GP Chronic Condition Management Plan
0.1.0 - CI Build
GP Chronic Condition Management Plan, published by AEHRC CSIRO. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/aehrc/gpccmp-fhir-ig/ and changes regularly. See the Directory of published versions
@prefix fhir: <http://hl7.org/fhir/> . @prefix loinc: <http://loinc.org/rdf#> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix sct: <http://snomed.info/id/> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/QuestionnaireResponse/gpccmp-form-foreman-caterina> a fhir:QuestionnaireResponse ; fhir:nodeRole fhir:treeRoot ; fhir:Resource.id [ fhir:value "gpccmp-form-foreman-caterina"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "https://gpccmp.csiro.au/ig/StructureDefinition/GPCCMPQuestionnaireResponse" ; fhir:index 0 ; fhir:link <https://gpccmp.csiro.au/ig/StructureDefinition/GPCCMPQuestionnaireResponse> ] ] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div style=\"color-scheme: light; -ms-text-size-adjust: 100%; -webkit-text-size-adjust: 100%; margin: 0; color: #1f2328; background-color: #ffffff; font-family: -apple-system,BlinkMacSystemFont,'Segoe UI','Noto Sans',Helvetica,Arial,sans-serif,'Apple Color Emoji','Segoe UI Emoji'; font-size: 16px; line-height: 1.5; word-wrap: break-word;\"><h1 style=\"margin-top: 0; margin-bottom: .67em; font-weight: 600; padding-bottom: .3em; font-size: 2em; border-bottom: 1px solid #d1d9e0b3;\">\n GP Chronic Condition Management Plan \n </h1><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Patient</strong>: Caterina FOREMAN<br/><strong style=\"font-weight: 600;\">Author</strong>: Dr Peter Primary<br/><strong style=\"font-weight: 600;\">Date Authored</strong>: 17/08/2026 11:36</p><div><h2 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; padding-bottom: 0.3em; font-size: 1.5em; border-bottom: 1px solid #d1d9e0b3;\">Patient details</h2><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Consent</h3><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Consent given to proceed with plan after discussion of the purpose, benefits, process and costs</strong><br/>Yes</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Name</strong><br/>Caterina FOREMAN</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Preferred pronouns</strong><br/>she/her/her/hers/herself</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Date of birth</strong><br/>24/07/1970</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Age</strong><br/>55</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Sex assigned at birth</strong><br/>Female</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Gender identity</strong><br/>Identifies as female gender</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Aboriginal and/or Torres Strait Islander status</strong><br/>Neither Aboriginal nor Torres Strait Islander origin</p></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">My Aged Care</h3><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Registered for My Aged Care</strong><br/>No</p></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">National Disability Insurance Scheme</h3><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Registered for NDIS</strong><br/>No</p></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Medicare card number</h3><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Number</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Reference number</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Expiry</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">3951333701</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">1</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">2028-08</td></tr></tbody></table></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Contact information</h3><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Home phone</strong></div><ul style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; padding-left: 2em;\"><li>0370109077</li></ul><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Mobile phone</strong></div><ul style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; padding-left: 2em;\"><li>0491576801</li></ul><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Email</strong></div><ul style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; padding-left: 2em;\"><li>caterina.foreman@my-own-personal-domain.com</li></ul><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Home address</h4><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Home address</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Street address</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">City</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">State</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Postcode</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">149 Farmer Cnr</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Sunshine</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Victoria</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">3020</td></tr></tbody></table></div></div></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Carers and key contacts</h3><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Preferred contact</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Role</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Name</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Phone</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Email</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Relationship to patient</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Present at appointment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Yes</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Contact person<br/>Carer</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Mia LEANNE BANKS</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">0270107520<br/>0491574632<br/>0270102724</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Emergency Contact</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Heather MACKAY</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">0370108075<br/>0491578148<br/>0370103228</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table></div></div><div><h2 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; padding-bottom: 0.3em; font-size: 1.5em; border-bottom: 1px solid #d1d9e0b3;\">Practitioner details</h2><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Name</strong><br/>Peter Primary</p><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Phone</strong></div><ul style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; padding-left: 2em;\"><li>(08) 7010 5556</li></ul><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Email</strong></div><ul style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; padding-left: 2em;\"><li>PPP@example.org</li></ul><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Medicare provider number</strong></div><ul style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; padding-left: 2em;\"><li>2426621B</li></ul><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Clinic details</h3><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Name</strong><br/>Quinninup Medical Clinic</p><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Address</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Street address</strong><br/>24 Grande Pl</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">City</strong><br/>Quinninup</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">State</strong><br/>Western Australia</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Postcode</strong><br/>6258</p></div></div></div><div><h2 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; padding-bottom: 0.3em; font-size: 1.5em; border-bottom: 1px solid #d1d9e0b3;\">Clinical details</h2><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Problems/Diagnoses</h3><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Recorded problems/diagnoses</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Condition</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Clinical status</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Onset date</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Abatement date</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Chronic lower back pain</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">01/01/2021</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Gastro-oesophageal reflux disease</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">01/08/2013</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">New problems/diagnoses</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Condition</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Onset date</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Uncontrolled type 2 diabetes</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">25/01/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Peripheral neuropathy due to diabetes</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/02/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Overweight</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">25/11/2025</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table></div></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Adverse reaction risks</h3><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Recorded adverse reaction risks</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Substance</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Status</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Manifestation</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Latex</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Rash</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Has reacted soon after exposure as well as a delayed reaction to latex, with a rash appearing 24 hours after exposure.