FHIR IG analytics| Package | hl7.fhir.be.patient-monitoring |
| Resource Type | Questionnaire |
| Id | Questionnaire-homehosp-opat-continuous-infusion.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/hl7-be/patient-monitoring/Questionnaire-homehosp-opat-continuous-infusion.html |
| URL | http://hl7belgium.org/fhir/patient-monitoring/Questionnaire/homehosp-opat-continuous-infusion |
| Version | 0.1.0 |
| Status | active |
| Date | 2026-05-27T09:31:20+00:00 |
| Name | HomehospOpatContinuousInfusionQuestionnaireDefinition |
| Title | OPAT - continu infuus |
| Realm | be |
| Authority | hl7 |
| Description | Questionnaire containing the necessary information for the home hospitalization of a patient treated with a continuous infusion in the context of an OPAT treatment |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire homehosp-opat-continuous-infusion
Structure| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  HomehospOpatContinuousInfusionQuestionnaireDefinition | Questionnaire containing the necessary information for the home hospitalization of a patient treated with a continuous infusion in the context of an OPAT treatment | Questionnaire | http://hl7belgium.org/fhir/patient-monitoring/Questionnaire/homehosp-opat-continuous-infusion#0.1.0 | |
  NursingAssessment | Verpleegkundig assessment | 0..1 | group | |
 MedicationStorage | MedicationStorage | 0..1 | group | |
 A1_MedicationStorage | Zijn er opmerkingen of bezorgdheden omtrent de (correcte) thuisbewaring van de medicatie? | 1..1 | choice | Options: 2 options |
  A2_MedicationStorageSpecify | > Indien opmerkingen of bezorgdheid: specifieer | 0..1 | string | Enable When: A1_MedicationStorage = Improper storage of medication (SNOMED CT#424363005) |
| MedicationPreparation | Voorbereiding medicatietoediening | 0..1 | group | |
| B1_MedicationFullyDissolved | De medicatie werd volledig opgelost tot een heldere oplossing zonder zichtbare deeltjes | 0..1 | choice | Value Set: Yes / No Value Set |
 B2_ContactCareTeam | > Indien nee: gelieve contact op te nemen met het zorgteam in het ziekenhuis | 0..1 | display | Enable When: B1_MedicationFullyDissolved = No (SNOMED CT#373067005) |
 B3_FullInfusorWeight | Gewicht van volle Infusor net voor nieuwe toediening | 1..1 | decimal | |
| B4_EmptyInfusorWeight | Gewicht bij afkoppelen van lege infusor | 1..1 | decimal | |
| B5_AdditionalObservation | Bijkomende observatie:(indien van toepassing) | 0..1 | string | |
| MedicationAdministration | MedicationAdministration | 0..1 | group | |
| C1_AdministrationCorrect | Kon de medicatie exact volgens de procedure worden toegediend (er waren geen afwijkingen)? | 1..1 | choice | Value Set: Yes / No Value Set |
| C2_SpecifyNo | > Indien neen: specifieer | 0..1 | string | Enable When: C1_AdministrationCorrect = No (SNOMED CT#373067005) |
| VitalParameters | Vitale parameters | 0..1 | group | |
| D1_BodyTemperature | Lichaamstemperatuur: | 1..1 | decimal | |
| D2_HeartRate | Pols: | 0..1 | decimal | |
| D3_SystolicBloodPressure | Bloeddruk - systolisch | 0..1 | decimal | |
| D4_DiastolicBloodPressure | Bloeddruk - diastolisch | 0..1 | decimal | |
| DressingInsertionSite | Observatie verband insteekplaats | 0..1 | group | |
| E1_DressingObservation | Observatie verband insteekplaats | 1..1 | choice | Value Set: Normal / Abnormal Finding |
| E2_SpecifyIfAbnormal | > Indien 'afwijkend': specifieer | 0..1 | display | Enable When: E1_DressingObservation = Abnormal (SNOMED CT#263654008) |
| E3_Bloody | Bloederig | 0..1 | choice | Value Set: Yes / No Value Set |
| E4_Purulent | Etterig | 0..1 | choice | Value Set: Yes / No Value Set |
| E5_Loose | Los | 0..1 | choice | Value Set: Yes / No Value Set |
| E6_Serous | Sereus | 0..1 | choice | Value Set: Yes / No Value Set |
| E7_Moist | Vochtig | 0..1 | choice | Value Set: Yes / No Value Set |
| E8_Other | Andere: (indien van toepassing) | 0..1 | string | |
| InsertionSite | Observatie insteekplaats | 0..1 | group | |
