SIL HIE Implementation Guide, published by Kathurima Kimathi. 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/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions

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• XML
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: Example HIE Questionnaire - XML Representation

Active as of 2025-11-20

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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="HIEQuestionnaire-example"/>
  <meta>
    <profile
             value="https://nshr.dha.go.ke/fhir/StructureDefinition/hie-questionnaire"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Questionnaire Summary</b></p><p>This form captures demographics, symptom screening, and appointment intent. Items are grouped for usability, typed for consistent capture, and use enableWhen for conditional logic.</p><ul><li>Status: active</li><li>Versioned URL: http://example.org/Questionnaire/hie-q-example</li><li>Root groups: Demographics, Symptoms, Visit</li></ul><p><b>Key Behaviors</b></p><ul><li>Unique linkIds across all items</li><li>Group items carry no answers or initial values</li><li>Non-group items define answer options or value sets when appropriate</li><li>Conditional item appears only when gender = female</li></ul></div>
  </text>
  <url value="http://example.org/Questionnaire/hie-q-example"/>
  <identifier>
    <use value="official"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="ACSN"/>
        <display value="Accession ID"/>
      </coding>
    </type>
    <system value="http://example.org/questionnaires"/>
    <value value="Q-INTAKE-001"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="HIE_Q_Demo_Symptoms_Visit"/>
  <title value="HIE Intake Questionnaire"/>
  <status value="active"/>
  <subjectType value="Patient"/>
  <date value="2025-11-20"/>
  <publisher value="Kathurima Kimathi"/>
  <contact>
    <name value="Kathurima Kimathi"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.linkedin.com/in/kathurima-kimathi/"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="kathurima@savannahinformatics.com"/>
    </telecom>
  </contact>
  <description
               value="Intake questionnaire capturing demographics, core symptoms, and visit intent for HIE workflows."/>
  <item>
    <linkId value="grp-demographics"/>
    <text value="Demographics"/>
    <type value="group"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="text-box"/>
            <display value="Text box"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="given-name"/>
      <text value="Given name"/>
      <type value="string"/>
      <required value="true"/>
    </item>
    <item>
      <linkId value="family-name"/>
      <text value="Family name"/>
      <type value="string"/>
      <required value="true"/>
    </item>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="drop-down"/>
            <display value="Drop down"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <linkId value="gender"/>
      <text value="Gender"/>
      <type value="choice"/>
      <required value="true"/>
      <answerOption>
        <valueCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="female"/>
          <display value="Female"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="male"/>
          <display value="Male"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="other"/>
          <display value="Other"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="unknown"/>
          <display value="Unknown"/>
        </valueCoding>
      </answerOption>
    </item>
  </item>
  <item>
    <linkId value="grp-symptoms"/>
    <text value="Symptoms"/>
    <type value="group"/>
    <item>
      <linkId value="has-headache"/>
      <text value="Headache present"/>
      <type value="boolean"/>
    </item>
    <item>
      <linkId value="headache-severity"/>
      <text value="Headache severity"/>
      <type value="choice"/>
      <enableWhen>
        <question value="has-headache"/>
        <operator value="="/>
        <answerBoolean value="true"/>
      </enableWhen>
      <answerOption>
        <valueCoding>
          <system value="http://example.org/vs/severity"/>
          <code value="mild"/>
          <display value="Mild"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <system value="http://example.org/vs/severity"/>
          <code value="moderate"/>
          <display value="Moderate"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <system value="http://example.org/vs/severity"/>
          <code value="severe"/>
          <display value="Severe"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="pregnancy-status"/>
      <text value="Are you currently pregnant?"/>
      <type value="boolean"/>
      <enableWhen>
        <question value="gender"/>
        <operator value="="/>
        <answerCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="female"/>
          <display value="Female"/>
        </answerCoding>
      </enableWhen>
    </item>
  </item>
  <item>
    <linkId value="grp-visit"/>
    <text value="Visit"/>
    <type value="group"/>
    <item>
      <linkId value="visit-intent"/>
      <text value="Reason for visit"/>
      <type value="choice"/>
      <required value="true"/>
      <answerOption>
        <valueCoding>
          <system value="http://example.org/vs/visit-intent"/>
          <code value="new-consult"/>
          <display value="New consultation"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <system value="http://example.org/vs/visit-intent"/>
          <code value="follow-up"/>
          <display value="Follow up"/>
        </valueCoding>
      </answerOption>
      <answerOption>
        <valueCoding>
          <system value="http://example.org/vs/visit-intent"/>
          <code value="procedure"/>
          <display value="Procedure"/>
        </valueCoding>
      </answerOption>
    </item>
    <item>
      <linkId value="requested-window"/>
      <text value="Preferred appointment window"/>
      <type value="choice"/>
    </item>
    <item>
      <linkId value="additional-notes"/>
      <text value="Additional notes"/>
      <type value="text"/>
    </item>
  </item>
</Questionnaire>