Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.5 - release
Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Official URL: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/EntericsInformQuestionnaire | Version: 1.0.0 | |||
| Active as of 2026-05-19 | Computable Name: EntericsInformQuestionnaire | |||
| Other Identifiers: EntericsInformQuestionnaire (use: official, ) | ||||
Te Whatu Ora survey of enterics disease symptoms and source locations
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
![]() | Te Whatu Ora survey of enterics disease symptoms and source locations | Questionnaire | https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/EntericsInformQuestionnaire#1.0.0 | ||
![]() ![]() | Diagnosis code | 1..1 | string | ||
![]() ![]() | Care Programme Enrollee Id | 0..1 | string | ||
![]() ![]() | Privacy Statement | 0..1 | group | ||
![]() ![]() ![]() | Privacy Statement | 0..1 | display | ||
![]() ![]() ![]() | Please confirm that you understand the information in the privacy statement. | 1..1 | choice | Options: 2 options | |
![]() ![]() ![]() | Thank you for your time, we are unable to continue with the questionnaire at this time. Someone may be in touch with you to discuss your illness further. | 0..1 | display | Enable When: Privacy5 = | |
![]() ![]() | 1. Contact Details | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | What is the best phone number to contact you on? | 0..1 | string | ||
![]() ![]() ![]() | What is the best email address to contact you on? | 0..1 | string | ||
![]() ![]() | 2. Occupation | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | What is your primary occupation? | 1..1 | string | ||
![]() ![]() ![]() | Does your work (outside of your home) or activities (e.g. volunteer work) involve any of the following: - Handling unwrapped food that will be eaten raw or without further cooking? - Providing direct, hands on care to unwell people in healthcare facilities? - Providing direct, hands on care to other people at increased risk due to age or disability? - An early childhood service or group, e.g. kindergarten, play centre or day care? | 1..1 | boolean | ||
![]() ![]() ![]() | Select all the high risk work / volunteer categories that apply: | 1..* | choice | Enable When: Occupation2 = Options: 5 options | |
![]() ![]() ![]() | Please avoid any high risk activities until free from all symptoms for 48 hours | 0..1 | display | ||
![]() ![]() | 4. Symptoms | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | Do you currently have or have you experienced any symptoms? | 1..1 | boolean | ||
![]() ![]() ![]() | Which of the following symptoms have you experienced? Select all that apply | 1..* | choice | Enable When: Symptom1 = Options: 7 options | |
![]() ![]() ![]() | Provide details of other symptoms | 1..1 | text | Enable When: Symptom2 = | |
![]() ![]() ![]() | What was your first symptom? | 1..1 | choice | Enable When: Symptom1 = Options: 7 options | |
![]() ![]() ![]() | What date did the first symptom appear? | 1..1 | date | Enable When: Symptom1 = | |
![]() ![]() ![]() | What date did the diarrhoea start? | 1..1 | date | Enable When: Symptom2 = | |
![]() ![]() ![]() | Has the diarrhoea stopped? | 1..1 | boolean | Enable When: Symptom2 = | |
![]() ![]() ![]() | What date did the diarrhoea stop? | 1..1 | date | Enable When: Symptom8 = | |
![]() ![]() ![]() | Have all your symptoms stopped? | 1..1 | boolean | Enable When: Symptom1 = | |
![]() ![]() ![]() | What date did your symptoms stop? | 1..1 | date | Enable When: Symptom10 = | |
![]() ![]() | 5. Source Investigation - Contact with Others | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | If you have not experienced any symptoms, use the date you produced the stool (poo) sample to answer all the following questions | 0..1 | display | ||
![]() ![]() ![]() | Before you became unwell, did you have contact with a confirmed case? | 1..1 | boolean | ||
![]() ![]() ![]() | What was their name? | 0..1 | string | Enable When: ContactWithOthers2 = | |
![]() ![]() ![]() | Do you know their date of birth or age? | 0..1 | string | Enable When: ContactWithOthers2 = | |
![]() ![]() ![]() | When did you first have contact with them? | 1..1 | date | Enable When: ContactWithOthers2 = | |
![]() ![]() ![]() | Where did you last have contact with them? | 1..1 | text | Enable When: ContactWithOthers2 = | |
![]() ![]() ![]() | Do you have a contact phone number for them? | 0..1 | string | Enable When: ContactWithOthers2 = | |
![]() ![]() ![]() | Before you became unwell, did you have contact with people with a similar illness? | 0..1 | boolean | Initial Value: boolean = true | |