| F1_InsertionSiteObservation | Observatie insteekplaats | 1..1 | choice | Value Set: Normal / Abnormal Finding |
| F2_SpecifyIfAbnormal | > Indien 'afwijkend': specifieer | 0..1 | display | Enable When: F1_InsertionSiteObservation = Abnormal (SNOMED CT#263654008) |
| F3_Blistering | Blaarvorming | 0..1 | choice | Value Set: Yes / No Value Set |
| F4_Redness | Rood | 0..1 | choice | Value Set: Yes / No Value Set |
| F5_Hematoma | Haematoom | 0..1 | choice | Value Set: Yes / No Value Set |
| F6_Pus | Etter | 0..1 | choice | Value Set: Yes / No Value Set |
| F7_Crusting | Korstvorming | 0..1 | choice | Value Set: Yes / No Value Set |
| F8_Swelling | Zwelling | 0..1 | choice | Value Set: Yes / No Value Set |
| F9_Extravasation | Extravasatie/infiltratie | 0..1 | choice | Value Set: Yes / No Value Set |
| F10_Other | Andere: (indien van toepassing) | 0..1 | string | |
| Catheter | Observatie katheter | 0..1 | group | |
| G1_CatheterObservation | Observatie katheter | 1..1 | choice | Value Set: Normal / Abnormal Finding |
| G2_SpecifyIfAbnormal | > Indien 'afwijkend': specifieer | 0..1 | display | Enable When: G1_CatheterObservation = Abnormal (SNOMED CT#263654008) |
| G_CatheterType | Kies kathetertype | 0..1 | choice | Value Set: Catheter Type |
| G_LumenColor | Kleur lumen | 0..1 | choice | Options: 4 options |
| G3_BloodAspiration | Bloedaspiratie | 0..1 | choice | Value Set: Catheter Patency Scale |
| G4_Infusion | Infusie | 0..1 | choice | Value Set: Catheter Patency Scale |
| G5_DamagedCatheter | Beschadigde katheter | 0..1 | choice | Value Set: Yes / No Value Set |
| G6_Other | Andere: (indien van toepassing) | 0..1 | string | |
| SideEffects | SideEffects | 0..1 | group | |
 H1_SkinRash | Huiduitslag | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H2_Itching | Jeuk | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H3_BlistersOrPeeling | Blaren/loslaten van de huid | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H4_Nausea | Misselijkheid | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H5_Vomiting | Braken | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H6_Diarrhea | Diarree | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H7_Constipation | Obstipatie | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H8_DecreasedAppetite | Verminderde eetlust | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H9_PainDuringAdministration | Pijn bij toediening | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H10_GeneralPain | Pijn (algemeen) | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H11_Fatigue | Moe | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H12_Chills | Rillingen | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H13_Candidiasis | Candidiase (schimmelinfectie) | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H14_JointPain | Gewrichtspijn | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H15_RespiratoryProblems | Ademhalingsproblemen | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H16_FacialSwelling | Zwelling gezicht/tong | 0..1 | choice | Value Set: Home Hospitalization Side Effect Severity Scale |
| H17_OtherObservations | Is er andere symptoomlast of zijn er andere relevante klinische en/of psychosociale observaties? (gelieve bij klinische bezorgdheid contact te nemen met het zorgteam in het ziekenhuis) | 0..1 | string | |
| QualityMonitoring | (Kwaliteits)opvolging | 0..1 | group | |
| I1_CommentsRegistration | Zijn er opmerkingen of bezorgdheden omtrent de aanmelding van deze patient, de gegevensdeling vanuit het ziekenhuis, de communicatie door en het contact met het ziekenhuis, de beschikbaarheid van de medicatie en materialen, of andere aspecten van de transmurale samenwerking rond thuishospitalisatie OPAT, we vragen je graag ze met ons te delen. Alvast dank. | 0..1 | string | |
| Documentation for this format | ||||
Options Sets
Answer options for A1_MedicationStorage
Answer options for G_LumenColor
