University of the Philippines Manila Viral Hepatitis Project Implementation Guide
0.2.1 - CI Build International flag

University of the Philippines Manila Viral Hepatitis Project Implementation Guide, published by UP Manila Viral Hepatitis Project. This guide is not an authorized publication; it is the continuous build for version 0.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/gpvillanuevasilab/UPVH_WHO_SMART-Template/ and changes regularly. See the Directory of published versions

Logical Model: VH Case Report Form Logical Model

Official URL: http://worldhealthorganization.github.io/smart-ig-upvhproject/StructureDefinition/ViralHepatitisCaseReportFormModel Version: 0.2.1
Draft as of 2026-02-06 Computable Name: ViralHepatitisCaseReportFormModel

Viral Hepatitis Case Report Form Logical Model

Usages:

  • This Logical Model is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ViralHepatitisCaseReportFormModel 0..* Base VH Case Report Form Logical Model
... ConsultDate 1..1 dateTime Consult Date (MM/DD/YYYY)
... PatientCode 1..1 Identifier Patient Code
... TestingFacilityName 1..1 Reference() Testing Facility Name
... ContactNo 0..* ContactPoint Contact Number
... FacilityAddress 1..1 Address Facility Address
... ClientType 1..1 code Client Type
... TestedPositiveForHepatitisB 0..1 BackboneElement If patient tested positive for Hepatitis B
... TestedPositiveForHepatitisC 0..1 BackboneElement If patient tested positive for Hepatitis C
... DateofBaselineHBsAgTest 0..1 dateTime Date of Baseline HBsAgTest (MM/DD/YYYY)
... DateofBaselineAnti-HCVTest 0..1 dateTime Date of Baseline Anti-HCV test (MM/DD/YYYY)
... FirstName 0..* HumanName First Name
... MiddleName 0..* HumanName Middle Name
... LastName 1..1 HumanName Last Name
... Suffix 0..* HumanName Suffix
... UniqueIdentifierCode 1..1 id Unique Identifier Code for the patient
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for id
.... FirstTwoLetterOfMothersName 1..1 id First two letters of mother's name
.... FirstTwoLetterOfFathersName 1..1 id First two letters of father's name
.... BirthOrder 1..1 integer Birth Order
.... BirthDate 1..1 date Birth Date
... SexAssignedAtBirth 0..1 code Sex Assigned at Birth
... SelfIdentity 0..1 code Patient Self Identity
... IsShePregnant 0..* code If female, is she pregnant?
.... @id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for code
.... IsShePregnant 0..* CodeableConcept If female, is she pregnant?
... NumberOfChildren 0..* integer Number of Children
... CivilStatus 0..* CodeableConcept Civil Status
... Nationality 0..* CodeableConcept Nationality
... AgeInYears 1..1 Age Age of Patient in Years
... PhilHealthNo 1..1 Identifier PhilHealth Number of the Patient
... CurrentAddressCityMunicipality 1..* Address Current City/Municipality Address of the Patient
... CurrentAddressProvince 1..* Address Current Province Address of the Patient
... CurrentAddressRegion 1..* Address Current Region Address of the Patient
... PermanentAddressCityMunicipality 1..* Address Permanent City/Municipality Address of the Patient
... PermanentAddressProvince 1..* Address Permanent Province Address of the Patient
