DRAFT PH Road Safety Implementation Guide
0.2.0 - ci-build Philippines flag

DRAFT PH Road Safety Implementation Guide, published by UP Manila - National Institutes of Health - National Telehealth Center. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/UPM-NTHC/PH-RoadSafetyIG/ and changes regularly. See the Directory of published versions

Questionnaire: RS ONEISS Questionnaire

Official URL: https://build.fhir.org/ig/UPM-NTHC/PH-RoadSafetyIG/Questionnaire/rs-oneiss Version: 0.2.0
Draft as of 2025-01-01 Computable Name: RSOneissQuestionnaire

Structured Data Capture questionnaire for the DOH ONEISS Patient Injury form. Captures patient demographics, encounter information, clinical findings, incident context, injuries, and financial data mapped to RS profiles, supporting SDC $extract.

Profile: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. RSOneissQuestionnaireStructured Data Capture questionnaire for the DOH ONEISS Patient Injury form. Captures patient demographics, encounter information, clinical findings, incident context, injuries, and financial data mapped to RS profiles, supporting SDC $extract.Questionnairehttps://build.fhir.org/ig/UPM-NTHC/PH-RoadSafetyIG/Questionnaire/rs-oneiss#0.2.0
... oneissONEISS Patient Injury Form0..1group
.... oneiss-patientPatient Demographics0..1group
..... oneiss-patient-name-familyPatient last name0..1stringDefinition: Patient.name.family
..... oneiss-patient-name-givenPatient given name(s)0..*stringDefinition: Patient.name.given
..... oneiss-patient-birthdateDate of birth0..1dateDefinition: Patient.birthDate
..... oneiss-patient-genderSex0..1choiceDefinition: Patient.gender
Value Set: AdministrativeGender
..... oneiss-patient-hospital-idHospital patient ID number0..1stringDefinition: Patient.identifier:patientHospitalID.value
..... oneiss-patient-telecomContact number0..1stringDefinition: Patient.telecom.value
..... oneiss-patient-identifiersPatient identifier0..*group
...... oneiss-patient-identifier-systemIdentifier system (URI)0..1urlDefinition: Patient.identifier.system
...... oneiss-patient-identifier-valueIdentifier value0..1stringDefinition: Patient.identifier.value
...... oneiss-patient-identifier-typeIdentifier type0..1stringDefinition: Patient.identifier.type.text
..... oneiss-patient-occupationOccupation0..*group
...... oneiss-patient-occupation-classificationOccupation classification0..1choiceDefinition: https://build.fhir.org/ig/UP-Manila-SILab/ph-core/StructureDefinition/occupation#Extension.extension:occupationClassification.valueCodeableConcept
Value Set: https://build.fhir.org/ig/UP-Manila-SILab/ph-core/ValueSet/occupation-classifications
...... oneiss-patient-occupation-lengthLength of time in occupation (years)0..1decimalDefinition: https://build.fhir.org/ig/UP-Manila-SILab/ph-core/StructureDefinition/occupation#Extension.extension:occupationLength.valueInteger
..... oneiss-patient-addressAddress0..*group
...... oneiss-patient-address-useAddress use0..1choiceDefinition: Patient.address.use
Options: 3 options
...... oneiss-patient-address-lineHouse No. and Street0..1textDefinition: Patient.address.line
...... oneiss-patient-address-barangayBarangay0..1stringDefinition: Patient.address.extension:barangay.value[x]
...... oneiss-patient-address-cityCity / Municipality0..1stringDefinition: Patient.address.extension:cityMunicipality.value[x]
...... oneiss-patient-address-provinceProvince0..1stringDefinition: Patient.address.extension:province.value[x]
...... oneiss-patient-address-regionRegion0..1stringDefinition: Patient.address.extension:region.value[x]
.... oneiss-encounterEncounter Details0..1group
..... oneiss-encounter-incident-numberIncident number0..1stringDefinition: Encounter.identifier:incidentNumber.value
..... oneiss-encounter-hospital-caseHospital case number0..1stringDefinition: Encounter.identifier:hospitalCaseNo.value
..... oneiss-encounter-classType of patient0..1choiceDefinition: Encounter.class
Value Set: SILPH - Type of Patient (VS)
..... oneiss-encounter-period-startDate/Time of consultation0..1dateTimeDefinition: Encounter.period.start
..... oneiss-encounter-service-providerReceiving medical facility0..1stringDefinition: Encounter.serviceProvider.display
..... oneiss-encounter-originating-organizationOriginating hospital0..1stringDefinition: Encounter.hospitalization.origin.display
..... oneiss-encounter-originating-practitionerOriginating physician0..1stringDefinition: Encounter.participant:receivedBy.individual.display
