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: Private Colposcopy Referral Summary Questionnaire

Official URL: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/PrivateColposcopyReferralQuestionnaire Version: 0.1.1
Draft as of 2025-01-07 Computable Name: PrivateColposcopyReferralQuestionnaire
Other Identifiers: PrivateColposcopyReferralQuestionnaire (use: official, )

Usage:Workflow Setting: 

To gather the referral details of Private colposcopy procedure.

Generated Narrative: Questionnaire PrivateColposcopyReferralQuestionnaire

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. PrivateColposcopyReferralQuestionnaireQuestionnairehttps://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/PrivateColposcopyReferralQuestionnaire#0.1.1
... p01-ClinicInformationpage 01. Clinic Information0..1group
.... p01-q01-FacilityIDpage 01 question 1. Colposcopy HPI facility ID1..1reference
... p02-ReferralInformationpage 02. Referral Information0..1group
.... p02-q01-SelfReferralpage 02 question 1. Self Referral?1..1boolean
..... p02-q02.1-SelfReferralpage 02 question 2.1. If your patient has self-referred enter in their GP’s HPI-CPN and HPI Health Facility ID0..1display
.... p02-q02-ReferredByNamepage 02 question 2. Referred by health worker name1..1reference
.... p02-q03-ReferredByFacilityIDpage 02 question 3. Referred by health facility ID1..1reference
.... p02-q04-ReferralDateReceivedpage 02 question 5. Referral received date0..1date
.... p02-q05-ReferralDateAcceptedpage 02 question 6. Referral accepted date1..1date
.... p02-q06-AppointmentDatepage 02 question 7. Appointment date0..1date
.... p02-q07-FirstVisitpage 02 question 8. First colposcopy visit?1..1boolean
.... p02-q8-FollowUpTypepage 02 question 9. Follow-up Colposcopy Visit1..1choiceEnable When: p02-q07-FirstVisit =
Options: 4 options
.... p02-q9-FollowUpTimeFramepage 02 question 9. Follow-up timeframe1..1choiceEnable When: p02-q07-FirstVisit =
Options: 15 options
... p03-RefferalReasonpage 03. Reason for Referral1..1group
.... p03-q01-AssessmentReasonpage 03 question 1. Assessment for the reason for referral1..1choiceOptions: 12 options
.... p03-q02-OtherReasonpage 03 question 2. Other Reason (if Any)0..1stringEnable When: p03-q01-AssessmentReason =

doco Documentation for this format

Options Sets

Answer options for p02-q8-FollowUpType

  • null#null ("1st Follow Up Visit")
  • null#null ("2nd Follow Up Visit")
  • null#null ("3rd Follow Up Visit")
  • null#null ("4th or more Follow up Visit")

Answer options for p02-q9-FollowUpTimeFrame

  • null#7D ("7 Days")
  • null#2W ("2 Weeks")
  • null#6W ("6 Weeks")
  • null#1M ("1 Month")
  • null#2M ("2 Months")
  • null#3M ("3 Months")
  • null#4M ("4 Months")
  • null#5M ("5 Months")
  • null#6M ("6 Months")
  • null#7M ("7 Months")
  • null#9M ("9 Months")
  • null#12M ("12 Months")
  • null#18M ("18 Months")
  • null#36M ("36 Months")
  • null#60M ("60 Months")

Answer options for p03-q01-AssessmentReason

  • null#null ("Any cytological evidence or suspicion of invasion")
  • null#null ("Any cytological glandular abnormality")
  • null#null ("HPV 16/18 with or without cytology")
  • null#null ("HPV other where the participant is immune compromised")
  • null#null ("HPV other with LSIL on two occasions if over 50 and 3 occasions if under 50")
  • null#null ("Positive test of cure")
  • null#null ("Low-grade clinical assessment")
  • null#null ("High-grade clinical assessment")
  • null#null ("Suspicion of an invasive cancer clinical assessment")
  • null#null ("HPV not detected with high-grade cytology")
  • null#null ("HPV not detected with suspicion or evidence of cancer on cytology")
  • null#null ("Other")