Healthcare Associated Infection Reports, FHIR STU 2 Ballot - US Realm Implementation Guide CI Build

This page is part of the Healthcare Associated Infection Implementation Guide (v1.1.0: STU 2 Ballot 1) based on FHIR R3. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

XML Format: Questionnaire-hai-questionnaire-opc-proc-denom

Raw xml 


<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="hai-questionnaire-opc-proc-denom"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-03-13T23:50:43.000-04:00"/>
    <profile
             value="http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire"/>
  </meta>
  <language value="en-US"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml" lang="en-US">
      <p>This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Denominator for Procedure. This report records the denominator information for outpatient procedures.</p>
      <h2>Outpatient Procedure Component Denominator for Procedure</h2>
      <table border="1">
        <tbody>
          <tr>
            <td>url</td>
            <td>http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-proc-denom</td>
          </tr>
          <tr>
            <td>Version</td>
            <td>R1</td>
          </tr>
          <tr>
            <td>title</td>
            <td>Outpatient Procedure Component Denominator for Procedure</td>
          </tr>
          <tr>
            <td>Publish date</td>
            <td>2019-04-01</td>
          </tr>
          <tr>
            <td>Realm</td>
            <td>US</td>
          </tr>
          <tr>
            <td>Code</td>
            <td>LOINC 51897-7: Healthcare Associated Infection report Document</td>
          </tr>
          <tr>
            <td>Subject type</td>
            <td>Patient</td>
          </tr>
        </tbody>
      </table>
      <h2>Questionnaire Items</h2>
      <table border="1">
        <thead>
          <tr>
            <th>Group</th>
            <th>Item</th>
            <th>Type</th>
            <th>Required</th>
            <th>Repeats</th>
          </tr>
        </thead>
        <tbody>
          <tr>
            <td/>
            <td>Facility ID</td>
            <td>url</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td/>
            <td>Event #</td>
            <td>url</td>
            <td>false</td>
            <td>false</td>
          </tr>
          <tr>
            <td/>
            <td>Event Type</td>
            <td>choice</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td/>
            <td>Encounter date</td>
            <td>date</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td/>
            <td>Risk Factors</td>
            <td>group</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Risk Factors</td>
            <td>Wound Class</td>
            <td>choice</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Risk Factors</td>
            <td>Endoscopy</td>
            <td>boolean</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Risk Factors</td>
            <td>Diabetes mellitus</td>
            <td>choice</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Risk Factors</td>
            <td>Height</td>
            <td>quantity</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Risk Factors</td>
            <td>Weight</td>
            <td>quantity</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Risk Factors</td>
            <td>ASA Class</td>
            <td>choice</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td/>
            <td>Procedure Details</td>
            <td>g</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Procedure Details</td>
            <td>NHSN Procedure Code Category</td>
            <td>choice</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Procedure Details</td>
            <td>CPT Procedure Code</td>
            <td>choice</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Procedure Details</td>
            <td>CPT Procedure Code</td>
            <td>choice</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Procedure Details</td>
            <td>Procedure Duration</td>
            <td>time</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Procedure Details</td>
            <td>General anesthesia</td>
            <td>boolean</td>
            <td>true</td>
            <td>false</td>
          </tr>
          <tr>
            <td>Procedure Details</td>
            <td>Surgeon code</td>
            <td>url</td>
            <td>true</td>
            <td>false</td>
          </tr>
        </tbody>
      </table>
    </div>
  </text>
  <url
       value="http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-proc-denom"/>
  <identifier>
    <value value="hai-questionnaire-opc-proc-denom-v1"/>
  </identifier>
  <version value="R1"/>
  <name value="hai-questionnaire-opc-proc-denom"/>
  <title value="Outpatient Procedure Component Denominator for Procedure"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2019-04-01"/>
  <publisher value="HL7"/>
  <description
               value="This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Denominator for Procedure. This report records datea on each patient having one of the NHSN procedures selected for monitoring."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <code>
