FHIR IG analytics| Package | myhie.v4 |
| Resource Type | QuestionnaireResponse |
| Id | example-questionnaireresponse.json |
| FHIR Version | R4 |
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No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "QuestionnaireResponse",
"id": "example-questionnaireresponse",
"identifier": [
{
"value": "KKS2-123"
}
],
"meta": {
"source": "http://protecthealth.hie.moh.gov.my",
"profile": [
"http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"
]
},
"questionnaire": "https://fhir.hie.moh.gov.my/baseR4/Questionnaire/mynhs-my-core",
"status": "completed",
"subject": {
"reference": "Patient/PH-001",
"display": "NAMA"
},
"authored": "2022-08-03T04:22:00.113Z",
"author": {
"display": "LAILA AJWA"
},
"extension": [
{
"url": "http://fhir.hie.moh.gov.my/StructureDefinition/service-provider-my-core",
"valueReference": {
"reference": "Organization/21-05060180",
"display": "Klinik Kesihatan Seremban 2"
}
}
],
"item": [
{
"linkId": "1",
"text": "User Demographic",
"item": [
{
"linkId": "1.1",
"text": "Name",
"answer": [
{
"valueString": "Abu"
}
]
},
{
"linkId": "1.2",
"text": "MySejahtera ID",
"answer": [
{
"valueString": "921005146620"
}
]
},
{
"linkId": "1.3",
"text": "Contact Number",
"answer": [
{
"valueString": "+60115640217"
}
]
},
{
"linkId": "1.4",
"text": "Type of Identification",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Ic Numbers"
}
}
]
},
{
"linkId": "1.5",
"text": "IC Number/Passport",
"answer": [
{
"valueString": "921005146620"
}
]
},
{
"linkId": "1.6",
"text": "Gender",
"answer": [
{
"valueCoding": {
"system": "http://hl7.org/fhir/administrative-gender",
"code": "male",
"display": "Male"
}
}
]
},
{
"linkId": "1.7",
"text": "Nationality",
"answer": [
{
"valueString": "Malaysia"
}
]
},
{
"linkId": "1.8",
"text": "Address",
"answer": [
{
"valueString": "KAMPUNG LAMA SALAK TENGGARA"
}
]
},
{
"linkId": "1.9",
"text": "Occupation",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Professional"
}
}
]
},
{
"linkId": "1.10",
"text": "Ethnicity",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Malay"
}
}
]
},
{
"linkId": "1.11",
"text": "Special Category of Population",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Not Applicable"
}
}
]
},
{
"linkId": "1.12",
"text": "Industry",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Accomodations"
}
}
]
},
{
"linkId": "1.13",
"text": "Comorbidities Present",
"answer": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "73211009",
"display": "Diabetes Mellitus"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "38341003",
"display": "Hypertension"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "195967001",
"display": "Asthma"
}
}
]
},
{
"linkId": "1.14",
"text": "Last Screening Date",
"item": [
{
"linkId": "1.14.1",
"text": "Has the patient performed health screening before?",
"answer": [
{
"valueBoolean": true
}
]
},
{
"linkId": "1.14.2",
"text": "If Yes:",
"answer": [
{
"valueDate": "2022-08-03"
}
]
}
]
}
]
},
{
"linkId": "2",
"text": "Assessments",
"item": [
{
"linkId": "2.1",
"text": "Does the patient have any family history?",
"answer": [
{
"valueBoolean": true,
"item": [
{
"linkId": "2.1.1",
"text": "If yes:",
"answer": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "38341003",
"display": "Hypertension"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "13644009",
"display": "Hypercholesterolemia"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "56265001",
"display": "Coronary Heart Disease"
}
}
]
}
]
}
]
},
{
"linkId": "2.2",
"text": "Does the patient have any medical history?",
"answer": [
{
"valueBoolean": true,
"item": [
{
"linkId": "2.2.1",
"text": "If yes:",
"answer": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "73211009",
"display": "Diabetes Mellitus"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "13644009",
"display": "Hypercholesterolemia"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "363346000",
"display": "Cancer"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "3",
"text": "Mental Health Assessments",
"item": [
{
"linkId": "3.1",
"text": "In the past 2 weeks, how often does this patient:",
"item": [
{
"linkId": "3.1.1",
"text": "Felt Down, depressed or hopeless",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "> 7 days"
}
}
]
},
{
"linkId": "3.1.2",
