New Zealand ICP Implementation Guide
1.0.0 - draft

New Zealand ICP Implementation Guide, published by Accident Compensation Corporation. 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/acc-fhir-publisher/icp/ and changes regularly. See the Directory of published versions

: icp-tbi-referral-decline - XML Representation

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<Encounter xmlns="http://hl7.org/fhir">
  <meta>
    <profile
             value="http://hl7.org.nz/fhir/StructureDefinition/acc-icp-tbi-referral-decline"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Encounter icp-tbi-referral-decline</b></p><a name="icp-tbi-referral-decline"> </a><a name="hcicp-tbi-referral-decline"> </a><a name="icp-tbi-referral-decline-und"> </a><blockquote><p><b>Referral Source</b></p><ul><li>referral-source-type: gp</li><li>received-date: 2022-11-17</li></ul></blockquote><blockquote><p><b>ICP Referral Declined</b></p><ul><li>date-declined: 2022-11-17</li><li>reason: alternate-acc-service</li><li>recommended-next-steps: recommended next steps</li></ul></blockquote><blockquote><p><b>ICP IDT Assessment</b></p><ul><li>cover-and-causation: <a href="#hcicp-tbi-referral-decline/icp-tbi-cover-measurement-internal">Response to Questionnaire '-&gt;Cover and Causation' about 'Unspecified Subject'</a></li><li>start-c: <a href="#hcicp-tbi-referral-decline/icp-tbi-start-c-measurement-internal">Response to Questionnaire '-&gt;STarT-C' about 'Unspecified Subject'</a></li></ul></blockquote><p><b>identifier</b>: <code>https://standards.digital.health.nz/ns/acc-45-number</code>/AB12345 (use: official, )</p><p><b>status</b>: Finished</p><p><b>class</b>: <a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-PRENC">ActCode PRENC</a>: pre-admission</p><p><b>serviceType</b>: <span title="Codes:{http://hl7.org.nz/fhir/CodeSystem/acc-icp-service-type tbi}">Traumatic Brain Injury</span></p><p><b>subject</b>: <a href="#hcicp-tbi-referral-decline/patient-internal">Anonymous Patient (no stated gender), DoB: 2003-03-20</a></p><h3>Participants</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Individual</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ParticipationType PPRF}">primary performer</span></td><td><a href="https://simplifier.net/resolve?scope=fhir.org.nz.ig.base@3.0.0&amp;canonical=http://fhir.org.nz/ig/base/acc-provider-tbi">??</a></td></tr></table><p><b>serviceProvider</b>: <a href="https://simplifier.net/resolve?scope=fhir.org.nz.ig.base@3.0.0&amp;canonical=http://fhir.org.nz/ig/base/Organization/ORG123">??</a></p><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner  #acc-provider</b></p><a name="icp-tbi-referral-decline/acc-provider"> </a><a name="hcicp-tbi-referral-decline/acc-provider"> </a><a name="icp-tbi-referral-decline/acc-provider-und"> </a><p><b>ACC Provider ID</b>: J99966</p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Patient  #patient-internal</b></p><a name="icp-tbi-referral-decline/patient-internal"> </a><a name="hcicp-tbi-referral-decline/patient-internal"> </a><a name="icp-tbi-referral-decline/patient-internal-und"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Anonymous Patient (no stated gender), DoB: 2003-03-20</p><hr/></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse  #icp-tbi-cover-measurement-internal</b></p><a name="icp-tbi-referral-decline/icp-tbi-cover-measurement-internal"> </a><a name="hcicp-tbi-referral-decline/icp-tbi-cover-measurement-internal"> </a><a name="icp-tbi-referral-decline/icp-tbi-cover-measurement-internal-und"> </a><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 : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Definition</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Answer</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" 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 : 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="QuestionnaireResponseRoot" class="hierarchy"/> icp-tbi-cover-measurement-internal</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire:<a href="Questionnaire-acc-cover-causation.html">Cover and Causation</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Does the client have a personal injury?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">true</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Did the client have an accident?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">true</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Could the client's injury be due to a work-related gradual process, disease or infection?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">true</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Did the accident cause the client's personal injury?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">true</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 5</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">On balance, do you think there's a causal link between the accident and the injury - could the client qualify for ACC support?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">true</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 6</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What information should be included in your clinical notes?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Test</td></tr>