..... oneiss-encounter-dispositionEncounter disposition0..1choiceDefinition: Encounter.hospitalization.dischargeDisposition
Value Set: SILPH - Outpatient/ER Disposition (VS)
..... oneiss-encounter-disposition-otherDisposition – other (specify)0..1textDefinition: Encounter.hospitalization.dischargeDisposition.text
..... oneiss-encounter-transfer-destinationTransferred to (destination facility)0..1stringDefinition: Encounter.hospitalization.destination.display
.... oneiss-clinicalClinical Assessments0..1group
..... oneiss-clinical-initial-impressionInitial impression0..1group
...... oneiss-clinical-initial-impression-textInitial impression (diagnosis text or code)0..1textDefinition: Condition.code.text
..... oneiss-clinical-final-diagnosisFinal diagnosis0..*group
...... oneiss-clinical-final-diagnosis-textFinal diagnosis (ICD-10 or text)0..1textDefinition: Condition.code.text
..... oneiss-clinical-icd10-natureICD-10 nature of injury0..*group
...... oneiss-clinical-icd10-nature-codeNature of injury code0..1choiceDefinition: Condition.code
Value Set: SILPH - ICD10 Nature of Injury (VS)
..... oneiss-clinical-icd10-externalICD-10 external cause0..*group
...... oneiss-clinical-icd10-external-codeExternal cause code0..1choiceDefinition: Condition.code
Value Set: SILPH - ICD10 External Cause of Injury (VS)
..... oneiss-clinical-condition-of-patientCondition of patient0..1group
...... oneiss-clinical-condition-of-patient-statusPatient condition0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - General Disposition (VS)
..... oneiss-clinical-status-on-arrivalStatus on arrival0..1group
...... oneiss-clinical-status-on-arrival-valueStatus on arrival0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Status (VS)
..... oneiss-clinical-psychosocial-supportPsychosocial support/condition0..1group
...... oneiss-clinical-psychosocial-support-statusPsychosocial support provided?0..1choiceDefinition: Procedure.status
Options: 2 options
...... oneiss-clinical-psychosocial-support-notesPsychosocial support notes0..1textDefinition: Procedure.note.text
..... oneiss-clinical-transport-coordinationTransport coordination with receiving hospital0..1group
...... oneiss-clinical-transport-coordination-statusTransport coordination done?0..1choiceDefinition: Procedure.status
Options: 2 options
...... oneiss-clinical-transport-coordination-notesTransport coordination notes0..1textDefinition: Procedure.note.text
..... oneiss-clinical-first-aidFirst aid provided0..1group
...... oneiss-clinical-first-aid-statusFirst aid given?0..1choiceDefinition: Procedure.status
Options: 2 options
...... oneiss-clinical-first-aid-whatIf yes, what first aid was given?0..1textDefinition: Procedure.code.text
...... oneiss-clinical-first-aid-by-whomIf yes, by whom?0..1textDefinition: Procedure.performer.actor.display
..... oneiss-clinical-blood-alcoholBlood alcohol concentration0..1group
...... oneiss-clinical-blood-alcohol-valueBlood alcohol concentration0..1decimalDefinition: Observation.valueQuantity.value
..... oneiss-clinical-other-risk-factorsOther risk factors at time of incident0..*group
...... oneiss-clinical-other-risk-factors-codeRisk factor0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Risk Factors (VS)
...... oneiss-clinical-other-risk-factors-otherRisk factor – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
..... oneiss-clinical-safety-accessoriesSafety accessories used0..*group
...... oneiss-clinical-safety-accessories-codeSafety accessory0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Safety Devices (VS)
...... oneiss-clinical-safety-accessories-otherSafety accessory – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
.... oneiss-incidentIncident Details0..1group
..... oneiss-incident-injury-datetimeDate and time of injury0..1group
...... oneiss-incident-injury-datetime-valueDate/Time of injury0..1dateTimeDefinition: Observation.valueDateTime
..... oneiss-incident-injury-intentInjury intent0..1group
...... oneiss-incident-injury-intent-valueIntent of injury0..1choiceDefinition: Observation.code
Value Set: SILPH - Injury Intent (VS)
..... oneiss-incident-transport-vehicularTransport/vehicular accident?0..1group
...... oneiss-incident-transport-vehicular-valueTransport accident?0..1booleanDefinition: Observation.valueBoolean
..... oneiss-incident-mode-of-transportMode of transport to facility0..1group
...... oneiss-incident-mode-of-transport-valueMode of transport0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Mode of Transport (VS)