    <system value="http://loinc.org"/>
    <code value="51897-7"/>
    <display value="Healthcare Associated Infection report Document"/>
  </code>
  <subjectType value="Patient"/>
  <item>
    <linkId value="facility-id"/>
    <text value="Facility ID"/>
    <type value="url"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="event-number"/>
    <text value="Event Number"/>
    <type value="url"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="encounter-date"/>
    <text value="Date of encounter"/>
    <type value="date"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="risk-factors"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="51898-5"/>
      <display value="Risk factors Document"/>
    </code>
    <text value="Risk Factors"/>
    <type value="group"/>
    <repeats value="false"/>
    <item>
      <linkId value="risk-factor-wound-class"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="420089007"/>
        <display value="CDC wound classification category"/>
      </code>
      <text value="Risk Factor: Wound class"/>
      <type value="choice"/>
      <required value="false"/>
      <repeats value="false"/>
      <options>
        <reference
                   value="http://hl7.org/fhir/us/hai/ValueSet/2.16.840.1.113883.13.9"/>
      </options>
    </item>
    <item>
      <linkId value="risk-factor-endoscopy"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="423827005"/>
        <display value="Endoscopy"/>
      </code>
      <text value="Risk Factor: Endoscopy used"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-diabetes-mellitus"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="73211009"/>
        <display value="Diabetes mellitus"/>
      </code>
      <text value="Risk Factor: Diabetes mellitus"/>
      <type value="boolean"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-height"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="50373000"/>
        <display value="Body Height"/>
      </code>
      <text value="Risk Factor: height"/>
      <type value="quantity"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-weight"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="27113001"/>
        <display value="Body Weight"/>
      </code>
      <text value="Risk Factor: height"/>
      <type value="quantity"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="risk-factor-asa-class"/>
      <code>
        <system value="http://snomed.info/sct"/>
        <code value="273270000"/>
        <display
                 value="American Society of Anesthesiologists physical status classification (assessment scale)"/>
      </code>
      <text value="Risk Factor: ASA Class"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference
                   value="http://hl7.org/fhir/us/hai/ValueSet/2.16.840.1.113883.13.10"/>
      </options>
    </item>
  </item>
  <item>
    <linkId value="procedure-details"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="51899-3"/>
      <display value="Details Document"/>
    </code>
    <text value="Procedure Details"/>
    <type value="group"/>
    <repeats value="false"/>
    <item>
      <linkId value="nhsn-procedure-code-category"/>
    <!-- <code>
        <system value="http://loinc.org" />
        <code value="29300-1" />
        <display value="Procedure" />
      </code> -->
      <text value="NHSN Procedure Code Category"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
      <options>
        <reference
                   value="http://hl7.org/fhir/us/hai/ValueSet/2.16.840.1.113883.10.20.5.9.34"/>
      </options>
    </item>
  <!-- <options>
        <reference value="http://hl7.org/fhir/ValueSet/cpt-all" />
      </options> -->
    <item>
      <linkId value="cpt-procedure-code"/>
    <!-- <code>
        <system value="http://loinc.org" />
        <code value="76448-0" />
        <display value="CPT billing code" />
      </code> -->
      <text value="CPT Procedure Code"/>
      <type value="choice"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
    <item>
      <linkId value="procedure-duration"/>
    <!-- <code>
        <system value="http://loinc.org" />
        <code value="89875-9" />
        <display value="Procedure duration" />
      </code> -->
      <text value="Procedure duration"/>
      <type value="quantity"/>
      <required value="true"/>
      <repeats value="false"/>
    </item>
  </item>
  <item>
    <linkId value="general-anesthesia"/>
    <text value="General anesthesia"/>
    <type value="boolean"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="surgeon-code"/>
    <text value="Surgeon code"/>
    <type value="url"/>
    <required value="true"/>
    <repeats value="false"/>
  </item>
  <item>
    <linkId value="nhsn-comment"/>
    <code>
      <system value="http://www.loinc.org"/>
      <code value="86468-6"/>
      <display value="Report Comment Section"/>
    </code>
    <text value="Comments"/>
    <type value="text"/>
    <required value="false"/>
    <repeats value="false"/>
    <maxLength value="2000"/>
  </item>
</Questionnaire>