Generated Narrative: Questionnaire RSOneissQuestionnaire Profile: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire Structure LinkID Text Cardinality Type Description & Constraints 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. Questionnaire https://build.fhir.org/ig/UPM-NTHC/PH-RoadSafetyIG/Questionnaire/rs-oneiss#0.2.0 #xD; oneiss ONEISS Patient Injury Form 0..1 group #xD; oneiss-patient Patient Demographics 0..1 group #xD; oneiss-patient-name-family Patient last name 0..1 string Definition: Patient.name.family #xD; oneiss-patient-name-given Patient given name(s) 0..* string Definition: Patient.name.given #xD; oneiss-patient-birthdate Date of birth 0..1 date Definition: Patient.birthDate #xD; oneiss-patient-gender Sex 0..1 choice Definition: Patient.gender Value Set: AdministrativeGender #xD; oneiss-patient-hospital-id Hospital patient ID number 0..1 string Definition: Patient.identifier:patientHospitalID.value #xD; oneiss-patient-telecom Contact number 0..1 string Definition: Patient.telecom.value #xD; oneiss-patient-identifiers Patient identifier 0..* group #xD; oneiss-patient-identifier-system Identifier system (URI) 0..1 url Definition: Patient.identifier.system #xD; oneiss-patient-identifier-value Identifier value 0..1 string Definition: Patient.identifier.value #xD; oneiss-patient-identifier-type Identifier type 0..1 string Definition: Patient.identifier.type.text #xD; oneiss-patient-occupation Occupation 0..* group #xD; oneiss-patient-occupation-classification Occupation classification 0..1 choice Definition: 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 #xD; oneiss-patient-occupation-length Length of time in occupation (years) 0..1 decimal Definition: https://build.fhir.org/ig/UP-Manila-SILab/ph-core/StructureDefinition/occupation#Extension.extension:occupationLength.valueInteger #xD; oneiss-patient-address Address 0..* group #xD; oneiss-patient-address-use Address use 0..1 choice Definition: Patient.address.use Options: 3 options #xD; oneiss-patient-address-line House No. and Street 0..1 text Definition: Patient.address.line #xD; oneiss-patient-address-barangay Barangay 0..1 string Definition: Patient.address.extension:barangay.value[x] #xD; oneiss-patient-address-city City / Municipality 0..1 string Definition: Patient.address.extension:cityMunicipality.value[x] #xD; oneiss-patient-address-province Province 0..1 string Definition: Patient.address.extension:province.value[x] #xD; oneiss-patient-address-region Region 0..1 string Definition: Patient.address.extension:region.value[x] #xD; oneiss-encounter Encounter Details 0..1 group #xD; oneiss-encounter-incident-number Incident number 0..1 string Definition: Encounter.identifier:incidentNumber.value #xD; oneiss-encounter-hospital-case Hospital case number 0..1 string Definition: Encounter.identifier:hospitalCaseNo.value #xD; oneiss-encounter-class Type of patient 0..1 choice Definition: Encounter.class Value Set: SILPH - Type of Patient (VS) #xD; oneiss-encounter-period-start Date/Time of consultation 0..1 dateTime Definition: Encounter.period.start #xD; oneiss-encounter-service-provider Receiving medical facility 0..1 string Definition: Encounter.serviceProvider.display #xD; oneiss-encounter-originating-organization Originating hospital 0..1 string Definition: Encounter.hospitalization.origin.display #xD; oneiss-encounter-originating-practitioner Originating physician 0..1 string Definition: Encounter.participant:receivedBy.individual.display #xD; oneiss-encounter-disposition Encounter disposition 0..1 choice Definition: Encounter.hospitalization.dischargeDisposition Value Set: SILPH - Outpatient/ER Disposition (VS) #xD; oneiss-encounter-disposition-other Disposition – other (specify) 0..1 text Definition: Encounter.hospitalization.dischargeDisposition.text #xD; oneiss-encounter-transfer-destination Transferred to (destination facility) 0..1 string Definition: Encounter.hospitalization.destination.display #xD; oneiss-clinical Clinical Assessments 0..1 group #xD; oneiss-clinical-initial-impression Initial impression 0..1 group #xD; oneiss-clinical-initial-impression-text Initial impression (diagnosis text or code) 0..1 text Definition: Condition.code.text #xD; oneiss-clinical-final-diagnosis Final diagnosis 0..* group #xD; oneiss-clinical-final-diagnosis-text Final diagnosis (ICD-10 or text) 0..1 text Definition: Condition.code.text #xD; oneiss-clinical-icd10-nature ICD-10 nature of injury 0..* group #xD; oneiss-clinical-icd10-nature-code Nature of injury code 0..1 choice Definition: Condition.code Value Set: SILPH - ICD10 Nature of Injury (VS) #xD; oneiss-clinical-icd10-external ICD-10 external cause 0..* group #xD; oneiss-clinical-icd10-external-code External cause code 0..1 choice Definition: Condition.code Value Set: SILPH - ICD10 External Cause of Injury (VS) #xD; oneiss-clinical-condition-of-patient Condition of patient 0..1 group #xD; oneiss-clinical-condition-of-patient-status Patient condition 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - General Disposition (VS) #xD; oneiss-clinical-status-on-arrival Status on arrival 0..1 group #xD; oneiss-clinical-status-on-arrival-value Status on arrival 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Status (VS) #xD; oneiss-clinical-psychosocial-support Psychosocial support/condition 0..1 group #xD; oneiss-clinical-psychosocial-support-status Psychosocial support provided? 