| Package | smart.who.int.hiv |
| Resource Type | Questionnaire |
| Id | HIV.H3RecordOutreachAndResult |
| FHIR Version | R4 |
| Source | http://smart.who.int/hiv/https://build.fhir.org/ig/WorldHealthOrganization/smart-hiv/Questionnaire-HIV.H3RecordOutreachAndResult.html |
| URL | http://smart.who.int/hiv/Questionnaire/HIV.H3RecordOutreachAndResult |
| Version | 0.4.4 |
| Status | draft |
| Date | 2025-07-24T19:24:35+00:00 |
| Title | Record outreach and result |
| Authority | who |
| Description | Questionnaire for record outreach and result |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire HIV.H3RecordOutreachAndResult
Language: en
Profiles: Extractable Questionnaire - StructureMap, CRMI Shareable Questionnaire, CRMI Publishable Questionnaire
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  | Questionnaire for record outreach and result | Questionnaire | http://smart.who.int/hiv/Questionnaire/HIV.H3RecordOutreachAndResult#0.4.4 | ||
  HIV.H.DE23 | Outcome from outreach attempt | 0..1 | choice | Value Set: #HIV.H.DE23 | |
 HIV.H.DE30 | Moved from catchment area | 0..1 | boolean | ||
 HIV.H.DE31 | Date client moved from catchment area | 0..1 | date | ||
 HIV.H.DE32 | New catchment area | 0..1 | string | ||
| HIV.H.DE38 | Date of death | 0..1 | date | ||
| HIV.H.DE39 | Cause of death | 0..1 | string | ||
| HIV.H.DE40 | Place of death | 0..1 | string | ||
| HIV.H.DE41 | HIV treatment outcome | 0..1 | choice | Value Set: #HIV.H.DE41 | |
| HIV.H.DE46 | Date patient lost to follow-up | 0..1 | date | ||
| HIV.H.DE47 | On ART | 0..1 | boolean | ||
| HIV.H.DE48 | Date HIV treatment outcome changed | 0..1 | date | ||
| HIV.H.DE49 | Transfer confirmed | 0..1 | boolean | ||
| HIV.H.DE50 | Transfer to facility | 0..1 | choice | Value Set: #HIV.H.DE50 | |
| HIV.H.DE51 | Date of transfer out | 0..1 | date | ||
| HIV.H.DE52 | Adherence assessment | 0..1 | boolean | ||
| HIV.H.DE53 | Reason(s) for adherence problem | 0..1 | choice | Value Set: #HIV.H.DE53 | |
| HIV.H.DE72 | Other (specify) | 0..1 | string | ||
| HIV.H.DE73 | Date ART stopped | 0..1 | date | ||
| HIV.H.DE74 | Reason ART stopped | 0..1 | choice | Value Set: #HIV.H.DE74 | |
 HIV.H.DE81 | Other reason for stopping ART (specify) | 0..1 | string | ||
| Documentation for this format | |||||
FHIR{
"resourceType": "Questionnaire",
"id": "HIV.H3RecordOutreachAndResult",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap",
"http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablequestionnaire",
"http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablequestionnaire"
]
},
"language": "en",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://smart.who.int/hiv/Questionnaire/HIV.H3RecordOutreachAndResult",
"version": "0.4.4",
"title": "Record outreach and result",
"status": "draft",
"experimental": true,
"subjectType": [
"Patient"
],
"date": "2025-07-24T19:24:35+00:00",
"publisher": "WHO",
"contact": [
{
"name": "WHO",
"telecom": [
{
"system": "url",
"value": "http://who.int"
}
]
}
],
"description": "Questionnaire for record outreach and result",
"item": [
{
"id": "HIV.H.DE23",
"linkId": "HIV.H.DE23",
"text": "Outcome from outreach attempt",
"type": "choice",
"required": false,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.H.DE23"
},
{
"id": "HIV.H.DE30",
"linkId": "HIV.H.DE30",
"text": "Moved from catchment area",
"type": "boolean",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE31",
"linkId": "HIV.H.DE31",
"text": "Date client moved from catchment area",
"type": "date",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE32",
"linkId": "HIV.H.DE32",
"text": "New catchment area",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE38",
"linkId": "HIV.H.DE38",
"text": "Date of death",
"type": "date",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE39",
"linkId": "HIV.H.DE39",
"text": "Cause of death",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE40",
"linkId": "HIV.H.DE40",
"text": "Place of death",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE41",
"linkId": "HIV.H.DE41",
"text": "HIV treatment outcome",
"type": "choice",
"required": false,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.H.DE41"
},
{
"id": "HIV.H.DE46",
"linkId": "HIV.H.DE46",
"text": "Date patient lost to follow-up",
"type": "date",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE47",
"linkId": "HIV.H.DE47",
"text": "On ART",
"type": "boolean",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE48",
"linkId": "HIV.H.DE48",
"text": "Date HIV treatment outcome changed",
"type": "date",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE49",
"linkId": "HIV.H.DE49",
"text": "Transfer confirmed",
"type": "boolean",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE50",
"linkId": "HIV.H.DE50",
"text": "Transfer to facility",
"type": "choice",
"required": false,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.H.DE50"
},
{
"id": "HIV.H.DE51",
"linkId": "HIV.H.DE51",
"text": "Date of transfer out",
"type": "date",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE52",
"linkId": "HIV.H.DE52",
"text": "Adherence assessment",
"type": "boolean",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE53",
"linkId": "HIV.H.DE53",
"text": "Reason(s) for adherence problem",
"type": "choice",
"required": false,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.H.DE53"
},
{
"id": "HIV.H.DE72",
"linkId": "HIV.H.DE72",
"text": "Other (specify)",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE73",
"linkId": "HIV.H.DE73",
"text": "Date ART stopped",
"type": "date",
"required": false,
"repeats": false,
"readOnly": false
},
{
"id": "HIV.H.DE74",
"linkId": "HIV.H.DE74",
"text": "Reason ART stopped",
"type": "choice",
"required": false,
"repeats": false,
"readOnly": false,
"answerValueSet": "#HIV.H.DE74"
},
{
"id": "HIV.H.DE81",
"linkId": "HIV.H.DE81",
"text": "Other reason for stopping ART (specify)",
"type": "string",
"required": false,
"repeats": false,
"readOnly": false
}
]
}