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "homehosp-opat-continuous-infusion",
"meta": {
"profile": [
"http://hl7belgium.org/fhir/patient-monitoring/StructureDefinition/homehosp-opat-continuous-infusion"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://hl7belgium.org/fhir/patient-monitoring/Questionnaire/homehosp-opat-continuous-infusion",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.4.642.40.54.35.2"
}
],
"version": "0.1.0",
"name": "HomehospOpatContinuousInfusionQuestionnaireDefinition",
"title": "OPAT - continu infuus",
"status": "active",
"subjectType": [
"Patient"
],
"date": "2026-05-27T09:31:20+00:00",
"publisher": "HL7 Belgium",
"contact": [
{
"name": "HL7 Belgium",
"telecom": [
{
"system": "url",
"value": "http://example.com/committees"
},
{
"system": "email",
"value": "my-group@example.com"
}
]
},
{
"name": "Bob Smith",
"telecom": [
{
"system": "email",
"value": "bobsmith@example.com",
"use": "work"
}
]
}
],
"description": "Questionnaire containing the necessary information for the home hospitalization of a patient treated with a continuous infusion in the context of an OPAT treatment",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "BE",
"display": "Belgium"
}
]
}
],
"item": [
{
"linkId": "NursingAssessment",
"text": "Verpleegkundig assessment",
"type": "group",
"item": [
{
"linkId": "MedicationStorage",
"text": "MedicationStorage",
"type": "group",
"item": [
{
"linkId": "A1_MedicationStorage",
"code": [
{
"system": "http://snomed.info/sct",
"code": "422413002",
"display": "Ability to store medications"
}
],
"text": "Zijn er opmerkingen of bezorgdheden omtrent de (correcte) thuisbewaring van de medicatie?",
"type": "choice",
"required": true,
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "710977001",
"display": "Safe storage and management of medication"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "424363005",
"display": "Improper storage of medication"
}
}
]
},
{
"linkId": "A2_MedicationStorageSpecify",
"text": "> Indien opmerkingen of bezorgdheid: specifieer",
"type": "string",
"enableWhen": [
{
"question": "A1_MedicationStorage",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "424363005",
"display": "Improper storage of medication"
}
}
]
}
]
},
{
"linkId": "MedicationPreparation",
"text": "Voorbereiding medicatietoediening",
"type": "group",
"item": [
{
"linkId": "B1_MedicationFullyDissolved",
"code": [
{
"system": "http://snomed.info/sct",
"code": "396076000",
"display": "Medication prefill preparation assessment"
}
],
"text": "De medicatie werd volledig opgelost tot een heldere oplossing zonder zichtbare deeltjes",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "B2_ContactCareTeam",
"text": "> Indien nee: gelieve contact op te nemen met het zorgteam in het ziekenhuis",
"type": "display",
"enableWhen": [
{
"question": "B1_MedicationFullyDissolved",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "373067005",
"display": "No"
}
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "g",
"display": "g"
}
}
],
"linkId": "B3_FullInfusorWeight",
"text": "Gewicht van volle Infusor net voor nieuwe toediening",
"type": "decimal",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "g",
"display": "g"
}
}
],
"linkId": "B4_EmptyInfusorWeight",
"text": "Gewicht bij afkoppelen van lege infusor",
"type": "decimal",
"required": true
},
{
"linkId": "B5_AdditionalObservation",
"code": [
{
"system": "http://snomed.info/sct",
"code": "396078004",
"display": "Medication prefill preparation management"
}
],
"text": "Bijkomende observatie:(indien van toepassing)",
"type": "string"
}
]
},
{
"linkId": "MedicationAdministration",
"text": "MedicationAdministration",
"type": "group",
"item": [
{
"linkId": "C1_AdministrationCorrect",
"code": [
{
"system": "http://snomed.info/sct",
"code": "373149000",
"display": "Medication administered following procedure"
}
],
"text": "Kon de medicatie exact volgens de procedure worden toegediend (er waren geen afwijkingen)?",
"type": "choice",