<tr><td colspan="4" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse  #icp-tbi-start-c-measurement-internal</b></p><a name="icp-tbi-referral-decline/icp-tbi-start-c-measurement-internal"> </a><a name="hcicp-tbi-referral-decline/icp-tbi-start-c-measurement-internal"> </a><a name="icp-tbi-referral-decline/icp-tbi-start-c-measurement-internal-und"> </a><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 : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Definition</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Answer</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" 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 : 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="QuestionnaireResponseRoot" class="hierarchy"/> icp-tbi-start-c-measurement-internal</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire:<a href="Questionnaire-acc-tbi-start-c.html">STarT-C</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">I have had headaches at some time in the last two weeks.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">I have had headaches at some time in the last two weeks.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">It is not really safe for a person with a condition like mine to be physically active.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">I have felt too tired to do work or daily activities in the last two weeks.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 5</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Turning my head quickly makes me feel dizzy or unsteady.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 6</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Worrying thoughts have been going through my mind a lot of the time in the last two weeks.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 7</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">I feel that my concussion symptoms are terrible and are never going to get any better.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" 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-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 8</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In general in the last two weeks, I have not enjoyed all the things I used to enjoy.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-agreedisagree.html#acc-icp-tbi-startc-answeroption-agreedisagree-agree">STarTC Answer Option agree</a>: Agree</span></span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" 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-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 9</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Overall, how bothersome have your concussion symptoms been in the last two weeks?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span><a href="CodeSystem-acc-icp-tbi-startc-answeroption-overall.html#acc-icp-tbi-startc-answeroption-overall-very-much">Start-C Overall Option CodeSystem very-much</a>: Very Much</span></span></td></tr>
<tr><td colspan="4" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></blockquote></div>
  </text>
  <contained>
    <Practitioner>
      <id value="acc-provider"/>
      <meta>
        <profile
                 value="http://hl7.org.nz/fhir/StructureDefinition/acc-provider"/>
      </meta>
      <extension
                 url="http://hl7.org.nz/fhir/StructureDefinition/acc-providerid">
        <valueString value="J99966"/>
      </extension>
    </Practitioner>
  </contained>
  <contained>
    <Patient>
      <id value="patient-internal"/>
      <meta>
        <profile
                 value="http://hl7.org.nz/fhir/StructureDefinition/acc-icp-patient"/>
      </meta>
      <birthDate value="2003-03-20"/>
    </Patient>
  </contained>
  <contained>
    <QuestionnaireResponse>
      <id value="icp-tbi-cover-measurement-internal"/>
      <meta>
        <profile
                 value="http://hl7.org.nz/fhir/StructureDefinition/acc-icp-tbi-cover-and-causation"/>
      </meta>
      <questionnaire
                     value="http://hl7.org.nz/fhir/Questionnaire/acc-cover-causation"/>
      <status value="completed"/>
      <item>
        <linkId value="1"/>
        <text value="Does the client have a personal injury?"/>
        <answer>
          <valueBoolean value="true"/>
        </answer>
      </item>
      <item>
        <linkId value="2"/>
        <text value="Did the client have an accident?"/>
        <answer>
          <valueBoolean value="true"/>
        </answer>
      </item>
      <item>
        <linkId value="3"/>
        <text
              value="Could the client's injury be due to a work-related gradual process, disease or infection?"/>
        <answer>
          <valueBoolean value="true"/>
        </answer>
      </item>
      <item>