</td></tr></tbody></table></div></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Medications (current)</h3><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Recorded medications</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Medication</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Status</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Dosage</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Indication</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Panadol Osteo 665 mg modified release tablet</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">2 tabs PRN/TDS</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Chronic lower back pain</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Panadol Osteo 665 mg modified release tablet</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">2 tabs PRN/TDS</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Chronic lower back pain</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Esomeprazole 20 mg enteric capsule</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">1 tab daily</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Gastro-oesophageal reflux disease</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Gastroscopy 2013 - mild reflux esophagitis, H pylori negative</td></tr></tbody></table></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">New medications</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Medication</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Dosage</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Indication</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Metformin hydrochloride 500 mg tablet</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">1 tab BD</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Uncontrolled type 2 diabetes</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Fish oil</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">2 caps daily</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Self-initiated for heart health</td></tr></tbody></table></div></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Observations</h3><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Observations</h4><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Height</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result</strong><br/>165 cm</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result date</strong><br/>17/08/2026</p></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Weight</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result</strong><br/>75.2 kg</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result date</strong><br/>17/08/2026</p></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">BMI (calculated)</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result</strong><br/>27.6 kg/m2</p></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Waist circumference</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result</strong><br/>82.5 cm</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result date</strong><br/>17/08/2026</p></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Pulse rate</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result</strong><br/>76 /min</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result date</strong><br/>17/08/2026</p></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Pulse rhythm</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result</strong><br/>Pulse regular</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result date</strong><br/>17/08/2026</p></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Oxygen saturation</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result</strong><br/>98 %</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New result date</strong><br/>17/08/2026</p></div></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Blood pressure</h4><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Blood pressure</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Systolic</strong><br/>130 mm[Hg]</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Diastolic</strong><br/>72 mm[Hg]</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Date performed</strong><br/>17/08/2026</p></div></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Substance use</h4><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Smoking status</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Comment</strong><br/>20 cigarettes per day since 17yo</p></div><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Alcohol consumption status</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Comment</strong><br/>2 drinks, 2 days per week (on weekends)</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Additional information</strong><br/>Family history: Mother - diabetes, stroke; Father - heart attack, depression; Paternal grandmother - breast cancer\nWork: Receptionist in building business</p></div></div></div></div><div><h2 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; padding-bottom: 0.3em; font-size: 1.5em; border-bottom: 1px solid #d1d9e0b3;\">Plan</h2><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">New plan or a review of an existing plan?</strong><br/>New</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Incomplete draft plan already exists?</strong><br/>Yes</p><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Conditions addressed</h3><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Condition</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Onset date</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comments</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Uncontrolled type 2 diabetes</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">25/01/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Chronic lower back pain</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">01/01/2021</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Gastro-oesophageal reflux disease</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">01/08/2013</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Overweight</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">25/11/2025</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Goals and tasks</h3><div style=\"border: 1px solid #d1d9e0; border-radius: 6px; padding: 1em; margin-bottom: 0.75em;\"><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Problems/Needs</strong></div><ul style=\"margin-top: 0; margin-bottom: 0.5rem; font-weight: 400; padding-left: 2em;\"><li>Uncontrolled type 2 diabetes</li><li>Hyperglycaemia</li><li>Peripheral neuropathy due to diabetes</li><li>Overweight</li></ul><h4 style=\"margin-top: 1rem; margin-bottom: 0.5rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Goal setting</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Goals</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Initiator</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Target date</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Status</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Controlled diabetes - aim HbA1c ≤7.0 and fasting BGL 4.0-7.0</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">GP</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/05/2027</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table><h4 style=\"margin-top: 1rem; margin-bottom: 0.5rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Interventions and actions</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Interventions/Actions</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Owner</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Target date</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Status</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diabetic education</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, diabetes educator</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/08/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diet education</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/08/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise regime</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/11/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Aim for 150 mins moderate physical activity per week</td></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Weight management program</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, GP</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/05/2027</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Aim for 5-10% weight loss, waist circumference <80cm</td></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diabetes medicine review</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, GP, pharmacist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/08/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Consider Home Medicines Review in 3-6 months</td></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Metformin therapy</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, GP, pharmacist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">03/06/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Detecting complications early</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, GP, podiatrist, optometrist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/05/2027</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Regular screening for diabetic nephropathy, neuropathy and retinopathy</td></tr></tbody></table><h4 style=\"margin-top: 1rem; margin-bottom: 0.5rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Services