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