{ "resourceType" : "Questionnaire", "id" : "DHOPatientScreeningToolIPC", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire DHOPatientScreeningToolIPC

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\"\"\"\" DHOPatientScreeningToolIPCPatient infection prevention and control screening tool for district use.Questionnairehttps://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOPatientScreeningToolIPC#1.0
\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-groupPlease complete this questionarie0..1group
\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / vomiting1. Diarrhoea / vomiting?0..1group
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / vomiting / bowelmotionHave you had 3 or more loose or watery bowel motions, or any vomiting, in the past 24 hours?0..1boolean
\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / Infectious Disease2. Other infectious disease?0..1group
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / Infectious Disease / otherinfectiousDo you currently have any other infectious disease or infection, such as a skin infection or wound infection, a known contagious illness or an infection requiring antibiotics?0..1boolean
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / Infectious Disease / specifyreasonIf Yes, please specify0..1stringEnable When: otherinfectious = true
\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / Acuterespiratoryillnesses3. Acute respiratory illnesses?0..1group
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / Acuterespiratoryillnesses / acuterespiratoryillnessHave you tested positive for a respiratory illness (e.g. COVID-19, influenza, or RSV) in the last 10 days (14 days if you are immunocompromised)?0..1boolean
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / Acuterespiratoryillnesses / specifyillenessIf Yes, please specify the name of the illness0..1stringEnable When: acuterespiratoryillness = true
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / Acuterespiratoryillnesses / dateofpositivetestDate of Positive Test0..1dateEnable When: acuterespiratoryillness = true
\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / symptomsworsen4. Do you have any of the following symptoms that are new or worsened in the last 10 days?0..*choiceOptions: 6 options
\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / covidcontact5. Contact with COVID?0..1group
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / covidcontact / householdcontactHas anyone in your household or communal living situation\u202ftested positive for COVID‑19 in the last 10 days?0..1boolean
\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / fever_026. Fever0..1group
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / fever_02 / feverHave you had a fever (38°C or higher) in the past 24 hours?0..1boolean
\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / measles_017. Measles0..1group
\"\"\"\"\"\"\"\"\"\" DHOPatientScreeningToolIPC / questions-a-e-group / measles_01 / measlesIn the last 21 days, have you been in close contact with anyone diagnosed with or suspected of having measles?0..1boolean

\"doco\" Documentation for this format

Options Sets

Answer options for symptomsworsen

" }, "url" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOPatientScreeningToolIPC", "identifier" : [{ "use" : "official", "value" : "DHOPatientScreeningToolIPC" }], "version" : "1.0", "name" : "DHOPatientScreeningToolIPC", "title" : "Patient Screening Tool IPC (District)", "status" : "active", "subjectType" : ["Patient"], "date" : "2026-10-13T01:26:02+00:00", "publisher" : "Te Whatu Ora", "contact" : [{ "name" : "Te Whatu Ora", "telecom" : [{ "system" : "url", "value" : "https://www.tewhatuora.govt.nz/" }] }, { "name" : "Te Whatu Ora Integration Team", "telecom" : [{ "system" : "email", "value" : "integration@tewhatuora.govt.nz", "use" : "work" }] }], "description" : "Patient infection prevention and control screening tool for district use.", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "NZ", "display" : "New Zealand" }] }], "purpose" : "Patient infection prevention and control screening tool for district use.", "item" : [{ "linkId" : "questions-a-e-group", "text" : "Please complete this questionarie", "type" : "group", "required" : false, "item" : [{ "linkId" : "vomiting", "text" : "1. Diarrhoea / vomiting?", "type" : "group", "required" : false, "item" : [{ "linkId" : "bowelmotion", "text" : "Have you had 3 or more loose or watery bowel motions, or any vomiting, in the past 24 hours?", "type" : "boolean", "required" : false }] }, { "linkId" : "Infectious Disease", "text" : "2. Other infectious disease?", "type" : "group", "required" : false, "item" : [{ "linkId" : "otherinfectious", "text" : "Do you currently have any other infectious disease or infection, such as a skin infection or wound infection, a known contagious illness or an infection requiring antibiotics?", "type" : "boolean", "required" : false }, { "linkId" : "specifyreason", "text" : "If Yes, please specify", "type" : "string", "enableWhen" : [{ "question" : "otherinfectious", "operator" : "=", "answerBoolean" : true }], "enableBehavior" : "all", "required" : false }] }, { "linkId" : "Acuterespiratoryillnesses", "text" : "3. Acute respiratory illnesses?", "type" : "group", "required" : false, "item" : [{ "linkId" : "acuterespiratoryillness", "text" : "Have you tested positive for a respiratory illness (e.g. COVID-19, influenza, or RSV) in the last 10 days (14 days if you are immunocompromised)?", "type" : "boolean", "required" : false }, { "linkId" : "specifyilleness", "text" : "If Yes, please specify the name of the illness", "type" : "string", "enableWhen" : [{ "question" : "acuterespiratoryillness", "operator" : "=", "answerBoolean" : true }], "enableBehavior" : "all", "required" : false }, { "linkId" : "dateofpositivetest", "text" : "Date of Positive Test", "type" : "date", "enableWhen" : [{ "question" : "acuterespiratoryillness", "operator" : "=", "answerBoolean" : true }], "enableBehavior" : "all", "required" : false }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "check-box", "display" : "Check-box" }] } }], "linkId" : "symptomsworsen", "text" : "4. Do you have any of the following symptoms that are new or worsened in the last 10 days?", "type" : "choice", "required" : false, "repeats" : true, "answerOption" : [{ "valueCoding" : { "code" : "1", "display" : "Runny nose or nasal congestion" } }, { "valueCoding" : { "code" : "2", "display" : "New or worsening cough" } }, { "valueCoding" : { "code" : "3", "display" : "Unexplained fever" } }, { "valueCoding" : { "code" : "4", "display" : "Sore or scratchy throat" } }, { "valueCoding" : { "code" : "5", "display" : "New shortness of breath" } }, { "valueCoding" : { "code" : "6", "display" : "Chills or body aches" } }] }, { "linkId" : "covidcontact", "text" : "5. Contact with COVID?", "type" : "group", "required" : false, "item" : [{ "linkId" : "householdcontact", "text" : "Has anyone in your household or communal living situation\u202ftested positive for COVID‑19 in the last 10 days?", "type" : "boolean", "required" : false }] }, { "linkId" : "fever_02", "text" : "6. Fever", "type" : "group", "required" : false, "item" : [{ "linkId" : "fever", "text" : "Have you had a fever (38°C or higher) in the past 24 hours?", "type" : "boolean", "required" : false }] }, { "linkId" : "measles_01", "text" : "7. Measles", "type" : "group", "required" : false, "item" : [{ "linkId" : "measles", "text" : "In the last 21 days, have you been in close contact with anyone diagnosed with or suspected of having measles?", "type" : "boolean", "required" : false }] }] }] }