and treatments</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Required services and treatments</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Activity</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Provider</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diabetes education service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Referral to diabetes nurse</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diabetes educator</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diabetes education service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diabetes diet education</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diabetes educator</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietetics service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Referral to dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietetics service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diet education</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiology service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Referral to exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiology service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise regime</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Medicine review service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Referral to pharmacist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Pharmacist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Medicine review service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Home medicines review</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Pharmacist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Consider Home Medicines Review in 3-6 months</td></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">General practice service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Ongoing review</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">GP, practice nurse</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table></div><div style=\"border: 1px solid #d1d9e0; border-radius: 6px; padding: 1em; margin-bottom: 0.75em;\"><div style=\"margin-bottom: 0.5em;\"><strong style=\"font-weight: 600;\">Problems/Needs</strong></div><ul style=\"margin-top: 0; margin-bottom: 0.5rem; font-weight: 400; padding-left: 2em;\"><li>Uncontrolled type 2 diabetes</li><li>Overweight</li><li>Gastro-oesophageal reflux disease</li><li>Chronic lower back pain</li><li>Low self-esteem</li></ul><h4 style=\"margin-top: 1rem; margin-bottom: 0.5rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Goal setting</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Goals</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Initiator</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Target date</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Status</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">5-10% weight loss (target weight 73.8-77.9kg) and decrease waist circumference (long term target <80cm)</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">GP</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/05/2027</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Comfortably wear dress purchased for niece’s wedding next year</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/05/2027</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">active</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table><h4 style=\"margin-top: 1rem; margin-bottom: 0.5rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Interventions and actions</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Interventions/Actions</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Owner</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Target date</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Status</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Low carbohydrate diet education</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/08/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Reduce ratio of carbohydrates in each meal – ¼ plate carbs, ¼ plate protein, ½ plate vegetables/salad</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/08/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Substitute high GI for low GI carbohydrates where possible</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/08/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Physical activity guidance</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina, exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/11/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Aim for 150 mins of aerobic activity per week</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/11/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">2-3 sessions of resistance exercise per week</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/11/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Management of impulse control</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Caterina</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">20/11/2026</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Planned</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Manage impulsivity/desire to eat when not actually hungry. Consider psychology input in future</td></tr></tbody></table><h4 style=\"margin-top: 1rem; margin-bottom: 0.5rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Services and treatments</h4><table style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400; border-spacing: 0; border-collapse: collapse; display: block; width: max-content; max-width: 100%; overflow: auto; font-variant: tabular-nums;\"><thead><tr style=\"background-color: #f6f8fa; border-top: 1px solid #d1d9e0b3;\"><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Required services and treatments</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Activity</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Provider</th><th style=\"padding: 6px 13px; border: 1px solid #d1d9e0; font-weight: 600;\">Comment</th></tr></thead><tbody><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietetics service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Referral to dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietetics service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Diet education</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Dietitian</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiology service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Referral to exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr><tr style=\"background-color: #fff; border-top: 1px solid #d1d9e0b3;\"><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiology service</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise regime</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\">Exercise physiologist</td><td style=\"padding: 6px 13px; border: 1px solid #d1d9e0;\"/></tr></tbody></table></div></div><div><h3 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1.25em;\">Completion</h3><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Consent given for sharing of information with relevant healthcare providers</strong><br/>Yes</p><div><h4 style=\"margin-top: 1.5rem; margin-bottom: 1rem; font-weight: 600; line-height: 1.25; font-size: 1em;\">Review</h4><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Appointment status</strong><br/>Proposed</p><p style=\"margin-top: 0; margin-bottom: 1rem; font-weight: 400;\"><strong style=\"font-weight: 600;\">Date</strong><br/>20/05/2027</p></div></div></div></div></div>" ] ; fhir:QuestionnaireResponse.questionnaire [ fhir:value "http://www.health.gov.au/assessments/GPChronicConditionManagementPlan|0.1.0" ; fhir:link <http://www.health.gov.au/assessments/GPChronicConditionManagementPlan|0.1.0> ] ; fhir:QuestionnaireResponse.status [ fhir:value "in-progress"] ; fhir:QuestionnaireResponse.subject [ fhir:link <http://hl7.org/fhir/Patient/foreman-caterina> ; fhir:Reference.reference [ fhir:value "Patient/foreman-caterina" ] ; fhir:Reference.type [ fhir:value "Patient" ] ; fhir:Reference.display [ fhir:value "Caterina FOREMAN" ] ] ; fhir:QuestionnaireResponse.authored [ fhir:value "2026-08-17T11:36:59+10:00"^^xsd:dateTime] ; fhir:QuestionnaireResponse.author [ fhir:link <http://hl7.org/fhir/Practitioner/primary-peter> ; fhir:Reference.reference [ fhir:value "Practitioner/primary-peter" ] ; fhir:Reference.type [ fhir:value "Practitioner" ] ; fhir:Reference.display [ fhir:value "Dr Peter Primary" ] ] ; fhir:QuestionnaireResponse.