FHIR IG analytics| Package | fhir.surveillanceIG |
| Resource Type | Questionnaire |
| Id | Questionnaire-VlCase.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/IntelliSOFT-Consulting/Surveillance-FHIR-IG/Questionnaire-VlCase.html |
| URL | http://example.org/Questionnaire/VlCase |
| Version | 0.1.0 |
| Status | draft |
| Date | 2026-05-04T06:19:40+00:00 |
| Title | VL Surveillance |
| Realm | us |
| Authority | hl7 |
| Description | Visceral Leishmaniasis surveillance case questionnaire |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire VlCase
Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  | Visceral Leishmaniasis surveillance case questionnaire | Questionnaire | http://example.org/Questionnaire/VlCase#0.1.0 | ||
  151479012557 | PRESENTATION PHASE | 0..1 | group | ||
  546255966914 | Hospital/Facility Location | 0..1 | display | ||
 user_role | User Role | 0..1 | string |  | |
| user_facility | User Facility | 0..1 | string | | |
| user_ward | User Ward | 0..1 | string | | |
| user_sub_county | User Sub County | 0..1 | string | | |
| user_county | User County | 0..1 | string | | |
| facility_level | null | 0..1 | group | Enable When: user_role = VACCINATOR | |
 294367770999 | County | 1..1 | reference | ||
| 819946803642 | Sub County | 1..1 | reference | ||
| 819943434 | Ward | 1..1 | reference | ||
| 819946803677 | Health Facility | 1..1 | reference | ||
  438862163919 | Type of health facility | 1..1 | choice | Options: 3 options | |
| sub_county_level | null | 0..1 | group | Enable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER | |
| 294367770999_sub_county | County | 1..1 | reference | ||
| 819946803642_sub_county | Sub County | 1..1 | reference | ||
| 819943434_sub_county | Ward | 1..1 | reference | ||
| 819946803677_sub_county | Health Facility | 1..1 | reference | ||
| 438862163919_sub_county | Type of health facility | 1..1 | choice | Options: 3 options | |
| county_level | null | 0..1 | group | Enable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER | |
| 294367770999_county | County | 1..1 | reference | ||
| 819946803642_county | Sub County | 1..1 | reference | ||
| 819943434_county | Ward | 1..1 | reference | ||
| 819946803677_county | Health Facility | 1..1 | reference | ||
| 438862163919_county | Type of health facility | 1..1 | choice | Options: 3 options | |
| national_level | null | 0..1 | group | Enable When: user_role = ADMINISTRATOR | |
| 294367770999_national | County | 1..1 | reference | ||
| 819946803642_national | Sub County | 1..1 | reference | ||
| 819943434_national | Ward | 1..1 | reference | ||
| 819946803677_national | Health Facility | 1..1 | reference | ||
| 438862163919_national | Type of health facility | 1..1 | choice | Options: 3 options | |
 185890957847 | Date of Diagnosis | 1..1 | date | ||
| 565301843046 | Case Information | 0..1 | group | ||
| 123103147447 | IP/OP Number | 1..1 | string | ||
| 817903655885 | Patient First Name | 1..1 | string | ||
| 164840483828 | Patient Middle Name | 0..1 | string | ||
| 606848143908 | Patient Family Name | 1..1 | string | ||
| 760016167922 | Patient Mobile Contact | 0..1 | string | ||
| 123456678 | 07xxxxxxxx | 0..1 | display | ||
| 442636360588 | Date of Birth known or unknown? | 0..1 | choice |  | Options: 2 options |
| 257830485990 | Date of Birth | 1..1 | date | Enable When: 442636360588 = Known (known) | |
| age-at-onset | Age at Onset | 0..1 | string | | Initial Value: string = 0 |
 492731638700 | Age in Years | 1..1 | integer | Enable When: 442636360588 = Unknown (unknown) | |
| 185726989867 | Age in Months | 0..1 | integer | Enable When: 442636360588 = Unknown (unknown) | |
| 828303331247 | Age in Days | 0..1 | integer | Enable When: 442636360588 = Unknown (unknown) | |
| 543806612685 | Gender | 1..1 | choice | | Options: 2 options |
| 743522593349 | Pregnancy Status | 1..1 | choice | Enable When: 543806612685 = Female (female) Options: 3 options | |
 832804021140 | Weight (Kg) | 1..1 | decimal | ||
| 856786488810 | Height (cm) | 1..1 | decimal | ||
| 361227700960 | Temperature (°C) | 1..1 | decimal | ||
| 350480749254 | Patient Location | 0..1 | display | ||
| a4-county | County | 1..1 | reference | ||
| a3-sub-county | Sub County | 1..1 | reference | ||
| 754362784943 | Ward | 1..1 | reference | ||
| 116279465819 | Village | 1..1 | string | ||
| 845666899224 | Nearest Health Facility | 1..1 | string | ||
| 999881476256 | Occupation | 1..1 | choice | Options: 6 options | |
| 673073919688 | Other Occupation(Specify) | 1..1 | string | Enable When: 999881476256 = Other (Specify) (occ-006) | |
| 899673957595 | Education Level | 1..1 | choice | Options: 5 options | |
