Package | tewhatuora.rheumaticfever |
Type | Questionnaire |
Id | Id |
FHIR Version | R4 |
Source | https://fhir-ig.digital.health.nz/rheumatic-fever/https://build.fhir.org/ig/tewhatuora/fhir-rheumatic-fever/Questionnaire-OralSecondaryProphylaxisHealthAssessmentQuestionnaire.html |
Url | https://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/OralSecondaryProphylaxisHealthAssessmentQuestionnaire |
Version | 1.0.0 |
Status | draft |
Date | 2024-06-17 |
Name | OralSecondaryProphylaxisHealthAssessmentQuestionnaire |
Title | Oral Secondary Prophylaxis Health Assessment Questionnaire |
Experimental | False |
Authority | national |
Description | Gathers information about patient health at an oral secondary prophylaxis medication appointment |
Purpose | Gathers information about patient health at an appointemnt for oral secondary prophylaxis medication |
No resources found
No resources found
{
"resourceType" : "Questionnaire",
"id" : "OralSecondaryProphylaxisHealthAssessmentQuestionnaire",
"url" : "https://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/OralSecondaryProphylaxisHealthAssessmentQuestionnaire",
"identifier" : [
{
"use" : "official",
"value" : "OralSecondaryProphylaxisHealthAssessmentQuestionnaire",
"period" : {
"start" : "2024-06-17"
}
}
],
"version" : "1.0.0",
"name" : "OralSecondaryProphylaxisHealthAssessmentQuestionnaire",
"title" : "Oral Secondary Prophylaxis Health Assessment Questionnaire",
"status" : "draft",
"experimental" : false,
"subjectType" : [
"Patient"
],
"date" : "2024-06-17",
"publisher" : "Te Whatu Ora",
"contact" : [
{
"name" : "Te Whatu Ora",
"telecom" : [
{
"system" : "url",
"value" : "https://www.tewhatuora.govt.nz/"
},
{
"system" : "email",
"value" : "integration@tewhatuora.govt.nz"
}
]
},
{
"name" : "HNZ Integration Team",
"telecom" : [
{
"system" : "email",
"value" : "integration@tewhatuora.govt.nz",
"use" : "work"
}
]
}
],
"description" : "Gathers information about patient health at an oral secondary prophylaxis medication appointment",
"purpose" : "Gathers information about patient health at an appointemnt for oral secondary prophylaxis medication",
"item" : [
{
"linkId" : "page1",
"prefix" : "page1",
"text" : "Please complete this questionnaire at the oral secondary prophylaxis appointment to assess a rheumatic fever patient's health.",
"type" : "display"
},
{
"linkId" : "MedicationIssues",
"prefix" : "1",
"text" : "Has the patient had any issues taking their medications?",
"type" : "boolean",
"required" : true
},
{
"linkId" : "DelaysObtainingMedication",
"prefix" : "2)",
"text" : "Were there delays in obtaining medications that interrupted the patientâs treatment?",
"type" : "boolean",
"required" : true
},
{
"linkId" : "DelaysObtainingMedicationDetail",
"prefix" : "2.1)",
"text" : "Enter details of delays in obtaining medication that interrupted patient's treatment (enter text)",
"type" : "text",
"enableWhen" : [
{
"question" : "DelaysObtainingMedication",
"operator" : "=",
"answerBoolean" : true
}
],
"required" : true
},
{
"linkId" : "SufficientMedication",
"prefix" : "3)",
"text" : "Does the patient have enough medication to last until their next check-in?",
"type" : "boolean",
"required" : true
},
{
"linkId" : "PlanForObtainingMedications",
"prefix" : "4)",
"text" : "Plan for obtaining medications to last until next check-in (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "AnyOtherConcerns",
"prefix" : "5)",
"text" : "Were There Any Other Concerns or Issues Identified During the Visit?",
"type" : "boolean",
"required" : true,
"initial" : [
{
"valueBoolean" : false
}
]
},
{
"linkId" : "OtherConcernsDetail",
"prefix" : "5.1)",
"text" : "If yes, describe details, actions taken, and follow-up planned (enter text)",
"type" : "text",
"enableWhen" : [
{
"question" : "AnyOtherConcerns",
"operator" : "=",
"answerBoolean" : true
}
],
"required" : true
},
{
"linkId" : "HealthEducationTopicsDiscussed",
"prefix" : "6)",
"text" : "Health education topics discussed? (multiple choice)",
"type" : "choice",
"required" : true,
"repeats" : true,
"answerOption" : [
{
"valueString" : "Secondary prophylaxis"
},
{
"valueString" : "Sore Throat Management"
},
{
"valueString" : "Skin Infection Management"
},
{
"valueString" : "Dental Health"
},
{
"valueString" : "Endocarditis Prophylaxis"
},
{
"valueString" : "Nutrition"
},
{
"valueString" : "Physical Activity"
},
{
"valueString" : "Healthy Home Environments"
},
{
"valueString" : "Sexual Health"
},
{
"valueString" : "Other"
}
]
},
{
"linkId" : "HealthEducationOtherDetail",
"prefix" : "6.1)",
"text" : "Enter details of other health education topic discussed (enter text)",
"type" : "text",
"enableWhen" : [
{
"question" : "HealthEducationTopicsDiscussed",
"operator" : "=",
"answerString" : "Other"
}
],
"required" : true
},
{
"linkId" : "RecentOrUpcomingAppointments",
"prefix" : "7)",
"text" : "Any recent or upcoming follow-up appointments?",
"type" : "boolean",
"required" : true
},
{
"linkId" : "RecentOrUpcomingAppointmentsDetails",
"prefix" : "7.1)",
"text" : "Enter details and dates of any recent or upcoming follow-up appointments (enter text)",
"type" : "text",
"enableWhen" : [
{
"question" : "RecentOrUpcomingAppointments",
"operator" : "=",
"answerBoolean" : true
}
],
"required" : true
},
{
"linkId" : "PlanForNextMedicationAppointment",
"prefix" : "8)",
"text" : "Comments for the next appointment (enter text)",
"type" : "text",
"required" : true
}
],
"text" : {
}
}
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