... PermanentAddressRegion 1..* Address Permanent Region Address of the Patient
... DidTheClientsMotherTestPositiveForHepatitisB 1..1 BackboneElement History of Client's mother for Hepatitis B
... DidTheClientsMotherTestPositiveForHepatitisC 1..1 BackboneElement History of Client's mother for Hepatitis C
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis B
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis C
... DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers 1..1 CodeableConcept History of client of using/sharing needle or syringe with others
... DoesTheClientHaveHistoryOfInjectingDrugs 1..1 CodeableConcept Does the client have history of injecting drugs?
... HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood 1..1 CodeableConcept Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
... DidTheClientReceiveATattoo 1..1 CodeableConcept Did the client receive a tattoo?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a male?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a female?
... DoesTheClientPayInCashOrInKindForSex 1..1 CodeableConcept Does the client pay (in cash or in kind) for sex?
... DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex 1..1 CodeableConcept Does the client accept payment (in cash or in kind) in exchange for sex?
... WasThereAHistoryOfEmploymentAbroadInThePast 1..1 CodeableConcept Was there a history of employment abroad in the past?
... IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer 1..1 BackboneElement History of Client's family on Hepatocellular Carcinoma (HCC)/Primary Liver Cancer
... DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis 1..1 CodeableConcept Client's History of having Hepatocellular Carcinoma
... DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts 1..1 CodeableConcept Client's History of Receiving Blood or Blood Products
... DoesTheClientHaveHistoryOfUndergoingHemodialysis 1..1 CodeableConcept Client's History of undergoing hemodialysis
... WasThereAHistoryOfBeingVaccinatedForHepatitisA 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis A
... WasThereAHistoryOfBeingVaccinatedForHepatitisB 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis B
... DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment 1..1 CodeableConcept Client's History of Undergoing HIV Treatment Prior to Enrollment
... HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV 1..1 BackboneElement The Client has history of testing positive for HIV prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHIVMedsTaken 1..1 BackboneElement List of Antiretroviral Drugs for HIV Taken
... HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB 1..1 BackboneElement The Client has history of testing positive for Hepatitis B prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisBMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis B Taken
... HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC 1..1 BackboneElement The Client has history of testing positive for Hepatitis C prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisCMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis C Taken

