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

Generated Narrative: Questionnaire RemoteMonitoringCOPDSymptomSurveyQuestionnaire

Structure\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\"\"\"\" RemoteMonitoringCOPDSymptomSurveyQuestionnaireA questionnaire for a daily symptom surveying for Remote Monitoring of COPD PatientsQuestionnairehttps://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/RemoteMonitoringCOPDSymptomSurveyQuestionnaire#0.4.7
\"\"\"\"\"\" RemoteMonitoringCOPDSymptomSurveyQuestionnaire / p01page 1. Welcome to today's survey, this is your chance to tell us about how you have been feeling for the past day. Do you have any of these symptoms?0..1group
\"\"\"\"\"\"\"\" RemoteMonitoringCOPDSymptomSurveyQuestionnaire / p01 / p01-q01-Symptomspage 1 question 1. Think about what symptoms you have had in the last 24 hours?0..*choiceOptions: 7 options
\"\"\"\"\"\"\"\" RemoteMonitoringCOPDSymptomSurveyQuestionnaire / p01 / p01-q02-Peakflowpage 1 question 2. Did you use your Peakflow meter today?1..1boolean
\"\"\"\"\"\"\"\" RemoteMonitoringCOPDSymptomSurveyQuestionnaire / p01 / p01-q02-1-Peakflow.Valuepage 1 question 2.1. What was the score?0..1integerEnable When: p01-q02-Peakflow = true
\"\"\"\"\"\"\"\" RemoteMonitoringCOPDSymptomSurveyQuestionnaire / p01 / p01-q03-OtherInfopage 1 question 3. Is there anything else you want to tell us about the last 24 hours?0..1text

\"doco\" Documentation for this format

Options Sets

Answer options for p01-q01-Symptoms

" }, "url" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/RemoteMonitoringCOPDSymptomSurveyQuestionnaire", "identifier" : [{ "use" : "official", "value" : "RemoteMonitoringCOPDSymptomSurveyQuestionnaire" }], "version" : "0.4.7", "name" : "RemoteMonitoringCOPDSymptomSurveyQuestionnaire", "title" : "Remote Monitoring COPD Survey", "status" : "draft", "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" : "A questionnaire for a daily symptom surveying for Remote Monitoring of COPD Patients", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "NZ", "display" : "New Zealand" }] }], "item" : [{ "linkId" : "p01", "prefix" : "page 1", "text" : "Welcome to today's survey, this is your chance to tell us about how you have been feeling for the past day. Do you have any of these symptoms?", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down", "display" : "Drop down" }] } }], "linkId" : "p01-q01-Symptoms", "prefix" : "page 1 question 1", "text" : "Think about what symptoms you have had in the last 24 hours?", "type" : "choice", "required" : false, "repeats" : true, "answerOption" : [{ "valueCoding" : { "display" : "I am more breathless today than yesterday" } }, { "valueCoding" : { "display" : "I need my reliever medicine more often than yesterday" } }, { "valueCoding" : { "display" : "I am unable to do things I normally do" } }, { "valueCoding" : { "display" : "I am more tired" } }, { "valueCoding" : { "display" : "I am losing my appetite or interest in eating" } }, { "valueCoding" : { "display" : "I have signs of a fever (hot/cold flushes, a temperature)" } }, { "valueCoding" : { "display" : "I did not sleep well" } }] }, { "linkId" : "p01-q02-Peakflow", "prefix" : "page 1 question 2", "text" : "Did you use your Peakflow meter today?", "type" : "boolean", "required" : true }, { "linkId" : "p01-q02-1-Peakflow.Value", "prefix" : "page 1 question 2.1", "text" : "What was the score?", "type" : "integer", "enableWhen" : [{ "question" : "p01-q02-Peakflow", "operator" : "=", "answerBoolean" : true }], "enableBehavior" : "all" }, { "linkId" : "p01-q03-OtherInfo", "prefix" : "page 1 question 3", "text" : "Is there anything else you want to tell us about the last 24 hours?", "type" : "text", "required" : false, "repeats" : false }] }] }