AntiViralEligibilityQuestionnaire
type: Questionnaire
node role: treeRoot
id:
  v: AntiViralEligibilityQuestionnaire
text:
  status:
    v: extensions
  div: Generated Narrative: Questionnaire AntiViralEligibilityQuestionnaire Structure LinkID Text Cardinality Type Flags Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> AntiViralEligibilityQuestionnaire A questionnaire defining eligibility criteria for anti-viral medication Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/AntiViralEligibilityQuestionnaire#1.0.1 #xD; CurrentDate Current Date/Time 1..1 dateTime #xD; CurrentDateTime_helpText Current date/time 0..1 display #xD; ReviewDate Date Review Performed 1..1 date #xD; ReviewDate_helpText The date that the review was performed 0..1 display #xD; case-definition-panel CASE DEFINITION The transition from PCR to RATs as a primary mode of testing requires the clinical criteria to be applied thoughtfully and practically alongside the Case Definition. The case definitions were based upon PCR tests being the primary mode of diagnosis and the focus has now changed to clinical decision making based on a RAT result in the majority of cases. Clinical discretion should be applied to household contacts who test negative by RAT but are presenting with symptoms typical of COVID-19 infection. Although this population is not defined by the Case Definition^, clinical discretion may support recognition as a likely case and initiation of treatment, where indicated. ^For definition see https://www.tewhatuora.govt.nz/for-the-health-sector/covid-19-information-for-health-professionals/case-definition-and-clinical-testing-guidelines-for-covid-19#:~:text=Case%20definitions&text=A%20case%20that%20has%20laboratory,a%20validated%20NAAT%20(PCR) 0..1 group #xD; COVID19-Positive Is the patient a COVID-19 case as per the case definition or clinical criteria? 1..1 boolean Initial Value: boolean = false #xD; criteria-panel Does the patient meet the current Pharmac criteria for COVID-19 Antivitals? 0..1 group #xD; SymptomsStart 1. Symptoms started: 1..1 choice Value Set: https://nzhts…
url:
  v: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/AntiViralEligibilityQuestionnaire
identifier:
  use:
    v: official
  value:
    v: AntiViralEligibilityQuestionnaire
  period:
    start:
      v: 2023-03-07
identifier:
  use:
    v: temp
  value:
    v: Questionnaire-AntiViralEligibilityQuestionnaire
  period:
    start:
      v: 2023-03-07
    end:
      v: 2026-03-07
version:
  v: 1.0.1
name:
  v: AntiViralEligibilityQuestionnaire
title:
  v: Antiviral medication eligibility questionnaire
status:
  v: draft
experimental:
  v: false
subject type:
  v: Patient
date:
  v: 2024-03-22
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
description:
  v: A questionnaire defining eligibility criteria for anti-viral medication
use context:
  code:
    system:
      v: http://terminology.hl7.org/CodeSystem/usage-context-type
    code:
      v: workflow
    display:
      v: Workflow Setting
  value: CodeableConcept
    text:
      v: AntiViral Eligibility Assessment
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: NZ
    display:
      v: New Zealand
purpose:
  v: Assess a patient's eligibility against criteria for anti-viral medication
item:
  link id:
    v: CurrentDate
  text:
    v: Current Date/Time
  type:
    v: dateTime
  required:
    v: true
  repeats:
    v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: CurrentDateTime_helpText
    text:
      v: Current date/time
    type:
      v: display
item:
  link id:
    v: ReviewDate
  text:
    v: Date Review Performed
  type:
    v: date
  required:
    v: true
  repeats:
    v: false
  read only:
    v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
      value: CodeableConcept
    link id:
      v: ReviewDate_helpText
    text:
      v: The date that the review was performed
    type:
      v: display
item:
  link id:
    v: case-definition-panel
  text:
    v: CASE DEFINITION The transition from PCR to RATs as a primary mode of testing requires the clinical criteria to be applied thoughtfully and practically alongside the Case Definition. The case definitions were based upon PCR tests being the primary mode of diagnosis and the focus has now changed to clinical decision making based on a RAT result in the majority of cases. Clinical discretion should be applied to household contacts who test negative by RAT but are presenting with symptoms typical of COVID-19 infection. Although this population is not defined by the Case Definition^, clinical discretion may support recognition as a likely case and initiation of treatment, where indicated. ^For definition see https://www.tewhatuora.govt.nz/for-the-health-sector/covid-19-information-for-health-professionals/case-definition-and-clinical-testing-guidelines-for-covid-19#:~:text=Case%20definitions&text=A%20case%20that%20has%20laboratory,a%20validated%20NAAT%20(PCR)
  type:
    v: group
  item:
    link id:
      v: COVID19-Positive
    text:
      v: Is the patient a COVID-19 case as per the case definition or clinical criteria?
    type:
      v: boolean
    required:
      v: true
    initial:
      value: boolean
        v: false
item:
  link id:
    v: criteria-panel
  text:
    v: Does the patient meet the current Pharmac criteria for COVID-19 Antivitals?
  type:
    v: group
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer
      value: url
        v: https://nzhts.digital.health.nz/fhir
    link id:
      v: SymptomsStart
    text:
      v: 1. Symptoms started:
    type:
      v: choice
    required:
      v: true
    answer value set:
      v: https://nzhts.digital.health.nz/fhir/ValueSet/antiviral-eligibility-symptoms-started
      link: https://nzhts.digital.health.nz/fhir/ValueSet/antiviral-eligibility-symptoms-started
  item:
    link id:
      v: supoxygen
    text:
      v: 2. My patient requires supplemental oxygen
    type:
      v: boolean
    required:
      v: true
    repeats:
      v: false
    read only:
      v: false
  item:
    extension:
      url:
        v: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer
      value: url
        v: https://nzhts.digital.health.nz/fhir
    link id:
      v: criteria
    text:
      v: 3. My patient's condition or circumstance (choose one):
    type:
      v: choice
    required:
      v: true
    repeats:
      v: false
    answer value set:
      v: https://nzhts.digital.health.nz/fhir/ValueSet/COVID-19-antiviral-eligibility-criteria
      link: https://nzhts.digital.health.nz/fhir/ValueSet/COVID-19-antiviral-eligibility-criteria

