PrivateColposcopyVisitQuestionnaire
type: Questionnaire
node role: treeRoot
text:
  status:
    v: extensions
  div: Generated Narrative: Questionnaire PrivateColposcopyVisitQuestionnaire Structure LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> PrivateColposcopyVisitQuestionnaire Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/PrivateColposcopyVisitQuestionnaire#0.1.1 #xD; p01-ClinicInformation page 01. Clinic Information 0..1 group #xD; p01-q01-ClinicName page 01 question 1. Colposcopy HPI facility ID 0..1 reference #xD; p02-VisitInformation page 02. Colposcopy Visit 0..1 group #xD; p02-q01-VisitDate page 02 question 1. Date of Visit 1..1 date #xD; p02-q02-AdmissionType page 02 question 2. Admission Type 1..1 choice Options: 3 options #xD; p02-q03-ColposcopyPerformed page 02 question 3. Colposcopy Performed 1..1 boolean #xD; p02-q04-ColposcopySite page 02 question 4. Colposcopy Site 1..1 choice Options: 4 options #xD; p02-q05-ColposcopySiteOther page 02 question 5. Please describe the Alternative Site 1..1 text Enable When: p02-q04-ColposcopySite = #xD; p02-q06-ResultsDiscussed page 02 question 6. Review / Results Discussed? 1..1 boolean #xD; p02-q07-ArrangedTreatment page 02 question 7. Arranged Treatment? 1..1 boolean #xD; p03-ColposcopyFindings page 03. Colposcopy Findings 0..1 group #xD; p03-q01-HysterectomyStatus page 03 question 1. Patient has total hysterectomy? 1..1 boolean #xD; p03-q02-SquamocolumnarJunction page 03 question 2. Squamocolumnar junction visible 1..1 choice Enable When: p03-q01-HysterectomyStatus = Options: 3 options #xD; p03-q03-TransformationZone page 03 question 3. Transformation Zone type 1..1 choice Enable When: p03-q01-HysterectomyStatus = Options: 3 options #xD; p03-q04-LesionPresent page 03 question 4. Lesion Present 1..1 choice Options: 3 options #xD; p03-q05-QuandrantsInvolved page 03 question 5. Number of Quadrants Involved 1..1 choice Enable When: p03-q04-LesionPresent = Options: 4 options #xD; p03-q06-ColposcopicAppearance page 03 question 6.…
url:
  v: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/PrivateColposcopyVisitQuestionnaire
identifier:
  use:
    v: official
  value:
    v: PrivateColposcopyVisitQuestionnaire
version:
  v: 0.1.1
name:
  v: PrivateColposcopyVisitQuestionnaire
title:
  v: Private Colposcopy Visit Summary Questionnaire
status:
  v: draft
experimental:
  v: false
subject type:
  v: Patient
date:
  v: 2025-11-25T01:49:39+00:00
publisher:
  v: Te Whatu Ora
contact:
  name:
    v: Te Whatu Ora
  telecom:
    system:
      v: url
    value:
      v: https://www.tewhatuora.govt.nz/
contact:
  name:
    v: Te Whatu Ora Integration Team
  telecom:
    system:
      v: email
    use:
      v: work
use context:
  code:
    system:
      v: http://terminology.hl7.org/CodeSystem/usage-context-type
    code:
      v: workflow
    display:
      v: Workflow Setting
  value: CodeableConcept
    text:
      v: Private Colposcopy Visit Summary
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: NZ
    display:
      v: New Zealand
purpose:
  v: To gather the Visit details of Private Colposcopy procedure.
item:
  link id:
    v: p01-ClinicInformation
  prefix:
    v: page 01
  text:
    v: Clinic Information
  type:
    v: group
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource
      value: code
        v: Location
    link id:
      v: p01-q01-ClinicName
    prefix:
      v: page 01 question 1
    text:
      v: Colposcopy HPI facility ID
    type:
      v: reference
    repeats:
      v: false
item:
  link id:
    v: p02-VisitInformation
  prefix:
    v: page 02
  text:
    v: Colposcopy Visit
  type:
    v: group
  item:
    link id:
      v: p02-q01-VisitDate
    prefix:
      v: page 02 question 1
    text:
      v: Date of Visit
    type:
      v: date
    required:
      v: true
    repeats:
      v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: p02-q02-AdmissionType
    prefix:
      v: page 02 question 2
    text:
      v: Admission Type
    type:
      v: choice
    required:
      v: true
    repeats:
      v: false
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
  item:
    link id:
      v: p02-q03-ColposcopyPerformed
    prefix:
      v: page 02 question 3
    text:
      v: Colposcopy Performed
    type:
      v: boolean
    required:
      v: true
    repeats:
      v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: p02-q04-ColposcopySite
    prefix:
      v: page 02 question 4
    text:
      v: Colposcopy Site
    type:
      v: choice
    required:
      v: true
    repeats:
      v: false
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
    answer option:
      value: Coding
  item:
    link id:
      v: p02-q05-ColposcopySiteOther
    prefix:
      v: page 02 question 5
    text:
      v: Please describe the Alternative Site
    type:
      v: text
    enable when:
      question:
        v: p02-q04-ColposcopySite
      operator:
        v: =
      answer: Coding
    enable behavior:
      v: all
    required:
      v: true
    repeats:
      v: false
  item:
    link id:
      v: p02-q06-ResultsDiscussed
    prefix:
      v: page 02 question 6
    text:
      v: Review / Results Discussed?