"text": "Little interest to do things",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Not At All"
}
}
]
},
{
"linkId": "3.1.3",
"text": "Trouble falling asleep/staying asleep or sleeping too much",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Almost everyday"
}
}
]
},
{
"linkId": "3.1.4",
"text": "Felt tired or having little energy",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Not At All"
}
}
]
},
{
"linkId": "3.1.5",
"text": "Had poor appetite or over eating",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Not At All"
}
}
]
},
{
"linkId": "3.1.6",
"text": "Felt bad about himself/herself, felt like a failure or he/she has let his/her family down",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Several Days"
}
}
]
},
{
"linkId": "3.1.7",
"text": "Trouble concentrating (e.g. watching television or reading newspaper)",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "> 7 days"
}
}
]
},
{
"linkId": "3.1.8",
"text": "Moved slowly or fidgeted excessively that is noticeable by people around him/her",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Almost everyday"
}
}
]
},
{
"linkId": "3.1.9",
"text": "Had thoughts that he/she would be better dead, or hurting yourself",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Not At All"
}
}
]
},
{
"linkId": "3.1.10",
"text": "Total Mental Health Test Score",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "10-14 : Moderate Depression"
}
}
]
}
]
},
{
"linkId": "3.2",
"text": "In the last 2 weeks, indicate how difficult these problems made it for this patient",
"item": [
{
"linkId": "3.2.1",
"text": "Do your work, take care of things at home, or get along with others",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Very difficult"
}
}
]
}
]
}
]
},
{
"linkId": "4",
"text": "Lifestyle Health Assessment",
"item": [
{
"linkId": "4.1",
"text": "Alcohol consumption",
"item": [
{
"linkId": "4.1.1",
"text": "How often do you consume alcohol?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Once a month"
}
}
]
},
{
"linkId": "4.1.2",
"text": "How many alcoholic beverages do you consume in a day?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "7-9"
}
}
]
},
{
"linkId": "4.1.3",
"text": "How often within the last year,",
"item": [
{
"linkId": "4.1.3.1",
"text": "Do you consume 6 or more drink in a day?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "< Once a month"
}
}
]
},
{
"linkId": "4.1.3.2",
"text": "Were you not able to stop drinking once started?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Once a month"
}
}
]
},
{
"linkId": "4.1.3.3",
"text": "Were you not able to perform normal activities due to drinking?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Weekly"
}
}
]
},
{
"linkId": "4.1.3.4",
"text": "You needed to drink first thing in the morning to get going after a heavy drinking session?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Once a month"
}
}
]
},
{
"linkId": "4.1.3.5",
"text": "That you felt guilt or remorse after drinking?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Once a month"
}
}
]
},
{
"linkId": "4.1.3.6",
"text": "Were you unable to remember what happened the night before due to drinking?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Weekly"
}
}
]
}
]
},
{
"linkId": "4.1.4",
"text": "Have you or someone else been injured because of your drinking?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Yes, during last year"
}
}
]
},
{
"linkId": "4.1.5",
"text": "Has a relative, friend, doctor, been concerned about your drinking habits?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Yes, but not last year"
}
}
]
},
{
"linkId": "4.1.6",
"text": "Total Alcohol Consumption Test Score",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": ">13 High Risk"
}
}
]
}
]
},
{
"linkId": "4.2",
"text": "Smoking Status",
"item": [
{
"linkId": "4.2.1",
"text": "Does the patient smoke?",
"answer": [
{
"valueBoolean": true
}
]
},
{
"linkId": "4.2.2",
"text": "Cigarettes per Day",
"answer": [
{
"valueInteger": 10
}
]
},
{
"linkId": "4.2.3",
"text": "Years of Smoking",
"answer": [
{
"valueInteger": 10
}
]
},
{
"linkId": "4.2.4",
"text": "Total pack-years",
"answer": [
{
"valueQuantity": {
"value": 10
}
}
]
}
]
}
]
},
{
"linkId": "5",
"text": "Clinical Parameters",
"item": [
{
"linkId": "5.1",
