| Package | fhir.giis |
| Resource Type | Questionnaire |
| Id | ESAVIQuestionnaire |
| FHIR Version | R4 |
| Source | https://paho.org/fhir/giis/https://build.fhir.org/ig/cens-chile/giis_fhir_IG/Questionnaire-ESAVIQuestionnaire.html |
| URL | https://paho.org/fhir/giis/Questionnaire/ESAVIQuestionnaire |
| Version | 0.1.8 |
| Status | draft |
| Date | 2025-07-23T19:39:25+00:00 |
| Name | GIIS-QuestionnaireESAVI |
| Title | ESAVI Questionnaire for GIIS |
| Realm | us |
| Authority | hl7 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire ESAVIQuestionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  GIIS-QuestionnaireESAVI | Questionnaire | https://paho.org/fhir/giis/Questionnaire/ESAVIQuestionnaire#0.1.8 | ||
  datosIdVacunado | Demographic data of the vaccinated that has generated an ESAVI | 1..1 | group | |
 datosPaciente | Vaccinated patient data | 1..1 | group | |
 numeroCaso | UUID that identifies the case or notification. A person can have more than one notification. | 0..1 | string | |
| idPaciente | UUID Identification of the person vaccinated/affected by ESAVI | 0..1 | string | |
 sexoPaciente | Patient's gender | 0..1 | choice | Value Set: AdministrativeGender |
  fechaNacimiento | Patient's birthdate | 0..1 | date | |
| antecedentesEnfermedadesPrevias | History of previous illnesses | 0..1 | group | |
 descripcionEnfPrevia | Description of the previous health problems of the patient affected by the ESAVI with emphasis on comorbidities or diseases concomitant to the adverse event, previous similar events and medical events relevant to the current health event (if the disease is coded, it is the description corresponding to the code). | 1..1 | string | |
| antecedentesFarmacosVacunas | Pharmacological Historys | 1..1 | group | |
| datosVacunas | Data of the administered vaccines | 0..1 | group | |
| nombreVacuna | Name of the vaccine administered | 0..1 | string | |
| codigoVacunaOtro | Vaccine code | 1..1 | choice | Value Set: Other Vaccine codes |
 numeroDosisVacuna | Ordinal number of the administered dose | 0..1 | integer | |
| datosVacunacion | Data related to the vaccination process | 0..1 | group | |
| nombreVacunatorio | Vacunatory's name | 0..1 | string | |
| codigoVacunatorio | Code of the institution where the vaccine was administered | 0..1 | integer | |
| tipoVacunacion | Data related to a vaccination ID | 1..1 | group | |
| vaccinationEventCalendarId | Id of a GIIS calendarized vaccination event | 0..1 | integer | |
| vaccinationEventId | Id of a NON calendarized GIIS vaccination event | 0..1 | integer | |
| registroESAVI | ESAVI registry developed by the vaccinated | 1..1 | group | |
| datosESAVI | Information on ESAVI and its classification according to severity | 1..1 | group | |
| nombreESAVI | ESAVI name | 1..* | choice | Value Set: Adverse Event codes |
| fechaESAVI | ESAVI start date referred by the patient or identified by the physician | 1..1 | date | |
| descripcionESAVI | Narrative description of ESAVI | 0..1 | string | |
| estadoPacienteESAVI | Health status of the patient related with this ESAVI event | 0..1 | choice | Value Set: Patient Status related to an AEFI codes |
| AEFIRecordCreatorID | Id of the AEFI record creator | 0..1 | integer | |
| AEFIRecordCreatorName | Name of the AEFI record creator | 0..1 | string | |
| gravedadESAVI | Determination of the severity status of ESAVI | 1..1 | group | |
| tipoGravedad | Is the ESAVI Serious? | 1..1 | choice | Value Set: Adverse Event severity codes |
| Documentation for this format | ||||
FHIR{
"resourceType": "Questionnaire",
"id": "ESAVIQuestionnaire",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "https://paho.org/fhir/giis/Questionnaire/ESAVIQuestionnaire",
"version": "0.1.8",
"name": "GIIS-QuestionnaireESAVI",
"title": "ESAVI Questionnaire for GIIS",
"status": "draft",
"date": "2025-07-23T19:39:25+00:00",
"publisher": "CENS",
"contact": [
{
"name": "CENS",
"telecom": [
{
"system": "url",
"value": "https://www.cens.cl"
}
]
}
],
"jurisdiction": [
{
"coding": [
{
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code": "001"
}
]
}
],
"item": [
{
"linkId": "datosIdVacunado",
"text": "Demographic data of the vaccinated that has generated an ESAVI",
"type": "group",
