Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.0 - release
Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.0 - release
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
| Draft as of 2023-07-19 |
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="COVIDPublicHealthHistoryQuestionnaire"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire COVIDPublicHealthHistoryQuestionnaire</b></p><a name="COVIDPublicHealthHistoryQuestionnaire"> </a><a name="hcCOVIDPublicHealthHistoryQuestionnaire"> </a><a name="COVIDPublicHealthHistoryQuestionnaire-en-NZ"> </a><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> COVIDPublicHealthHistoryQuestionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questions about a patient's recent COVID-19 history</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">https://fhir-ig.digital.health.nz/shared-care/Questionnaire/COVIDPublicHealthHistoryQuestionnaire#0.4.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.summary" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> summary</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questions about a patient's recent COVID-19 history</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item.p01" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> p01</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Public Health History</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q01-PlacesVisitedRecently" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="text" class="hierarchy"/> p01-q01-PlacesVisitedRecently</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 1. Places visited in last 14 days</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q02-PrevPositive" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="boolean" class="hierarchy"/> p01-q02-PrevPositive</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 2. Previous positive COVID-19 test?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q02-1-PrevPositiveMonth" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> p01-q02-1-PrevPositiveMonth</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 2-1. Month of positive COVID-19 test?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q02-PrevPositive">p01-q02-PrevPositive</a> = </span><br/>Options: <a href="#opt-item.p01-q02-1-PrevPositiveMonth">12 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q02-2-PrevPositiveYear" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> p01-q02-2-PrevPositiveYear</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 2-2. Year of positive COVID-19 test?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q02-PrevPositive">p01-q02-PrevPositive</a> = </span><br/>Options: <a href="#opt-item.p01-q02-2-PrevPositiveYear">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q03-HighSuspicionOfCOVID" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="boolean" class="hierarchy"/> p01-q03-HighSuspicionOfCOVID</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 3. High suspicion of prev. COVID-19?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q04-PotentialCloseContact" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="boolean" class="hierarchy"/> p01-q04-PotentialCloseContact</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 4. Potential close contact with a COVID-19 positive person in the last 14 days?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q05-COVID19Vaccine" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> p01-q05-COVID19Vaccine</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 5. COVID-19 vaccine?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.p01-q05-COVID19Vaccine">3 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose1-date" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: white; background-color: inherit" title="date" class="hierarchy"/> p01-q06-dose1-date</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 1st Dose. Date</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose1-vaccine" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> p01-q06-dose1-vaccine</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 1st Dose. Vaccine given</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q06-dose1-date">p01-q06-dose1-date</a> exists </span><br/>Options: <a href="#opt-item.p01-q06-dose1-vaccine">8 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose1-country" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> p01-q06-dose1-country</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 1st Dose. Country where vaccinated</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q06-dose1-date">p01-q06-dose1-date</a> exists </span><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-iso3166-1-2.html">Iso 3166 Part 1: 2 Letter Codes</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose2-date" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="date" class="hierarchy"/> p01-q06-dose2-date</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 