HealthcareAssociatedInfectionReports Implementation Guide CI Build

This page is part of the Healthcare Associated Infection Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

JSON Format: QuestionnaireResponse-hai-questionnaireresponse-opc-ssi-event

Raw json

{
  "resourceType" : "QuestionnaireResponse",
  "id" : "hai-questionnaireresponse-opc-ssi-event",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaireresponse"
    ]
  },
  "language" : "en-US",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en-US\">\n         <table xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\" class=\"bare\">\n            <tr>\n               <td>\n                  <b>Id:</b>\n               </td>\n               <td>hai-questionnaireresponse-opc-ssi-event</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Profile:</b>\n               </td>\n               <td>http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaireresponse</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Language:</b>\n               </td>\n               <td>en-US</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Identifier:</b>\n               </td>\n               <td>\n                  <span title=\"Code system: urn:oid:2.16.840.1.113883.3.117.1.1.5.2.1.1.2\">20202206</span>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Questionnaire:</b>\n               </td>\n               <td>http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-ssi-event</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Status:</b>\n               </td>\n               <td>completed</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Subject:</b>\n               </td>\n               <td>\n                  <a href=\"Patient-hai-patient-1.html\">hai-patient-1</a>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Author:</b>\n               </td>\n               <td>\n                  <a href=\"Device-hai-authoring-device.html\">hai-authoring-device</a>\n               </td>\n            </tr>\n         </table>\n         <br xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\"/>\n         <h2 xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">QuestionnaireResponse Answers</h2>\n         <ul xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\" style=\"list-style:none;\">\n            <li>\n               <span style=\"font-weight:bold\">Facility ID</span> [<span style=\"font-style:italic\">facility-id</span>]: \n        <span style=\"text-decoration:underline\">urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:9W</span>\n            </li>\n            <li>\n               <span style=\"font-weight:bold\">Date of encounter</span> [<span style=\"font-style:italic\">encounter-date</span>]: \n        <span style=\"text-decoration:underline\">2018-08-05</span>\n            </li>\n            <li>\n               <span style=\"font-weight:bold\">Infection details</span> [<span style=\"font-style:italic\">infection-details</span>]: \n        <ul style=\"list-style:none;\">\n                  <li>\n                     <span style=\"font-weight:bold\">Event Type</span> [<span style=\"font-style:italic\">event-type</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Surgical Site Infection</li>\n                           <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                           </li>\n                           <li>Code: 433202001</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Date of event</span> [<span style=\"font-style:italic\">event-date</span>]: \n        <span style=\"text-decoration:underline\">2018-08-06</span>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">NHSN Procedure Code Category</span> [<span style=\"font-style:italic\">nhsn-procedure-code-category</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Appendix surgery</li>\n                           <li>Code system: <a href=\"http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277\">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277</a>\n                           </li>\n                           <li>Code: 2108-9</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Primary CPT Procedure Code</span> [<span style=\"font-style:italic\">primary-cpt-procedure-code</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Laparoscopic Procedures on the Appendix</li>\n                           <li>Code system: <a href=\"http://www.ama-assn.org/go/cpt\">http://www.ama-assn.org/go/cpt</a>\n                           </li>\n                           <li>Code: 44970</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Procedure Id</span> [<span style=\"font-style:italic\">procedure-id</span>]: \n        <span style=\"text-decoration:underline\">urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.5:21987654321</span>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Surgical Site Infection (SSI) Level</span> [<span style=\"font-style:italic\">ssi-level</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Superficial incisional primary SSI</li>\n                           <li>Code system: <a href=\"http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277\">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277</a>\n                           </li>\n                           <li>Code: 1620-4</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Criteria of Diagnosis</span> [<span style=\"font-style:italic\">criteria-of-diagnosis</span>]: \n        <ul style=\"list-style:none;\">\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Abscess</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-abscess</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Redness</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-redness</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Fever</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-fever</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Heat</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-heat</span>]: \n        <span style=\"text-decoration:underline\">true</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Purulent drainage</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-incision-purulent-drainage</span>]: \n        <span style=\"text-decoration:underline\">true</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Wound spontaneously dehisced</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-wound-dehisced</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Incision deliberately opened</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-incision-opened</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Other evidence of infection found on invasive procedure, gross anatomic exam, or histopathologic exam</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-evidence-found</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Localized swelling</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-localized-swelling</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Pain or tenderness</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-pain-tenderness</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Organism Identified</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-organism-identified</span>]: \n        <span style=\"text-decoration:underline\">true</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Culture or non-culture based testing not performed</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-testing-not-performed</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Imaging test evidence of infection</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-imaging-test</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                        <li>\n                           <span style=\"font-weight:bold\">Criteria of Diagnosis: Diagnosis of superficial SSI by surgeon or attending physician</span> [<span style=\"font-style:italic\">criteria-of-diagnosis-physician-diagnosis</span>]: \n        <span style=\"text-decoration:underline\">false</span>\n                        </li>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Surveillence method type (active/passive) through which the SSI was detected</span> [<span style=\"font-style:italic\">ssi-detection-method-type</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Active SSI Detection Method</li>\n                           <li>Code system: <a href=\"http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277\">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277</a>\n                           </li>\n                           <li>Code: 1309-4</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Surveillence method through which the SSI was detected</span> [<span style=\"font-style:italic\">ssi-detection-method</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Review of patient's medical record</li>\n                           <li>Code system: <a href=\"http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277\">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277</a>\n                           </li>\n                           <li>Code: 1321-9</li>\n                        </span>\n                     </ul>\n                  </li>\n               </ul>\n            </li>\n            <li>\n               <span style=\"font-weight:bold\">Findings Group</span> [<span style=\"font-style:italic\">findings-group</span>]: \n        <ul style=\"list-style:none;\">\n                  <li>\n                     <span style=\"font-weight:bold\">Pathogen Identified</span> [<span style=\"font-style:italic\">pathogen-identified</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Staphylococcus, coagulase negative (organism)</li>\n                           <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                           </li>\n                           <li>Code: 116197008</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Pathogen Ranking</span> [<span style=\"font-style:italic\">pathogen-ranking</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>First</li>\n                           <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                           </li>\n                           <li>Code: 255216001</li>\n                        </span>\n                     </ul>\n                  </li>\n               </ul>\n            </li>\n            <li>\n               <span style=\"font-weight:bold\">Findings Group</span> [<span style=\"font-style:italic\">findings-group</span>]: \n        <ul style=\"list-style:none;\">\n                  <li>\n                     <span style=\"font-weight:bold\">Pathogen Identified</span> [<span style=\"font-style:italic\">pathogen-identified</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Life form of parasite (organism)</li>\n                           <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                           </li>\n                           <li>Code: 103535006</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Pathogen Ranking</span> [<span style=\"font-style:italic\">pathogen-ranking</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Second</li>\n                           <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                           </li>\n                           <li>Code: 81170007</li>\n                        </span>\n                     </ul>\n                  </li>\n               </ul>\n            </li>\n            <li>\n               <span style=\"font-weight:bold\">Findings Group</span> [<span style=\"font-style:italic\">findings-group</span>]: \n        <ul style=\"list-style:none;\">\n                  <li>\n                     <span style=\"font-weight:bold\">Pathogen Identified</span> [<span style=\"font-style:italic\">pathogen-identified</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Acid-fast bacillus</li>\n                           <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                           </li>\n                           <li>Code: 243365003</li>\n                        </span>\n                     </ul>\n                  </li>\n                  <li>\n                     <span style=\"font-weight:bold\">Pathogen Ranking</span> [<span style=\"font-style:italic\">pathogen-ranking</span>]: \n        <ul>\n                        <span style=\"text-decoration:underline\">\n                           <li>Third</li>\n                           <li>Code system: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a>\n                           </li>\n                           <li>Code: 70905002</li>\n                        </span>\n                     </ul>\n                  </li>\n               </ul>\n            </li>\n            <li>\n               <span style=\"font-weight:bold\">Comments</span> [<span style=\"font-style:italic\">nhsn-comment</span>]: \n        <span style=\"text-decoration:underline\">NHSN text comment that is less than 2000 characters.</span>\n            </li>\n         </ul>\n      </div>"
