{ "resourceType" : "Questionnaire", "id" : "ChEkmQuestionnaireMpox-it-CH", "meta" : { "source" : "https://github.com/ahdis/ch-ekm/blob/master/tests/assemble-questionnaire.sh", "profile" : ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-exp"] }, "language" : "it-CH", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire ChEkmQuestionnaireMpox-it-CH

Language: it-CH;

Information Source: https://github.com/ahdis/ch-ekm/blob/master/tests/assemble-questionnaire.sh

Profile: Populatable Questionnaire - Expression

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeFlagsDescription & Constraints\"doco\"
\".\"\".\" ChEkmQuestionnaireMpoxitCHGENERATED FILE — do not edit by hand. Assembled from the modular questionnaire ChEkmQuestionnaireMpox and its sub-questionnaires via Questionnaire/$assemble (tests/assemble-questionnaire.sh). Re-run that script after changing any child questionnaire to keep this resource in sync.Questionnairehttp://fhir.ch/ig/ch-ekm/Questionnaire/ChEkmQuestionnaireMpox-it-CH#0.0.1
\".\"\".\"\".\" mpox-formNotifica del referto clinico: Mpox0..1group
\".\"\".\"\".\"\".\" personDati relativi alla persona interessata0..1group
\".\"\".\"\".\"\".\"\".\" surnameCognome1..1stringDefinition: ChEkmPersonForm.surname
\".\"\".\"\".\"\".\"\".\" givennameNome1..1stringDefinition: ChEkmPersonForm.givenname
\".\"\".\"\".\"\".\"\".\" dateOfBirthData di nascita1..1dateDefinition: ChEkmPersonForm.dateOfBirth
\".\"\".\"\".\"\".\"\".\" ahvn13Numero AVS (OASI)0..1stringMax Length: 13
Definition: ChEkmPersonForm.ahvn13
\".\"\".\"\".\"\".\"\".\" nationalityNazionalità0..1choiceDefinition: ChEkmPersonForm.nationality
Options: 196 options
\".\"\".\"\".\"\".\"\".\" zipCodeNAP0..1stringDefinition: ChEkmPersonForm.zipCode
\".\"\".\"\".\"\".\"\".\" cityLocalità0..1stringDefinition: ChEkmPersonForm.city
\".\"\".\"\".\"\".\"\".\" countryPaese0..1choiceDefinition: ChEkmPersonForm.country
Options: 196 options
\".\"\".\"\".\"\".\"\".\" cantonCantone0..1open-choiceDefinition: ChEkmPersonForm.canton
Options: 26 options
\".\"\".\"\".\"\".\"\".\" administrativeGenderSesso1..1choice\"icon\"/\"icon\"/Definition: ChEkmPersonForm.administrativeGender
Value Set:
Options: 4 options
\".\"\".\"\".\"\".\" manifestation-groupDiagnosi e manifestazione0..1group
\".\"\".\"\".\"\".\"\".\" manifestationManifestazioni0..1choice\"icon\"/\"icon\"/Definition: http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmMpoxManifestationForm#ChEkmMpoxManifestationForm.manifestation
Value Set:
Options: 13 options
\".\"\".\"\".\"\".\"\".\" manifestationBeginUnknownInizio delle manifestazioni sconosciuto0..1booleanDefinition: ChEkmManifestationForm.manifestationBeginUnknown
Initial Value: boolean = false
\".\"\".\"\".\"\".\"\".\" manifestationBeginDateInizio delle manifestazioni (data)0..1dateDefinition: ChEkmManifestationForm.manifestationBeginDate
Enable When: manifestationBeginUnknown = false
\".\"\".\"\".\"\".\" exposureEsposizione0..1group
\".\"\".\"\".\"\".\"\".\" transmissionCome (via di trasmissione)0..1group
