Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.3 - release

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.3) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Questionnaire: Question Template for COVID-19 Regular Health Check

Official URL: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/COVIDRegularHealthCheckQuestionnaire | Version: 0.4.3
Draft as of 2023-07-19 | Computable Name: COVIDRegularHealthCheckQuestionnaire
Other Identifiers: COVIDRegularHealthCheckQuestionnaire (use: official, period: 7/19/23 --> (ongoing)), QuestionTemplate-CitC-COVID19-RegularHealthCheck (use: temp, period: 9/12/22 --> 7/19/23)
Usage:Workflow Setting:

Gather the status of a patient who is self isolating

Template for the description of a phone or online video health check to gather the status of a set of conditions for a patient who is self isolating.

Structure

LinkID | Text | Cardinality | Type | Description & Constraints
--- | --- | --- | --- | ---
COVIDRegularHealthCheckQuestionnaire | Gather the status of a patient who is self isolating |  | Questionnaire | https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/COVIDRegularHealthCheckQuestionnaire#0.4.3
1 | 1.. Symptoms - Pay attention to the signs of talking with single words or short sentences, pausing to catch their breath, noisy breathing, persistent coughing, etc. | 0..1 | group |
1.1 | 1.1.. Fever chills (feeling hot and cold) | 1..1 | boolean | Initial Value: boolean = false
1.2 | 1.2.. Cough | 1..1 | boolean | Initial Value: boolean = false
1.3 | 1.3.. Runny nose | 1..1 | boolean | Initial Value: boolean = false
1.4 | 1.4.. Headache | 1..1 | boolean | Initial Value: boolean = false
1.5 | 1.5.. Joint pain | 1..1 | boolean | Initial Value: boolean = false
1.6 | 1.6.. Diarrhoea | 1..1 | boolean | Initial Value: boolean = false
1.7 | 1.7.. Nausea / Vomiting | 1..1 | boolean | Initial Value: boolean = false
1.8 | 1.8.. Shortness of breath | 1..1 | boolean | Initial Value: boolean = false
1.8.1 | 1.8.1.. While at rest? | 1..1 | boolean | Enable When: 1.8 = Initial Value: boolean = false
1.8.2 | 1.8.2.. New SOB on exertion? | 1..1 | boolean | Enable When: 1.8 = Initial Value: boolean = false
1.8.3 | 1.8.3.. Sudden onset of SOB? (with or without chest pain) | 1..1 | boolean | Enable When: 1.8 = Initial Value: boolean = false
1.8.4 | 1.8.4.. Able to speak in full sentences? | 1..1 | boolean | Enable When: 1.8 = Initial Value: boolean = false
1.8.5 | 1.8.5.. Assessment? | 1..1 | choice | Enable When: 1.8 = Options: 3 options
1.8.6 | 1.8.6.. Further details/what could you do yesterday that you can't do today? | 0..1 | string | Enable When: 1.8 =
1.9 | 1.9.. Sore throat | 1..1 | boolean | Initial Value: boolean = false
1.10 | 1.10.. Loss of sense of smell / taste | 1..1 | boolean | Initial Value: boolean = false
1.11 | 1.11.. Chest pain | 1..1 | boolean | Initial Value: boolean = false
1.12 | 1.12.. Muscular pain (Myalgia) | 1..1 | boolean | Initial Value: boolean = false
1.13 | 1.13.. Abdominal pain | 1..1 | boolean | Initial Value: boolean = false
1.14 | 1.14.. Any light headedness on standing? | 1..1 | boolean | Initial Value: boolean = false
1.15 | 1.15.. Concentrated urine? | 1..1 | boolean | Initial Value: boolean = false
1.16 | 1.16.. Other COVID related symptoms | 0..1 | string |
2 | 2.. Further Details | 0..1 | group |
2.1 | 2.1.. How are you feeling today compared to yesterday? | 1..1 | choice | Options: 3 options
2.2 | 2.2.. Do you have any health concerns? | 1..1 | boolean | Initial Value: boolean = false
2.3 | 2.3.. Have you been eating / sleeping well? | 1..1 | boolean | Initial Value: boolean = true
2.4 | 2.4.. Please provide further eating / sleeping details | 0..1 | string |
2.5 | 2.5.. Have you left the room without your mask or has anyone outside your bubble visited your room? | 1..1 | boolean | Initial Value: boolean = false
2.6 | 2.6.. Please provide further details regarding whether you had visitors in your room / bubble | 0..1 | string |
3 | 3.. Vital Signs | 0..1 | group |
3.1 | 3.1.. Temperature (°C) | 1..1 | decimal |
3.2 | 3.2.. Heart Rate (BPM) | 1..1 | integer |
3.3 | 3.3.. BP (Systolic) (mmHg) | 1..1 | integer |
3.4 | 3.4.. BP (Diastolic) (mmHg) | 1..1 | integer |
3.5 | 3.5.. Oxygen Saturation, SpO2 (%) | 0..1 | integer |
3.6 | 3.6.. Respiration (RPM) | 0..1 | integer |
3.7 | 3.7.. Other vital signs | 0..1 | string |
3.8 | 3.8.. Mood (/10) | 0..1 | integer |
4 | 4.. Health check note | 0..1 | group |
4.1 | 4.1.. Acuity Rating | 1..1 | choice | Options: 6 options
4.2 | 4.2.. Regular health check note | 0..1 | string |
4.3 | 4.3.. Care Management Plan | 1..1 | choice | Options: 2 options
Documentation for this format

Options Sets

Answer options for 1.8.5

- Same
- Better
- Worse

Answer options for 2.1

- Same
- Better
- Worse

Answer options for 4.1

- 1
- 2
- 3
- 4
- 5
- 6

Answer options for 4.3

- Self Management
- Active Management