| 261509225024 | Other Education ( Specify) | 1..1 | string | Enable When: 899673957595 = Other (Specify) (edu-005) | |
| 657999955440 | Name of Contact Person | 1..1 | string | ||
| 354738003178 | Mobile Contact (of Contact Person) | 1..1 | string | ||
 984586235 | 07xxxxxxxx | 0..1 | display | ||
| 682361027621 | History of the disease | 0..1 | group | ||
| 728034137219 | Date of Onset of Symptoms | 1..1 | date | ||
| 920645761660 | Days Since Onset of Symptoms | 0..1 | string | | Initial Value: string = 0 |
| 997694179371 | Name of Village Where Patient Probably Got Infected | 1..1 | string | ||
| 648643802331 | Is It an Imported Case (from outside the country)? | 1..1 | choice | | Options: 2 options |
| 405254523776 | If Yes, Indicate Name of Country | 1..1 | string | Enable When: 648643802331 = Yes (yes) | |
| 241783748776 | Did Patient Travel to Endemic Area in Last 6 Months? (In country) | 1..1 | choice | | Options: 2 options |
| 240876879827 | If yes, indicate the place(s) visited: | 0..1 | display | Enable When: 241783748776 = Yes (yes) | |
| 751649865991 | County | 1..1 | reference | Enable When: 241783748776 = Yes (yes) | |
| 751649866545 | Sub-county | 1..1 | reference | Enable When: 241783748776 = Yes (yes) | |
| 683913433621 | Ward | 0..1 | reference | Enable When: 241783748776 = Yes (yes) | |
| 304570397907 | Village | 1..1 | string | Enable When: 241783748776 = Yes (yes) | |
| 201707720724 | Location | 1..1 | string | Enable When: 241783748776 = Yes (yes) | |
| 742577347417 | Did Patient Visit Traditional Healer before visiting Health Facility? | 1..1 | choice | | Options: 2 options |
| 291919290357 | Previous Admission Due to Visceral Leishmaniasis? | 1..1 | choice | | Options: 2 options |
| 653200828098 | If Yes, When Admitted? | 1..1 | choice | Enable When: 291919290357 = Yes (yes) Options: 4 options | |
| 119408288668 | Physical Examination | 0..1 | group | ||
| 699010843343 | Has Patient Had Fever for Last 2 Weeks? | 1..1 | choice | | Options: 2 options |
| clinician-action | Clinician should perform spleen and liver palpation | 0..1 | display | Enable When: 699010843343 = Yes (yes) | |
| 458194698702 | Abdominal Distension Present? | 1..1 | choice | | Options: 2 options |
| 788908031336 | Organ Enlargement | 0..1 | display | ||
| 594158306957 | Liver Enlarged? | 1..1 | choice | | Options: 2 options |
| 754134389540 | Liver Measurement below Costal Margin (cm) | 1..1 | decimal | Enable When: 594158306957 = Yes (yes) | |
| 433410405758 | Spleen Enlarged? | 1..1 | choice | | Options: 2 options |
| 808046746150 | Spleen Measurement below Costal Margin (cm) | 1..1 | decimal | Enable When: 433410405758 = Yes (yes) | |
| 496596553090 | Presence of Concomitant Infections at presentation? | 1..1 | choice | | Options: 2 options |
| 968034282530 | Name(s) of Concomitant Infections | 1..1 | string | Enable When: 496596553090 = Yes (yes) | |
| 332723314026 | Clinician's Name | 1..1 | string | ||
| 493012943787 | Clinician's Signature | 1..1 | string | ||
| Documentation for this format | |||||
Options Sets
Answer options for 438862163919
Answer options for 438862163919_sub_county
Answer options for 438862163919_county
Answer options for 438862163919_national
Answer options for 442636360588
Answer options for 543806612685
Answer options for 743522593349
Answer options for 999881476256
Answer options for 899673957595
Answer options for 648643802331
Answer options for 241783748776
Answer options for 742577347417
Answer options for 291919290357
Answer options for 653200828098
Answer options for 699010843343
Answer options for 458194698702
Answer options for 594158306957
Answer options for 433410405758
Answer options for 496596553090
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "VlCase",
"meta": {
"profile": [
"http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "patient"
}
},
{
"url": "type",
"valueCode": "Patient"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "countyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "patientCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='a4-county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "patientSubCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='a3-sub-county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedFacilityName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_county').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedRole",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_role').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_sub_county').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedWard",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_ward').