2nd Dose. Date</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose2-vaccine" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> p01-q06-dose2-vaccine</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 2nd Dose. Vaccine given</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q06-dose2-date">p01-q06-dose2-date</a> exists </span><br/>Options: <a href="#opt-item.p01-q06-dose2-vaccine">8 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose2-country" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> p01-q06-dose2-country</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 2nd Dose. Country where vaccinated</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q06-dose2-date">p01-q06-dose2-date</a> exists </span><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-iso3166-1-2.html">Iso 3166 Part 1: 2 Letter Codes</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose3-date" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: white; background-color: inherit" title="date" class="hierarchy"/> p01-q06-dose3-date</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 3rd Dose. Date</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.p01-q06-dose3-vaccine" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> p01-q06-dose3-vaccine</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 3rd Dose. Vaccine given</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q06-dose3-date">p01-q06-dose3-date</a> exists </span><br/>Options: <a href="#opt-item.p01-q06-dose3-vaccine">8 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" id="item.p01-q06-dose3-country" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> p01-q06-dose3-country</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">question 6 - 3rd Dose. Country where vaccinated</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.p01-q06-dose3-date">p01-q06-dose3-date</a> exists </span><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-iso3166-1-2.html">Iso 3166 Part 1: 2 Letter Codes</a></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.p01-q02-1-PrevPositiveMonth"> </a><p><b>Answer options for p01-q02-1-PrevPositiveMonth </b></p><ul><li style="font-size: 11px">January</li><li style="font-size: 11px">February</li><li style="font-size: 11px">March</li><li style="font-size: 11px">April</li><li style="font-size: 11px">May</li><li style="font-size: 11px">June</li><li style="font-size: 11px">July</li><li style="font-size: 11px">August</li><li style="font-size: 11px">September</li><li style="font-size: 11px">October</li><li style="font-size: 11px">November</li><li style="font-size: 11px">December</li></ul><a name="opt-item.p01-q02-2-PrevPositiveYear"> </a><p><b>Answer options for p01-q02-2-PrevPositiveYear </b></p><ul><li style="font-size: 11px">2020</li><li style="font-size: 11px">2021</li><li style="font-size: 11px">2022</li><li style="font-size: 11px">2023</li><li style="font-size: 11px">2024</li><li style="font-size: 11px">2025</li><li style="font-size: 11px">2026</li><li style="font-size: 11px">2027</li><li style="font-size: 11px">2028</li><li style="font-size: 11px">2029</li><li style="font-size: 11px">2030</li></ul><a name="opt-item.p01-q05-COVID19Vaccine"> </a><p><b>Answer options for p01-q05-COVID19Vaccine </b></p><ul><li style="font-size: 11px">null#Full ("Full")</li><li style="font-size: 11px">null#Partial ("Partial")</li><li style="font-size: 11px">null#Nil ("Nil")</li></ul><a name="opt-item.p01-q06-dose1-vaccine"> </a><p><b>Answer options for p01-q06-dose1-vaccine </b></p><ul><li style="font-size: 11px">null#207 ("Moderna")</li><li style="font-size: 11px">null#208 ("Pfizer/BioNtech")</li><li style="font-size: 11px">null#210 ("AstraZeneca / Covishield")</li><li style="font-size: 11px">null#211 ("Novavax")</li><li style="font-size: 11px">null#212 ("Janssen")</li><li style="font-size: 11px">null#505 ("Sputnik V")</li><li style="font-size: 11px">null#510 ("Sinopharm")</li><li style="font-size: 11px">null#511 ("CoronaVac")</li></ul><a name="opt-item.p01-q06-dose2-vaccine"> </a><p><b>Answer options for p01-q06-dose2-vaccine </b></p><ul><li style="font-size: 11px">null#207 ("Moderna")</li><li style="font-size: 11px">null#208 ("Pfizer/BioNtech")</li><li style="font-size: 11px">null#210 ("AstraZeneca / Covishield")</li><li style="font-size: 11px">null#211 ("Novavax")</li><li style="font-size: 11px">null#212 ("Janssen")</li><li style="font-size: 11px">null#505 ("Sputnik V")</li><li style="font-size: 11px">null#510 ("Sinopharm")</li><li style="font-size: 11px">null#511 ("CoronaVac")</li></ul><a name="opt-item.p01-q06-dose3-vaccine"> </a><p><b>Answer options for p01-q06-dose3-vaccine </b></p><ul><li style="font-size: 11px">null#207 ("Moderna")</li><li style="font-size: 11px">null#208 ("Pfizer/BioNtech")</li><li style="font-size: 11px">null#210 ("AstraZeneca / Covishield")</li><li style="font-size: 11px">null#211 ("Novavax")</li><li style="font-size: 11px">null#212 ("Janssen")</li><li style="font-size: 11px">null#505 ("Sputnik V")</li><li style="font-size: 11px">null#510 ("Sinopharm")</li><li style="font-size: 11px">null#511 ("CoronaVac")</li></ul></div>