![]() ![]() ![]() | What was their name? | 0..1 | string | Enable When: ContactWithOthers8 = | |
![]() ![]() ![]() | Before you became unwell, did you visit any particular places where you might have been exposed to the illness? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of the place / setting and date/s. | 1..1 | text | Enable When: ContactWithOthers10 = | |
![]() ![]() ![]() | Before you became unwell, did you have any visitors from overseas? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of the visitors, including their country of origin and the nature of contact. | 1..1 | text | Enable When: ContactWithOthers12 = | |
![]() ![]() | 6. Source Investigation - International and Domestic Travel | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | Before you became unwell, were you overseas? | 1..1 | boolean | ||
![]() ![]() ![]() | If usually residing in New Zealand, what date did you leave? | 1..1 | date | Enable When: InternationalAndDomesticTravel1 = | |
![]() ![]() ![]() | What date did you arrive in New Zealand? | 1..1 | date | Enable When: InternationalAndDomesticTravel1 = | |
![]() ![]() ![]() | Last Country Visited | 1..1 | choice | Enable When: InternationalAndDomesticTravel1 = Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/country-code | |
![]() ![]() ![]() | What region/city did you visit in this country? | 1..1 | string | Enable When: InternationalAndDomesticTravel1 = | |
![]() ![]() ![]() | What date did you enter this country? | 1..1 | date | Enable When: InternationalAndDomesticTravel1 = | |
![]() ![]() ![]() | What date did you leave this country? | 1..1 | date | Enable When: InternationalAndDomesticTravel1 = | |
![]() ![]() ![]() | Did you visit any other countries? | 0..1 | boolean | Enable When: InternationalAndDomesticTravel1 = | |
![]() ![]() ![]() | 2nd Last Country Visited | 1..1 | choice | Enable When: InternationalAndDomesticTravel9 = Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/country-code | |
![]() ![]() ![]() | What City/Region in that country? | 1..1 | text | Enable When: InternationalAndDomesticTravel9 = | |
![]() ![]() ![]() | What date did you enter this country? | 1..1 | date | Enable When: InternationalAndDomesticTravel9 = | |
![]() ![]() ![]() | What date did you leave this country? | 1..1 | date | Enable When: InternationalAndDomesticTravel9 = | |
![]() ![]() ![]() | Did you visit any additional countries? | 1..1 | boolean | Enable When: InternationalAndDomesticTravel9 = | |
![]() ![]() ![]() | 3rd last Country Visited | 1..1 | choice | Enable When: InternationalAndDomesticTravel15 = Value Set: https://nzhts.digital.health.nz/fhir/ValueSet/country-code | |
![]() ![]() ![]() | What City/Region in that country? | 1..1 | text | Enable When: InternationalAndDomesticTravel15 = | |
![]() ![]() ![]() | What date did you enter this country? | 1..1 | date | Enable When: InternationalAndDomesticTravel15 = | |
![]() ![]() ![]() | What date did you leave this country | 1..1 | date | Enable When: InternationalAndDomesticTravel15 = | |
![]() ![]() ![]() | Considering that the incubation period (the time between you being exposed to the illness and you developing symptoms) may be longer than 1-10 days in some situations, do you have a history of overseas travel that could explain this infection, even if the travel was not recent? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of prior overseas travel | 0..1 | text | Enable When: InternationalAndDomesticTravel20 = | |
![]() ![]() ![]() | Before you became unwell, did you travel within New Zealand? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of your travel within New Zealand | 1..1 | text | Enable When: InternationalAndDomesticTravel23 = | |
![]() ![]() | 7. Source Investigation - Food and Drinking water | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | Before you became unwell, did you eat out? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of the food you ate out and where it was purchased from | 1..1 | text | Enable When: FoodAndDrinkingWater1 = | |
![]() ![]() ![]() | Before you became unwell, did you purchase, handle or eat any of the following products at home products at home? | 0..1 | group | Enable When: DiagnosisCode = | |
![]() ![]() ![]() ![]() | Raw or undercooked meats (with pink flesh or unclear juices)? | 0..* | choice | Enable When: DiagnosisCode = Options: 9 options | |
![]() ![]() ![]() ![]() | Raw or undercooked seafood? | 0..* | choice | Enable When: DiagnosisCode = Options: 3 options | |
![]() ![]() ![]() ![]() | Please provide details of the food products you ate at home | 0..1 | string | Enable When: DiagnosisCode = | |