"text": "Anthropometry: Height",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "cm"
}
}
]
},
{
"linkId": "5.2",
"text": "Anthropometry: Weight",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "kg"
}
}
]
},
{
"linkId": "5.3",
"text": "Anthropometry: Waistline",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "cm"
}
}
]
},
{
"linkId": "5.4",
"text": "BMI calculation",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "kg/m2"
}
}
]
},
{
"linkId": "5.5",
"text": "BMI Outcome",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Normal Weight (18.5-24.9)"
}
}
]
},
{
"linkId": "5.6",
"text": "Vital Signs: Blood Pressure (systolic)",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "mm[Hg]"
}
}
]
},
{
"linkId": "5.7",
"text": "Vital Signs: Blood Pressure (diastolic)",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "mm[Hg]"
}
}
]
},
{
"linkId": "5.8",
"text": "Vital Signs: Pulse Rate",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "/min"
}
}
]
},
{
"linkId": "5.9",
"text": "Blood Pressure Outcome",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Normal (Systolic <130,Diastolic <85)"
}
}
]
},
{
"linkId": "5.10",
"text": "Point of Care Testing: Blood Glucose",
"item": [
{
"linkId": "5.10.1",
"text": "Fasting",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "mmol/L"
}
}
]
},
{
"linkId": "5.10.2",
"text": "Random",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "mmol/L"
}
}
]
},
{
"linkId": "5.10.3",
"text": "Blood Glucose Outcome",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Normal Random (<7.8)"
}
}
]
}
]
},
{
"linkId": "5.11",
"text": "Point of Care Testing: Blood Cholesterol",
"item": [
{
"linkId": "5.11.1",
"text": "Fasting",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "mmol/L"
}
}
]
},
{
"linkId": "5.11.2",
"text": "Random",
"answer": [
{
"valueQuantity": {
"value": 10,
"unit": "mmol/L"
}
}
]
},
{
"linkId": "5.11.3",
"text": "Blood Cholesterol Outcome",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "High >= 5.2 mmol/L"
}
}
]
}
]
}
]
},
{
"linkId": "6",
"text": "Advanced Health Screening (Optional)",
"item": [
{
"linkId": "6.1",
"text": "Cardiovascular",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Chest Pain"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Ankle Swelling"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Intermittent claudication"
}
}
]
},
{
"linkId": "6.2",
"text": "Gastrointestinal",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Abdominal pain"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Dyspepsia"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "06",
"display": "Cough with or without sputum"
}
}
]
},
{
"linkId": "6.3",
"text": "Genitourinary",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Haematuria"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Menstual irregularity - women"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "05",
"display": "Frequency"
}
}
]
},
{
"linkId": "6.4",
"text": "Locomotor",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Joint pain"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Change in mobility"
}
}
]
},
{
"linkId": "6.5",
"text": "Neurological",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Transient loss of function (vision, speech, sight)"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Eyesight"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Collapses"
}
}
]
},
{
"linkId": "6.6",
"text": "ENT Symptoms",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Otalgia"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "05",
"display": "Dysphonia"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "06",
"display": "Trismus"
}
}
]
},
{
"linkId": "6.7",
"text": "Dermatology",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Ulcers"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Skin color changes"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Skin lesions"
}
}
]
}
]
},
{
"linkId": "7",
"text": "Advanced Systemic Examination (Optional)",
"item": [
{
"linkId": "7.1",
"text": "General Appearance",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Abnormal"
},
"item": [
{
"linkId": "7.1.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Dehydrated"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Cachexic"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Abnormal gait"