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ViralHepatitisCaseReportFormModel 0..* Base VH Case Report Form Logical Model
... ConsultDate 1..1 dateTime Consult Date (MM/DD/YYYY)
... PatientCode 1..1 Identifier Patient Code
... TestingFacilityName 1..1 Reference() Testing Facility Name
... ContactNo 0..* ContactPoint Contact Number
... FacilityAddress 1..1 Address Facility Address
... ClientType 1..1 code Client Type
... TestedPositiveForHepatitisB 0..1 BackboneElement If patient tested positive for Hepatitis B
... TestedPositiveForHepatitisC 0..1 BackboneElement If patient tested positive for Hepatitis C
... DateofBaselineHBsAgTest 0..1 dateTime Date of Baseline HBsAgTest (MM/DD/YYYY)
... DateofBaselineAnti-HCVTest 0..1 dateTime Date of Baseline Anti-HCV test (MM/DD/YYYY)
... FirstName 0..* HumanName First Name
... MiddleName 0..* HumanName Middle Name
... LastName 1..1 HumanName Last Name
... Suffix 0..* HumanName Suffix
... UniqueIdentifierCode 1..1 id Unique Identifier Code for the patient
.... FirstTwoLetterOfMothersName 1..1 id First two letters of mother's name
.... FirstTwoLetterOfFathersName 1..1 id First two letters of father's name
.... BirthOrder 1..1 integer Birth Order
.... BirthDate 1..1 date Birth Date
... SexAssignedAtBirth 0..1 code Sex Assigned at Birth
... SelfIdentity 0..1 code Patient Self Identity
... IsShePregnant 0..* code If female, is she pregnant?
.... IsShePregnant 0..* CodeableConcept If female, is she pregnant?
... NumberOfChildren 0..* integer Number of Children
... CivilStatus 0..* CodeableConcept Civil Status
... Nationality 0..* CodeableConcept Nationality
... AgeInYears 1..1 Age Age of Patient in Years
... PhilHealthNo 1..1 Identifier PhilHealth Number of the Patient
... CurrentAddressCityMunicipality 1..* Address Current City/Municipality Address of the Patient
... CurrentAddressProvince 1..* Address Current Province Address of the Patient
... CurrentAddressRegion 1..* Address Current Region Address of the Patient
... PermanentAddressCityMunicipality 1..* Address Permanent City/Municipality Address of the Patient
... PermanentAddressProvince 1..* Address Permanent Province Address of the Patient
... PermanentAddressRegion 1..* Address Permanent Region Address of the Patient
... DidTheClientsMotherTestPositiveForHepatitisB 1..1 BackboneElement History of Client's mother for Hepatitis B
... DidTheClientsMotherTestPositiveForHepatitisC 1..1 BackboneElement History of Client's mother for Hepatitis C
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis B
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis C
... DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers 1..1 CodeableConcept History of client of using/sharing needle or syringe with others
... DoesTheClientHaveHistoryOfInjectingDrugs 1..1 CodeableConcept Does the client have history of injecting drugs?
... HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood 1..1 CodeableConcept Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
... DidTheClientReceiveATattoo 1..1 CodeableConcept Did the client receive a tattoo?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a male?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a female?
... DoesTheClientPayInCashOrInKindForSex 1..1 CodeableConcept Does the client pay (in cash or in kind) for sex?
... DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex 1..1 CodeableConcept Does the client accept payment (in cash or in kind) in exchange for sex?
... WasThereAHistoryOfEmploymentAbroadInThePast 1..1 CodeableConcept Was there a history of employment abroad in the past?
... IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer 1..1 BackboneElement History of Client's family on Hepatocellular Carcinoma (HCC)/Primary Liver Cancer
... DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis 1..1 CodeableConcept Client's History of having Hepatocellular Carcinoma
... DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts 1..1 CodeableConcept Client's History of Receiving Blood or Blood Products
... DoesTheClientHaveHistoryOfUndergoingHemodialysis 1..1 CodeableConcept Client's History of undergoing hemodialysis
... WasThereAHistoryOfBeingVaccinatedForHepatitisA 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis A
... WasThereAHistoryOfBeingVaccinatedForHepatitisB 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis B
... DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment 1..1 CodeableConcept Client's History of Undergoing HIV Treatment Prior to Enrollment
... HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV 1..1 BackboneElement The Client has history of testing positive for HIV prior to the baseline diagnosis of viral hepatitis
.... NoYesHIVMedsTaken 1..1 BackboneElement List of Antiretroviral Drugs for HIV Taken
... HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB 1..1 BackboneElement The Client has history of testing positive for Hepatitis B prior to the baseline diagnosis of viral hepatitis
.... NoYesHepatitisBMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis B Taken
... HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC 1..1 BackboneElement The Client has history of testing positive for Hepatitis C prior to the baseline diagnosis of viral hepatitis
.... NoYesHepatitisCMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis C Taken