![]() ![]() ![]() | null | 0..1 | group | Enable When: DiagnosisCode = | |
![]() ![]() ![]() ![]() | Raw or undercooked meats (with pink flesh or unclear juices)? | 0..* | choice | Enable When: DiagnosisCode = Options: 9 options | |
![]() ![]() ![]() ![]() | Raw or unwashed vegetables/fruit | 0..* | choice | Enable When: DiagnosisCode = Options: 8 options | |
![]() ![]() ![]() ![]() | Unpasteurised or fermented Juices | 0..* | choice | Enable When: DiagnosisCode = Options: 3 options | |
![]() ![]() ![]() ![]() | Other | 0..* | choice | Enable When: DiagnosisCode = Options: 2 options | |
![]() ![]() ![]() | null | 0..1 | group | Enable When: DiagnosisCode = | |
![]() ![]() ![]() ![]() | Raw or undercooked meats (with pink flesh or unclear juices)? | 0..* | choice | Enable When: DiagnosisCode = Options: 9 options | |
![]() ![]() ![]() ![]() | Raw or unwashed vegetables/fruit | 0..* | choice | Enable When: DiagnosisCode = Options: 8 options | |
![]() ![]() ![]() ![]() | Unpasteurised or fermented Juices | 0..* | choice | Enable When: DiagnosisCode = Options: 1 option | |
![]() ![]() ![]() ![]() | Other | 0..* | choice | Enable When: DiagnosisCode = Options: 5 options | |
![]() ![]() ![]() | null | 0..1 | group | Enable When: DiagnosisCode = | |
![]() ![]() ![]() ![]() | Raw or undercooked meats (with pink flesh or unclear juices)? | 0..* | choice | Enable When: DiagnosisCode = Options: 2 options | |
![]() ![]() ![]() ![]() | Raw or unwashed vegetables/fruit | 0..* | choice | Enable When: DiagnosisCode = Options: 8 options | |
![]() ![]() ![]() ![]() | Eat any of the following deli foods? | 0..* | choice | Enable When: DiagnosisCode = Options: 6 options | |
![]() ![]() ![]() | Before you became unwell, did you consume untreated/raw (unpasteurised) milk or products made with raw milk? | 1..1 | boolean | ||
![]() ![]() ![]() | Can you provide details of the untreated/raw (unpasteurised) milk or products you consumed? | 1..1 | text | Enable When: FoodAndDrinkingWater5 = | |
![]() ![]() ![]() | What is your usual drinking water supply at home? e.g. council supply, bore, rainwater, etc… | 1..1 | text | ||
![]() ![]() ![]() | Before you became unwell, did you consume untreated water? | 1..1 | boolean | ||
![]() ![]() ![]() | Can you provide details of the untreated water you've consumed? | 1..1 | text | Enable When: FoodAndDrinkingWater8 = | |
![]() ![]() | 8. Source Investigation - Recreational Water | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | Before you became unwell, did you go swimming or spend time in recreational water? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of your recreational contact with water | 1..1 | text | Enable When: RecreationalWater1 = | |
![]() ![]() | 9. Source Investigation - Contact with Animals | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | Before you became unwell, did you have contact with any animals or their faeces? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of the contact you've had with animals or their faeces | 1..1 | text | Enable When: ContactWithAnimals1 = | |
![]() ![]() | 10. Source Investigation - Contact with Faecal Matter | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | Before you became unwell, did you have any contact with human sources of faeces? | 1..1 | boolean | ||
![]() ![]() ![]() | Please provide details of the contact you've had with human sources of faeces | 1..1 | text | Enable When: ContactWithFaecalMatter1 = | |
![]() ![]() | 11. Source Investigation - Other Potential Sources | 0..1 | group | Enable When: Privacy5 = | |
![]() ![]() ![]() | Do you have any ideas about what you think might have made you unwell? | 0..1 | text | ||
![]() ![]() | Thank you for taking the time to answer these questions that help in the investigation of this disease. | 0..1 | display | Enable When: Privacy5 = | |
Options Sets
Answer options for Privacy5
Answer options for Occupation3
Answer options for Symptom2
Answer options for Symptom5
Answer options for FoodAtHome_CAMP_RawMeat
Answer options for FoodAtHome_CAMP_Seafood
Answer options for FoodAndDrinkingWater4_1_VTEC
Answer options for FoodAndDrinkingWater4_2_VTECH
Answer options for FoodAndDrinkingWater4_3_VTECH
Answer options for FoodAndDrinkingWater4_4_VTEC
Answer options for FoodAndDrinkingWater4_1_SALM
Answer options for FoodAndDrinkingWater4_2_SALM
Answer options for FoodAndDrinkingWater4_3_SALM
Answer options for FoodAndDrinkingWater4_4_SALM
Answer options for FoodAndDrinkingWater4_1YERS
Answer options for FoodAndDrinkingWater4_2YERS
Answer options for DeliFood_YERS