FHIR © HL7.org  |  Server Home  |  XIG Home  |  XIG Stats  |  Server Source  |  FHIR  

FHIR IG Statistics: Questionnaire/MemoryAndThinking

Packagecsiro.fhir.au.smartforms
Resource TypeQuestionnaire
IdMemoryAndThinking
FHIR VersionR4
Sourcehttps://smartforms.csiro.au/ig/https://build.fhir.org/ig/aehrc/smart-forms-ig/Questionnaire-MemoryAndThinking.html
URLhttp://www.health.gov.au/assessments/mbs/715/MemoryAndThinking
Version0.3.0
Statusdraft
Date2025-03-14
NameMemoryAndThinking
TitleAboriginal and Torres Strait Islander Health Check - Memory And Thinking
Realmau
CopyrightCopyright © 2022+ Australian Government Department of Health and Aged Care - All rights reserved. This content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. See https://creativecommons.org/licenses/by-sa/4.0/.

Resources that use this resource

No resources found


Resources that this resource uses

No resources found


Narrative

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

Generated Narrative: Questionnaire MemoryAndThinking

LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. MemoryAndThinkingQuestionnairehttp://www.health.gov.au/assessments/mbs/715/MemoryAndThinking#0.3.0
... 1bd58e7b-2cb7-45fb-965f-d5fa33d0bb4cMemory and thinking0..1group
.... CD-in-progress-18In progress0..1displayEnable When: MarkComplete-18 !=
.... CD-complete-18Complete0..1displayEnable When: MarkComplete-18 =
.... 64fd0c95-b57b-4319-bf40-ad77d10a9832Personal concerns about your memory or thinking0..1group
..... e29701be-2b79-471d-a42e-7e3830459080Do you have any worries about your memory or thinking?0..1choiceiconiconValue Set: Yes/No
..... 69985e2e-4619-42fa-a111-e6fb3118ef74Details0..1textEnable When: e29701be-2b79-471d-a42e-7e3830459080 =
.... 44da9ba8-4636-4eaa-8bb1-aaa65f117fabFamily concerns about your memory or thinking0..1group
..... 06a67326-9e3d-4c4c-b271-af5b168d077cDoes anyone in your family have any worries about your memory or thinking?0..1choiceiconiconValue Set: Yes/No
..... 43d2cb6c-29a7-4293-a6c8-87a228a82e19Details0..1textEnable When: 06a67326-9e3d-4c4c-b271-af5b168d077c =
.... 4ebb3c30-936b-4932-a330-f1e643b5ccd4If any concerns are raised and/or high risk for cognitive impairment identified, follow up with cognitive screening (eg clock test, GPCOG, KICA-Cog, MMSE)0..1text
..... c563f52d-d3cc-4687-9863-0f1b7d00d942Details0..1display
.... 1f0e7fde-e964-4f36-9151-dbdc5e145f94Health priorities, actions and follow-up0..1text
.... MarkComplete-18Mark section as complete0..1boolean

doco Documentation for this format

Contained Resources


ValueSet #YesNo

Expansion based on codesystem expandedYes-NoIndicator v2.1.0 (CodeSystem)

This value set contains 2 concepts

CodeSystemDisplay (en-US)Definition
  Yhttp://terminology.hl7.org/CodeSystem/v2-0532YesYes
  Nhttp://terminology.hl7.org/CodeSystem/v2-0532NoNo

