This page is part of the FHIR Specification (v4.2.0: R5 Preview #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3
FHIR Infrastructure Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Not linked to any defined compartments |
Raw JSON (canonical form + also see JSON Format Specification)
Example instrument for assessing Zika virus exposure potential
{ "resourceType": "Questionnaire", "id": "zika-virus-exposure-assessment", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <pre>\n </pre>\n </div>" }, "url": "http://example.org/Questionnaire/zika-virus-exposure-assessment", "name": "ExampleZikaVirusExposureAssessment", "title": "Example Zika Virus Exposure Assessment", "status": "draft", "subjectType": [ "Patient" ], "date": "2016-11-14", "description": "Example questionnaire to assess Zika virus exposure potential.", "effectivePeriod": { "start": "2016-11-14" }, "item": [ { "extension": [ { "url": "http://example.org/additional-information", "valueAttachment": { "url": "http://www.cdc.gov/zika/geo/index.html", "title": "Areas with active Zika virus transmission/exposure risk" } } ], "linkId": "1", "code": [ { "system": "http://example.org/questionnaires", "code": "CDE: Resident of or Frequent Traveler to Zika Area" } ], "text": "Are you a resident of, or do you travel frequently to, an area with active Zika transmission?", "type": "boolean" }, { "extension": [ { "url": "http://example.org/additional-information", "valueAttachment": { "url": "http://www.cdc.gov/zika/geo/index.html", "title": "Areas with active Zika virus transmission/exposure risk" } } ], "linkId": "2", "code": [ { "system": "http://example.org/questionnaires", "code": "CDE: Recent Travel to Zika Area" } ], "text": "Have you recently traveled to an area with active Zika transmission?", "type": "boolean", "enableWhen": [ { "question": "1", "operator": "=", "answerBoolean": false } ] }, { "linkId": "3", "code": [ { "system": "http://example.org/questionnaires", "code": "CDE: Time Since Returned From Travel" } ], "text": "How long has it been since you returned?", "type": "quantity", "enableWhen": [ { "question": "2", "operator": "=", "answerBoolean": true } ] }, { "extension": [ { "url": "http://example.org/additional-information", "valueAttachment": { "url": "http://www.cdc.gov/zika/geo/index.html", "title": "Areas with active Zika virus transmission/exposure risk" } } ], "linkId": "4", "code": [ { "system": "http://example.org/questionnaires", "code": "CDE: Recent Sexual Encounter with Traveler to Zika Area" } ], "text": "Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?", "type": "boolean", "enableWhen": [ { "question": "2", "operator": "=", "answerBoolean": false } ] }, { "linkId": "5", "code": [ { "system": "http://example.org/questionnaires", "code": "CDE: Time Since Sexual Encounter" } ], "text": "How long has it been since your last condomless sexual encounter?", "type": "quantity", "enableWhen": [ { "question": "4", "operator": "=", "answerBoolean": true } ] }, { "extension": [ { "url": "http://example.org/additional-information", "valueAttachment": { "url": "http://www.cdc.gov/zika/geo/index.html", "title": "Areas with active Zika virus transmission/exposure risk" } } ], "linkId": "6", "code": [ { "system": "http://example.org/questionnaires", "code": "CDE: Planned Travel to Zika Area" } ], "text": "Do you plan to travel to an area with active Zika transmission?", "type": "boolean", "enableWhen": [ { "question": "4", "operator": "=", "answerBoolean": false } ] } ] }
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.