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ViralHepatitisCaseReportFormModel 0..* Base VH Case Report Form Logical Model
... ConsultDate 1..1 dateTime Consult Date (MM/DD/YYYY)
... PatientCode 1..1 Identifier Patient Code
... TestingFacilityName 1..1 Reference() Testing Facility Name
... ContactNo 0..* ContactPoint Contact Number
... FacilityAddress 1..1 Address Facility Address
... ClientType 1..1 code Client Type
... TestedPositiveForHepatitisB 0..1 BackboneElement If patient tested positive for Hepatitis B
... TestedPositiveForHepatitisC 0..1 BackboneElement If patient tested positive for Hepatitis C
... DateofBaselineHBsAgTest 0..1 dateTime Date of Baseline HBsAgTest (MM/DD/YYYY)
... DateofBaselineAnti-HCVTest 0..1 dateTime Date of Baseline Anti-HCV test (MM/DD/YYYY)
... FirstName 0..* HumanName First Name
... MiddleName 0..* HumanName Middle Name
... LastName 1..1 HumanName Last Name
... Suffix 0..* HumanName Suffix
... UniqueIdentifierCode 1..1 id Unique Identifier Code for the patient
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for id
.... FirstTwoLetterOfMothersName 1..1 id First two letters of mother's name
.... FirstTwoLetterOfFathersName 1..1 id First two letters of father's name
.... BirthOrder 1..1 integer Birth Order
.... BirthDate 1..1 date Birth Date
... SexAssignedAtBirth 0..1 code Sex Assigned at Birth
... SelfIdentity 0..1 code Patient Self Identity
... IsShePregnant 0..* code If female, is she pregnant?
.... @id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for code
.... IsShePregnant 0..* CodeableConcept If female, is she pregnant?
... NumberOfChildren 0..* integer Number of Children
... CivilStatus 0..* CodeableConcept Civil Status
... Nationality 0..* CodeableConcept Nationality
... AgeInYears 1..1 Age Age of Patient in Years
... PhilHealthNo 1..1 Identifier PhilHealth Number of the Patient
... CurrentAddressCityMunicipality 1..* Address Current City/Municipality Address of the Patient
... CurrentAddressProvince 1..* Address Current Province Address of the Patient
... CurrentAddressRegion 1..* Address Current Region Address of the Patient
... PermanentAddressCityMunicipality 1..* Address Permanent City/Municipality Address of the Patient
... PermanentAddressProvince 1..* Address Permanent Province Address of the Patient
... PermanentAddressRegion 1..* Address Permanent Region Address of the Patient
... DidTheClientsMotherTestPositiveForHepatitisB 1..1 BackboneElement History of Client's mother for Hepatitis B
... DidTheClientsMotherTestPositiveForHepatitisC 1..1 BackboneElement History of Client's mother for Hepatitis C
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis B
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis C
... DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers 1..1 CodeableConcept History of client of using/sharing needle or syringe with others
... DoesTheClientHaveHistoryOfInjectingDrugs 1..1 CodeableConcept Does the client have history of injecting drugs?
... HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood 1..1 CodeableConcept Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
... DidTheClientReceiveATattoo 1..1 CodeableConcept Did the client receive a tattoo?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a male?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a female?
... DoesTheClientPayInCashOrInKindForSex 1..1 CodeableConcept Does the client pay (in cash or in kind) for sex?
... DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex 1..1 CodeableConcept Does the client accept payment (in cash or in kind) in exchange for sex?
... WasThereAHistoryOfEmploymentAbroadInThePast 1..1 CodeableConcept Was there a history of employment abroad in the past?
... IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer 1..1 BackboneElement History of Client's family on Hepatocellular Carcinoma (HCC)/Primary Liver Cancer
... DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis 1..1 CodeableConcept Client's History of having Hepatocellular Carcinoma
... DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts 1..1 CodeableConcept Client's History of Receiving Blood or Blood Products
... DoesTheClientHaveHistoryOfUndergoingHemodialysis 1..1 CodeableConcept Client's History of undergoing hemodialysis
... WasThereAHistoryOfBeingVaccinatedForHepatitisA 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis A
... WasThereAHistoryOfBeingVaccinatedForHepatitisB 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis B
... DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment 1..1 CodeableConcept Client's History of Undergoing HIV Treatment Prior to Enrollment
... HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV 1..1 BackboneElement The Client has history of testing positive for HIV prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHIVMedsTaken 1..1 BackboneElement List of Antiretroviral Drugs for HIV Taken
... HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB 1..1 BackboneElement The Client has history of testing positive for Hepatitis B prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisBMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis B Taken
... HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC 1..1 BackboneElement The Client has history of testing positive for Hepatitis C prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisCMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis C Taken

