Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.0 - release New Zealand flag

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Questionnaire: COVID19 Initial Health Assessment Questionnaire

Official URL: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/COVIDInitialHealthAssessmentQuestionnaire Version: 0.4.0
Draft as of 2023-07-19 Computable Name: COVIDInitialHealthAssessmentQuestionnaire
Other Identifiers: COVIDInitialHealthAssessmentQuestionnaire (use: official, period: 7/19/23 --> (ongoing)), QuestionTemplate-CitC-COVID19-InitialAssessment (use: temp, period: (?) --> 7/19/23)

Usage:Workflow Setting: 

An initial assessment for a patient who has tested positive for COVID-19

Gather status and conditions for a patient who is self-isolating.

Generated Narrative: Questionnaire COVIDInitialHealthAssessmentQuestionnaire

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. COVIDInitialHealthAssessmentQuestionnaireAn initial assessment for a patient who has tested positive for COVID-19Questionnairehttps://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/COVIDInitialHealthAssessmentQuestionnaire#0.4.0
... 11.. Past Health and Wellbeing History - ask questions to find out about:0..1group
.... 1.11.1.. Hypertension?1..1booleanInitial Value: boolean = false
.... 1.21.2.. Diabetes?1..1booleanInitial Value: boolean = false
.... 1.2.11.2.1. If using insulin please provide details?0..1stringEnable When: 1.2 =
.... 1.31.3.. Asthma?1..1booleanInitial Value: boolean = false
.... 1.41.4.. Previous stroke?1..1booleanInitial Value: boolean = false
.... 1.51.5.. Cancer?1..1booleanInitial Value: boolean = false
.... 1.5.11.5.1. Please provide cancer details0..1textEnable When: 1.5 =
.... 1.61.6.. Current/recent pregnancy?1..1booleanInitial Value: boolean = false
.... 1.6.a1.6.a.. Pregnancy assessment0..1groupEnable When: 1.6 =
..... 1.6.11.6.1. Gestation (number of weeks)0..1string
..... 1.6.21.6.2. Postpartum (number of weeks)0..1string
.... 1.71.7.. Immunocompromised?1..1booleanInitial Value: boolean = false
.... 1.7.11.7.1. Specify immunocompromised further details0..1textEnable When: 1.7 =
.... 1.81.8.. Previous heart attack or heart failure?1..1booleanInitial Value: boolean = false
.... 1.91.9.. Epilepsy?1..1booleanInitial Value: boolean = false
.... 1.101.10.. Other respiratory disease?1..1booleanInitial Value: boolean = false
.... 1.111.11.. Mental health and/or addiction?1..1booleanInitial Value: boolean = false
.... 1.121.12.. Kidney disease?1..1booleanInitial Value: boolean = false
.... 1.131.13.. CPAP device used?1..1booleanInitial Value: boolean = false
.... 1.141.14.. Weight?1..1choiceOptions: 4 options
.... 1.151.15.. Other0..1string
... 22.. Medication and Allergies0..1group
.... 2.12.1.. Smoking?1..1booleanInitial Value: boolean = false
.... 2.1b2.1b.. Would you like NRT?0..1booleanEnable When: 2.1 =
.... 2.22.2.. Alcohol?1..1booleanInitial Value: boolean = false
.... 2.2.12.2.1.. Drinks per week?0..1choiceEnable When: 2.2 =
Options: 3 options
.... 2.32.3.. Recreational drugs?0..1booleanInitial Value: boolean = false
.... 2.42.4.. Allergies?1..1booleanInitial Value: boolean = false
.... 2.4.12.4.1.. Medication Allergies1..1booleanEnable When: 2.4 =
Initial Value: boolean = false
.... 2.4.1.12.4.1.1.. Medicine0..1stringEnable When: 2.4.1 =
.... 2.4.1.22.4.1.2.. Category (select)0..1choiceEnable When: 2.4.1 =
Options: 3 options
.... 2.4.1.32.4.1.3.. Reaction (select)0..1choiceEnable When: 2.4.1 =
Options: 4 options
.... 2.4.1.42.4.1.4.. Onset Date0..1dateEnable When: 2.4.1 =
.... 2.4.1.52.4.1.5.. Date of Entry0..1dateEnable When: 2.4.1 =
.... 2.4.1.62.4.1.6.. Active?1..1booleanEnable When: 2.4.1 =
Initial Value: boolean = true
.... 2.4.1.6.12.4.1.6.1.. Specify Reason for deactivation0..1stringEnable When: 2.4.1.6 =
.... 2.4.1.72.4.1.7.. Comments0..1textEnable When: 2.4.1 =
.... 2.4.22.4.2.. Other allergies1..1textEnable When: 2.4 =
.... 2.52.5.. Prescription medication or medical devices (eg. CPAP, nebuliser, blood glucose meter)?1..1booleanInitial Value: boolean = false
.... 2.62.6.. Details of medications, medical devices, recreational drugs here0..1text
.... 2.72.7.. Able to manage meds independently?0..1booleanInitial Value: boolean = false
.... 2.82.8.. Sufficient supply for 14 days?0..1boolean
.... 2.92.9.. Taking immunosuppressant?0..1boolean
... 33.. Individual assessment plan/guideline0..1group
.... 3.13.1.. Individual assessment plan / guideline0..1text

doco Documentation for this format

Options Sets

Answer options for 1.14

  • Under
  • Average
  • Over
  • Obese

Answer options for 2.2.1

  • <10
  • 10-16
  • >16

Answer options for 2.4.1.2

  • Allergy
  • Patient Complaint
  • Side Effect

Answer options for 2.4.1.3

  • Mild
  • Moderate
  • Severe
  • Anaphylaxis