"required": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/minValue",
"valueDate": "1900-01-01"
}
],
"linkId": "datosPaciente",
"text": "Vaccinated patient data",
"type": "group",
"required": true,
"item": [
{
"linkId": "numeroCaso",
"text": "UUID that identifies the case or notification. A person can have more than one notification.",
"type": "string",
"required": false
},
{
"linkId": "idPaciente",
"text": "UUID Identification of the person vaccinated/affected by ESAVI",
"type": "string",
"required": false
},
{
"linkId": "sexoPaciente",
"text": "Patient's gender",
"type": "choice",
"required": false,
"answerValueSet": "http://hl7.org/fhir/ValueSet/administrative-gender"
},
{
"linkId": "fechaNacimiento",
"text": "Patient's birthdate",
"type": "date",
"required": false
}
]
},
{
"linkId": "antecedentesEnfermedadesPrevias",
"text": "History of previous illnesses",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "descripcionEnfPrevia",
"text": "Description of the previous health problems of the patient affected by the ESAVI with emphasis on comorbidities or diseases concomitant to the adverse event, previous similar events and medical events relevant to the current health event (if the disease is coded, it is the description corresponding to the code).",
"type": "string",
"required": true
}
]
}
]
},
{
"linkId": "antecedentesFarmacosVacunas",
"text": "Pharmacological Historys",
"type": "group",
"required": true,
"item": [
{
"linkId": "datosVacunas",
"text": "Data of the administered vaccines",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "nombreVacuna",
"text": "Name of the vaccine administered",
"type": "string",
"required": false
},
{
"linkId": "codigoVacunaOtro",
"text": "Vaccine code",
"type": "choice",
"required": true,
"answerValueSet": "https://paho.org/fhir/giis/ValueSet/OtherVaccineVS"
},
{
"linkId": "numeroDosisVacuna",
"text": "Ordinal number of the administered dose",
"type": "integer",
"required": false
}
]
},
{
"linkId": "datosVacunacion",
"text": "Data related to the vaccination process",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "nombreVacunatorio",
"text": "Vacunatory's name",
"type": "string",
"required": false
},
{
"linkId": "codigoVacunatorio",
"text": "Code of the institution where the vaccine was administered",
"type": "integer",
"required": false
}
]
}
]
},
{
"linkId": "tipoVacunacion",
"text": "Data related to a vaccination ID",
"type": "group",
"required": true,
"repeats": false,
"item": [
{
"linkId": "vaccinationEventCalendarId",
"text": "Id of a GIIS calendarized vaccination event",
"type": "integer",
"required": false
},
{
"linkId": "vaccinationEventId",
"text": "Id of a NON calendarized GIIS vaccination event",
"type": "integer",
"required": false
}
]
},
{
"linkId": "registroESAVI",
"text": "ESAVI registry developed by the vaccinated",
"type": "group",
"required": true,
"item": [
{
"linkId": "datosESAVI",
"text": "Information on ESAVI and its classification according to severity",
"type": "group",
"required": true,
"repeats": false,
"item": [
{
"linkId": "nombreESAVI",
"text": "ESAVI name",
"type": "choice",
"required": true,
"repeats": true,
"answerValueSet": "https://paho.org/fhir/giis/ValueSet/AEFINameVS"
},
{
"linkId": "fechaESAVI",
"text": "ESAVI start date referred by the patient or identified by the physician",
"type": "date",
"required": true
},
{
"linkId": "descripcionESAVI",
"text": "Narrative description of ESAVI",
"type": "string",
"required": false
},
{
"linkId": "estadoPacienteESAVI",
"text": "Health status of the patient related with this ESAVI event",
"type": "choice",
"required": false,
"answerValueSet": "https://paho.org/fhir/giis/ValueSet/AEFIPatientStatusVS"
},
{
"linkId": "AEFIRecordCreatorID",
"text": "Id of the AEFI record creator",
"type": "integer",
"required": false
},
{
"linkId": "AEFIRecordCreatorName",
"text": "Name of the AEFI record creator",
"type": "string",
"required": false
}
]
},
{
"linkId": "gravedadESAVI",
"text": "Determination of the severity status of ESAVI",
"type": "group",
"required": true,
"item": [
{
"linkId": "tipoGravedad",
"text": "Is the ESAVI Serious?",
"type": "choice",
"required": true,
"answerValueSet": "https://paho.org/fhir/giis/ValueSet/AEFISeverityVS"
}
]
}
]
}
]
}