...... oneiss-incident-mode-of-transport-otherMode of transport – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
..... oneiss-incident-triage-priorityTriage priority0..1group
...... oneiss-incident-triage-priority-valueTriage priority category0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Triage (VS)
..... oneiss-incident-urgencyPriority level (urgency)0..1group
...... oneiss-incident-urgency-valueUrgency level0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Status (VS)
..... oneiss-incident-placePlace of occurrence0..1group
...... oneiss-incident-place-valuePlace of occurrence0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Place of Occurrence (VS)
..... oneiss-incident-activityActivity at time of incident0..1group
...... oneiss-incident-activity-valueActivity at time0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Activity (VS)
..... oneiss-incident-collision-typeCollision vs non-collision0..1group
...... oneiss-incident-collision-type-valueCollision classification0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Transport Accident: Collision or Noncollision (VS)
..... oneiss-incident-patient-vehiclePatient's vehicle0..1group
...... oneiss-incident-patient-vehicle-codePatient's vehicle0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Patient's Vehicle (VS)
...... oneiss-incident-patient-vehicle-otherPatient's vehicle – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
..... oneiss-incident-other-vehicleOther vehicle/object involved0..*group
...... oneiss-incident-other-vehicle-codeOther vehicle/object0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Other Vehicle in Collision (VS)
...... oneiss-incident-other-vehicle-otherOther vehicle/object – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
..... oneiss-incident-position-of-patientPosition of patient0..1group
...... oneiss-incident-position-of-patient-valuePosition0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Position of Patient (VS)
...... oneiss-incident-position-of-patient-otherPosition – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
..... oneiss-incident-place-namePlace of occurrence – workplace name0..1stringDefinition: Observation.note.text
..... oneiss-incident-activity-otherActivity – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
.... oneiss-injuriesNature of Injuries0..1group
..... oneiss-injuries-multipleMultiple injuries?0..1group
...... oneiss-injuries-multiple-flagMultiple injuries present?0..1booleanDefinition: Observation.valueBoolean
..... oneiss-injuries-abrasionAbrasion0..1group
...... oneiss-injuries-abrasion-presentAbrasion present?0..1booleanDefinition: Observation.valueBoolean
...... oneiss-injuries-abrasion-siteAbrasion site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-abrasion-detailsAbrasion details0..1textDefinition: Observation.note.text
..... oneiss-injuries-avulsionAvulsion0..1group
...... oneiss-injuries-avulsion-presentAvulsion present?0..1booleanDefinition: Observation.valueBoolean
...... oneiss-injuries-avulsion-siteAvulsion site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-avulsion-detailsAvulsion details0..1textDefinition: Observation.note.text
..... oneiss-injuries-burnBurn0..1group
...... oneiss-injuries-burn-presentBurn present?0..1booleanDefinition: Observation.valueBoolean
...... oneiss-injuries-burn-degreeBurn degree0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Burns (VS)
...... oneiss-injuries-burn-degree-otherBurn degree – other (specify)0..1textDefinition: Observation.valueCodeableConcept.text
..... oneiss-injuries-concussionConcussion0..1group
...... oneiss-injuries-concussion-presentConcussion present?0..1booleanDefinition: Observation.valueBoolean
...... oneiss-injuries-concussion-siteConcussion site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-concussion-detailsConcussion details0..1textDefinition: Observation.note.text
..... oneiss-injuries-contusionContusion0..1group
...... oneiss-injuries-contusion-presentContusion present?0..1booleanDefinition: Observation.valueBoolean
...... oneiss-injuries-contusion-siteContusion site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-contusion-detailsContusion details0..1textDefinition: Observation.note.text
..... oneiss-injuries-fractureFracture0..1group
...... oneiss-injuries-fracture-typeFracture type0..1choiceDefinition: Observation.valueCodeableConcept
Value Set: SILPH - Fracture Type (VS)