\".\"\".\"\".\"\".\"\".\"\".\" sexualContactPartnerRapporto sessuale con una persona infetta (sesso)0..1choice\"icon\"/\"icon\"/Definition: ChEkmGonorrhoeaExpositionForm.transmission.sexualContactPartner
Options: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" relationshipTypeTipo di relazione0..1choice\"icon\"/\"icon\"/Definition: ChEkmGonorrhoeaExpositionForm.transmission.relationshipType
Options: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" otherTransmissionAltra via di trasmissione (testo libero)0..1stringDefinition: ChEkmGonorrhoeaExpositionForm.transmission.otherTransmission
\".\"\".\"\".\"\".\"\".\"\".\" unknownVia di trasmissione sconosciuta0..1booleanDefinition: ChEkmGonorrhoeaExpositionForm.transmission.unknown
\".\"\".\"\".\"\".\" treatingPhysicianMedico curante0..1group
\".\"\".\"\".\"\".\"\".\" treatingPhysicianPractitionerMedico curante0..1group
\".\"\".\"\".\"\".\"\".\"\".\" physicianGivennameNome1..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.givenname
\".\"\".\"\".\"\".\"\".\"\".\" physicianSurnameCognome1..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.surname
\".\"\".\"\".\"\".\"\".\"\".\" physicianStreetLineIndirizzo (via, numero civico)0..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.streetLine
\".\"\".\"\".\"\".\"\".\"\".\" physicianZipCodeNAP1..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.zipCode
\".\"\".\"\".\"\".\"\".\"\".\" physicianCityLocalità1..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.city
\".\"\".\"\".\"\".\"\".\"\".\" physicianPhoneNumero di telefono1..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.phone
\".\"\".\"\".\"\".\"\".\"\".\" physicianEmailE-mail0..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.email
\".\"\".\"\".\"\".\"\".\"\".\" physicianGlnGLN0..1stringDefinition: ChEkmTreatingPhysicianPractitionerForm.gln
\".\"\".\"\".\"\".\"\".\" treatingPhysicianOrganizationOrganizzazione mittente0..1group
\".\"\".\"\".\"\".\"\".\"\".\" orgNameNome1..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.name
\".\"\".\"\".\"\".\"\".\"\".\" orgDepartmentReparto0..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.department
\".\"\".\"\".\"\".\"\".\"\".\" orgStreetLineIndirizzo (via, numero civico)0..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.streetLine
\".\"\".\"\".\"\".\"\".\"\".\" orgZipCodeNAP1..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.zipCode
\".\"\".\"\".\"\".\"\".\"\".\" orgCityLocalità1..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.city
\".\"\".\"\".\"\".\"\".\"\".\" orgPhoneNumero di telefono1..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.phone
\".\"\".\"\".\"\".\"\".\"\".\" orgEmailE-mail0..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.email
\".\"\".\"\".\"\".\"\".\"\".\" orgBerRIS0..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.ber
\".\"\".\"\".\"\".\"\".\"\".\" orgGlnGLN0..1stringDefinition: ChEkmTreatingPhysicianOrganizationForm.gln