"required": true,
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "C2_SpecifyNo",
"text": "> Indien neen: specifieer",
"type": "string",
"enableWhen": [
{
"question": "C1_AdministrationCorrect",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "373067005",
"display": "No"
}
}
]
}
]
},
{
"linkId": "VitalParameters",
"text": "Vitale parameters",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "Cel",
"display": "Cel"
}
}
],
"linkId": "D1_BodyTemperature",
"code": [
{
"system": "http://loinc.org",
"code": "8310-5",
"display": "Body temperature"
}
],
"text": "Lichaamstemperatuur:",
"type": "decimal",
"required": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "{beats}/min",
"display": "{beats}/min"
}
}
],
"linkId": "D2_HeartRate",
"code": [
{
"system": "http://snomed.info/sct",
"code": "364075005",
"display": "Heart rate"
}
],
"text": "Pols:",
"type": "decimal"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]",
"display": "mm[Hg]"
}
}
],
"linkId": "D3_SystolicBloodPressure",
"code": [
{
"system": "http://loinc.org",
"code": "8480-6",
"display": "Systolic blood pressure"
}
],
"text": "Bloeddruk - systolisch",
"type": "decimal"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"system": "http://unitsofmeasure.org",
"code": "mm[Hg]",
"display": "mm[Hg]"
}
}
],
"linkId": "D4_DiastolicBloodPressure",
"code": [
{
"system": "http://loinc.org",
"code": "8462-4",
"display": "Diastolic blood pressure"
}
],
"text": "Bloeddruk - diastolisch",
"type": "decimal"
}
]
},
{
"linkId": "DressingInsertionSite",
"text": "Observatie verband insteekplaats",
"type": "group",
"item": [
{
"linkId": "E1_DressingObservation",
"code": [
{
"system": "http://snomed.info/sct",
"code": "364554009",
"display": "Wound observable"
}
],
"text": "Observatie verband insteekplaats",
"type": "choice",
"required": true,
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/normal-abnormal"
},
{
"linkId": "E2_SpecifyIfAbnormal",
"text": "> Indien 'afwijkend': specifieer",
"type": "display",
"enableWhen": [
{
"question": "E1_DressingObservation",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "263654008",
"display": "Abnormal"
}
}
]
},
{
"linkId": "E3_Bloody",
"code": [
{
"system": "http://snomed.info/sct",
"code": "297968009",
"display": "Bleeding skin"
}
],
"text": "Bloederig",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "E4_Purulent",
"code": [
{
"system": "http://snomed.info/sct",
"code": "225550006",
"display": "Purulent discharge from wound"
}
],
"text": "Etterig",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "E5_Loose",
"code": [
{
"system": "http://snomed.info/sct",
"code": "78799005",
"display": "Loose"
}
],
"text": "Los",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "E6_Serous",
"code": [
{
"system": "http://snomed.info/sct",
"code": "447112000",
"display": "Serous discharge from wound"
}
],
"text": "Sereus",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "E7_Moist",
"code": [
{
"system": "http://snomed.info/sct",
"code": "17461003",
"display": "Wet"
}
],
"text": "Vochtig",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "E8_Other",
"code": [
{
"system": "http://snomed.info/sct",
"code": "1481000124102",
"display": "Wound dressing observable"
}
],
"text": "Andere: (indien van toepassing)",
"type": "string"
}
]
},
{
"linkId": "InsertionSite",
"text": "Observatie insteekplaats",
"type": "group",
"item": [
{
"linkId": "F1_InsertionSiteObservation",
"code": [
{
"system": "http://snomed.info/sct",
"code": "386141001",
"display": "Insertion site"
}
],
"text": "Observatie insteekplaats",
"type": "choice",
"required": true,
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/normal-abnormal"
},
{
"linkId": "F2_SpecifyIfAbnormal",
"text": "> Indien 'afwijkend': specifieer",
"type": "display",
"enableWhen": [
{
"question": "F1_InsertionSiteObservation",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "263654008",
"display": "Abnormal"
}
}
]
},
{
"linkId": "F3_Blistering",
"code": [
{