...... oneiss-injuries-fracture-siteFracture site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-fracture-detailsFracture details0..1textDefinition: Observation.note.text
..... oneiss-injuries-open-woundOpen wound0..1group
...... oneiss-injuries-open-wound-presentOpen wound present?0..1booleanDefinition: Observation.valueBoolean
...... oneiss-injuries-open-wound-siteOpen wound site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-open-wound-typeOpen wound type0..1textDefinition: Observation.valueCodeableConcept.text
...... oneiss-injuries-open-wound-detailsOpen wound details0..1textDefinition: Observation.note.text
..... oneiss-injuries-traumatic-amputationTraumatic amputation0..1group
...... oneiss-injuries-traumatic-amputation-presentTraumatic amputation present?0..1booleanDefinition: Observation.valueBoolean
...... oneiss-injuries-traumatic-amputation-siteTraumatic amputation site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-traumatic-amputation-detailsTraumatic amputation details0..1textDefinition: Observation.note.text
..... oneiss-injuries-otherOther specified injury0..1group
...... oneiss-injuries-other-typeOther injury type0..1textDefinition: Observation.valueCodeableConcept.text
...... oneiss-injuries-other-siteOther injury site0..1choiceDefinition: Observation.bodySite
Value Set: SILPH - List of Body Sites (VS)
...... oneiss-injuries-other-detailsOther injury details0..1textDefinition: Observation.note.text
.... oneiss-clinical-outcome-releaseOutcome at release0..1group
..... oneiss-clinical-outcome-release-statusOutcome at release0..1choiceDefinition: https://build.fhir.org/ig/UPM-NTHC/PH-RoadSafetyIG/StructureDefinition/rs-observation-outcome#Observation.valueCodeableConcept
Value Set: SILPH - Outcome (VS)
.... oneiss-clinical-outcome-dischargeOutcome at discharge0..1group
..... oneiss-clinical-outcome-discharge-statusOutcome at discharge0..1choiceDefinition: https://build.fhir.org/ig/UPM-NTHC/PH-RoadSafetyIG/StructureDefinition/rs-observation-outcome#Observation.valueCodeableConcept
Value Set: SILPH - Outcome (VS)
.... oneiss-postcrashPost-crash Investigation0..1group
..... oneiss-postcrash-collision-typeCollision type0..1group
...... oneiss-postcrash-collision-type-valueCollision type0..1stringDefinition: Observation.valueCodeableConcept.text
..... oneiss-postcrash-traffic-investigatorTraffic investigator present?0..1group
...... oneiss-postcrash-traffic-investigator-flagTraffic investigator present?0..1booleanDefinition: Observation.valueBoolean
..... oneiss-postcrash-cctvCCTV availability0..1group
...... oneiss-postcrash-cctv-availableCCTV available?0..1booleanDefinition: Observation.valueBoolean
..... oneiss-postcrash-evidencePost-crash evidence documents0..1group
...... oneiss-postcrash-evidence-causeCause of crash document0..1group
....... oneiss-postcrash-evidence-cause-urlDocument URL0..1urlDefinition: DocumentReference.content.attachment.url
...... oneiss-postcrash-evidence-faultParty at fault document0..1group
....... oneiss-postcrash-evidence-fault-urlDocument URL0..1urlDefinition: DocumentReference.content.attachment.url
...... oneiss-postcrash-evidence-traffic-managementTraffic incident management log0..1group
....... oneiss-postcrash-evidence-traffic-management-urlDocument URL0..1urlDefinition: DocumentReference.content.attachment.url
...... oneiss-postcrash-evidence-road-networkRoad network shape files0..1group
....... oneiss-postcrash-evidence-road-network-urlDocument URL0..1urlDefinition: DocumentReference.content.attachment.url
.... oneiss-financeFinance0..1group
..... oneiss-finance-costCost of care0..1decimalDefinition: Claim.total.value
.... oneiss-commentsComments0..1group
..... oneiss-comments-textComments0..1textDefinition: Observation.valueString

doco Documentation for this format

Options Sets

Answer options for oneiss-patient-address-use

  • http://hl7.org/fhir/address-use#home
  • http://hl7.org/fhir/address-use#temp
  • http://hl7.org/fhir/address-use#work

Answer options for oneiss-clinical-psychosocial-support-status

  • http://hl7.org/fhir/event-status#completed
  • http://hl7.org/fhir/event-status#not-done

Answer options for oneiss-clinical-transport-coordination-status

  • http://hl7.org/fhir/event-status#completed
  • http://hl7.org/fhir/event-status#not-done

Answer options for oneiss-clinical-first-aid-status

  • http://hl7.org/fhir/event-status#completed
  • http://hl7.org/fhir/event-status#not-done