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: drop-down
display:
  v: Drop down

v: O

v: Outpatient

v: D

v: Day Patient

v: I

v: Inpatient

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: drop-down
display:
  v: Drop down

v: R

v: Cervical

v: V

v: Vaginal

v: B

v: Both Cervical and Vaginal

v: Other

v: Other

v: boolean

v: true

v: false

link id:
  v: p02-q07-ArrangedTreatment
prefix:
  v: page 02 question 7
text:
  v: Arranged Treatment?
type:
  v: boolean
required:
  v: true
repeats:
  v: false

link id:
  v: p03-ColposcopyFindings
prefix:
  v: page 03
text:
  v: Colposcopy Findings
type:
  v: group
item:
  link id:
    v: p03-q01-HysterectomyStatus
  prefix:
    v: page 03 question 1
  text:
    v: Patient has total hysterectomy?
  type:
    v: boolean
  required:
    v: true
  repeats:
    v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q02-SquamocolumnarJunction
  prefix:
    v: page 03 question 2
  text:
    v: Squamocolumnar junction visible
  type:
    v: choice
  enable when:
    question:
      v: p03-q01-HysterectomyStatus
    operator:
      v: =
    answer: boolean
      v: false
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      code:
        v: COMPL
      display:
        v: Completely
  answer option:
    value: Coding
      code:
        v: PART
      display:
        v: Partially
  answer option:
    value: Coding
      code:
        v: NVIS
      display:
        v: Not Visible
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q03-TransformationZone
  prefix:
    v: page 03 question 3
  text:
    v: Transformation Zone type
  type:
    v: choice
  enable when:
    question:
      v: p03-q01-HysterectomyStatus
    operator:
      v: =
    answer: boolean
      v: false
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      code:
        v: COMPL
      display:
        v: Completely
  answer option:
    value: Coding
      code:
        v: PART
      display:
        v: Partially
  answer option:
    value: Coding
      code:
        v: NVIS
      display:
        v: Not Visible
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q04-LesionPresent
  prefix:
    v: page 03 question 4
  text:
    v: Lesion Present
  type:
    v: choice
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      code:
        v: Y
      display:
        v: Yes
  answer option:
    value: Coding
      code:
        v: N
      display:
        v: No
  answer option:
    value: Coding
      display:
        v: Inconclusive
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q05-QuandrantsInvolved
  prefix:
    v: page 03 question 5
  text:
    v: Number of Quadrants Involved
  type:
    v: choice
  enable when:
    question:
      v: p03-q04-LesionPresent
    operator:
      v: =
    answer: Coding
      code:
        v: Y
      display:
        v: Yes
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      display:
        v: 1
  answer option:
    value: Coding
      display:
        v: 2
  answer option:
    value: Coding
      display:
        v: 3
  answer option:
    value: Coding
      display:
        v: 4
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p03-q06-ColposcopicAppearance
  prefix:
    v: page 03 question 6
  text:
    v: Colposcopic appearance
  type:
    v: choice
  required:
    v: true