        <linkId value="4"/>
        <text value="Did the accident cause the client's personal injury?"/>
        <answer>
          <valueBoolean value="true"/>
        </answer>
      </item>
      <item>
        <linkId value="5"/>
        <text
              value="On balance, do you think there's a causal link between the accident and the injury - could the client qualify for ACC support?"/>
        <answer>
          <valueBoolean value="true"/>
        </answer>
      </item>
      <item>
        <linkId value="6"/>
        <text
              value="What information should be included in your clinical notes?"/>
        <answer>
          <valueString value="Test"/>
        </answer>
      </item>
    </QuestionnaireResponse>
  </contained>
  <contained>
    <QuestionnaireResponse>
      <id value="icp-tbi-start-c-measurement-internal"/>
      <meta>
        <profile
                 value="http://hl7.org.nz/fhir/StructureDefinition/acc-icp-tbi-start-c"/>
      </meta>
      <questionnaire
                     value="http://hl7.org.nz/fhir/Questionnaire/acc-tbi-start-c"/>
      <status value="completed"/>
      <item>
        <linkId value="1"/>
        <text
              value="I have had headaches at some time in the last two weeks."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="2"/>
        <text
              value="I have had headaches at some time in the last two weeks."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="3"/>
        <text
              value="It is not really safe for a person with a condition like mine to be physically active."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="4"/>
        <text
              value="I have felt too tired to do work or daily activities in the last two weeks."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="5"/>
        <text
              value="Turning my head quickly makes me feel dizzy or unsteady."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="6"/>
        <text
              value="Worrying thoughts have been going through my mind a lot of the time in the last two weeks."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="7"/>
        <text
              value="I feel that my concussion symptoms are terrible and are never going to get any better."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="8"/>
        <text
              value="In general in the last two weeks, I have not enjoyed all the things I used to enjoy."/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-agreedisagree"/>
            <code value="agree"/>
          </valueCoding>
        </answer>
      </item>
      <item>
        <linkId value="9"/>
        <text
              value="Overall, how bothersome have your concussion symptoms been in the last two weeks?"/>
        <answer>
          <valueCoding>
            <system
                    value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-tbi-startc-answeroption-overall"/>
            <code value="very-much"/>
          </valueCoding>
        </answer>
      </item>
    </QuestionnaireResponse>
  </contained>
  <extension
             url="http://hl7.org.nz/fhir/StructureDefinition/acc-icp-referral-source">
    <extension url="referral-source-type">
      <valueCode value="gp"/>
    </extension>
    <extension url="received-date">
      <valueDate value="2022-11-17"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org.nz/fhir/StructureDefinition/acc-icp-referral-declined">
    <extension url="date-declined">
      <valueDate value="2022-11-17"/>
    </extension>
    <extension url="reason">
      <valueCode value="alternate-acc-service"/>
    </extension>
    <extension url="recommended-next-steps">
      <valueString value="recommended next steps"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org.nz/fhir/StructureDefinition/acc-icp-idt-assessment">
    <extension url="cover-and-causation">
      <valueReference>
        <reference value="#icp-tbi-cover-measurement-internal"/>
      </valueReference>
    </extension>
    <extension url="start-c">
      <valueReference>
        <reference value="#icp-tbi-start-c-measurement-internal"/>
      </valueReference>
    </extension>
  </extension>
  <identifier>
    <use value="official"/>
    <system value="https://standards.digital.health.nz/ns/acc-45-number"/>
    <value value="AB12345"/>
  </identifier>
  <status value="finished"/>
  <class>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
    <code value="PRENC"/>
  </class>
  <serviceType>
    <coding>
      <system value="http://hl7.org.nz/fhir/CodeSystem/acc-icp-service-type"/>
      <code value="tbi"/>
    </coding>
  </serviceType>
  <subject>
    <reference value="#patient-internal"/>
  </subject>
  <participant>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
        <code value="PPRF"/>
      </coding>
    </type>
    <individual>
      <reference value="acc-provider-tbi"/>
    </individual>
  </participant>
  <serviceProvider>
    <reference value="Organization/ORG123"/>
  </serviceProvider>
</Encounter>