US Core Implementation Guide
5.0.1 - STU5 Release US

This page is part of the US Core (v5.0.1: STU5) based on FHIR R4. The current version which supercedes this version is 6.1.0. For a full list of available versions, see the Directory of published versions. Page versions: STU6.1 STU6 STU5

Example QuestionnaireResponse: PRAPARE Example

LinkIdTextDefinitionAnswerdoco
.. PRAPARE-exampleQuestionnaireResponse
... /93025-5Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]
.... /93043-8Personal characteristics
..... /93043-8/56051-6Do you consider yourself Hispanic/Latino?LOINC LA32-8: No
..... /93043-8/32624-9Race
..... /93043-8/93035-4At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?LOINC LA33-6: Yes
..... /93043-8/93034-7Have you been discharged from the armed forces of the United States?LOINC LA32-8: No
..... /93043-8/54899-0Preferred languageLOINC LA43-5: English
.... /93042-0Family and home
..... /93042-0/63512-8How many people are living or staying at this address?6
..... /93042-0/71802-3Housing statusLOINC LA30190-5: I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)
..... /93042-0/93033-9Are you worried about losing your housing?LOINC LA30122-8: I choose not to answer this question
..... /93042-0/56799-0AddressBroadway
.... /93041-2Money and resources
..... /93041-2/82589-3Highest level of educLOINC LA30191-3: Less than high school degree
..... /93041-2/67875-5Employment status currentLOINC LA17956-6: Unemployed
..... /93041-2/76437-3Primary insuranceLOINC LA17849-3: Medicaid
..... /93041-2/63586-2What was your best estimate of the total income of all family members from all sources, before taxes, in last year?25000
..... /93041-2/93031-3In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?
..... /93041-2/93030-5Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?LOINC LA30134-3: Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need
.... /93040-4Social and emotional health
..... /93040-4/93029-7How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?LOINC LA30130-1: 1 or 2 times a week
..... /93040-4/93038-8Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?LOINC LA13909-9: Somewhat
.... /93039-6Optional additional questions
..... /93039-6/93028-9In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?LOINC LA32-8: No
..... /93039-6/93027-1Are you a refugee?LOINC LA32-8: No
..... /93039-6/93026-3Do you feel physically and emotionally safe where you currently live?LOINC LA32-8: No
..... /93039-6/76501-6Within the last year, have you been afraid of your partner or ex-partner?LOINC LA32-8: No

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