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: false

value: Coding
  code:
    v: NRML
  display:
    v: Normal

value: Coding
  code:
    v: ABML
  display:
    v: Abnormal

value: Coding
  code:
    v: INCON
  display:
    v: Inconclusive

link id:
  v: p03-q07-LesionVisible
prefix:
  v: page 03 question 7
text:
  v: Limits of Lesion Visible
type:
  v: boolean
enable when:
  question:
    v: p03-q04-LesionPresent
  operator:
    v: =
  answer: Coding
    code:
      v: Y
    display:
      v: Yes
enable behavior:
  v: all
required:
  v: true
repeats:
  v: false

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: drop-down
      display:
        v: Drop down
link id:
  v: p03-q08-AbnormalityGrade
prefix:
  v: page 03 question 8
text:
  v: Predicted Grade of Abnormality
type:
  v: choice
enable when:
  question:
    v: p03-q06-ColposcopicAppearance
  operator:
    v: =
  answer: Coding
    code:
      v: ABML
    display:
      v: Abnormal
enable behavior:
  v: all
required:
  v: true
repeats:
  v: false
answer option:
  value: Coding
    code:
      v: Low-Grade Squamous
    display:
      v: Low-Grade Squamous
answer option:
  value: Coding
    code:
      v: ABML
    display:
      v: High-Grade Squamous
answer option:
  value: Coding
    code:
      v: INCON
    display:
      v: Glandular (AIS)
answer option:
  value: Coding
    code:
      v: INCON
    display:
      v: Micro-invasive cancer
answer option:
  value: Coding
    code:
      v: INCON
    display:
      v: Invasive cancer (squamous/glandular)

link id:
  v: p04-ActionsTaken
prefix:
  v: page 04
text:
  v: Actions Taken
type:
  v: group
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p04-q01-CervicalSample
  prefix:
    v: page 04 question 1
  text:
    v: Cervical / vaginal sample
  type:
    v: choice
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      code:
        v: RPT
      display:
        v: Cervical / Vaginal Smear
  answer option:
    value: Coding
      code:
        v: HPV
      display:
        v: HPV test
  answer option:
    value: Coding
      display:
        v: Neither
  answer option:
    value: Coding
      display:
        v: Both
item:
  link id:
    v: p04-q02-PunchBiopsy
  prefix:
    v: page 04 question 2
  text:
    v: Punch biopsy
  type:
    v: boolean
  required:
    v: true
  repeats:
    v: false
item:
  link id:
    v: p04-q03-BiopsySite
  prefix:
    v: page 04 question 3
  text:
    v: Site of Biopsy(s)
  type:
    v: text
  enable when:
    question:
      v: p04-q02-PunchBiopsy
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p04-q04-BiopsyReason
  prefix:
    v: page 04 question 4
  text:
    v: Reason for not taking biopsy(s)
  type:
    v: choice
  enable when:
    question:
      v: p04-q02-PunchBiopsy
    operator:
      v: =
    answer: boolean
      v: false
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      display:
        v: Declined
  answer option:
    value: Coding
      display:
        v: Pregnant
  answer option:
    value: Coding
      display:
        v: Discarded as inadequate
  answer option:
    value: Coding
      display:
        v: Other
item:
  link id:
    v: p04-q05-BiopsyReasonOther
  prefix:
    v: page 04 question 5
  text:
    v: Other Reason for biopsy not taken
  type:
    v: text
  enable when:
    question:
      v: p04-q04-BiopsyReason
    operator:
      v: =
    answer: Coding
      display:
        v: Other
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
item:
  link id:
    v: p04-q06-TreatmentTaken
  prefix:
    v: page 04 question 6
  text:
    v: Treatment this visit
  type:
    v: boolean
  required:
    v: true
  repeats:
    v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p04-q07-TreatmentType
  prefix:
    v: page 04 question 7
  text:
    v: Type of treatment
  type:
    v: choice
  enable when:
    question:
      v: p04-q06-TreatmentTaken
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      code:
        v: ELCT
      display:
        v: Wireloop excisional procedure
  answer option:
    value: Coding
      code:
        v: LASA
      display:
        v: Laser ablation
  answer option:
    value: Coding
      display:
        v: Ablation by means other than laser
  answer option:
    value: Coding
      code:
        v: CKNF