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Base

Summary

Mandatory: 0 element(45 nested mandatory elements)

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ViralHepatitisCaseReportFormModel 0..* Base VH Case Report Form Logical Model
... ConsultDate 1..1 dateTime Consult Date (MM/DD/YYYY)
... PatientCode 1..1 Identifier Patient Code
... TestingFacilityName 1..1 Reference() Testing Facility Name
... ContactNo 0..* ContactPoint Contact Number
... FacilityAddress 1..1 Address Facility Address
... ClientType 1..1 code Client Type
... TestedPositiveForHepatitisB 0..1 BackboneElement If patient tested positive for Hepatitis B
... TestedPositiveForHepatitisC 0..1 BackboneElement If patient tested positive for Hepatitis C
... DateofBaselineHBsAgTest 0..1 dateTime Date of Baseline HBsAgTest (MM/DD/YYYY)
... DateofBaselineAnti-HCVTest 0..1 dateTime Date of Baseline Anti-HCV test (MM/DD/YYYY)
... FirstName 0..* HumanName First Name
... MiddleName 0..* HumanName Middle Name
... LastName 1..1 HumanName Last Name
... Suffix 0..* HumanName Suffix
... UniqueIdentifierCode 1..1 id Unique Identifier Code for the patient
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for id
.... FirstTwoLetterOfMothersName 1..1 id First two letters of mother's name
.... FirstTwoLetterOfFathersName 1..1 id First two letters of father's name
.... BirthOrder 1..1 integer Birth Order
.... BirthDate 1..1 date Birth Date
... SexAssignedAtBirth 0..1 code Sex Assigned at Birth
... SelfIdentity 0..1 code Patient Self Identity
... IsShePregnant 0..* code If female, is she pregnant?
.... @id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for code
.... IsShePregnant 0..* CodeableConcept If female, is she pregnant?
... NumberOfChildren 0..* integer Number of Children
... CivilStatus 0..* CodeableConcept Civil Status
... Nationality 0..* CodeableConcept Nationality
... AgeInYears 1..1 Age Age of Patient in Years
... PhilHealthNo 1..1 Identifier PhilHealth Number of the Patient
... CurrentAddressCityMunicipality 1..* Address Current City/Municipality Address of the Patient
... CurrentAddressProvince 1..* Address Current Province Address of the Patient
... CurrentAddressRegion 1..* Address Current Region Address of the Patient
... PermanentAddressCityMunicipality 1..* Address Permanent City/Municipality Address of the Patient
... PermanentAddressProvince 1..* Address Permanent Province Address of the Patient
... PermanentAddressRegion 1..* Address Permanent Region Address of the Patient
... DidTheClientsMotherTestPositiveForHepatitisB 1..1 BackboneElement History of Client's mother for Hepatitis B
... DidTheClientsMotherTestPositiveForHepatitisC 1..1 BackboneElement History of Client's mother for Hepatitis C
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis B
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis C
... DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers 1..1 CodeableConcept History of client of using/sharing needle or syringe with others
... DoesTheClientHaveHistoryOfInjectingDrugs 1..1 CodeableConcept Does the client have history of injecting drugs?
... HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood 1..1 CodeableConcept Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
... DidTheClientReceiveATattoo 1..1 CodeableConcept Did the client receive a tattoo?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a male?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a female?
... DoesTheClientPayInCashOrInKindForSex 1..1 CodeableConcept Does the client pay (in cash or in kind) for sex?
... DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex 1..1 CodeableConcept Does the client accept payment (in cash or in kind) in exchange for sex?
... WasThereAHistoryOfEmploymentAbroadInThePast 1..1 CodeableConcept Was there a history of employment abroad in the past?
... IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer 1..1 BackboneElement History of Client's family on Hepatocellular Carcinoma (HCC)/Primary Liver Cancer
... DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis 1..1 CodeableConcept Client's History of having Hepatocellular Carcinoma
... DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts 1..1 CodeableConcept Client's History of Receiving Blood or Blood Products
... DoesTheClientHaveHistoryOfUndergoingHemodialysis 1..1 CodeableConcept Client's History of undergoing hemodialysis
... WasThereAHistoryOfBeingVaccinatedForHepatitisA 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis A
... WasThereAHistoryOfBeingVaccinatedForHepatitisB 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis B
... DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment 1..1 CodeableConcept Client's History of Undergoing HIV Treatment Prior to Enrollment
... HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV 1..1 BackboneElement The Client has history of testing positive for HIV prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHIVMedsTaken 1..1 BackboneElement List of Antiretroviral Drugs for HIV Taken
... HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB 1..1 BackboneElement The Client has history of testing positive for Hepatitis B prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisBMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis B Taken
... HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC 1..1 BackboneElement The Client has history of testing positive for Hepatitis C prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisCMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis C Taken

