US Core Implementation Guide
8.0.1 - STU 8

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 8.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

## : Questionnaire Hunger Vital Sign (HVS) Example - XML Representation

Page standards status: Informative

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    <Questionnaire xmlns="http://hl7.org/fhir">
      <id value="hunger-vital-sign-example"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire hunger-vital-sign-example</b></p><a name="hunger-vital-sign-example"> </a><a name="hchunger-vital-sign-example"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire.html">SDCBaseQuestionnaire</a></p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> HungerVitalSignExample</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://hl7.org/fhir/us/core/Questionnaire/hunger-vital-sign-example#8.0.1</td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./88122-7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> /88122-7</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Within the past 12 months we worried whether our food would run out before we got money to buy more</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./88122-7">4 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./88123-5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> /88123-5</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Within the past 12 months the food we bought just didn't last and we didn't have money to get more</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./88123-5">4 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item./88124-3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> /88124-3</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Food insecurity risk</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./88124-3">2 options</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" id="item./88124-3-help" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> /88124-3-help</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">An answer of &quot;often true&quot; or &quot;sometimes true&quot; to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI).</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item./88122-7"> </a><p><b>Answer options for /88122-7 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA28397-0 (&quot;Often true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6729-3 (&quot;Sometimes true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA28398-8 (&quot;Never true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA15775-2 (&quot;Don't know/refused&quot;)</li></ul><a name="opt-item./88123-5"> </a><p><b>Answer options for /88123-5 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA28397-0 (&quot;Often true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6729-3 (&quot;Sometimes true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA28398-8 (&quot;Never true&quot;)</li><li style="font-size: 11px">http://loinc.org#LA15775-2 (&quot;Don't know/refused&quot;)</li></ul><a name="opt-item./88124-3"> </a><p><b>Answer options for /88124-3 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA19952-3 (&quot;At risk&quot;)</li><li style="font-size: 11px">http://loinc.org#LA19983-8 (&quot;No risk&quot;)</li></ul></div>
      </text>
      <url
           value="http://hl7.org/fhir/us/core/Questionnaire/hunger-vital-sign-example"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.4.642.40.2.35.4"/>
      </identifier>
      <version value="8.0.1"/>
      <name value="HungerVitalSignExample"/>
      <title value="Hunger Vital Sign Example"/>
      <status value="active"/>
      <experimental value="true"/>
      <subjectType value="Patient"/>
      <date value="2023-03-31"/>
      <publisher value="HL7 International / Cross-Group Projects"/>
      <contact>
        <name value="HL7 International / Cross-Group Projects"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/cgp"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="cgp@lists.HL7.org"/>
        </telecom>
      </contact>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
        </coding>
      </jurisdiction>
      <copyright
                 value="This material contains content from LOINC® (http://loinc.org). LOINC is copyright © 1995-2024, Regenstrief Institute, Inc. and the LOINC Committee, and is available at no cost under the license at http://loinc.org/license.  Copyright © 2010 Dr. Erin Hager and Dr. Anna Quigg and the Children's HealthWatch research team (http://www.childrenshealthwatch.org) used with permission."/>
      <code>
        <system value="http://loinc.org"/>
        <code value="88121-9"/>
        <display value="Hunger Vital Sign [HVS]"/>
      </code>
      <item>
        <linkId value="/88122-7"/>
        <code>
          <system value="http://loinc.org"/>
          <code value="88122-7"/>
          <display
                   value="Within the past 12 months we worried whether our food would run out before we got money to buy more"/>
        </code>
        <text
              value="Within the past 12 months we worried whether our food would run out before we got money to buy more"/>
        <type value="choice"/>
        <required value="false"/>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA28397-0"/>
            <display value="Often true"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA6729-3"/>
            <display value="Sometimes true"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA28398-8"/>
            <display value="Never true"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA15775-2"/>
            <display value="Don't know/refused"/>
          </valueCoding>
        </answerOption>
      </item>
      <item>
        <linkId value="/88123-5"/>
        <code>
          <system value="http://loinc.org"/>
          <code value="88123-5"/>
          <display
                   value="Within the past 12 months the food we bought just didn't last and we didn't have money to get more"/>
        </code>
        <text
              value="Within the past 12 months the food we bought just didn't last and we didn't have money to get more"/>
        <type value="choice"/>
        <required value="false"/>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA28397-0"/>
            <display value="Often true"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA6729-3"/>
            <display value="Sometimes true"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA28398-8"/>
            <display value="Never true"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA15775-2"/>
            <display value="Don't know/refused"/>
          </valueCoding>
        </answerOption>
      </item>
      <item>
        <linkId value="/88124-3"/>
        <code>
          <system value="http://loinc.org"/>
          <code value="88124-3"/>
          <display value="Food insecurity risk [HVS]"/>
        </code>
        <text value="Food insecurity risk"/>
        <type value="choice"/>
        <required value="false"/>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA19952-3"/>
            <display value="At risk"/>
          </valueCoding>
        </answerOption>
        <answerOption>
          <valueCoding>
            <system value="http://loinc.org"/>
            <code value="LA19983-8"/>
            <display value="No risk"/>
          </valueCoding>
        </answerOption>
        <item>
          <linkId value="/88124-3-help"/>
          <text
                value="An answer of &quot;often true&quot; or &quot;sometimes true&quot; to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI)."/>
          <type value="display"/>
        </item>
      </item>
    </Questionnaire>