</text>
<url
value="https://fhir-ig.digital.health.nz/shared-care/Questionnaire/COVIDPublicHealthHistoryQuestionnaire"/>
<identifier>
<use value="official"/>
<value value="COVIDRegularHealthCheckQuestionnaire"/>
<period>
<start value="2023-07-01"/>
</period>
</identifier>
<version value="0.4.0"/>
<name value="COVIDPublicHealthHistoryQuestionnaire"/>
<title value="COVID19 Public Health History Questionnaire"/>
<status value="draft"/>
<experimental value="false"/>
<subjectType value="Patient"/>
<date value="2023-07-19"/>
<publisher value="Te Whatu Ora"/>
<contact>
<name value="Te Whatu Ora"/>
<telecom>
<system value="url"/>
<value value="https://www.tewhatuora.govt.nz/"/>
</telecom>
</contact>
<contact>
<name value="David Grainger"/>
<telecom>
<system value="email"/>
<value value="david.grainger@middleware.co.nz"/>
<use value="work"/>
</telecom>
</contact>
<description value="Questions about a patient's recent COVID-19 history"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="workflow"/>
<display value="Workflow Setting"/>
</code>
<valueCodeableConcept>
<text value="COVID Public Health History Questionnaire"/>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="NZ"/>
<display value="New Zealand"/>
</coding>
</jurisdiction>
<purpose
value="For assessing patient's recent history of COVID-19 for public health purposes"/>
<code>
<system value="http://snomed.info/sct"/>
<code value="292508471000119105"/>
<display
value="History of disease caused by severe acute respiratory syndrome coronavirus 2 (situation)"/>
</code>
<item>
<linkId value="summary"/>
<text value="Questions about a patient's recent COVID-19 history"/>
<type value="display"/>
</item>
<item>
<linkId value="p01"/>
<text value="Public Health History"/>
<type value="group"/>
<item>
<linkId value="p01-q01-PlacesVisitedRecently"/>
<prefix value="question 1"/>
<text value="Places visited in last 14 days"/>
<type value="text"/>
<required value="false"/>
</item>
<item>
<linkId value="p01-q02-PrevPositive"/>
<prefix value="question 2"/>
<text value="Previous positive COVID-19 test?"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<linkId value="p01-q02-1-PrevPositiveMonth"/>
<prefix value="question 2-1"/>
<text value="Month of positive COVID-19 test?"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q02-PrevPositive"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="true"/>
<answerOption>
<valueString value="January"/>
</answerOption>
<answerOption>
<valueString value="February"/>
</answerOption>
<answerOption>
<valueString value="March"/>
</answerOption>
<answerOption>
<valueString value="April"/>
</answerOption>
<answerOption>
<valueString value="May"/>
</answerOption>
<answerOption>
<valueString value="June"/>
</answerOption>
<answerOption>
<valueString value="July"/>
</answerOption>
<answerOption>
<valueString value="August"/>
</answerOption>
<answerOption>
<valueString value="September"/>
</answerOption>
<answerOption>
<valueString value="October"/>
</answerOption>
<answerOption>
<valueString value="November"/>
</answerOption>
<answerOption>
<valueString value="December"/>
</answerOption>
</item>
<item>
<linkId value="p01-q02-2-PrevPositiveYear"/>
<prefix value="question 2-2"/>
<text value="Year of positive COVID-19 test?"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q02-PrevPositive"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="true"/>
<answerOption>
<valueDate value="2020"/>
</answerOption>
<answerOption>
<valueDate value="2021"/>
</answerOption>
<answerOption>
<valueDate value="2022"/>
</answerOption>
<answerOption>
<valueDate value="2023"/>
</answerOption>
<answerOption>
<valueDate value="2024"/>
</answerOption>
<answerOption>
<valueDate value="2025"/>
</answerOption>
<answerOption>
<valueDate value="2026"/>
</answerOption>
<answerOption>
<valueDate value="2027"/>
</answerOption>
<answerOption>
<valueDate value="2028"/>
</answerOption>
<answerOption>
<valueDate value="2029"/>
</answerOption>
<answerOption>
<valueDate value="2030"/>
</answerOption>
</item>
<item>
<linkId value="p01-q03-HighSuspicionOfCOVID"/>
<prefix value="question 3"/>
<text value="High suspicion of prev. COVID-19?"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<linkId value="p01-q04-PotentialCloseContact"/>
<prefix value="question 4"/>
<text
value="Potential close contact with a COVID-19 positive person in the last 14 days?"/>
<type value="boolean"/>
<required value="true"/>
</item>
<item>
<linkId value="p01-q05-COVID19Vaccine"/>
<prefix value="question 5"/>
<text value="COVID-19 vaccine?"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueCoding>
<code value="Full"/>
<display value="Full"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="Partial"/>