\"doco\" Documentation for this format

Options Sets

Answer options for nationality

Answer options for country

Answer options for canton

Answer options for administrativeGender

Answer options for manifestation

Answer options for sexualContactPartner

Answer options for relationshipType

" }, "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm", "valueCoding" : { "system" : "http://hl7.org/fhir/version-algorithm", "code" : "semver" } }, { "extension" : [{ "url" : "name", "valueCoding" : { "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext", "code" : "patient", "display" : "Patient" } }, { "url" : "type", "valueCode" : "Patient" }, { "url" : "description", "valueString" : "The patient to pre-populate the form with" }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext" }, { "extension" : [{ "url" : "name", "valueCoding" : { "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext", "code" : "user", "display" : "User" } }, { "url" : "type", "valueCode" : "PractitionerRole" }, { "url" : "description", "valueString" : "The treating physician's PractitionerRole (practitioner + sending organization) to pre-populate the form with" }], "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext" }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom", "valueCanonical" : "http://fhir.ch/ig/ch-ekm/Questionnaire/ChEkmQuestionnairePersonName|0.0.1" }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom", "valueCanonical" : "http://fhir.ch/ig/ch-ekm/Questionnaire/ChEkmQuestionnairePersonGeneral|0.0.1" }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom", "valueCanonical" : "http://fhir.ch/ig/ch-ekm/Questionnaire/ChEkmQuestionnaireManifestationBeginUnknown|0.0.1" }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom", "valueCanonical" : "http://fhir.ch/ig/ch-ekm/Questionnaire/ChEkmQuestionnaireTransmissionHow|0.0.1" }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembledFrom", "valueCanonical" : "http://fhir.ch/ig/ch-ekm/Questionnaire/ChEkmQuestionnaireTreatingPhysician|0.0.1" }], "url" : "http://fhir.ch/ig/ch-ekm/Questionnaire/ChEkmQuestionnaireMpox-it-CH", "version" : "0.0.1", "name" : "ChEkmQuestionnaireMpoxitCH", "title" : "CH EKM Questionnaire: Mpox (assembled) (preview it-CH, pre-expanded)", "status" : "active", "experimental" : false, "subjectType" : ["Patient"], "date" : "2026-07-14T21:00:26+00:00", "publisher" : "Federal Office of Public Health FOPH", "contact" : [{ "name" : "Federal Office of Public Health FOPH", "telecom" : [{ "system" : "url", "value" : "https://www.bag.admin.ch/bag/en/home/das-bag/kontakt-standort.html" }] }], "description" : "GENERATED FILE — do not edit by hand. Assembled from the modular questionnaire ChEkmQuestionnaireMpox and its sub-questionnaires via Questionnaire/$assemble (tests/assemble-questionnaire.sh). Re-run that script after changing any child questionnaire to keep this resource in sync.", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "CH" }] }], "copyright" : "CC0-1.0", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/variable", "valueExpression" : { "name" : "homeOrFirstAddress", "language" : "text/fhirpath", "expression" : "%patient.address.where(use='home').combine(%patient.address).first()" } }], "linkId" : "mpox-form", "text" : "Notifica del referto clinico: Mpox", "type" : "group", "item" : [{ "linkId" : "person", "text" : "Dati relativi alla persona interessata", "type" : "group", "item" : [{ "linkId" : "surname", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmPersonForm#ChEkmPersonForm.surname", "text" : "Cognome", "type" : "string", "required" : true }, { "linkId" : "givenname", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmPersonForm#ChEkmPersonForm.givenname", "text" : "Nome", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%patient.birthDate" } }], "linkId" : "dateOfBirth", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmPersonForm#ChEkmPersonForm.dateOfBirth", "text" : "Data di nascita", "type" : "date", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/regex", "valueString" : "^756[0-9]{10}$" }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%patient.identifier.where(system = 'urn:oid:2.16.756.5.32').value.first()" } }], "linkId" : "ahvn13", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmPersonForm#ChEkmPersonForm.ahvn13", "text" : "Numero AVS (OASI)", "type" : "string", "maxLength" : 13 }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "drop-down" }] } }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%patient.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/patient-citizenship').extension.where(url = 'code').valueCodeableConcept.coding.first()" } }], "linkId" : "nationality", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmPersonForm#ChEkmPersonForm.nationality", "text" : "Nazionalità", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CH", "display" : "Svizzera" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "AL", "display" : "Albania" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "AD", "display" : "Andorra" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BE", "display" : "Belgio" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BG", "display" : "Bulgaria" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "DK", "display" : "Danimarca" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "DE", "display" : "Germania" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "FI", "display" : "Finlandia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "FR", "display" : "Francia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GR", "display" : "Grecia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GB", "display" : "Regno Unito" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "IE", "display" : "Irlanda" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "IS", "display" : "Islanda" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "IT", "display" : "Italia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "LI", "display" : "Liechtenstein" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "LU", "display" : "Lussemburgo" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MT", "display" : "Malta" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MC", "display" : "Monaco" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "NL", "display" : "Paesi Bassi" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "NO", "display" : "Norvegia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "AT", "display" : "Austria" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "PL", "display" : "Polonia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "PT", "display" : "Portogallo" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "RO", "display" : "Romania" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "SM", "display" : "San Marino" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "SE", "display" : "Svezia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "ES", "display" : "Spagna" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "TR", "display" : "Türkiye" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "HU", "display" : "Ungheria" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "VA", "display" : "Città del Vaticano" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CY", "display" : "Cipro" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "SK", "display" : "Slovacchia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CZ", "display" : "Cechia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "RS", "display" : "Serbia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "HR", "display" : "Croazia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "SI", "display" : "Slovenia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BA", "display" : "Bosnia