Source

{
  "resourceType": "Questionnaire",
  "id": "MemoryAndThinking",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-render",
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-modular"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "ValueSet",
      "id": "YesNo",
      "url": "https://smartforms.csiro.au/ig/ValueSet/YesNo",
      "name": "YesNo",
      "title": "Yes/No",
      "status": "draft",
      "experimental": false,
      "description": "Concepts for Yes and No",
      "compose": {
        "include": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
            "concept": [
              {
                "code": "Y",
                "display": "Yes"
              },
              {
                "code": "N",
                "display": "No"
              }
            ]
          }
        ]
      },
      "expansion": {
        "identifier": "urn:uuid:41cccc66-fd57-4bc4-bab1-8c5c878d95f7",
        "timestamp": "2025-05-01T10:00:50+10:00",
        "total": 2,
        "offset": 0,
        "parameter": [
          {
            "name": "displayLanguage",
            "valueCode": "en-US"
          },
          {
            "name": "count",
            "valueInteger": 1000
          },
          {
            "name": "offset",
            "valueInteger": 0
          },
          {
            "name": "excludeNested",
            "valueBoolean": false
          },
          {
            "name": "used-codesystem",
            "valueUri": "http://terminology.hl7.org/CodeSystem/v2-0532|2.1.0"
          }
        ],
        "contains": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
            "code": "Y",
            "display": "Yes"
          },
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
            "code": "N",
            "display": "No"
          }
        ]
      }
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assemble-expectation",
      "valueCode": "assemble-child"
    },
    {
      "extension": [
        {
          "url": "name",
          "valueCoding": {
            "system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
            "code": "patient"
          }
        },
        {
          "url": "type",
          "valueCode": "Patient"
        },
        {
          "url": "description",
          "valueString": "The patient that is to be used to pre-populate the form"
        }
      ],
      "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": "user"
          }
        },
        {
          "url": "type",
          "valueCode": "Practitioner"
        },
        {
          "url": "description",
          "valueString": "The practitioner user that is to be used to pre-populate the form"
        }
      ],
      "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": "encounter"
          }
        },
        {
          "url": "type",
          "valueCode": "Encounter"
        },
        {
          "url": "description",
          "valueString": "The encounter that is to be used to pre-populate the form"
        }
      ],
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
    },
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembleContext",
      "valueString": "age"
    },
    {
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]",
      "valueCoding": {
        "system": "http://hl7.org/fhir/version-algorithm",
        "code": "semver"
      }
    }
  ],
  "url": "http://www.health.gov.au/assessments/mbs/715/MemoryAndThinking",
  "version": "0.3.0",
  "name": "MemoryAndThinking",
  "title": "Aboriginal and Torres Strait Islander Health Check - Memory And Thinking",
  "status": "draft",
  "experimental": false,
  "subjectType": [
    "Patient"
  ],
  "date": "2025-03-14",
  "publisher": "AEHRC CSIRO",
  "contact": [
    {
      "name": "AEHRC CSIRO",
      "telecom": [
        {
          "system": "url",
          "value": "https://confluence.csiro.au/display/PCDQFPhase2/Primary+Care+Data+Quality+Foundations+-+Phase+2"
        }
      ]
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "AU",
          "display": "Australia"
        }
      ]
    }
  ],
  "copyright": "Copyright © 2022+ Australian Government Department of Health and Aged Care - All rights reserved.\nThis content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.\nSee https://creativecommons.org/licenses/by-sa/4.0/.\n",
  "item": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
          "valueExpression": {
            "language": "text/fhirpath",
            "expression": "%age >= 50"
          }
        }
      ],
      "linkId": "1bd58e7b-2cb7-45fb-965f-d5fa33d0bb4c",
      "text": "Memory and thinking",
      "type": "group",
      "repeats": false,
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "https://smartforms.csiro.au/ig/CodeSystem/QuestionnaireItemControlExtended",
                    "code": "context-display"
                  }
                ]
              }
            }
          ],
          "linkId": "CD-in-progress-18",
          "text": "In progress",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<div title=\"In progress\" xmlns=\"http://www.w3.org/1999/xhtml\">\r\n\t<div style=\"display: flex; flex-direction: row;\">\r\n\t\t<img width='24' height='24' src='data:image/svg+xml;base64,\r\n\t\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' \r\n\t\tstyle=\"align-self: center;\"/>\r\n\t</div>\r\n</div>"
              }
            ]
          },
          "type": "display",