}
}
]
}
]
}
]
},
{
"linkId": "7.2",
"text": "Hands and Arms:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.2.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Koilonychia"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Leuchonychia"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Palmar erythema"
}
}
]
}
]
}
]
},
{
"linkId": "7.3",
"text": "Head, Ears, Eyes, Nose and Throat",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Abnormal"
},
"item": [
{
"linkId": "7.3.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Discharges"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Bleeding"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Abnormal Breath"
}
}
]
}
]
}
]
},
{
"linkId": "7.4",
"text": "Eyes:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.4.1",
"text": "If Abnormal (Conjuntival):",
"answer": [
{
"valueCoding": {
"display": "Pallor"
}
}
]
},
{
"linkId": "7.4.2",
"text": "If Abnormal (Sclera):",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Jaundice"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Iritis"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Hemorrhage"
}
}
]
},
{
"linkId": "7.4.3",
"text": "If Abnormal (Cornea):",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Kaiser Fleischer’s ring (Wilson Disease)"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Protruded eyeballs"
}
}
]
}
]
}
]
},
{
"linkId": "7.5",
"text": "Fundoscopy",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.5.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Absence of red reflex"
}
}
]
},
{
"linkId": "7.5.2",
"text": "Optic Disc",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Swollen"
}
}
]
},
{
"linkId": "7.5.3",
"text": "Retina",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Arteriolar narrowing"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Arteriovenous nicking"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Cotton-wool spots"
}
}
]
},
{
"linkId": "7.5.4",
"text": "Macula",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Pigmented"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Exudates"
}
}
]
}
]
}
]
},
{
"linkId": "7.6",
"text": "Snellen Eye Chart Score:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.6.1",
"text": "If Abnormal (Right Eye):",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "60/6"
}
}
]
},
{
"linkId": "7.6.2",
"text": "If Abnormal (Left Eye):",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "36/6"
}
}
]
}
]
}
]
},
{
"linkId": "7.7",
"text": "Lips:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Abnormal"
},
"item": [
{
"linkId": "7.7.1",
"text": "If Abnormal (Lips):",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Angular Stomatitis"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Ulceritis"
}
}
]
},
{
"linkId": "7.7.2",
"text": "If Abnormal (Gums)",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Gingivitis"
}
}
]
}
]
}
]
},
{
"linkId": "7.8",
"text": "Tongue:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.8.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "glossitis"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Atrophic"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "05",
"display": "Tonsils"
}
}
]
}
]
}
]
},
{
"linkId": "7.9",
"text": "Neck",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Abnormal"
},
"item": [
{
"linkId": "7.9.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Neck mass"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Lymphadenopathy"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Skin lesion"
}
}
]
}
]
}
]
},
{
"linkId": "7.10",
"text": "Cardiorespiratory Examination",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.10.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Raised JVP"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Tracheal Deviation"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "05",
"display": "Peripheal edema"
}
}
]
}
]
}
]
},
{
"linkId": "7.11",
"text": "Abdominal Examination",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.11.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Distension"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Striae"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "06",
"display": "Pigmentation"
}
}
]
}
]
}
]
},
{
"linkId": "7.12",