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: help
display:
  v: Help-Button

v: Help-Button

system:
  v: http://hl7.org/fhir/questionnaire-item-control
code:
  v: help
display:
  v: Help-Button

v: Help-Button

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
  value: CodeableConcept
    coding:
      system:
        v: http://hl7.org/fhir/questionnaire-item-control
      code:
        v: help
      display:
        v: Help-Button
    text:
      v: Help-Button
link id:
  v: myPatientCriteria_helpText
text:
  v: [1]For definition of Ministry of Health criteria of ‘severe immunocompromise’ for third primary dose see: https://www.health.govt.nz/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-severely-immunocompromised-people#criteria [2]A primary dose for most people is 2 vaccinations [3]For Ministry of Health's definition of high-risk conditions see https://covid19.govt.nz/testing-and-isolation/if-you-have-covid-19/medicines-to-treat-covid-19/
type:
  v: display

link id:
  v: eligible-no
text:
  v: Assessment: No - the patient IS NOT eligible for COVID-19 Antivirals
type:
  v: choice
enable when:
  question:
    v: SymptomsStart
  operator:
    v: =
  answer: Coding
    system:
      v: https://nzhts.digital.health.nz/fhir/ValueSet/antiviral-eligibility-symptoms-started
    code:
      v: not-recent
enable when:
  question:
    v: supoxygen
  operator:
    v: =
  answer: boolean
    v: true
enable when:
  question:
    v: criteria
  operator:
    v: =
  answer: Coding
    system:
      v: https://nzhts.digital.health.nz/fhir/ValueSet/COVID-19-antiviral-eligibility-criteria
    code:
      v: none-of-the-above
enable behavior:
  v: any
required:
  v: false
answer option:
  value: Coding
    code:
      v: confirm
    display:
      v: confirm

link id:
  v: eligible-yes
text:
  v: Assessment: Yes - the patient IS eligible for COVID-19 Antivirals
type:
  v: choice
enable when:
  question:
    v: SymptomsStart
  operator:
    v: !=
  answer: Coding
    system:
      v: https://nzhts.digital.health.nz/fhir/ValueSet/antiviral-eligibility-symptoms-started
    code:
      v: not-recent
enable when:
  question:
    v: supoxygen
  operator:
    v: !=
  answer: boolean
    v: true
enable when:
  question:
    v: criteria
  operator:
    v: !=
  answer: Coding
    system:
      v: https://nzhts.digital.health.nz/fhir/ValueSet/COVID-19-antiviral-eligibility-criteria
    code:
      v: none-of-the-above
enable behavior:
  v: all
required:
  v: false
answer option:
  value: Coding
    code:
      v: confirm
    display:
      v: confirm

link id:
  v: PharmacistInformation
text:
  v: Please provide pharmacist details
type:
  v: group
item:
  link id:
    v: PharmacistName
  text:
    v: Pharmacist Name
  type:
    v: string
  required:
    v: true
item:
  link id:
    v: PharmacistID
  text:
    v: Pharmacist ID
  type:
    v: string
  required:
    v: true

link id:
  v: PharmacyInformation
text:
  v: Please provide details about the pharmacy organisation
type:
  v: group
item:
  link id:
    v: PharmacyName
  text:
    v: Pharmacy Name
  type:
    v: string
  required:
    v: true
item:
  link id:
    v: PharmacyHPI
  text:
    v: Pharmacy HPI
  type:
    v: string
  required:
    v: true
item:
  link id:
    v: PharmacyAddress
  text:
    v: Pharmacy address details
  type:
    v: text

link id:
  v: GeneralPracticeInformation
text:
  v: Please provide details about the patient's general practice
type:
  v: group
item:
  link id:
    v: GPName
  text:
    v: GP Practice Name
  type:
    v: string
  required:
    v: false
item:
  link id:
    v: GPEDI
  text:
    v: Practice EDI
  type:
    v: string
  required:
    v: false

link id:
  v: SendToGP
text:
  v: Send note to GP Inbox?
type:
  v: boolean
required:
  v: false
initial:
  value: boolean
    v: false
item:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl
    value: CodeableConcept
      text:
        v: Help-Button
  link id:
    v: SendToGP_helpText
  text:
    v: It may not be necessary to send this message. Please consider if clinically-relevant before sending.
  type:
    v: display

v: help

v: Help-Button