Person-Centered Outcomes (PCO) Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/pco-ig/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/pco/Questionnaire/health-inventory-example | Version: 1.0.0 | ||||
| Standards status: Informative Active as of 2025-02-05 | Computable Name: PersonalHealthInventory | ||||
Usage: Clinical Focus: What Matters |
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Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License |
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A Questionnaire for a person's assessment of what matters most in their health and well-being.
Profile: SDCBaseQuestionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints![]() |
|---|---|---|---|---|
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A Questionnaire for a person's assessment of what matters most in their health and well-being. | Questionnaire | http://hl7.org/fhir/us/pco/Questionnaire/health-inventory-example#1.0.0 | |
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Personal Health Inventory | 0..1 | group | Value Set: |
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What matters most to you in your life right now? Write a few words to capture your thoughts: | 0..1 | text | Value Set: |
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For each of the following areas, consider "Where you are" and "Where you want to be." Select a number between 1 (low) and 5 (high) that best represents where you are and where you want to be. You do not need to be a "5" in any of the areas now, nor even wish to be a "5" in the future. | 0..1 | display | Value Set: |
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Moving the Body | 0..1 | group | Value Set: |
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Our physical, mental, and emotional health are impacted by the amount and kind of movement we do. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Power of the Mind | 0..1 | group | Value Set: |
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Our bodies and minds need rest in order to optimize our health. Recharging also involves activities that replenish your mental and physical energy. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Food & Drink | 0..1 | group | Value Set: |
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What we eat, and drink can have a huge effect on how we experience life, both physically and mentally. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Recharge | 0..1 | group | Value Set: |
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Our bodies and minds must rest and recharge in order to optimize our health. Getting a good night's rest, as well as recharging our mental and physical energy throughout the day, are vital to well-being. Taking short breaks or doing something you enjoy or feels good for moments throughout the day are examples of ways to refresh. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Surroundings | 0..1 | group | Value Set: |
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Our surroundings, both at work and where we live, indoors and out, can affect our health and outlook on life. Changes within our control such as organizing, decluttering, adding a plant or artwork can improve mood and health. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Personal Development | 0..1 | group | Value Set: |
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Our health is impacted by how we choose to spend our time. Aligning our work and personal activities with what really matters to us, or what brings us joy, can have a big effect on our health and outlook on life. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Spirit & Soul | 0..1 | group | Value Set: |
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Connecting with something greater than ourselves may provide a sense of meaning and purpose, peace, or comfort. Connecting and aligning spiritually is very individual and may take the form of religious affiliation, connection to nature, or engaging in things like music or art. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Family, Friends & Co-Workers | 0..1 | group | Value Set: |
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Our relationships, including those with pets, have as significant an effect on our physical and emotional health as any other factor associated with well-being. Spending more time in relationships that "fuel" us and less in relationships that "drain" us is one potential option. Improving our relationship skills or creating new relationships through community activities are other options to consider. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Professional Care | 0..1 | group | Value Set: |
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Staying up to date on prevention and understanding your health concerns, care options, treatment plan, and their role in your health. | 0..1 | display | Value Set: |
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Where are you now? | 0..1 | integer | Value Set: |
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Where would you like to be? | 0..1 | integer | Value Set: |
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Reflections | 0..1 | group | Value Set: |
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Now that you have thought about what matters to you in all of these areas, what would your life look like if you had the health you want? What kind of activities would you be doing? Or how might you feel different? What area might you focus on? | 0..1 | text | Value Set: |
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What might get in the way? How might you start? | 0..1 | text | Value Set: |
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After completing the Personal Health Inventory, talk to a friend, a family member, your health coach, a peer, or someone on your health care team about areas you would like to explore further. | 0..1 | display | Value Set: |
Documentation for this format | ||||
Profile: SDCBaseQuestionnaire
Personal Health Inventory
What matters most to you in your life right now? Write a few words to capture your thoughts:
For each of the following areas, consider "Where you are" and "Where you want to be." Select a number between 1 (low) and 5 (high) that best represents where you are and where you want to be. You do not need to be a "5" in any of the areas now, nor even wish to be a "5" in the future.
Moving the Body
Our physical, mental, and emotional health are impacted by the amount and kind of movement we do.
Where are you now?
Where would you like to be?
Power of the Mind
Our bodies and minds need rest in order to optimize our health. Recharging also involves activities that replenish your mental and physical energy.
Where are you now?
Where would you like to be?
Food & Drink
What we eat, and drink can have a huge effect on how we experience life, both physically and mentally.
Where are you now?
Where would you like to be?
Recharge
Our bodies and minds must rest and recharge in order to optimize our health. Getting a good night's rest, as well as recharging our mental and physical energy throughout the day, are vital to well-being. Taking short breaks or doing something you enjoy or feels good for moments throughout the day are examples of ways to refresh.
Where are you now?
Where would you like to be?
Surroundings
Our surroundings, both at work and where we live, indoors and out, can affect our health and outlook on life. Changes within our control such as organizing, decluttering, adding a plant or artwork can improve mood and health.
Where are you now?
Where would you like to be?
Personal Development
Our health is impacted by how we choose to spend our time. Aligning our work and personal activities with what really matters to us, or what brings us joy, can have a big effect on our health and outlook on life.
Where are you now?
Where would you like to be?
Spirit & Soul
Connecting with something greater than ourselves may provide a sense of meaning and purpose, peace, or comfort. Connecting and aligning spiritually is very individual and may take the form of religious affiliation, connection to nature, or engaging in things like music or art.
Where are you now?
Where would you like to be?
Family, Friends & Co-Workers
Our relationships, including those with pets, have as significant an effect on our physical and emotional health as any other factor associated with well-being. Spending more time in relationships that "fuel" us and less in relationships that "drain" us is one potential option. Improving our relationship skills or creating new relationships through community activities are other options to consider.
Where are you now?
Where would you like to be?
Professional Care
Staying up to date on prevention and understanding your health concerns, care options, treatment plan, and their role in your health.
Where are you now?
Where would you like to be?
Reflections
Now that you have thought about what matters to you in all of these areas, what would your life look like if you had the health you want? What kind of activities would you be doing? Or how might you feel different? What area might you focus on?
What might get in the way? How might you start?
After completing the Personal Health Inventory, talk to a friend, a family member, your health coach, a peer, or someone on your health care team about areas you would like to explore further.
Profile: SDCBaseQuestionnaire
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Documentation for this format | |
Try this questionnaire out:
There are currently no QuestionnaireResponse instances for this Questionnaire defined in this IG.