"system": "http://snomed.info/sct",
"code": "339008",
"display": "Blister"
}
],
"text": "Blaarvorming",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "F4_Redness",
"code": [
{
"system": "http://snomed.info/sct",
"code": "371240000",
"display": "Red colour"
}
],
"text": "Rood",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "F5_Hematoma",
"code": [
{
"system": "http://snomed.info/sct",
"code": "35566002",
"display": "Hematoma"
}
],
"text": "Haematoom",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "F6_Pus",
"code": [
{
"system": "http://snomed.info/sct",
"code": "367646009",
"display": "Pus"
}
],
"text": "Etter",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "F7_Crusting",
"code": [
{
"system": "http://snomed.info/sct",
"code": "69640009",
"display": "Crust"
}
],
"text": "Korstvorming",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "F8_Swelling",
"code": [
{
"system": "http://snomed.info/sct",
"code": "65124004",
"display": "Swelling"
}
],
"text": "Zwelling",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "F9_Extravasation",
"code": [
{
"system": "http://snomed.info/sct",
"code": "76676007",
"display": "Extravasation"
}
],
"text": "Extravasatie/infiltratie",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "F10_Other",
"code": [
{
"system": "http://snomed.info/sct",
"code": "364554009",
"display": "Wound observable"
}
],
"text": "Andere: (indien van toepassing)",
"type": "string"
}
]
},
{
"linkId": "Catheter",
"text": "Observatie katheter",
"type": "group",
"item": [
{
"linkId": "G1_CatheterObservation",
"code": [
{
"system": "http://snomed.info/sct",
"code": "1156071007",
"display": "Catheter observable"
}
],
"text": "Observatie katheter",
"type": "choice",
"required": true,
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/normal-abnormal"
},
{
"linkId": "G2_SpecifyIfAbnormal",
"text": "> Indien 'afwijkend': specifieer",
"type": "display",
"enableWhen": [
{
"question": "G1_CatheterObservation",
"operator": "=",
"answerCoding": {
"system": "http://snomed.info/sct",
"code": "263654008",
"display": "Abnormal"
}
}
]
},
{
"linkId": "G_CatheterType",
"code": [
{
"system": "http://snomed.info/sct",
"code": "246138005",
"display": "Type of catheter"
}
],
"text": "Kies kathetertype",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/catheter-type"
},
{
"linkId": "G_LumenColor",
"code": [
{
"system": "http://snomed.info/sct",
"code": "1396483008",
"display": "Color of intravascular catheter lumen hub"
}
],
"text": "Kleur lumen",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "371253002",
"display": "Gray color"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "371251000",
"display": "White colour"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "371240000",
"display": "Red colour"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "371250004",
"display": "Purple colour"
}
}
]
},
{
"linkId": "G3_BloodAspiration",
"code": [
{
"system": "http://snomed.info/sct",
"code": "25797006",
"display": "Blood aspiration"
}
],
"text": "Bloedaspiratie",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/catheter-patency"
},
{
"linkId": "G4_Infusion",
"code": [
{
"system": "http://snomed.info/sct",
"code": "36576007",
"display": "Infusion"
}
],
"text": "Infusie",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/catheter-patency"
},
{
"linkId": "G5_DamagedCatheter",
"code": [
{
"system": "http://snomed.info/sct",
"code": "1156074004",
"display": "Device failure"
}
],
"text": "Beschadigde katheter",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/YesNoVS"
},
{
"linkId": "G6_Other",
"text": "Andere: (indien van toepassing)",
"type": "string"
}
]
},
{
"linkId": "SideEffects",
"text": "SideEffects",
"type": "group",
"item": [
{
"linkId": "H1_SkinRash",
"code": [
{
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption"
}
],
"text": "Huiduitslag",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H2_Itching",
"code": [
{
"system": "http://snomed.info/sct",
"code": "418290006",
