New Zealand Rheumatic Fever FHIR Implementation Guide
0.4.7 - draft

New Zealand Rheumatic Fever FHIR Implementation Guide - Local Development build (v0.4.7) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Secondary prophylaxis medication allergy questionnaire - JSON Representation

Draft as of 2024-08-07

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{
  "resourceType" : "Questionnaire",
  "id" : "PatientMedicationAllergyQuestionnaire",
  "url" : "https://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/PatientMedicationAllergyQuestionnaire",
  "identifier" : [
    {
      "use" : "official",
      "value" : "PatientMedicationAllergyQuestionnaire",
      "period" : {
        "start" : "2023-10-16"
      }
    }
  ],
  "version" : "1.0.0",
  "name" : "PatientMedicationAllergyQuestionnaire",
  "title" : "Secondary prophylaxis medication allergy questionnaire",
  "status" : "draft",
  "experimental" : false,
  "subjectType" : [
    "Patient"
  ],
  "date" : "2024-08-07",
  "publisher" : "Te Whatu Ora",
  "contact" : [
    {
      "name" : "Te Whatu Ora",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.tewhatuora.govt.nz/"
        }
      ]
    },
    {
      "name" : "David Grainger",
      "telecom" : [
        {
          "system" : "email",
          "value" : "david.grainger@middleware.co.nz",
          "use" : "work"
        }
      ]
    }
  ],
  "description" : "Describes any known patient allergies to medications used in rheumatic fever secondary prophylaxis",
  "purpose" : "Gathers information which is specific to rheumatic fever secondary prophylaxis treatment in New Zealand",
  "item" : [
    {
      "linkId" : "page1",
      "prefix" : "page1",
      "text" : "Please complete this questionnaire to record a patient's allergies to secondary prophylaxis medication.",
      "type" : "display"
    },
    {
      "linkId" : "MedicationAllergies",
      "prefix" : "1)",
      "text" : "Medication allergies? (Yes/No/Unknown)",
      "type" : "choice",
      "required" : true,
      "repeats" : false,
      "answerValueSet" : "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code",
      "initial" : [
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "261665006",
            "display" : "Unknown (qualifier value)"
          }
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer",
          "valueUrl" : "https://nzhts.digital.health.nz/fhir"
        }
      ],
      "linkId" : "AllergyDetails",
      "prefix" : "1.1",
      "text" : "If yes, select which substances apply",
      "type" : "choice",
      "enableWhen" : [
        {
          "question" : "MedicationAllergies",
          "operator" : "=",
          "answerCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "373066001",
            "display" : "Yes (qualifier value)"
          }
        }
      ],
      "required" : true,
      "repeats" : true,
      "answerValueSet" : "https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/rf-medicationallergy-code"
    }
  ]
}