHA Assessment Required",
          "prefix": "2.a.",
          "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no"
        },
        {
          "type": "choice",
          "extension": [
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                ]
              }
            }
          ],
          "linkId": "C2b",
          "text": "Client Agrees to have interRAI CHA Completed",
          "prefix": "2.b.",
          "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no-not-applicable"
        },
        {
          "type": "string",
          "linkId": "C3a",
          "text": "Signature of Person Coordinating /Completing the Assessment",
          "prefix": "3."
        },
        {
          "type": "date",
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/entryFormat",
              "valueString": "yyyy/MM/dd"
            }
          ],
          "linkId": "C3b",
          "text": "Date Screener Signed as Complete**"
        },
        {
          "type": "text",
          "linkId": "Cnote",
          "maxLength": 4000,
          "text": "Notes"
        }
      ]
    },
    {
      "linkId": "D",
      "text": "Outcomes",
      "type": "group",
      "_text": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
            "valueString": "<b>Outcomes</b>"
          }
        ]
      },
      "item": [
        {
          "linkId": "O1",
          "text": "OUTCOMES",
          "type": "group",
          "item": [
            {
              "type": "choice",
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "drop-down",
                        "display": "Drop down"
                      }
                    ]
                  }
                }
              ],
              "linkId": "O1a",
              "text": "Self Reliance Index",
              "answerValueSet": "http://ontariohealth.ca/fhir/iar/ValueSet/self-reliance-index"
            },
            {
              "type": "integer",
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/minValue",
                  "valueDecimal": 1
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/maxValue",
                  "valueDecimal": 6
                }
              ],
              "linkId": "O1b",
              "text": "Assessment Urgeny Algorithm",
              "prefix": "1."
            },
            {
              "type": "choice",
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "radio-button",
                        "display": "Radio Button"
                      }
                    ]
                  }
                }
              ],
              "linkId": "O1c",
              "text": "InterRAI CHA Assessment Required",
              "answerValueSet": "http://cihi.ca/fhir/irrs/ValueSet/irrs-yes-no"
            }
          ]
        }
      ]
    }
  ]
}