"display": "Itching"
}
],
"text": "Jeuk",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H3_BlistersOrPeeling",
"code": [
{
"system": "http://snomed.info/sct",
"code": "271767006",
"display": "Peeling of skin"
}
],
"text": "Blaren/loslaten van de huid",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H4_Nausea",
"code": [
{
"system": "http://snomed.info/sct",
"code": "422587007",
"display": "Nausea"
}
],
"text": "Misselijkheid",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H5_Vomiting",
"code": [
{
"system": "http://snomed.info/sct",
"code": "249497008",
"display": "Vomiting symptom"
}
],
"text": "Braken",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H6_Diarrhea",
"code": [
{
"system": "http://snomed.info/sct",
"code": "62315008",
"display": "Diarrhea"
}
],
"text": "Diarree",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H7_Constipation",
"code": [
{
"system": "http://snomed.info/sct",
"code": "14760008",
"display": "Constipation"
}
],
"text": "Obstipatie",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H8_DecreasedAppetite",
"code": [
{
"system": "http://snomed.info/sct",
"code": "64379006",
"display": "Decrease in appetite"
}
],
"text": "Verminderde eetlust",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H9_PainDuringAdministration",
"code": [
{
"system": "http://snomed.info/sct",
"code": "698749006",
"display": "Pain on flushing of implanted venous access device"
}
],
"text": "Pijn bij toediening",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H10_GeneralPain",
"code": [
{
"system": "http://snomed.info/sct",
"code": "112104007",
"display": "Localized pain"
}
],
"text": "Pijn (algemeen)",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H11_Fatigue",
"code": [
{
"system": "http://snomed.info/sct",
"code": "224960004",
"display": "Tired"
}
],
"text": "Moe",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H12_Chills",
"code": [
{
"system": "http://snomed.info/sct",
"code": "43724002",
"display": "Shivering"
}
],
"text": "Rillingen",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H13_Candidiasis",
"code": [
{
"system": "http://snomed.info/sct",
"code": "78048006",
"display": "Candidiasis"
}
],
"text": "Candidiase (schimmelinfectie)",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H14_JointPain",
"code": [
{
"system": "http://snomed.info/sct",
"code": "57676002",
"display": "Joint pain"
}
],
"text": "Gewrichtspijn",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H15_RespiratoryProblems",
"code": [
{
"system": "http://snomed.info/sct",
"code": "267036007",
"display": "Dyspnea"
}
],
"text": "Ademhalingsproblemen",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H16_FacialSwelling",
"code": [
{
"system": "http://snomed.info/sct",
"code": "278528006",
"display": "Facial swelling"
}
],
"text": "Zwelling gezicht/tong",
"type": "choice",
"answerValueSet": "http://hl7belgium.org/fhir/patient-monitoring/ValueSet/homehosp-side-effect-severity"
},
{
"linkId": "H17_OtherObservations",
"code": [
{
"system": "http://snomed.info/sct",
"code": "365275006",
"display": "General well-being finding"
}
],
"text": "Is er andere symptoomlast of zijn er andere relevante klinische en/of psychosociale observaties? \n(gelieve bij klinische bezorgdheid contact te nemen met het zorgteam in het ziekenhuis)",
"type": "string"
}
]
}
]
},
{
"linkId": "QualityMonitoring",
"text": "(Kwaliteits)opvolging",
"type": "group",
"item": [
{
"linkId": "I1_CommentsRegistration",
"code": [
{
"system": "http://snomed.info/sct",
"code": "276238005",
"display": "Comments on own writing"
}
],
"text": "Zijn er opmerkingen of bezorgdheden omtrent de aanmelding van deze patient, de gegevensdeling vanuit het ziekenhuis, de communicatie door en het contact met het ziekenhuis, de beschikbaarheid van de medicatie en materialen, of andere aspecten van de transmurale samenwerking rond thuishospitalisatie OPAT, we vragen je graag ze met ons te delen. Alvast dank.",
"type": "string"
}
]
}
]
}