New Zealand Rheumatic Fever FHIR Implementation Guide
0.4.9 - draft
New Zealand Rheumatic Fever FHIR Implementation Guide
0.4.9 - draft
New Zealand Rheumatic Fever FHIR Implementation Guide - Local Development build (v0.4.9) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft as of 2023-10-16 |
{
"resourceType" : "Questionnaire",
"id" : "PatientWhanauGoalsPreferencesQuestionnaire",
"url" : "https://fhir-ig.digital.health.nz/rheumatic-fever/Questionnaire/PatientWhanauGoalsPreferencesQuestionnaire",
"identifier" : [
{
"use" : "official",
"value" : "PatientWhanauGoalsPreferencesQuestionnaire",
"period" : {
"start" : "2023-10-16"
}
}
],
"version" : "1.0.0",
"name" : "PatientWhanauGoalsPreferencesQuestionnaire",
"title" : "Patient & whanau goals and preferences questionnaire",
"status" : "draft",
"experimental" : false,
"subjectType" : [
"Patient"
],
"date" : "2023-10-16",
"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" : "Gathers patient and whanau preferences and goals for rheumatic fever care",
"purpose" : "Gathers patient and whanau preferences and goals for rheumatic fever care",
"item" : [
{
"linkId" : "page1",
"prefix" : "page1",
"text" : "Please complete this questionnaire to record goals and preferences of a patient or their whanau in relation to rheumatic fever prevention treatment.",
"type" : "display"
},
{
"linkId" : "ImportantToMe",
"prefix" : "1)",
"text" : "What things that are important to me and my family that support my health and wellbeing? (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "WhanauInvolvement",
"prefix" : "2)",
"text" : "How would I like my whanau and support persons to be involved? (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "BestWayToCommunicate",
"prefix" : "3)",
"text" : "The best way to communicate with me is…? (choose one)",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerOption" : [
{
"valueString" : "phone call"
},
{
"valueString" : "text message"
},
{
"valueString" : "email"
}
]
},
{
"linkId" : "AppointmentsContact",
"prefix" : "4)",
"text" : "I know who to contact about my appointments? (choose one)",
"type" : "boolean",
"required" : false,
"item" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "help",
"display" : "Help-Button"
}
],
"text" : "Help-Button"
}
}
],
"linkId" : "AppointmentsContactHelp",
"text" : "I understand who I should phone or text if I need to change my appointments, OR if I am going to be away, OR if I have questions.",
"type" : "display"
}
]
},
{
"linkId" : "PreferredAppointmentsLocation",
"prefix" : "5)",
"text" : "What location do I prefer to receive injected antibiotics at? (choose one)",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerOption" : [
{
"valueString" : "School"
},
{
"valueString" : "Home"
},
{
"valueString" : "Work"
},
{
"valueString" : "Clinic"
},
{
"valueString" : "Other"
}
]
},
{
"linkId" : "InjectionLocationDetail",
"prefix" : "6)",
"text" : "More detail about this location (eg. at school during term time, but at home with Dad if out of term time)? (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "ImportantDuringInjectionVisits",
"prefix" : "7)",
"text" : "What things that are important to me during my injection visits eg. karakia, kaiawhina support? (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "InjectionVisitsNoNos",
"prefix" : "8)",
"text" : "What things don't work well for me during my injection visits? (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "MakingInjectionsComfortable",
"prefix" : "9)",
"text" : "What things do I like to have with my injections to make them more comfortable? (multiple choice)",
"type" : "choice",
"required" : true,
"repeats" : true,
"answerOption" : [
{
"valueString" : "Lignocaine"
},
{
"valueString" : "Ice pack"
},
{
"valueString" : "Buzzy bee"
},
{
"valueString" : "Numbing cream (Emla)"
},
{
"valueString" : "Numbing spray"
},
{
"valueString" : "Distraction"
},
{
"valueString" : "Very slow injection"
}
]
},
{
"linkId" : "InjectionOtherComfort",
"prefix" : "10)",
"text" : "What other things make my injections more comfortable? (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "MedsPreferredSupplyMethod",
"prefix" : "11)",
"text" : "I would prefer to get my oral antibiotic medicines from? (choose one)",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerOption" : [
{
"valueString" : "GP prescription"
},
{
"valueString" : "Monthly visit from a nurse"
},
{
"valueString" : "3 monthly visit from a nurse"
},
{
"valueString" : "Pick-up from a pharmacy"
},
{
"valueString" : "Other"
}
]
},
{
"linkId" : "MedsSupplyOtherDetail",
"prefix" : "11.1)",
"text" : "If other, enter details",
"type" : "text",
"enableWhen" : [
{
"question" : "MedsPreferredSupplyMethod",
"operator" : "=",
"answerString" : "Other"
}
],
"required" : true
},
{
"linkId" : "EasierToGetToAppointments",
"prefix" : "12)",
"text" : "What things make it easier for me to get to hospital appointments? (multiple choice)",
"type" : "choice",
"required" : true,
"repeats" : true,
"answerOption" : [
{
"valueString" : "Support with transport"
},
{
"valueString" : "Morning appointments"
},
{
"valueString" : "Afternoon appointments"
},
{
"valueString" : "Choice of clinic days"
},
{
"valueString" : "Cultural support"
},
{
"valueString" : "Other"
}
]
},
{
"linkId" : "HospitalAppointmentsImportant",
"prefix" : "13)",
"text" : "More detail about the things that are important to me about hospital appointments (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "HospitalAppointmentsNoNos",
"prefix" : "14)",
"text" : "Things that don't work well for me about hospital appointments (enter text)",
"type" : "text",
"required" : true
},
{
"linkId" : "SupportGettingToHospitalAppointments",
"prefix" : "15)",
"text" : "Do I need support getting to and from hospital appointment? (choose one)",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerOption" : [
{
"valueString" : "Yes - always"
},
{
"valueString" : "Yes - sometimes, please check each time"
},
{
"valueString" : "No"
},
{
"valueString" : "Not sure"
},
{
"valueString" : "Other"
}
]
},
{
"linkId" : "HospitalAppointmentsTransportSupport",
"prefix" : "question 16",
"text" : "Which transport support option do I need? (choose one)",
"type" : "choice",
"required" : true,
"repeats" : false,
"answerOption" : [
{
"valueString" : "Taxi vouchers"
},
{
"valueString" : "Top up on public transport card"
},
{
"valueString" : "Hospital to provide transport"
},
{
"valueString" : "Other"
}
]
},
{
"linkId" : "HospitalAppointmentsTransportOtherDetail",
"prefix" : "question 17",
"text" : "What other details are there about getting to hospital appointments? (enter text)",
"type" : "text",
"required" : true
}
]
}