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: drop-down

v: Drop down

v: Cold knife cone biopsy cervix

value: Coding
  code:
    v: DIC
  display:
    v: Diathermy cone

value: Coding
  code:
    v: LASE
  display:
    v: Laser cone

value: Coding
  code:
    v: HYST
  display:
    v: Total hysterectomy

value: Coding
  code:
    v: SUBH
  display:
    v: Sub-total hysterectomy

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: radio-button
      display:
        v: Radio Button
link id:
  v: p04-q08-AnaesthesiaUsed
prefix:
  v: page 04 question 8
text:
  v: Local or general anaesthesia used
type:
  v: choice
required:
  v: true
repeats:
  v: false
answer option:
  value: Coding
    code:
      v: GEN
    display:
      v: General
answer option:
  value: Coding
    code:
      v: LOCAL
    display:
      v: Local
answer option:
  value: Coding
    code:
      v: NA
    display:
      v: N/A

link id:
  v: p04-q09-AnaesthesiaReason
prefix:
  v: page 04 question 9
text:
  v: Reason for General Anasthesia
type:
  v: text
enable when:
  question:
    v: p04-q08-AnaesthesiaUsed
  operator:
    v: =
  answer: Coding
    code:
      v: GEN
    display:
      v: General
enable behavior:
  v: all
required:
  v: true
repeats:
  v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Help-Button
  link id:
    v: p04-q09.1-AnaesthesiaReasonHelpText
  prefix:
    v: page 04 question 9.1
  text:
    v: This information is required as 80% of anaesthesia should be local
  type:
    v: display

v: help

v: Help-Button

link id:
  v: p05-DataRecieved
prefix:
  v: page 05
text:
  v: Data Recieved
type:
  v: group
item:
  link id:
    v: p05-q01-HistologyReport
  prefix:
    v: page 05 question 1
  text:
    v: Date histology specimen report received
  type:
    v: date
  required:
    v: false
  repeats:
    v: false
item:
  link id:
    v: p05-q02-DecisionDate
  prefix:
    v: page 05 question 2
  text:
    v: Decision to treat date
  type:
    v: date
  required:
    v: false
  repeats:
    v: false
item:
  link id:
    v: p05-q03-InformParticipantDate
  prefix:
    v: page 05 question 3
  text:
    v: Date participant informed
  type:
    v: date
  required:
    v: false
  repeats:
    v: false
item:
  link id:
    v: p05-q04-FollowupRecommended
  prefix:
    v: page 05 question 4
  text:
    v: Follow-up management at colposcopy recommended
  type:
    v: boolean
  required:
    v: false
  repeats:
    v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
  link id:
    v: p05-q05-NextVisit
  prefix:
    v: page 05 question 5
  text:
    v: Next visit recommended in (months
  type:
    v: choice
  enable when:
    question:
      v: p05-q04-FollowupRecommended
    operator:
      v: =
    answer: boolean
      v: true
  enable behavior:
    v: all
  required:
    v: true
  repeats:
    v: false
  answer option:
    value: Coding
      code:
        v: 7D
      display:
        v: 7 Days
  answer option:
    value: Coding
      code:
        v: 2W
      display:
        v: 2 Weeks
  answer option:
    value: Coding
      code:
        v: 6W
      display:
        v: 6 Weeks
  answer option:
    value: Coding
      code:
        v: 1M
      display:
        v: 1 Month
  answer option:
    value: Coding
      code:
        v: 2M
      display:
        v: 2 Months
  answer option:
    value: Coding
      code:
        v: 3M
      display:
        v: 3 Months
  answer option:
    value: Coding
      code:
        v: 4M
      display:
        v: 4 Months
  answer option:
    value: Coding
      code:
        v: 5M
      display:
        v: 5 Months
  answer option:
    value: Coding
      code:
        v: 6M
      display:
        v: 6 Months
  answer option:
    value: Coding
      code:
        v: 7M
      display:
        v: 7 Months
  answer option:
    value: Coding
      code:
        v: 9M
      display:
        v: 9 Months
  answer option:
    value: Coding
      code:
        v: 12M
      display:
        v: 12 Months
  answer option:
    value: Coding
      code:
        v: 18M
      display:
        v: 18 Months
  answer option:
    value: Coding
      code:
        v: 36M
      display:
        v: 36 Months
  answer option:
    value: Coding
      code:
        v: 60M
      display:
        v: 60 Months

v: drop-down

v: Drop down