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Packageus.co.bha-ig
Resource TypeQuestionnaireResponse
IdQuestionnaireResponse-BHASubstanceUseDisorderQuestionnaireResponseExampleNorth.json
FHIR VersionR4

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: QuestionnaireResponse BHASubstanceUseDisorderQuestionnaireResponseExampleNorth

LinkIDTextDefinitionAnswerdoco
.. BHASubstanceUseDisorderQuestionnaireResponseExampleNorthQuestionnaire:BHA Substance Use Disorder Questionnaire
... lastUpdated2025-02-18T10:15:00Z
... ASAM_LEVEL_OF_CAREASAM Level of Care: the ASAM Level of Care must match the LADDERS Provider/Clinic's ASAM Level of CareBHA ASAM Levels of Care: 2.1 (ASAM Level 2.1 - Intensive Outpatient Services (IOP))
... PRIMARY_SUBSTANCE_USEPrimary Substance UseBHA Substance Use Codes: 1 (Alcohol)
... PRIMARY_LAST_USED_30_DAYSTimes Used Primary Substance in Last 30 Days3
... PRIMARY_ROUTE_OF_USERoute of Use of Primary SubstancesBHA Substance Use Route of Administration Codes: 1 (Oral)
... PRIMARY_START_AGEAge of First Use of Primary Substances28
... SECONDARY_SUBSTANCE_USESecondary Substance UseBHA Substance Use Codes: 6 (Other tranquilizer)
... SECONDARY_LAST_USED_30_DAYSTimes Used Secondary Substance in Last 30 Days4
... SECONDARY_ROUTE_OF_USERoute of Use of Secondary SubstancesBHA Substance Use Route of Administration Codes: 3 (Inhalation (nose/mouth))
... SECONDARY_START_AGEAge of First Use of Secondary Substances28
... TERTIARY_SUBSTANCE_USETertiary Substance UseBHA Substance Use Codes: 10 (Other stimulants)
... TERTIARY_LAST_USED_30_DAYSTimes Used Tertiary Substance in Last 30 Days2
... TERTIARY_ROUTE_OF_USERoute of Use of Tertiary SubstanceBHA Substance Use Route of Administration Codes: 1 (Oral)
... TERTIARY_START_AGEAge of First Use of Tertiary Substance29
... episodeOfCareEpisode of Care InformationEpisodeOfCare: status = finished; type = Substance Use Disorder; period = 2023-06-01 --> 2025-02-18

doco Documentation for this format

Source1

{
  "resourceType": "QuestionnaireResponse",
  "id": "BHASubstanceUseDisorderQuestionnaireResponseExampleNorth",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "questionnaire": "http://bha.colorado.gov/fhir/bha-ig/Questionnaire/BHASubstanceUseDisorderQuestionnaire",
  "status": "completed",
  "subject": {
    "reference": "Patient/BHAClientExampleNorth",
    "display": "Sofia Martinez"
  },
  "authored": "2025-02-18T10:15:00Z",
  "item": [
    {
      "linkId": "lastUpdated",
      "answer": [
        {
          "valueDateTime": "2025-02-18T10:15:00Z"
        }
      ]
    },
    {
      "linkId": "ASAM_LEVEL_OF_CARE",
      "text": "ASAM Level of Care: the ASAM Level of Care must match the LADDERS Provider/Clinic's ASAM Level of Care",
      "answer": [
        {
          "valueCoding": {
            "system": "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-asam-level-of-care-cs",
            "code": "2.1"
          }
        }
      ]
    },
    {
      "linkId": "PRIMARY_SUBSTANCE_USE",
      "text": "Primary Substance Use",
      "answer": [
        {
          "valueCoding": {
            "system": "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
            "code": "1"
          }
        }
      ]
    },
    {
      "linkId": "PRIMARY_LAST_USED_30_DAYS",
      "text": "Times Used Primary Substance in Last 30 Days",
      "answer": [
        {
          "valueInteger": 3
        }
      ]
    },
    {
      "linkId": "PRIMARY_ROUTE_OF_USE",
      "text": "Route of Use of Primary Substances",
      "answer": [
        {
          "valueCoding": {
            "system": "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-route-of-administration-cs",
            "code": "1"
          }
        }
      ]
    },
    {
      "linkId": "PRIMARY_START_AGE",
      "text": "Age of First Use of Primary Substances",
      "answer": [
        {
          "valueInteger": 28
        }
      ]
    },
    {
      "linkId": "SECONDARY_SUBSTANCE_USE",
      "text": "Secondary Substance Use",
      "answer": [
        {
          "valueCoding": {
            "system": "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
            "code": "6"
          }
        }
      ]
    },
    {
      "linkId": "SECONDARY_LAST_USED_30_DAYS",
      "text": "Times Used Secondary Substance in Last 30 Days",
      "answer": [
        {
          "valueInteger": 4
        }
      ]
    },
    {
      "linkId": "SECONDARY_ROUTE_OF_USE",
      "text": "Route of Use of Secondary Substances",
      "answer": [
        {
          "valueCoding": {
            "system": "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-route-of-administration-cs",
            "code": "3"
          }
        }
      ]
    },
    {
      "linkId": "SECONDARY_START_AGE",
      "text": "Age of First Use of Secondary Substances",
      "answer": [
        {
          "valueInteger": 28
        }
      ]
    },
    {
      "linkId": "TERTIARY_SUBSTANCE_USE",
      "text": "Tertiary Substance Use",
      "answer": [
        {
          "valueCoding": {
            "system": "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-cs",
            "code": "10"
          }
        }
      ]
    },
    {
      "linkId": "TERTIARY_LAST_USED_30_DAYS",
      "text": "Times Used Tertiary Substance in Last 30 Days",
      "answer": [
        {
          "valueInteger": 2
        }
      ]
    },
    {
      "linkId": "TERTIARY_ROUTE_OF_USE",
      "text": "Route of Use of Tertiary Substance",
      "answer": [
        {
          "valueCoding": {
            "system": "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-substance-use-route-of-administration-cs",
            "code": "1"
          }
        }
      ]
    },
    {
      "linkId": "TERTIARY_START_AGE",
      "text": "Age of First Use of Tertiary Substance",
      "answer": [
        {
          "valueInteger": 29
        }
      ]
    },
    {
      "linkId": "episodeOfCare",
      "text": "Episode of Care Information",
      "answer": [
        {
          "valueReference": {
            "reference": "EpisodeOfCare/BHAEpisodeOfCareExampleNorthSUD"
          }
        }
      ]
    }
  ]
}