<display value="Partial"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="Nil"/>
<display value="Nil"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p01-q06-dose1-date"/>
<prefix value="question 6 - 1st Dose"/>
<text value="Date"/>
<type value="date"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="p01-q06-dose1-vaccine"/>
<prefix value="question 6 - 1st Dose"/>
<text value="Vaccine given"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q06-dose1-date"/>
<operator value="exists"/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="false"/>
<repeats value="false"/>
<answerOption>
<valueCoding>
<code value="207"/>
<display value="Moderna"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="208"/>
<display value="Pfizer/BioNtech"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="210"/>
<display value="AstraZeneca / Covishield"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="211"/>
<display value="Novavax"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="212"/>
<display value="Janssen"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="505"/>
<display value="Sputnik V"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="510"/>
<display value="Sinopharm"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="511"/>
<display value="CoronaVac"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p01-q06-dose1-country"/>
<prefix value="question 6 - 1st Dose"/>
<text value="Country where vaccinated"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q06-dose1-date"/>
<operator value="exists"/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="false"/>
<repeats value="false"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/iso3166-1-2"/>
</item>
<item>
<linkId value="p01-q06-dose2-date"/>
<prefix value="question 6 - 2nd Dose"/>
<text value="Date"/>
<type value="date"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="p01-q06-dose2-vaccine"/>
<prefix value="question 6 - 2nd Dose"/>
<text value="Vaccine given"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q06-dose2-date"/>
<operator value="exists"/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="false"/>
<repeats value="false"/>
<answerOption>
<valueCoding>
<code value="207"/>
<display value="Moderna"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="208"/>
<display value="Pfizer/BioNtech"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="210"/>
<display value="AstraZeneca / Covishield"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="211"/>
<display value="Novavax"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="212"/>
<display value="Janssen"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="505"/>
<display value="Sputnik V"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="510"/>
<display value="Sinopharm"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="511"/>
<display value="CoronaVac"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p01-q06-dose2-country"/>
<prefix value="question 6 - 2nd Dose"/>
<text value="Country where vaccinated"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q06-dose2-date"/>
<operator value="exists"/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="false"/>
<repeats value="false"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/iso3166-1-2"/>
</item>
<item>
<linkId value="p01-q06-dose3-date"/>
<prefix value="question 6 - 3rd Dose"/>
<text value="Date"/>
<type value="date"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="p01-q06-dose3-vaccine"/>
<prefix value="question 6 - 3rd Dose"/>
<text value="Vaccine given"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q06-dose3-date"/>
<operator value="exists"/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="false"/>
<repeats value="false"/>
<answerOption>
<valueCoding>
<code value="207"/>
<display value="Moderna"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="208"/>
<display value="Pfizer/BioNtech"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="210"/>
<display value="AstraZeneca / Covishield"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="211"/>
<display value="Novavax"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="212"/>
<display value="Janssen"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="505"/>
<display value="Sputnik V"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="510"/>
<display value="Sinopharm"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<code value="511"/>
<display value="CoronaVac"/>
</valueCoding>
</answerOption>
</item>
<item>
<linkId value="p01-q06-dose3-country"/>
<prefix value="question 6 - 3rd Dose"/>
<text value="Country where vaccinated"/>
<type value="choice"/>
<enableWhen>
<question value="p01-q06-dose3-date"/>
<operator value="exists"/>
<answerBoolean value="true"/>
</enableWhen>
<enableBehavior value="any"/>
<required value="false"/>
<repeats value="false"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/iso3166-1-2"/>
</item>
</item>
</Questionnaire>