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "assignedFacility",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='user_facility').answer.value"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedCountyNameCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyNameCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardNameCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedCountyNameNational",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999_national').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyNameNational",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642_national').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardNameNational",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434_national').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedCountyNameSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='294367770999_sub_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedSubCountyNameSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819946803642_sub_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "selectedWardNameSubCounty",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='819943434_sub_county').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "historyCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='751649865991').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "historySubCountyName",
"language": "text/fhirpath",
"expression": "%resource.descendants().where(linkId='751649866545').answer.value.reference"
}
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode",
"valueCode": "prior-edit"
}
],
"url": "http://example.org/Questionnaire/VlCase",
"version": "0.1.0",
"title": "VL Surveillance",
"status": "draft",
"date": "2026-05-04T06:19:40+00:00",
"publisher": "Kenya National Public Health Institute",
"contact": [
{
"name": "Kenya National Public Health Institute",
"telecom": [
{
"system": "url",
"value": "https://www.nphi.go.ke/"
}
]
},
{
"name": "Kenya National Public Health Institute",
"telecom": [
{
"system": "url",
"value": "https://www.nphi.go.ke/",
"use": "work"
}
]
}
],
"description": "Visceral Leishmaniasis surveillance case questionnaire",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "KE",
"display": "Kenya"
}
]
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "page",
"display": "Page"
}
]
}
}
],
"linkId": "151479012557",
"text": "PRESENTATION PHASE",
"type": "group",
"item": [
{
"linkId": "546255966914",
"text": "Hospital/Facility Location",
"type": "display"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_role",
"text": "User Role",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_facility",
"text": "User Facility",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_ward",
"text": "User Ward",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_sub_county",
"text": "User Sub County",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "user_county",
"text": "User County",
"type": "string"
},
{
"linkId": "facility_level",
"type": "group",
"enableWhen": [
{
"question": "user_role",
"operator": "=",
"answerString": "VACCINATOR"
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "294367770999",
"text": "County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedSubCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803642",
"text": "Sub County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedWard}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819943434",
"text": "Ward",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedFacility}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803677",
"text": "Health Facility",
"type": "reference",
"required": true
},
{
"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": "438862163919",
"text": "Type of health facility",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"code": "Private",
"display": "Private"
}
},
{
"valueCoding": {
"code": "Public",
"display": "Public"
}
},
{
"valueCoding": {
"code": "Faith Based",
"display": "Faith Based"
}
}
]
}
]
},
{
"linkId": "sub_county_level",
"type": "group",
"enableWhen": [
{
"question": "user_role",
"operator": "=",
"answerString": "SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER"
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "294367770999_sub_county",
"text": "County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?_id={{%assignedSubCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId": "819946803642_sub_county",
"text": "Sub County",
"type": "reference",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Location?partof={{%selectedSubCountyNameSubCounty}}&_sort=name"
}
},
{
"extension": [
{
"url": "path",
"valueString": "name"
},
{
"url": "forDisplay",
"valueBoolean": true
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
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