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ViralHepatitisCaseReportFormModel 0..* Base VH Case Report Form Logical Model
... ConsultDate 1..1 dateTime Consult Date (MM/DD/YYYY)
... PatientCode 1..1 Identifier Patient Code
... TestingFacilityName 1..1 Reference() Testing Facility Name
... ContactNo 0..* ContactPoint Contact Number
... FacilityAddress 1..1 Address Facility Address
... ClientType 1..1 code Client Type
... TestedPositiveForHepatitisB 0..1 BackboneElement If patient tested positive for Hepatitis B
... TestedPositiveForHepatitisC 0..1 BackboneElement If patient tested positive for Hepatitis C
... DateofBaselineHBsAgTest 0..1 dateTime Date of Baseline HBsAgTest (MM/DD/YYYY)
... DateofBaselineAnti-HCVTest 0..1 dateTime Date of Baseline Anti-HCV test (MM/DD/YYYY)
... FirstName 0..* HumanName First Name
... MiddleName 0..* HumanName Middle Name
... LastName 1..1 HumanName Last Name
... Suffix 0..* HumanName Suffix
... UniqueIdentifierCode 1..1 id Unique Identifier Code for the patient
.... FirstTwoLetterOfMothersName 1..1 id First two letters of mother's name
.... FirstTwoLetterOfFathersName 1..1 id First two letters of father's name
.... BirthOrder 1..1 integer Birth Order
.... BirthDate 1..1 date Birth Date
... SexAssignedAtBirth 0..1 code Sex Assigned at Birth
... SelfIdentity 0..1 code Patient Self Identity
... IsShePregnant 0..* code If female, is she pregnant?
.... IsShePregnant 0..* CodeableConcept If female, is she pregnant?
... NumberOfChildren 0..* integer Number of Children
... CivilStatus 0..* CodeableConcept Civil Status
... Nationality 0..* CodeableConcept Nationality
... AgeInYears 1..1 Age Age of Patient in Years
... PhilHealthNo 1..1 Identifier PhilHealth Number of the Patient
... CurrentAddressCityMunicipality 1..* Address Current City/Municipality Address of the Patient
... CurrentAddressProvince 1..* Address Current Province Address of the Patient
... CurrentAddressRegion 1..* Address Current Region Address of the Patient
... PermanentAddressCityMunicipality 1..* Address Permanent City/Municipality Address of the Patient
... PermanentAddressProvince 1..* Address Permanent Province Address of the Patient
... PermanentAddressRegion 1..* Address Permanent Region Address of the Patient
... DidTheClientsMotherTestPositiveForHepatitisB 1..1 BackboneElement History of Client's mother for Hepatitis B
... DidTheClientsMotherTestPositiveForHepatitisC 1..1 BackboneElement History of Client's mother for Hepatitis C
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis B
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis C
... DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers 1..1 CodeableConcept History of client of using/sharing needle or syringe with others
... DoesTheClientHaveHistoryOfInjectingDrugs 1..1 CodeableConcept Does the client have history of injecting drugs?
... HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood 1..1 CodeableConcept Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
... DidTheClientReceiveATattoo 1..1 CodeableConcept Did the client receive a tattoo?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a male?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a female?
... DoesTheClientPayInCashOrInKindForSex 1..1 CodeableConcept Does the client pay (in cash or in kind) for sex?
... DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex 1..1 CodeableConcept Does the client accept payment (in cash or in kind) in exchange for sex?
... WasThereAHistoryOfEmploymentAbroadInThePast 1..1 CodeableConcept Was there a history of employment abroad in the past?
... IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer 1..1 BackboneElement History of Client's family on Hepatocellular Carcinoma (HCC)/Primary Liver Cancer
... DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis 1..1 CodeableConcept Client's History of having Hepatocellular Carcinoma
... DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts 1..1 CodeableConcept Client's History of Receiving Blood or Blood Products
... DoesTheClientHaveHistoryOfUndergoingHemodialysis 1..1 CodeableConcept Client's History of undergoing hemodialysis
... WasThereAHistoryOfBeingVaccinatedForHepatitisA 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis A
... WasThereAHistoryOfBeingVaccinatedForHepatitisB 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis B
... DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment 1..1 CodeableConcept Client's History of Undergoing HIV Treatment Prior to Enrollment
... HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV 1..1 BackboneElement The Client has history of testing positive for HIV prior to the baseline diagnosis of viral hepatitis
.... NoYesHIVMedsTaken 1..1 BackboneElement List of Antiretroviral Drugs for HIV Taken
... HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB 1..1 BackboneElement The Client has history of testing positive for Hepatitis B prior to the baseline diagnosis of viral hepatitis
.... NoYesHepatitisBMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis B Taken
... HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC 1..1 BackboneElement The Client has history of testing positive for Hepatitis C prior to the baseline diagnosis of viral hepatitis
.... NoYesHepatitisCMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis C Taken

