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 - XML Representation

Draft as of 2024-08-07

Raw xml | Download



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