"text": "Genital Examination",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.12.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Discharges"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Anal fissure"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "05",
"display": "Anal fistula"
}
}
]
}
]
}
]
},
{
"linkId": "7.13",
"text": "Musculoskeletal Examination",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Abnormal"
},
"item": [
{
"linkId": "7.13.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Swelling"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Scars"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "05",
"display": "Deformities"
}
}
]
}
]
}
]
},
{
"linkId": "7.14",
"text": "Neurological Examination",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "00",
"display": "Normal"
},
"item": [
{
"linkId": "7.14.1",
"text": "If Abnormal:",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Muscle Tone (Hypertonia/Hypotonia)"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Muscle Power (Score from 0-5)"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Babinski (Present/Absent)"
}
}
]
}
]
}
]
}
]
},
{
"linkId": "8",
"text": "Further Investigations",
"item": [
{
"linkId": "8.1",
"text": "Urine dipstick",
"answer": [
{
"valueString": "10"
}
]
},
{
"linkId": "8.2",
"text": "Urine FEME",
"answer": [
{
"valueString": "10"
}
]
},
{
"linkId": "8.3",
"text": "ECG",
"answer": [
{
"valueString": "10"
}
]
},
{
"linkId": "8.4",
"text": "Haemoglobin",
"answer": [
{
"valueString": "10"
}
]
}
]
},
{
"linkId": "9",
"text": "Diagnosis",
"item": [
{
"linkId": "9.1",
"text": "Normal Healthy individual?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "No"
}
}
]
},
{
"linkId": "9.2",
"text": "Diagnosis",
"item": [
{
"linkId": "9.2.1",
"text": "Display",
"answer": [
{
"valueString": "Dengue NOS"
}
]
},
{
"linkId": "9.2.2",
"text": "Code",
"answer": [
{
"valueString": " 1D2Z"
}
]
},
{
"linkId": "9.2.3",
"text": "Code System",
"answer": [
{
"valueString": "http://hl7.org/fhir/sid/icd-11"
}
]
}
]
},
{
"linkId": "9.3",
"text": "Provisional diagnosis",
"item": [
{
"linkId": "9.3.1",
"text": "Display",
"answer": [
{
"valueString": "Hypertension NOS"
}
]
},
{
"linkId": "9.3.2",
"text": "Code",
"answer": [
{
"valueString": "BA00.Z"
}
]
},
{
"linkId": "9.3.3",
"text": "Code System",
"answer": [
{
"valueString": "http://hl7.org/fhir/sid/icd-11"
}
]
}
]
},
{
"linkId": "9.3",
"text": "Provisional diagnosis",
"item": [
{
"linkId": "9.3.1",
"text": "Display",
"answer": [
{
"valueString": "Monkeypox"
}
]
},
{
"linkId": "9.3.2",
"text": "Code",
"answer": [
{
"valueString": "1E71"
}
]
},
{
"linkId": "9.3.3",
"text": "Code System",
"answer": [
{
"valueString": "http://hl7.org/fhir/sid/icd-11"
}
]
}
]
}
]
},
{
"linkId": "10",
"text": "Management",
"item": [
{
"linkId": "10.1",
"text": "General management",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "Dietary advice"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "Physiotherapy"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "02",
"display": "Smoking cessation"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "Physical activity advice"
}
}
]
},
{
"linkId": "10.2",
"text": "Doctor’s notes",
"answer": [
{
"valueString": "This note is a markdown\nIt should save user entry formats"
}
]
},
{
"linkId": "10.3",
"text": "Prescription",
"item": [
{
"linkId": "10.3.1",
"text": "Any medication prescribed?",
"answer": [
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "01",
"display": "T. AMLODIPINE 5MG"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "03",
"display": "T. FELODIPINE 5MG"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "04",
"display": "T. FELODIPINE 10MG"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "05",
"display": "T. PERINDOPRIL 4MG"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "06",
"display": "T. METOPROLOL 50MG"
}
},
{
"valueCoding": {
"system": "http://fhir.hie.moh.gov.my/CodeSystem/questionnaire-my-core",
"code": "08",
"display": "T. LOSARTAN 50MG"
}
}
]
}
]
}
]
},
{
"linkId": "11",
"text": "Verified by",
"item": [
{
"linkId": "11.1",
"text": "Officer incharge",
"answer": [
{
"valueString": "Saiful"
}
]
},
{
"linkId": "11.2",
"text": "Registration Number/ IC number",
"answer": [
{
"valueString": "81751"
}
]
}
]
}
]
}