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ViralHepatitisCaseReportFormModel 0..* Base VH Case Report Form Logical Model
... ConsultDate 1..1 dateTime Consult Date (MM/DD/YYYY)
... PatientCode 1..1 Identifier Patient Code
... TestingFacilityName 1..1 Reference() Testing Facility Name
... ContactNo 0..* ContactPoint Contact Number
... FacilityAddress 1..1 Address Facility Address
... ClientType 1..1 code Client Type
... TestedPositiveForHepatitisB 0..1 BackboneElement If patient tested positive for Hepatitis B
... TestedPositiveForHepatitisC 0..1 BackboneElement If patient tested positive for Hepatitis C
... DateofBaselineHBsAgTest 0..1 dateTime Date of Baseline HBsAgTest (MM/DD/YYYY)
... DateofBaselineAnti-HCVTest 0..1 dateTime Date of Baseline Anti-HCV test (MM/DD/YYYY)
... FirstName 0..* HumanName First Name
... MiddleName 0..* HumanName Middle Name
... LastName 1..1 HumanName Last Name
... Suffix 0..* HumanName Suffix
... UniqueIdentifierCode 1..1 id Unique Identifier Code for the patient
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for id
.... FirstTwoLetterOfMothersName 1..1 id First two letters of mother's name
.... FirstTwoLetterOfFathersName 1..1 id First two letters of father's name
.... BirthOrder 1..1 integer Birth Order
.... BirthDate 1..1 date Birth Date
... SexAssignedAtBirth 0..1 code Sex Assigned at Birth
... SelfIdentity 0..1 code Patient Self Identity
... IsShePregnant 0..* code If female, is she pregnant?
.... @id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional content defined by implementations
.... @value 0..1 string Primitive value for code
.... IsShePregnant 0..* CodeableConcept If female, is she pregnant?
... NumberOfChildren 0..* integer Number of Children
... CivilStatus 0..* CodeableConcept Civil Status
... Nationality 0..* CodeableConcept Nationality
... AgeInYears 1..1 Age Age of Patient in Years
... PhilHealthNo 1..1 Identifier PhilHealth Number of the Patient
... CurrentAddressCityMunicipality 1..* Address Current City/Municipality Address of the Patient
... CurrentAddressProvince 1..* Address Current Province Address of the Patient
... CurrentAddressRegion 1..* Address Current Region Address of the Patient
... PermanentAddressCityMunicipality 1..* Address Permanent City/Municipality Address of the Patient
... PermanentAddressProvince 1..* Address Permanent Province Address of the Patient
... PermanentAddressRegion 1..* Address Permanent Region Address of the Patient
... DidTheClientsMotherTestPositiveForHepatitisB 1..1 BackboneElement History of Client's mother for Hepatitis B
... DidTheClientsMotherTestPositiveForHepatitisC 1..1 BackboneElement History of Client's mother for Hepatitis C
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis B
... DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC 1..1 BackboneElement History of Client's Spouse/Partner for Hepatitis C
... DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers 1..1 CodeableConcept History of client of using/sharing needle or syringe with others
... DoesTheClientHaveHistoryOfInjectingDrugs 1..1 CodeableConcept Does the client have history of injecting drugs?
... HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood 1..1 CodeableConcept Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
... DidTheClientReceiveATattoo 1..1 CodeableConcept Did the client receive a tattoo?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a male?
... WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale 1..1 CodeableConcept Was there a history(past year) of sexual intercourse with a female?
... DoesTheClientPayInCashOrInKindForSex 1..1 CodeableConcept Does the client pay (in cash or in kind) for sex?
... DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex 1..1 CodeableConcept Does the client accept payment (in cash or in kind) in exchange for sex?
... WasThereAHistoryOfEmploymentAbroadInThePast 1..1 CodeableConcept Was there a history of employment abroad in the past?
... IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer 1..1 BackboneElement History of Client's family on Hepatocellular Carcinoma (HCC)/Primary Liver Cancer
... DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis 1..1 CodeableConcept Client's History of having Hepatocellular Carcinoma
... DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts 1..1 CodeableConcept Client's History of Receiving Blood or Blood Products
... DoesTheClientHaveHistoryOfUndergoingHemodialysis 1..1 CodeableConcept Client's History of undergoing hemodialysis
... WasThereAHistoryOfBeingVaccinatedForHepatitisA 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis A
... WasThereAHistoryOfBeingVaccinatedForHepatitisB 1..1 CodeableConcept Client's History of Being Vaccinated for Hepatitis B
... DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment 1..1 CodeableConcept Client's History of Undergoing HIV Treatment Prior to Enrollment
... HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV 1..1 BackboneElement The Client has history of testing positive for HIV prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHIVMedsTaken 1..1 BackboneElement List of Antiretroviral Drugs for HIV Taken
... HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB 1..1 BackboneElement The Client has history of testing positive for Hepatitis B prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisBMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis B Taken
... HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC 1..1 BackboneElement The Client has history of testing positive for Hepatitis C prior to the baseline diagnosis of viral hepatitis
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... NoYesHepatitisCMedsTaken 1..1 BackboneElement List of Antiviral Drugs for Hepatitis C Taken

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Base

Summary

Mandatory: 0 element(45 nested mandatory elements)

 

Other representations of profile: CSV, Excel