e Erzegovina" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "ME", "display" : "Montenegro" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MK", "display" : "Macedonia del Nord" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "XK", "display" : "Kosovo" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "EE", "display" : "Estonia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "LV", "display" : "Lettonia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "LT", "display" : "Lituania" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MD", "display" : "Moldova" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "RU", "display" : "Russia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "UA", "display" : "Ucraina" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BY", "display" : "Belarus" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GQ", "display" : "Guinea equatoriale" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "ET", "display" : "Etiopia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "DJ", "display" : "Gibuti" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "DZ", "display" : "Algeria" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "AO", "display" : "Angola" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BW", "display" : "Botswana" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BI", "display" : "Burundi" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BJ", "display" : "Benin" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CI", "display" : "Côte d'Ivoire" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GA", "display" : "Gabon" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GM", "display" : "Gambia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GH", "display" : "Ghana" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GW", "display" : "Guinea-Bissau" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "GN", "display" : "Guinea" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CM", "display" : "Camerun" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CV", "display" : "Cabo Verde" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "KE", "display" : "Kenia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "KM", "display" : "Comore" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CG", "display" : "Congo (Brazzaville)" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "CD", "display" : "Congo (Kinshasa)" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "LS", "display" : "Lesotho" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "LR", "display" : "Liberia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "LY", "display" : "Libia" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MG", "display" : "Madagascar" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MW", "display" : "Malawi" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "ML", "display" : "Mali" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MA", "display" : "Marocco" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MR", "display" : "Mauritania" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MU", "display" : "Maurizio" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "MZ", "display" : "Mozambico" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "NE", "display" : "Niger" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "NG", "display" : "Nigeria" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "BF", "display" : "Burkina Faso" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "ZW", "display" : "Zimbabwe" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "RW", "display" : "Ruanda" } }, { "valueCoding" : { "system" : "urn:iso:std:iso:3166", "code" : "ZM", "display" : 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"http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "NE" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "NW" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "OW" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "SH" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "SZ" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "SO" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "SG" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "TI" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "TG" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "UR" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "VD" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "VS" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "ZG" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-7-cantonflabbreviation", "code" : "ZH" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%patient.gender" } }], "linkId" : "administrativeGender", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmPersonForm#ChEkmPersonForm.administrativeGender", "text" : "Sesso", "type" : "choice", "required" : true, "_answerValueSet" : { "extension" : [{ "extension" : [{ "url" : "name", "valueCode" : "useSupplement" }, { "url" : "expression", "valueString" : "http://fhir.ch/ig/ch-ekm/CodeSystem/ch-ekm-administrative-gender-language-supplement" }], "url" : "http://hl7.org/fhir/tools/StructureDefinition/binding-parameter" }] }, "answerOption" : [{ "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "male", "display" : "maschile" } }, { "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "female", "display" : "femminile" } }, { "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "other", "display" : "altro" } }, { "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "unknown", "display" : "sconosciuto" } }] }] }, { "linkId" : "manifestation-group", "text" : "Diagnosi e manifestazione", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button" }] } }], "linkId" : "manifestation", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmMpoxManifestationForm#ChEkmMpoxManifestationForm.manifestation", "text" : "Manifestazioni", "type" : "choice", "_answerValueSet" : { "extension" : [{ "extension" : [{ "url" : "name", "valueCode" : "useSupplement" }, { "url" : "expression", "valueString" : "http://fhir.ch/ig/ch-ekm/CodeSystem/ch-ekm-snomed-language-supplement" }], "url" : "http://hl7.org/fhir/tools/StructureDefinition/binding-parameter" }] }, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "74964007", "display" : "Other" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373572006", "display" : "Clinical finding absent" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "261665006", "display" : "Unknown" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "95324001:{363698007=280158000}", "display" : "Lesione cutanea della regione anogenitale" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "95324001:{363698007=73897004}", "display" : "Lesione cutanea del viso" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "95324001:{363698007=116370005}", "display" : "Lesione cutanea degli arti" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "95324001", "display" : "Lesione cutanea" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "30746006", "display" : "Linfoadenopatia" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "68962001", "display" : "Mialgia" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "25064002", "display" : "Cefalea" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "161891005", "display" : "Mal