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "container" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Patient details" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-consent" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Consent" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-consent-consentforplan" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Consent given to proceed with plan after discussion of the purpose, benefits, process and costs" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueBoolean [ fhir:value "true"^^xsd:boolean ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-name" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Name" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina FOREMAN" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-preferredpronouns" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Preferred pronouns" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a loinc:LA29519-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA29519-8" ] ; fhir:Coding.display [ fhir:value "she/her/her/hers/herself" ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-dob" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Date of birth" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "1970-07-24"^^xsd:date ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-age" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Age" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "55"^^xsd:integer ] ] ], [ fhir:index 5 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-sexatbirth" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Sex assigned at birth" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:248152002 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "248152002" ] ; fhir:Coding.display [ fhir:value "Female" ] ] ] ], [ fhir:index 6 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-genderidentity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Gender identity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:446141000124107 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "446141000124107" ] ; fhir:Coding.display [ fhir:value "Identifies as female gender" ] ] ] ], [ fhir:index 7 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-firstnationsstatus" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Aboriginal and/or Torres Strait Islander status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "https://healthterminologies.gov.au/fhir/CodeSystem/australian-indigenous-status-1" ] ; fhir:Coding.code [ fhir:value "4" ] ; fhir:Coding.display [ fhir:value "Neither Aboriginal nor Torres Strait Islander origin" ] ] ] ], [ fhir:index 8 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-myagedcare" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "My Aged Care" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-myagedcare-registered" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Registered for My Aged Care" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0532" ] ; fhir:Coding.code [ fhir:value "N" ] ; fhir:Coding.display [ fhir:value "No" ] ] ] ] ], [ fhir:index 9 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-ndis" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "National Disability Insurance Scheme" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-ndis-registered" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Registered for NDIS" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0532" ] ; fhir:Coding.code [ fhir:value "N" ] ; fhir:Coding.display [ fhir:value "No" ] ] ] ] ], [ fhir:index 10 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-medicare" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medicare card number" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-medicare-number" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Number" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "3951333701" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-medicare-referencenumber" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Reference number" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "1" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-medicare-expiry" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Expiry" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "2028-08" ] ] ] ], [ fhir:index 11 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Contact information" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-homephone" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Home phone" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0370109077" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-mobilephone" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Mobile phone" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0491576801" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-email" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Email" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "caterina.foreman@my-own-personal-domain.com" ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-homeaddress" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Home address" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-homeaddress-details" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Home address" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-homeaddress-details-streetaddress" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Street address" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "149 Farmer Cnr" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-homeaddress-details-city" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "City" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Sunshine" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-homeaddress-details-state" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "State" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "https://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1" ] ; fhir:Coding.code [ fhir:value "VIC" ] ; fhir:Coding.display [ fhir:value "Victoria" ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contact-homeaddress-details-postcode" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Postcode" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "3020" ] ] ] ] ] ], [ fhir:index 12 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Carers and key contacts" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts-preferred" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Preferred contact" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueBoolean [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts-role" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Role" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0131" ] ; fhir:Coding.code [ fhir:value "CP" ] ; fhir:Coding.display [ fhir:value "Contact person" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:133932002 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "133932002" ] ; fhir:Coding.display [ fhir:value "Carer" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts-name" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Name" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Mia LEANNE BANKS" ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts-phone" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Phone" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0270107520" ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0491574632" ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0270102724" ] ] ] ], [ fhir:index 13 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Carers and key contacts" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts-role" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Role" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0131" ] ; fhir:Coding.code [ fhir:value "C" ] ; fhir:Coding.display [ fhir:value "Emergency Contact" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts-name" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Name" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Heather MACKAY" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "patient-contacts-phone" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Phone" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0370108075" ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0491578148" ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "0370103228" ] ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Practitioner details" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-name" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Name" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "practitioner-name-calculatedExpression-fUYsm3tua-58Nat11-atp" ] ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Peter Primary" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-phone" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Phone" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "practitioner-phone-calculatedExpression-pXL5hXh_jQ7qb7uht3Tnc" ] ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "(08) 7010 5556" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-email" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Email" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "practitioner-email-calculatedExpression-iKT3aoXLu-MAQjlKbIJav" ] ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "PPP@example.org" ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-medicareprovidernumber" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medicare provider number" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "practitioner-medicareprovidernumber-calculatedExpression-NbVRyrfUcRerVxYxg8kS7" ] ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "2426621B" ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-clinicdetails" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Clinic details" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-clinicdetails-name" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Name" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Quinninup Medical Clinic" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-clinicdetails-address" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Address" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-clinicdetails-address-streetaddress" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Street address" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "24 Grande Pl" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-clinicdetails-address-city" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "City" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Quinninup" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-clinicdetails-address-state" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "State" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "https://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1" ] ; fhir:Coding.code [ fhir:value "WA" ] ; fhir:Coding.display [ fhir:value "Western Australia" ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "practitioner-clinicdetails-address-postcode" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Postcode" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "6258" ] ] ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Clinical details" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Problems/Diagnoses" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Recorded problems/diagnoses" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:278860009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "278860009" ] ; fhir:Coding.display [ fhir:value "Chronic lower back pain" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems-clinicalstatus" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Clinical status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/condition-clinical" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "Active" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2021-01-01"^^xsd:date ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Recorded problems/diagnoses" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:235595009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "235595009" ] ; fhir:Coding.display [ fhir:value "Gastro-oesophageal reflux disease" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems-clinicalstatus" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Clinical status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/condition-clinical" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "Active" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-recordedproblems-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2013-08-01"^^xsd:date ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New problems/diagnoses" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:443694000 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "443694000" ] ; fhir:Coding.display [ fhir:value "Uncontrolled type 2 diabetes" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-01-25"^^xsd:date ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New problems/diagnoses" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:424736006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "424736006" ] ; fhir:Coding.display [ fhir:value "Peripheral neuropathy due to diabetes" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-02-20"^^xsd:date ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New problems/diagnoses" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:238131007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "238131007" ] ; fhir:Coding.display [ fhir:value "Overweight" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-problemsdiagnoses-newproblems-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-allergies" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Adverse reaction risks" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-allergies-recordedallergies" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Recorded adverse reaction risks" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-allergies-recordedallergies-substance" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Substance" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:111088007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "111088007" ] ; fhir:Coding.display [ fhir:value "Latex" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-allergies-recordedallergies-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "Active" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-allergies-recordedallergies-manifestation" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Manifestation" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:271807003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "271807003" ] ; fhir:Coding.display [ fhir:value "Rash" ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-allergies-recordedallergies-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Has reacted soon after exposure as well as a delayed reaction to latex, with a rash appearing 24 hours after exposure." ] ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medications (current)" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Recorded medications" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-medication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:5848011000036106 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "5848011000036106" ] ; fhir:Coding.display [ fhir:value "Panadol Osteo 665 mg modified release tablet" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/CodeSystem/medication-statement-status" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "Active" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-dosage" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Dosage" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "2 tabs PRN/TDS" ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-indication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Indication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:278860009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "278860009" ] ; fhir:Coding.display [ fhir:value "Chronic lower back pain" ] ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Recorded medications" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-medication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:5848011000036106 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "5848011000036106" ] ; fhir:Coding.display [ fhir:value "Panadol Osteo 665 mg modified release tablet" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/CodeSystem/medication-statement-status" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "Active" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-dosage" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Dosage" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "2 tabs PRN/TDS" ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-indication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Indication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:278860009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "278860009" ] ; fhir:Coding.display [ fhir:value "Chronic lower back pain" ] ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Recorded medications" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-medication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:682641000168107 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "682641000168107" ] ; fhir:Coding.display [ fhir:value "Esomeprazole 20 mg enteric capsule" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/CodeSystem/medication-statement-status" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "Active" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-dosage" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Dosage" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "1 tab daily" ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-indication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Indication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:235595009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "235595009" ] ; fhir:Coding.display [ fhir:value "Gastro-oesophageal reflux disease" ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-recordedmedications-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Gastroscopy 2013 - mild reflux esophagitis, H pylori negative" ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New medications" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications-medication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:23358011000036102 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "23358011000036102" ] ; fhir:Coding.display [ fhir:value "Metformin hydrochloride 500 mg tablet" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications-dosage" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Dosage" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "1 tab BD" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications-indication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Indication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-medications-newmedications-indication-repeat-gXGDcl_GVQjMVeCu7AXYA" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:443694000 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "443694000" ] ; fhir:Coding.display [ fhir:value "Uncontrolled type 2 diabetes" ] ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New medications" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications-medication" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Medication" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:77436011000036106 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "77436011000036106" ] ; fhir:Coding.display [ fhir:value "Fish oil" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications-dosage" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Dosage" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "2 caps daily" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-medications-newmedications-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Self-initiated for heart health" ] ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Observations" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Observations" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-height" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Height" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-height-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "165"^^xsd:decimal ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-height-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-height-newresultvalue" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "165"^^xsd:decimal ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-height-newresultdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-maingrid-height-newresultdate-calculatedExpression-iXSGrbpZZ72TWdf7hfhZa" ] ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-17"^^xsd:date ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-weight" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Weight" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-weight-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "74"^^xsd:decimal ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-weight-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-weight-newresultvalue" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "75.2"^^xsd:decimal ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-weight-newresultdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-maingrid-weight-newresultdate-calculatedExpression-0j45-p5KlskDigOIhTBZy" ] ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-17"^^xsd:date ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-bmi" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "BMI (calculated)" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-bmi-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "27.2"^^xsd:decimal ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-bmi-newresultvalue" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-maingrid-bmi-newresultvalue-calculatedExpression-b9cln3WXN9du6QQOT-iza" ] ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "27.6"^^xsd:decimal ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-waistcircumference" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Waist circumference" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-waistcircumference-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "82"^^xsd:decimal ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-waistcircumference-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-waistcircumference-newresultvalue" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "82.5"^^xsd:decimal ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-waistcircumference-newdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-maingrid-waistcircumference-newdate-calculatedExpression-OhPSkVcJghlCw39S-xZEj" ] ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-17"^^xsd:date ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Pulse rate" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserate-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "74"^^xsd:decimal ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserate-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserate-newresultvalue" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "76"^^xsd:integer ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserate-newresultdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-maingrid-pulserate-newresultdate-calculatedExpression-zjP85zTBr6RRCz11nxYFq" ] ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-17"^^xsd:date ] ] ] ], [ fhir:index 5 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserhythm" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Pulse rhythm" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserhythm-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:271636001 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "271636001" ] ; fhir:Coding.display [ fhir:value "Pulse regular" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserhythm-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserhythm-newresultvalue" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:271636001 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "271636001" ] ; fhir:Coding.display [ fhir:value "Pulse regular" ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-pulserhythm-newresultdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-maingrid-pulserhythm-newresultdate-calculatedExpression-7qjYTWIJ0C1IxBh06ivNN" ] ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-17"^^xsd:date ] ] ] ], [ fhir:index 6 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-oxygensaturation" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Oxygen saturation" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-oxygensaturation-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "98"^^xsd:decimal ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-oxygensaturation-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-06-20"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-oxygensaturation-newresultvalue" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "98"^^xsd:integer ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-maingrid-oxygensaturation-newresultdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New result date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-maingrid-oxygensaturation-newresultdate-calculatedExpression-NnWeBq3fu4aRUXaR9KQAI" ] ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-17"^^xsd:date ] ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Blood pressure" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid-bp" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Blood pressure" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid-bp-lastresultvaluesystolic" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "128"^^xsd:decimal ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid-bp-lastresultvaluediastolic" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDecimal [ fhir:value "72"^^xsd:decimal ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid-bp-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid-bp-newresultsystolic" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Systolic" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "130"^^xsd:integer ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid-bp-newresultdiastolic" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Diastolic" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "72"^^xsd:integer ] ] ], [ fhir:index 5 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-bpgrid-bp-newresultdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Date performed" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "clinicaldetails-observations-bpgrid-bp-newresultdate-calculatedExpression-fuQBmY_mop4Ih5z-c_35H" ] ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-17"^^xsd:date ] ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Substance use" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid-smokingstatus" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Smoking status" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid-smokingstatus-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:77176002 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "77176002" ] ; fhir:Coding.display [ fhir:value "Current smoker" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid-smokingstatus-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-02-20"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-smokingstatusgrid-smokingstatus-newresultcomment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "20 cigarettes per day since 17yo" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid-alcoholstatus" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Alcohol consumption status" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid-alcoholstatus-lastresultvalue" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:219006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "219006" ] ; fhir:Coding.display [ fhir:value "Current drinker" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid-alcoholstatus-lastresultdate" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-02-20"^^xsd:date ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-substanceusegrid-alcoholstatus-newresultcomment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "2 drinks, 2 days per week (on weekends)" ] ] ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "clinicaldetails-observations-additionalinformation" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Additional information" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Family history: Mother - diabetes, stroke; Father - heart attack, depression; Paternal grandmother - breast cancer\nWork: Receptionist in building business" ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Plan" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-type" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "New plan or a review of an existing plan?" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "New" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-inprogress" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Incomplete draft plan already exists?" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueBoolean [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Conditions addressed" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:443694000 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "443694000" ] ; fhir:Coding.display [ fhir:value "Uncontrolled type 2 diabetes" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-01-25"^^xsd:date ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Conditions addressed" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:278860009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "278860009" ] ; fhir:Coding.display [ fhir:value "Chronic lower back pain" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2021-01-01"^^xsd:date ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Conditions addressed" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:235595009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "235595009" ] ; fhir:Coding.display [ fhir:value "Gastro-oesophageal reflux disease" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2013-08-01"^^xsd:date ] ] ] ], [ fhir:index 5 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Conditions addressed" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-condition" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Condition" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:238131007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "238131007" ] ; fhir:Coding.display [ fhir:value "Overweight" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-conditions-onsetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Onset date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2025-11-25"^^xsd:date ] ] ] ], [ fhir:index 6 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goals and tasks" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-problemneed" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Problems/Needs" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-Sr9JIDYmhKLPJ6An9exHM" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:443694000 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "443694000" ] ; fhir:Coding.display [ fhir:value "Uncontrolled type 2 diabetes" ] ] ], [ fhir:index 1 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-SEwMPioQ72kX-AYelOqvH" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:80394007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "80394007" ] ; fhir:Coding.display [ fhir:value "Hyperglycaemia" ] ] ], [ fhir:index 2 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-rQ5fyiwTTHDWZKLnrZbIv" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:424736006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "424736006" ] ; fhir:Coding.display [ fhir:value "Peripheral neuropathy due to diabetes" ] ] ], [ fhir:index 3 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-FzJSY57DfMsFzBuNXmVUT" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:238131007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "238131007" ] ; fhir:Coding.display [ fhir:value "Overweight" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goal setting" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-goals" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goals" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Controlled diabetes - aim HbA1c ≤7.0 and fasting BGL 4.0-7.0" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-initiator" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Initiator" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "GP" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2027-05-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/goal-status" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "active" ] ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:6143009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "6143009" ] ; fhir:Coding.display [ fhir:value "Diabetic education" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, diabetes educator" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:11816003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "11816003" ] ; fhir:Coding.display [ fhir:value "Diet education" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, dietitian" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Exercise regime" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, exercise physiologist" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-11-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Aim for 150 mins moderate physical activity per week" ] ] ] ], [ fhir:index 5 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Weight management program" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, GP" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2027-05-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Aim for 5-10% weight loss, waist circumference <80cm" ] ] ] ], [ fhir:index 6 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Diabetes medicine review" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, GP, pharmacist" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Consider Home Medicines Review in 3-6 months" ] ] ] ], [ fhir:index 7 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1340186004 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1340186004" ] ; fhir:Coding.display [ fhir:value "Metformin therapy" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, GP, pharmacist" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-06-03"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 8 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Detecting complications early" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, GP, podiatrist, optometrist" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2027-05-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Regular screening for diabetic nephropathy, neuropathy and retinopathy" ] ] ] ], [ fhir:index 9 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:734920002 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "734920002" ] ; fhir:Coding.display [ fhir:value "Diabetes education service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:312856000 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "312856000" ] ; fhir:Coding.display [ fhir:value "Referral to diabetes nurse" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Diabetes educator" ] ] ] ], [ fhir:index 10 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:734920002 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "734920002" ] ; fhir:Coding.display [ fhir:value "Diabetes education service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:284350006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "284350006" ] ; fhir:Coding.display [ fhir:value "Diabetes diet education" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Diabetes educator" ] ] ] ], [ fhir:index 11 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:310090003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "310090003" ] ; fhir:Coding.display [ fhir:value "Dietetics service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:103699006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "103699006" ] ; fhir:Coding.display [ fhir:value "Referral to dietitian" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Dietitian" ] ] ] ], [ fhir:index 12 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:310090003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "310090003" ] ; fhir:Coding.display [ fhir:value "Dietetics service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:11816003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "11816003" ] ; fhir:Coding.display [ fhir:value "Diet education" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Dietitian" ] ] ] ], [ fhir:index 13 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1240761000168106 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1240761000168106" ] ; fhir:Coding.display [ fhir:value "Exercise physiology service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1100681000168103 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1100681000168103" ] ; fhir:Coding.display [ fhir:value "Referral to exercise physiologist" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Exercise physiologist" ] ] ] ], [ fhir:index 14 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1240761000168106 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1240761000168106" ] ; fhir:Coding.display [ fhir:value "Exercise physiology service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:229080003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "229080003" ] ; fhir:Coding.display [ fhir:value "Exercise regime" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Exercise physiologist" ] ] ] ], [ fhir:index 15 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:23911000087104 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "23911000087104" ] ; fhir:Coding.display [ fhir:value "Medicine review service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:306362008 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "306362008" ] ; fhir:Coding.display [ fhir:value "Referral to pharmacist" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Pharmacist" ] ] ] ], [ fhir:index 16 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:23911000087104 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "23911000087104" ] ; fhir:Coding.display [ fhir:value "Medicine review service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1348931000168107 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1348931000168107" ] ; fhir:Coding.display [ fhir:value "Home medicines review" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Pharmacist" ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Consider Home Medicines Review in 3-6 months" ] ] ] ], [ fhir:index 17 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:788007007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "788007007" ] ; fhir:Coding.display [ fhir:value "General practice service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:395101001 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "395101001" ] ; fhir:Coding.display [ fhir:value "Ongoing review" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "GP, practice nurse" ] ] ] ] ], [ fhir:index 7 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goals and tasks" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-problemneed" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Problems/Needs" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-9g64YCvHill3V992KwhdT" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:443694000 