{"contact":[{"telecom":[{"system":"url"}]}],"date":"2016-11-14","description":"Example questionnaire to assess Zika virus exposure potential.","effectivePeriod":{"start":"2016-11-14"},"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-wg","valueCode":"fhir"}],"id":"zika-virus-exposure-assessment","identifier":[{"system":"urn:ietf:rfc:3986","value":"urn:oid:2.16.840.1.113883.4.642.20.1"}],"item":[{"code":[{"code":"CDE: Resident of or Frequent Traveler to Zika Area","system":"http://example.org/questionnaires"}],"extension":[{"url":"http://example.org/additional-information","valueAttachment":{"title":"Areas with active Zika virus transmission/exposure risk","url":"http://www.cdc.gov/zika/geo/index.html"}}],"linkId":"1","text":"Are you a resident of, or do you travel frequently to, an area with active Zika transmission?","type":"boolean"},{"code":[{"code":"CDE: Recent Travel to Zika Area","system":"http://example.org/questionnaires"}],"enableWhen":[{"answerBoolean":false,"operator":"=","question":"1"}],"extension":[{"url":"http://example.org/additional-information","valueAttachment":{"title":"Areas with active Zika virus transmission/exposure risk","url":"http://www.cdc.gov/zika/geo/index.html"}}],"linkId":"2","text":"Have you recently traveled to an area with active Zika transmission?","type":"boolean"},{"code":[{"code":"CDE: Time Since Returned From Travel","system":"http://example.org/questionnaires"}],"enableWhen":[{"answerBoolean":true,"operator":"=","question":"2"}],"linkId":"3","text":"How long has it been since you returned?","type":"quantity"},{"code":[{"code":"CDE: Recent Sexual Encounter with Traveler to Zika Area","system":"http://example.org/questionnaires"}],"enableWhen":[{"answerBoolean":false,"operator":"=","question":"2"}],"extension":[{"url":"http://example.org/additional-information","valueAttachment":{"title":"Areas with active Zika virus transmission/exposure risk","url":"http://www.cdc.gov/zika/geo/index.html"}}],"linkId":"4","text":"Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?","type":"boolean"},{"code":[{"code":"CDE: Time Since Sexual Encounter","system":"http://example.org/questionnaires"}],"enableWhen":[{"answerBoolean":true,"operator":"=","question":"4"}],"linkId":"5","text":"How long has it been since your last condomless sexual encounter?","type":"quantity"},{"code":[{"code":"CDE: Planned Travel to Zika Area","system":"http://example.org/questionnaires"}],"enableWhen":[{"answerBoolean":false,"operator":"=","question":"4"}],"extension":[{"url":"http://example.org/additional-information","valueAttachment":{"title":"Areas with active Zika virus transmission/exposure risk","url":"http://www.cdc.gov/zika/geo/index.html"}}],"linkId":"6","text":"Do you plan to travel to an area with active Zika transmission?","type":"boolean"}],"name":"ExampleZikaVirusExposureAssessment","publisher":"HL7 International / FHIR Infrastructure","resourceType":"Questionnaire","status":"draft","subjectType":["Patient"],"text":{"div":"
Generated Narrative: Questionnaire
Resource Questionnaire "zika-virus-exposure-assessment"
StructureDefinition Work Group: fhir
url: http://example.org/Questionnaire/zika-virus-exposure-assessment
identifier: URI/urn:oid:2.16.840.1.113883.4.642.20.1
name: ExampleZikaVirusExposureAssessment
title: Example Zika Virus Exposure Assessment
status: draft
subjectType: Patient
date: 2016-11-14
publisher: HL7 International / FHIR Infrastructure
contact:
description: Example questionnaire to assess Zika virus exposure potential.
effectivePeriod: 2016-11-14 --> (ongoing)
item
linkId: 1
code: CDE: Resident of or Frequent Traveler to Zika Area (Details: http://example.org/questionnaires code CDE: Resident of or Frequent Traveler to Zika Area = 'CDE: Resident of or Frequent Traveler to Zika Area', stated as 'null')
text: Are you a resident of, or do you travel frequently to, an area with active Zika transmission?
type: boolean
item
linkId: 2
code: CDE: Recent Travel to Zika Area (Details: http://example.org/questionnaires code CDE: Recent Travel to Zika Area = 'CDE: Recent Travel to Zika Area', stated as 'null')
text: Have you recently traveled to an area with active Zika transmission?
type: boolean
EnableWhens
- Question Operator Answer[x] * 1 = false
item
linkId: 3
code: CDE: Time Since Returned From Travel (Details: http://example.org/questionnaires code CDE: Time Since Returned From Travel = 'CDE: Time Since Returned From Travel', stated as 'null')
text: How long has it been since you returned?
type: quantity
EnableWhens
- Question Operator Answer[x] * 2 = true
item
linkId: 4
code: CDE: Recent Sexual Encounter with Traveler to Zika Area (Details: http://example.org/questionnaires code CDE: Recent Sexual Encounter with Traveler to Zika Area = 'CDE: Recent Sexual Encounter with Traveler to Zika Area', stated as 'null')
text: Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?
type: boolean
EnableWhens
- Question Operator Answer[x] * 2 = false
item
linkId: 5
code: CDE: Time Since Sexual Encounter (Details: http://example.org/questionnaires code CDE: Time Since Sexual Encounter = 'CDE: Time Since Sexual Encounter', stated as 'null')
text: How long has it been since your last condomless sexual encounter?
type: quantity
EnableWhens
- Question Operator Answer[x] * 4 = true
item
linkId: 6
code: CDE: Planned Travel to Zika Area (Details: http://example.org/questionnaires code CDE: Planned Travel to Zika Area = 'CDE: Planned Travel to Zika Area', stated as 'null')
text: Do you plan to travel to an area with active Zika transmission?
type: boolean
EnableWhens
- Question Operator Answer[x] * 4 = false