0..1 choice Definition: Procedure.status Options: 2 options #xD; oneiss-clinical-psychosocial-support-notes Psychosocial support notes 0..1 text Definition: Procedure.note.text #xD; oneiss-clinical-transport-coordination Transport coordination with receiving hospital 0..1 group #xD; oneiss-clinical-transport-coordination-status Transport coordination done? 0..1 choice Definition: Procedure.status Options: 2 options #xD; oneiss-clinical-transport-coordination-notes Transport coordination notes 0..1 text Definition: Procedure.note.text #xD; oneiss-clinical-first-aid First aid provided 0..1 group #xD; oneiss-clinical-first-aid-status First aid given? 0..1 choice Definition: Procedure.status Options: 2 options #xD; oneiss-clinical-first-aid-what If yes, what first aid was given? 0..1 text Definition: Procedure.code.text #xD; oneiss-clinical-first-aid-by-whom If yes, by whom? 0..1 text Definition: Procedure.performer.actor.display #xD; oneiss-clinical-blood-alcohol Blood alcohol concentration 0..1 group #xD; oneiss-clinical-blood-alcohol-value Blood alcohol concentration 0..1 decimal Definition: Observation.valueQuantity.value #xD; oneiss-clinical-other-risk-factors Other risk factors at time of incident 0..* group #xD; oneiss-clinical-other-risk-factors-code Risk factor 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Risk Factors (VS) #xD; oneiss-clinical-other-risk-factors-other Risk factor – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-clinical-safety-accessories Safety accessories used 0..* group #xD; oneiss-clinical-safety-accessories-code Safety accessory 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Safety Devices (VS) #xD; oneiss-clinical-safety-accessories-other Safety accessory – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-incident Incident Details 0..1 group #xD; oneiss-incident-injury-datetime Date and time of injury 0..1 group #xD; oneiss-incident-injury-datetime-value Date/Time of injury 0..1 dateTime Definition: Observation.valueDateTime #xD; oneiss-incident-injury-intent Injury intent 0..1 group #xD; oneiss-incident-injury-intent-value Intent of injury 0..1 choice Definition: Observation.code Value Set: SILPH - Injury Intent (VS) #xD; oneiss-incident-transport-vehicular Transport/vehicular accident? 0..1 group #xD; oneiss-incident-transport-vehicular-value Transport accident? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-incident-mode-of-transport Mode of transport to facility 0..1 group #xD; oneiss-incident-mode-of-transport-value Mode of transport 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Mode of Transport (VS) #xD; oneiss-incident-mode-of-transport-other Mode of transport – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-incident-triage-priority Triage priority 0..1 group #xD; oneiss-incident-triage-priority-value Triage priority category 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Triage (VS) #xD; oneiss-incident-urgency Priority level (urgency) 0..1 group #xD; oneiss-incident-urgency-value Urgency level 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Status (VS) #xD; oneiss-incident-place Place of occurrence 0..1 group #xD; oneiss-incident-place-value Place of occurrence 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Place of Occurrence (VS) #xD; oneiss-incident-activity Activity at time of incident 0..1 group #xD; oneiss-incident-activity-value Activity at time 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Activity (VS) #xD; oneiss-incident-collision-type Collision vs non-collision 0..1 group #xD; oneiss-incident-collision-type-value Collision classification 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Transport Accident: Collision or Noncollision (VS) #xD; oneiss-incident-patient-vehicle Patient's vehicle 0..1 group #xD; oneiss-incident-patient-vehicle-code Patient's vehicle 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Patient's Vehicle (VS) #xD; oneiss-incident-patient-vehicle-other Patient's vehicle – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-incident-other-vehicle Other vehicle/object involved 0..* group #xD; oneiss-incident-other-vehicle-code Other vehicle/object 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Other Vehicle in Collision (VS) #xD; oneiss-incident-other-vehicle-other Other vehicle/object – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-incident-position-of-patient Position of patient 0..1 group #xD; oneiss-incident-position-of-patient-value Position 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Position of Patient (VS) #xD; oneiss-incident-position-of-patient-other Position – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-incident-place-name Place of occurrence – workplace name 0..1 string Definition: Observation.note.text #xD; oneiss-incident-activity-other Activity – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-injuries Nature of Injuries 0..1 group #xD; oneiss-injuries-multiple Multiple injuries? 