New Zealand rheumatic fever FHIR Implementation Guide, published by Te Whatu Ora. This guide is not an authorized publication; it is the continuous build for version 0.4.6 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/rheumatic-fever/ and changes regularly. See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Medications and Follow-up Guidance Questionnaire - JSON Representation

Draft as of 2023-11-10

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{
  "resourceType" : "Questionnaire",
  "id" : "MedicationsAndFollowUpGuidanceQuestionnaire",
  "url" : "https://build.fhir.org/ig/tewhatuora/rheumatic-fever/Questionnaire/MedicationsAndFollowUpGuidanceQuestionnaire",
  "identifier" : [
    {
      "use" : "official",
      "value" : "MedicationsAndFollowUpGuidanceQuestionnaire",
      "period" : {
        "start" : "2023-10-16"
      }
    }
  ],
  "version" : "1.0.0",
  "name" : "MedicationsAndFollowUpGuidanceQuestionnaire",
  "title" : "Medications and Follow-up Guidance Questionnaire",
  "status" : "draft",
  "experimental" : false,
  "subjectType" : [
    "Patient"
  ],
  "date" : "2023-11-10",
  "publisher" : "Te Whatu Ora",
  "contact" : [
    {
      "name" : "Te Whatu Ora",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.tewhatuora.govt.nz/"
        }
      ]
    },
    {
      "name" : "David Grainger",
      "telecom" : [
        {
          "system" : "email",
          "value" : "david.grainger@middleware.co.nz",
          "use" : "work"
        }
      ]
    }
  ],
  "description" : "Gathers information in secondary prophylaxis planning which guides subsequent medication appointments and follow-up",
  "purpose" : "Gathers information in secondary prophylaxis planning which guides subsequent medication appointments and follow-up",
  "item" : [
    {
      "linkId" : "page1",
      "prefix" : "page1",
      "text" : "Please complete this questionnaire to guide practitioners carrying out rheumatic fever secondary prophylaxis.",
      "type" : "display"
    },
    {
      "linkId" : "SourceOfOralMedications",
      "prefix" : "1)",
      "text" : "Source of oral medications? (choose one)",
      "type" : "choice",
      "required" : true,
      "repeats" : false,
      "answerOption" : [
        {
          "valueString" : "GP prescription"
        },
        {
          "valueString" : "3 monthly visit from a nurse"
        },
        {
          "valueString" : "Monthly visit from a nurse"
        },
        {
          "valueString" : "Pick-up from a pharmacy"
        },
        {
          "valueString" : "Other"
        }
      ]
    },
    {
      "linkId" : "CaseOnWarfarin",
      "prefix" : "2)",
      "text" : "Case on warfarin? (Yes/No/Unknown)",
      "type" : "choice",
      "required" : true,
      "repeats" : false,
      "answerValueSet" : "https://build.fhir.org/ig/tewhatuora/rheumatic-fever/ValueSet/nz-questionnaireresponse-qualifiedyesno-code"
    },
    {
      "linkId" : "WarfarinSupervisionService",
      "prefix" : "2.1)",
      "text" : "Warfarin supervision service (choose one)",
      "type" : "choice",
      "enableWhen" : [
        {
          "question" : "CaseOnWarfarin",
          "operator" : "=",
          "answerCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "373066001",
            "display" : "Yes (qualifier value)"
          }
        }
      ],
      "required" : true,
      "repeats" : false,
      "answerOption" : [
        {
          "valueString" : "GP"
        },
        {
          "valueString" : "Pharmacy"
        },
        {
          "valueString" : "Hospital service"
        },
        {
          "valueString" : "Patient"
        },
        {
          "valueString" : "Whanau"
        }
      ]
    },
    {
      "linkId" : "MonitoringResultSource",
      "prefix" : "3)",
      "text" : "International normalised ratio (INR) monitoring result source (choose one)",
      "type" : "choice",
      "required" : true,
      "repeats" : false,
      "answerOption" : [
        {
          "valueString" : "Patient"
        },
        {
          "valueString" : "Parent"
        },
        {
          "valueString" : "Éclair"
        },
        {
          "valueString" : "GP"
        },
        {
          "valueString" : "Pharmacy"
        },
        {
          "valueString" : "INROnline"
        },
        {
          "valueString" : "Other"
        }
      ]
    },
    {
      "linkId" : "FollowUpClinicalService",
      "prefix" : "4)",
      "text" : "Follow-up clinical service? (choose one)",
      "type" : "choice",
      "required" : true,
      "repeats" : false,
      "answerOption" : [
        {
          "valueString" : "Specialist"
        },
        {
          "valueString" : "GP"
        },
        {
          "valueString" : "To be determined"
        }
      ]
    },
    {
      "linkId" : "PrescribingMethod",
      "prefix" : "5)",
      "text" : "Method of prescribing (choose one)",
      "type" : "choice",
      "required" : true,
      "repeats" : false,
      "answerOption" : [
        {
          "valueString" : "Community Medication Authority"
        },
        {
          "valueString" : "Standing Order (local)"
        },
        {
          "valueString" : "Standing Order (national)"
        },
        {
          "valueString" : "Individual prescription"
        }
      ]
    }
  ]
}