di schiena" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "13791008", "display" : "Astenia" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "386661006", "display" : "Febbre" } }] }, { "linkId" : "manifestationBeginUnknown", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmManifestationForm#ChEkmManifestationForm.manifestationBeginUnknown", "text" : "Inizio delle manifestazioni sconosciuto", "type" : "boolean", "initial" : [{ "valueBoolean" : false }] }, { "linkId" : "manifestationBeginDate", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmManifestationForm#ChEkmManifestationForm.manifestationBeginDate", "text" : "Inizio delle manifestazioni (data)", "type" : "date", "enableWhen" : [{ "question" : "manifestationBeginUnknown", "operator" : "=", "answerBoolean" : false }] }] }, { "linkId" : "exposure", "text" : "Esposizione", "type" : "group", "item" : [{ "linkId" : "transmission", "text" : "Come (via di trasmissione)", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "sexualContactPartner", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmGonorrhoeaExpositionForm#ChEkmGonorrhoeaExpositionForm.transmission.sexualContactPartner", "text" : "Rapporto sessuale con una persona infetta (sesso)", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "male", "display" : "maschile" } }, { "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "female", "display" : "femminile" } }, { "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "other", "display" : "altro" } }, { "valueCoding" : { "system" : "http://hl7.org/fhir/administrative-gender", "code" : "unknown", "display" : "sconosciuto" } }] }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "radio-button" }] } }, { "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCode" : "horizontal" }], "linkId" : "relationshipType", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmGonorrhoeaExpositionForm#ChEkmGonorrhoeaExpositionForm.transmission.relationshipType", "text" : "Tipo di relazione", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "http://fhir.ch/ig/ch-ekm/CodeSystem/ch-ekm-relationship-type", "code" : "steady-partner", "display" : "Partner fisso" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-ekm/CodeSystem/ch-ekm-relationship-type", "code" : "non-steady-partner", "display" : "Partner non fisso" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-ekm/CodeSystem/ch-ekm-relationship-type", "code" : "offered-paid-sex", "display" : "Offerta di sesso a pagamento" } }, { "valueCoding" : { "system" : "http://fhir.ch/ig/ch-ekm/CodeSystem/ch-ekm-relationship-type", "code" : "used-paid-sex", "display" : "Ricorso a sesso a pagamento" } }] }, { "linkId" : "otherTransmission", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmGonorrhoeaExpositionForm#ChEkmGonorrhoeaExpositionForm.transmission.otherTransmission", "text" : "Altra via di trasmissione (testo libero)", "type" : "string" }, { "linkId" : "unknown", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmGonorrhoeaExpositionForm#ChEkmGonorrhoeaExpositionForm.transmission.unknown", "text" : "Via di trasmissione sconosciuta", "type" : "boolean" }] }] }, { "linkId" : "treatingPhysician", "text" : "Medico curante", "type" : "group", "item" : [{ "linkId" : "treatingPhysicianPractitioner", "text" : "Medico curante", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().name.first().given.first()" } }], "linkId" : "physicianGivenname", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.givenname", "text" : "Nome", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().name.first().family" } }], "linkId" : "physicianSurname", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.surname", "text" : "Cognome", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().address.where(use='work').combine(%user.practitioner.resolve().address).first().line.first()" } }], "linkId" : "physicianStreetLine", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.streetLine", "text" : "Indirizzo (via, numero civico)", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().address.where(use='work').combine(%user.practitioner.resolve().address).first().postalCode" } }], "linkId" : "physicianZipCode", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.zipCode", "text" : "NAP", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().address.where(use='work').combine(%user.practitioner.resolve().address).first().city" } }], "linkId" : "physicianCity", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.city", "text" : "Località", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().telecom.where(system='phone').value.first()" } }], "linkId" : "physicianPhone", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.phone", "text" : "Numero di telefono", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().telecom.where(system='email').value.first()" } }], "linkId" : "physicianEmail", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.email", "text" : "E-mail", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.practitioner.resolve().identifier.where(system='urn:oid:2.51.1.3').value.first()" } }], "linkId" : "physicianGln", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianPractitionerForm#ChEkmTreatingPhysicianPractitionerForm.gln", "text" : "GLN", "type" : "string" }] }, { "linkId" : "treatingPhysicianOrganization", "text" : "Organizzazione mittente", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().name" } }], "linkId" : "orgName", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.name", "text" : "Nome", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().extension.where(url='http://fhir.ch/ig/ch-ekm/StructureDefinition/ch-ekm-ext-department').valueString" } }], "linkId" : "orgDepartment", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.department", "text" : "Reparto", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().address.first().line.first()" } }], "linkId" : "orgStreetLine", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.streetLine", "text" : "Indirizzo (via, numero civico)", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().address.first().postalCode" } }], "linkId" : "orgZipCode", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.zipCode", "text" : "NAP", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().address.first().city" } }], "linkId" : "orgCity", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.city", "text" : "Località", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().telecom.where(system='phone').value.first()" } }], "linkId" : "orgPhone", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.phone", "text" : "Numero di telefono", "type" : "string", "required" : true }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().telecom.where(system='email').value.first()" } }], "linkId" : "orgEmail", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.email", "text" : "E-mail", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().identifier.where(system='urn:oid:2.16.756.5.45').value.first()" } }], "linkId" : "orgBer", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.ber", "text" : "RIS", "type" : "string" }, { "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "%user.organization.resolve().identifier.where(system='urn:oid:2.51.1.3').value.first()" } }], "linkId" : "orgGln", "definition" : "http://fhir.ch/ig/ch-ekm/StructureDefinition/ChEkmTreatingPhysicianOrganizationForm#ChEkmTreatingPhysicianOrganizationForm.gln", "text" : "GLN", "type" : "string" }] }] }] }] }