0..1 group #xD; oneiss-injuries-multiple-flag Multiple injuries present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-abrasion Abrasion 0..1 group #xD; oneiss-injuries-abrasion-present Abrasion present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-abrasion-site Abrasion site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-abrasion-details Abrasion details 0..1 text Definition: Observation.note.text #xD; oneiss-injuries-avulsion Avulsion 0..1 group #xD; oneiss-injuries-avulsion-present Avulsion present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-avulsion-site Avulsion site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-avulsion-details Avulsion details 0..1 text Definition: Observation.note.text #xD; oneiss-injuries-burn Burn 0..1 group #xD; oneiss-injuries-burn-present Burn present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-burn-degree Burn degree 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Burns (VS) #xD; oneiss-injuries-burn-degree-other Burn degree – other (specify) 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-injuries-concussion Concussion 0..1 group #xD; oneiss-injuries-concussion-present Concussion present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-concussion-site Concussion site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-concussion-details Concussion details 0..1 text Definition: Observation.note.text #xD; oneiss-injuries-contusion Contusion 0..1 group #xD; oneiss-injuries-contusion-present Contusion present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-contusion-site Contusion site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-contusion-details Contusion details 0..1 text Definition: Observation.note.text #xD; oneiss-injuries-fracture Fracture 0..1 group #xD; oneiss-injuries-fracture-type Fracture type 0..1 choice Definition: Observation.valueCodeableConcept Value Set: SILPH - Fracture Type (VS) #xD; oneiss-injuries-fracture-site Fracture site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-fracture-details Fracture details 0..1 text Definition: Observation.note.text #xD; oneiss-injuries-open-wound Open wound 0..1 group #xD; oneiss-injuries-open-wound-present Open wound present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-open-wound-site Open wound site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-open-wound-type Open wound type 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-injuries-open-wound-details Open wound details 0..1 text Definition: Observation.note.text #xD; oneiss-injuries-traumatic-amputation Traumatic amputation 0..1 group #xD; oneiss-injuries-traumatic-amputation-present Traumatic amputation present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-injuries-traumatic-amputation-site Traumatic amputation site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-traumatic-amputation-details Traumatic amputation details 0..1 text Definition: Observation.note.text #xD; oneiss-injuries-other Other specified injury 0..1 group #xD; oneiss-injuries-other-type Other injury type 0..1 text Definition: Observation.valueCodeableConcept.text #xD; oneiss-injuries-other-site Other injury site 0..1 choice Definition: Observation.bodySite Value Set: SILPH - List of Body Sites (VS) #xD; oneiss-injuries-other-details Other injury details 0..1 text Definition: Observation.note.text #xD; oneiss-clinical-outcome-release Outcome at release 0..1 group #xD; oneiss-clinical-outcome-release-status Outcome at release 0..1 choice Definition: https://build.fhir.org/ig/UPM-NTHC/PH-RoadSafetyIG/StructureDefinition/rs-observation-outcome#Observation.valueCodeableConcept Value Set: SILPH - Outcome (VS) #xD; oneiss-clinical-outcome-discharge Outcome at discharge 0..1 group #xD; oneiss-clinical-outcome-discharge-status Outcome at discharge 0..1 choice Definition: https://build.fhir.org/ig/UPM-NTHC/PH-RoadSafetyIG/StructureDefinition/rs-observation-outcome#Observation.valueCodeableConcept Value Set: SILPH - Outcome (VS) #xD; oneiss-postcrash Post-crash Investigation 0..1 group #xD; oneiss-postcrash-collision-type Collision type 0..1 group #xD; oneiss-postcrash-collision-type-value Collision type 0..1 string Definition: Observation.valueCodeableConcept.text #xD; oneiss-postcrash-traffic-investigator Traffic investigator present? 0..1 group #xD; oneiss-postcrash-traffic-investigator-flag Traffic investigator present? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-postcrash-cctv CCTV availability 0..1 group #xD; oneiss-postcrash-cctv-available CCTV available? 0..1 boolean Definition: Observation.valueBoolean #xD; oneiss-postcrash-evidence Post-crash evidence documents 0..1 group #xD; oneiss-postcrash-evidence-cause Cause of crash document 0..1 group #xD; oneiss-postcrash-evidence-cause-url Document URL 0..1 url Definition: DocumentReference.content.attachment.url #xD; oneiss-postcrash-evidence-fault Party at fault document 0..1 group #xD; oneiss-postcrash-evidence-fault-url Document URL 0..1 url Definition: DocumentReference.content.attachment.url #xD; oneiss-postcrash-evidence-traffic-management Traffic incident management log 0..1 group #xD; oneiss-postcrash-evidence-traffic-management-url Document URL 0..1 url Definition: DocumentReference.content.attachment.url #xD; oneiss-postcrash-evidence-road-network Road network shape files 0..1 group #xD; oneiss-postcrash-evidence-road-network-url Document URL 0..1 url Definition: DocumentReference.content.attachment.url #xD; oneiss-finance Finance 0..1 group #xD; oneiss-finance-cost Cost of care 0..1 decimal Definition: Claim.total.value #xD; oneiss-comments Comments 0..1 group #xD; oneiss-comments-text Comments 0..1 text Definition: Observation.valueString #xD; 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
UP Manila - National Institutes of Health - National Telehealth Center
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.
Initial impression (diagnosis text or code)
Transport coordination with receiving hospital