          "enableWhen": [
            {
              "question": "MarkComplete-18",
              "operator": "!=",
              "answerBoolean": true
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "https://smartforms.csiro.au/ig/CodeSystem/QuestionnaireItemControlExtended",
                    "code": "context-display"
                  }
                ]
              }
            }
          ],
          "linkId": "CD-complete-18",
          "text": "Complete",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<div title=\"Section completed\" xmlns=\"http://www.w3.org/1999/xhtml\">\r\n\t<div style=\"display: flex; flex-direction: row;\">\r\n\t\t<img width='24' height='24' src='data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIxZW0iIGhlaWdodD0iMWVtIiB2aWV3Qm94PSIwIDAgMjQgMjQiPjxwYXRoIGZpbGw9IiMyZTdkMzIiIGQ9Ik0yMCAxMmE4IDggMCAwIDEtOCA4YTggOCAwIDAgMS04LThhOCA4IDAgMCAxIDgtOGMuNzYgMCAxLjUuMTEgMi4yLjMxbDEuNTctMS41N0E5LjgyMiA5LjgyMiAwIDAgMCAxMiAyQTEwIDEwIDAgMCAwIDIgMTJhMTAgMTAgMCAwIDAgMTAgMTBhMTAgMTAgMCAwIDAgMTAtMTBNNy45MSAxMC4wOEw2LjUgMTEuNUwxMSAxNkwyMSA2bC0xLjQxLTEuNDJMMTEgMTMuMTdsLTMuMDktMy4wOVoiLz48L3N2Zz4='\r\n\t\tstyle=\"align-self: center;\"/>\r\n\t</div>\r\n</div>"
              }
            ]
          },
          "type": "display",
          "enableWhen": [
            {
              "question": "MarkComplete-18",
              "operator": "=",
              "answerBoolean": true
            }
          ]
        },
        {
          "linkId": "64fd0c95-b57b-4319-bf40-ad77d10a9832",
          "text": "Personal concerns about your memory or thinking",
          "type": "group",
          "repeats": false,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "radio-button"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "e29701be-2b79-471d-a42e-7e3830459080",
              "text": "Do you have any worries about your memory or thinking?",
              "type": "choice",
              "repeats": false,
              "answerValueSet": "#YesNo"
            },
            {
              "linkId": "69985e2e-4619-42fa-a111-e6fb3118ef74",
              "text": "Details",
              "type": "text",
              "enableWhen": [
                {
                  "question": "e29701be-2b79-471d-a42e-7e3830459080",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                    "code": "Y"
                  }
                }
              ],
              "repeats": false
            }
          ]
        },
        {
          "linkId": "44da9ba8-4636-4eaa-8bb1-aaa65f117fab",
          "text": "Family concerns about your memory or thinking",
          "type": "group",
          "repeats": false,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "radio-button"
                      }
                    ]
                  }
                },
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
                  "valueCode": "horizontal"
                }
              ],
              "linkId": "06a67326-9e3d-4c4c-b271-af5b168d077c",
              "text": "Does anyone in your family have any worries about your memory or thinking?",
              "type": "choice",
              "repeats": false,
              "answerValueSet": "#YesNo"
            },
            {
              "linkId": "43d2cb6c-29a7-4293-a6c8-87a228a82e19",
              "text": "Details",
              "type": "text",
              "enableWhen": [
                {
                  "question": "06a67326-9e3d-4c4c-b271-af5b168d077c",
                  "operator": "=",
                  "answerCoding": {
                    "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                    "code": "Y"
                  }
                }
              ],
              "repeats": false
            }
          ]
        },
        {
          "linkId": "4ebb3c30-936b-4932-a330-f1e643b5ccd4",
          "text": "If any concerns are raised and/or high risk for cognitive impairment identified, follow up with cognitive screening (eg clock test, GPCOG, KICA-Cog, MMSE)",
          "type": "text",
          "repeats": false,
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "prompt"
                      }
                    ]
                  }
                }
              ],
              "linkId": "c563f52d-d3cc-4687-9863-0f1b7d00d942",
              "text": "Details",
              "type": "display"
            }
          ]
        },
        {
          "linkId": "1f0e7fde-e964-4f36-9151-dbdc5e145f94",
          "text": "Health priorities, actions and follow-up",
          "type": "text",
          "repeats": false
        },
        {
          "linkId": "MarkComplete-18",
          "text": "Mark section as complete",
          "_text": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
                "valueString": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\r\n<head>\r\n    <style type=\"text/css\">\r\n        .alert {\r\n            padding: 0.875rem;\r\n            margin-bottom: 1rem;\r\n            font-size: 0.875rem;\r\n            color: #29712D;\r\n            border-radius: 0.5rem;\r\n            background-color: #D9E8DA;\r\n            font-weight: 700;\r\n        max-width: 205px;\r\n        }\r\n    </style>\r\n</head>\r\n<body>\r\n<div class=\"alert\">Mark section as complete</div>\r\n</body>\r\n</div>"
              }
            ]
          },
          "type": "boolean",
          "repeats": false
        }
      ]
    }
  ]
}