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "443694000" ] ; fhir:Coding.display [ fhir:value "Uncontrolled type 2 diabetes" ] ] ], [ fhir:index 1 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-YV0DNHjxVa4d-xxo0cKnu" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:238131007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "238131007" ] ; fhir:Coding.display [ fhir:value "Overweight" ] ] ], [ fhir:index 2 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-47mdKuLSYw0dnl3VlkLHt" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:235595009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "235595009" ] ; fhir:Coding.display [ fhir:value "Gastro-oesophageal reflux disease" ] ] ], [ fhir:index 3 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-nNu5Y4c2JCEp-DhqTFk2b" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:278860009 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "278860009" ] ; fhir:Coding.display [ fhir:value "Chronic lower back pain" ] ] ], [ fhir:index 4 ; fhir:Element.id [ fhir:value "plan-goalstasks-problemneed-repeat-ObITmA57Lkq0iaTX5Po8A" ] ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:286647002 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "286647002" ] ; fhir:Coding.display [ fhir:value "Low self-esteem" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goal setting" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-goals" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goals" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "5-10% weight loss (target weight 73.8-77.9kg) and decrease waist circumference (long term target <80cm)" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-initiator" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Initiator" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "GP" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2027-05-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/goal-status" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "active" ] ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goal setting" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-goals" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Goals" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Comfortably wear dress purchased for niece’s wedding next year" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-initiator" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Initiator" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2027-05-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-goalsetting-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/goal-status" ] ; fhir:Coding.code [ fhir:value "active" ] ; fhir:Coding.display [ fhir:value "active" ] ] ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:183065007 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "183065007" ] ; fhir:Coding.display [ fhir:value "Low carbohydrate diet education" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, dietitian" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Reduce ratio of carbohydrates in each meal – ¼ plate carbs, ¼ plate protein, ½ plate vegetables/salad" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 5 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Substitute high GI for low GI carbohydrates where possible" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-08-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 6 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Physical activity guidance" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina, exercise physiologist" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-11-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 7 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Aim for 150 mins of aerobic activity per week" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-11-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 8 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "2-3 sessions of resistance exercise per week" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-11-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ] ], [ fhir:index 9 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions and actions" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-interventionsactions" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Interventions/Actions" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Management of impulse control" ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-owner" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Owner" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Caterina" ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-targetdate" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Target date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2026-11-20"^^xsd:date ] ] ], [ fhir:index 3 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-status" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/care-plan-activity-status" ] ; fhir:Coding.code [ fhir:value "not-started" ] ; fhir:Coding.display [ fhir:value "Planned" ] ] ] ], [ fhir:index 4 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-interventionsactions-comment" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Comment" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Manage impulsivity/desire to eat when not actually hungry. Consider psychology input in future" ] ] ] ], [ fhir:index 10 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:310090003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "310090003" ] ; fhir:Coding.display [ fhir:value "Dietetics service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:103699006 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "103699006" ] ; fhir:Coding.display [ fhir:value "Referral to dietitian" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Dietitian" ] ] ] ], [ fhir:index 11 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:310090003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "310090003" ] ; fhir:Coding.display [ fhir:value "Dietetics service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:11816003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "11816003" ] ; fhir:Coding.display [ fhir:value "Diet education" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Dietitian" ] ] ] ], [ fhir:index 12 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1240761000168106 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1240761000168106" ] ; fhir:Coding.display [ fhir:value "Exercise physiology service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1100681000168103 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1100681000168103" ] ; fhir:Coding.display [ fhir:value "Referral to exercise physiologist" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Exercise physiologist" ] ] ] ], [ fhir:index 13 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Services and treatments" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-servicestreatments" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Required services and treatments" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:1240761000168106 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "1240761000168106" ] ; fhir:Coding.display [ fhir:value "Exercise physiology service" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-activity" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Activity" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ a sct:229080003 ; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ; fhir:Coding.code [ fhir:value "229080003" ] ; fhir:Coding.display [ fhir:value "Exercise regime" ] ] ] ], [ fhir:index 2 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "plan-goalstasks-details-servicestreatments-provider" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Provider" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Exercise physiologist" ] ] ] ] ], [ fhir:index 8 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "completion" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Completion" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "completion-consentforsharing" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Consent given for sharing of information with relevant healthcare providers" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueBoolean [ fhir:value "true"^^xsd:boolean ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "completion-review" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Review" ] ; fhir:QuestionnaireResponse.item.item [ fhir:index 0 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "completion-review-appointmentstatus" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Appointment status" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/appointmentstatus" ] ; fhir:Coding.code [ fhir:value "proposed" ] ; fhir:Coding.display [ fhir:value "Proposed" ] ] ] ], [ fhir:index 1 ; fhir:QuestionnaireResponse.item.linkId [ fhir:value "completion-review-date" ] ; fhir:QuestionnaireResponse.item.text [ fhir:value "Date" ] ; fhir:QuestionnaireResponse.item.answer [ fhir:index 0 ; fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2027-05-20"^^xsd:date ] ] ] ] ] ] ] . <http://hl7.org/fhir/Patient/foreman-caterina> a fhir:Patient . <http://hl7.org/fhir/Practitioner/primary-peter> a fhir:Practitioner . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/QuestionnaireResponse/gpccmp-form-foreman-caterina.ttl> a owl:Ontology ; owl:imports fhir:fhir.ttl ; owl:versionIRI <http://build.fhir.org/QuestionnaireResponse/gpccmp-form-foreman-caterina.ttl> .
IG © 2025+ AEHRC CSIRO. Package csiro.fhir.au.gpccmp#0.1.0 based on FHIR 4.0.1. Generated 2026-08-18
Links: Table of Contents |
QA Report