Smart Forms
0.1.0 - ci-build
Smart Forms, published by AEHRC CSIRO. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/aehrc/smart-forms-ig/ and changes regularly. See the Directory of published versions
Official URL: http://www.health.gov.au/assessments/mbs/715/PatientDetails | Version: 0.1.0 | |||
Draft as of 2024-04-02 |
Realm: |
Computable Name: PatientDetails | ||
Copyright/Legal: Copyright © 2022+ Australian Government Department of Health and Aged Care - All rights reserved. This content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. See https://creativecommons.org/licenses/by-sa/4.0/. |
Patient Details sub-questionnaire for Aboriginal and Torres Strait Islander Health Check.
LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
---|---|---|---|---|---|
![]() ![]() | Patient Details sub-questionnaire for Aboriginal and Torres Strait Islander Health Check. | Questionnaire | http://www.health.gov.au/assessments/mbs/715/PatientDetails#0.1.0 | ||
![]() ![]() ![]() | Patient Details | 0..1 | group | ||
![]() ![]() ![]() ![]() | In progress | 0..1 | display | Enable When: MarkComplete-32 != true | |
![]() ![]() ![]() ![]() | Complete | 0..1 | display | Enable When: MarkComplete-32 = true | |
![]() ![]() ![]() ![]() | Important: The patient record may not be updated with information entered here. Information intended for the patient record should be entered there first. | 0..1 | display | ||
![]() ![]() ![]() ![]() | Name | 0..1 | string | ![]() ![]() | Expressions:
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![]() ![]() ![]() ![]() | Preferred name | 0..1 | string | ![]() ![]() | Expressions:
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![]() ![]() ![]() ![]() | Preferred pronouns | 0..1 | choice | ![]() ![]() | Value Set: Australian Pronouns Expressions:
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![]() ![]() ![]() ![]() | Gender identity | 0..1 | choice | ![]() ![]() | Value Set: Gender Identity Response Expressions:
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![]() ![]() ![]() ![]() | Administrative gender | 0..1 | choice | ![]() ![]() | Value Set: AdministrativeGender Expressions:
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![]() ![]() ![]() ![]() | Sex assigned at birth | 0..1 | choice | ![]() ![]() | Value Set: Biological Sex Expressions:
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![]() ![]() ![]() ![]() | Date of birth | 0..1 | date | ![]() ![]() | Expressions:
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![]() ![]() ![]() ![]() | Age | 0..1 | integer | ![]() ![]() | Expressions:
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![]() ![]() ![]() ![]() | Aboriginal and/or Torres Strait Islander status | 0..1 | choice | ![]() ![]() | Value Set: Aboriginal and/or Torres Strait Islander Expressions:
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![]() ![]() ![]() ![]() | Parents/primary carer/s | 0..* | choice | Value Set: Primary Carer Of Parent Or Grandparent Expressions:
| |
![]() ![]() ![]() ![]() | Other family | 0..* | string | Expressions:
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![]() ![]() ![]() ![]() ![]() | details | 0..1 | display | ||
![]() ![]() ![]() ![]() | Other | 0..* | string | Expressions:
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![]() ![]() ![]() ![]() ![]() | details | 0..1 | display | ||
![]() ![]() ![]() ![]() | Parents/primary carer/s details | 0..* | group | Expressions:
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![]() ![]() ![]() ![]() ![]() | Name of parent/primary carer | 0..1 | string | ||
![]() ![]() ![]() ![]() ![]() | Relationship to child | 0..1 | string | ||
![]() ![]() ![]() ![]() | Home address | 0..1 | group | ||
![]() ![]() ![]() ![]() ![]() | No fixed address | 0..1 | boolean | Definition: Address.extension:noFixedAddress Expressions:
| |
![]() ![]() ![]() ![]() ![]() | null | 0..* | group | Enable When: 311d83bb-f22e-4f60-9b50-b6e38dd2059b != true | |
![]() ![]() ![]() ![]() ![]() ![]() | Street address | 0..1 | string | Definition: Address.line Expressions:
| |
![]() ![]() ![]() ![]() ![]() ![]() | City | 0..1 | string | Definition: Address.city Expressions:
| |
![]() ![]() ![]() ![]() ![]() ![]() | State | 0..1 | choice | Definition: Address.state Value Set: Australian States and Territories Expressions:
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![]() ![]() ![]() ![]() ![]() ![]() | Postcode | 0..1 | string | Definition: Address.postalCode Expressions:
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![]() ![]() ![]() ![]() | Postal address | 0..* | group | ![]() ![]() | Expressions:
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![]() ![]() ![]() ![]() ![]() | Purpose of use | 0..1 | string | Definition: Address.use Expressions:
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![]() ![]() ![]() ![]() ![]() | Address | 0..1 | string | Definition: Address.line Expressions:
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![]() ![]() ![]() ![]() ![]() | City | 0..1 | string | Definition: Address.city Expressions:
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![]() ![]() ![]() ![]() ![]() | State | 0..1 | choice | Definition: Address.state Value Set: Australian States and Territories Expressions:
| |
![]() ![]() ![]() ![]() ![]() | Postcode | 0..1 | string | Definition: Address.postalCode Expressions:
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![]() ![]() ![]() ![]() | Home phone | 0..* | string | Expressions:
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![]() ![]() ![]() ![]() | Mobile phone | 0..* | string | Expressions:
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![]() ![]() ![]() ![]() | Emergency contact | 0..* | group | ||
![]() ![]() ![]() ![]() ![]() | Name | 0..1 | string | Expressions:
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![]() ![]() ![]() ![]() ![]() | Relationship to child | 0..1 | string | Expressions:
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![]() ![]() ![]() ![]() ![]() | Relationship to patient | 0..1 | string | Expressions:
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![]() ![]() ![]() ![]() ![]() | Phone | 0..* | string | Expressions:
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![]() ![]() ![]() ![]() | Medicare number | 0..1 | group | ||
![]() ![]() ![]() ![]() ![]() | Number | 0..1 | string | Expressions:
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![]() ![]() ![]() ![]() ![]() | Reference number | 0..1 | string | Expressions:
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![]() ![]() ![]() ![]() ![]() | Expiry | 0..1 | string | Expressions:
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![]() ![]() ![]() ![]() | Pensioner Card Number | 0..1 | string | Max Length: 10 Expressions:
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![]() ![]() ![]() ![]() | Health Care Card Number | 0..1 | string | Max Length: 10 Expressions:
| |
![]() ![]() ![]() ![]() | Registered for Closing the Gap PBS Co-payment Measure (CTG) | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() | Child has a birth certificate | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA Expressions:
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![]() ![]() ![]() ![]() | My Aged Care | 0..1 | group | Expressions:
| |
![]() ![]() ![]() ![]() ![]() | Registered for My Aged Care | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() | My Aged Care Number | 0..1 | string | Enable When: 7165c072-e3d8-4564-9d1d-d17f6807787c = Yes (v2 Y/N Indicator#Y) | |
![]() ![]() ![]() ![]() | National Disability Insurance Scheme | 0..1 | group | ||
![]() ![]() ![]() ![]() ![]() | Registered for NDIS | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() | NDIS Number | 0..1 | string | Enable When: 924b4500-53ac-4c4e-831b-7ab5569ff981 = Yes (v2 Y/N Indicator#Y) | |
![]() ![]() ![]() ![]() | Children | 0..1 | group | Expressions:
| |
![]() ![]() ![]() ![]() ![]() | Do you have children? | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() | Number of children | 0..1 | integer | Enable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y) | |
![]() ![]() ![]() ![]() ![]() | Number of children in your care | 0..1 | integer | Enable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y) | |
![]() ![]() ![]() ![]() | Someone's carer | 0..1 | group | Expressions:
| |
![]() ![]() ![]() ![]() ![]() | Are you responsible for caring for someone else? | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() | Details | 0..1 | text | Enable When: a08271f1-194b-4fe9-91f9-4f3398858eb0 = Yes (v2 Y/N Indicator#Y) | |
![]() ![]() ![]() ![]() | Your carer | 0..1 | group | Expressions:
| |
![]() ![]() ![]() ![]() ![]() | Do you have a carer? | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() | Details | 0..1 | text | Enable When: d05558fb-a3cc-4bd6-b803-b672b36b9c51 = Yes (v2 Y/N Indicator#Y) | |
![]() ![]() ![]() ![]() | Providers | 0..1 | group | ||
![]() ![]() ![]() ![]() ![]() | Are name and contact details of other key providers (eg case workers, support services) up to date? | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() | Details | 0..1 | text | ||
![]() ![]() ![]() ![]() | Advance care planning | 0..1 | group | Expressions:
| |
![]() ![]() ![]() ![]() ![]() | Enduring Power of Attorney | 0..1 | group | ||
![]() ![]() ![]() ![]() ![]() ![]() | Enduring Power of Attorney | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() ![]() | Discussed today | 0..1 | text | ||
![]() ![]() ![]() ![]() ![]() | Advance Health Directive | 0..1 | group | ||
![]() ![]() ![]() ![]() ![]() ![]() | Advance Health Directive | 0..1 | choice | ![]() ![]() | Value Set: Yes/No/NA |
![]() ![]() ![]() ![]() ![]() ![]() | Discussed today | 0..1 | text | ||
![]() ![]() ![]() ![]() | Mark section as complete | 0..1 | boolean | ||