  },
  "identifier" : {
    "system" : "urn:oid:2.16.840.1.113883.3.117.1.1.5.2.1.1.2",
    "value" : "20202206"
  },
  "questionnaire" : "http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-ssi-event",
  "status" : "completed",
  "subject" : {
    "reference" : "Patient/hai-patient-1",
    "display" : "hai-patient-1"
  },
  "author" : {
    "reference" : "Device/hai-authoring-device",
    "display" : "hai-authoring-device"
  },
  "item" : [
    {
      "linkId" : "facility-id",
      "text" : "Facility ID",
      "answer" : [
        {
          "valueUri" : "urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:9W"
        }
      ]
    },
    {
      "linkId" : "encounter-date",
      "text" : "Date of encounter",
      "answer" : [
        {
          "valueDate" : "2018-08-05"
        }
      ]
    },
    {
      "linkId" : "infection-details",
      "text" : "Infection details",
      "item" : [
        {
          "linkId" : "event-type",
          "text" : "Event Type",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "433202001",
                "display" : "Surgical Site Infection"
              }
            }
          ]
        },
        {
          "linkId" : "event-date",
          "text" : "Date of event",
          "answer" : [
            {
              "valueDate" : "2018-08-06"
            }
          ]
        },
        {
          "linkId" : "nhsn-procedure-code-category",
          "text" : "NHSN Procedure Code Category",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
                "code" : "2108-9",
                "display" : "Appendix surgery"
              }
            }
          ]
        },
        {
          "linkId" : "primary-cpt-procedure-code",
          "text" : "Primary CPT Procedure Code",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://www.ama-assn.org/go/cpt",
                "code" : "44970",
                "display" : "Laparoscopic Procedures on the Appendix"
              }
            }
          ]
        },
        {
          "linkId" : "procedure-id",
          "text" : "Procedure Id",
          "answer" : [
            {
              "valueUri" : "urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.5:21987654321"
            }
          ]
        },
        {
          "linkId" : "ssi-level",
          "text" : "Surgical Site Infection (SSI) Level",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
                "code" : "1620-4",
                "display" : "Superficial incisional primary SSI"
              }
            }
          ]
        },
        {
          "linkId" : "criteria-of-diagnosis",
          "text" : "Criteria of Diagnosis",
          "item" : [
            {
              "linkId" : "criteria-of-diagnosis-abscess",
              "text" : "Criteria of Diagnosis: Abscess",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-redness",
              "text" : "Criteria of Diagnosis: Redness",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-fever",
              "text" : "Criteria of Diagnosis: Fever",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-heat",
              "text" : "Criteria of Diagnosis: Heat",
              "answer" : [
                {
                  "valueBoolean" : true
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-incision-purulent-drainage",
              "text" : "Criteria of Diagnosis: Purulent drainage",
              "answer" : [
                {
                  "valueBoolean" : true
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-wound-dehisced",
              "text" : "Criteria of Diagnosis: Wound spontaneously dehisced",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-incision-opened",
              "text" : "Criteria of Diagnosis: Incision deliberately opened",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-evidence-found",
              "text" : "Criteria of Diagnosis: Other evidence of infection found on invasive procedure, gross anatomic exam, or histopathologic exam",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-localized-swelling",
              "text" : "Criteria of Diagnosis: Localized swelling",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-pain-tenderness",
              "text" : "Criteria of Diagnosis: Pain or tenderness",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-organism-identified",
              "text" : "Criteria of Diagnosis: Organism Identified",
              "answer" : [
                {
                  "valueBoolean" : true
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-testing-not-performed",
              "text" : "Criteria of Diagnosis: Culture or non-culture based testing not performed",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-imaging-test",
              "text" : "Criteria of Diagnosis: Imaging test evidence of infection",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            },
            {
              "linkId" : "criteria-of-diagnosis-physician-diagnosis",
              "text" : "Criteria of Diagnosis: Diagnosis of superficial SSI by surgeon or attending physician",
              "answer" : [
                {
                  "valueBoolean" : false
                }
              ]
            }
          ]
        },
        {
          "linkId" : "ssi-detection-method-type",
          "text" : "Surveillence method type (active/passive) through which the SSI was detected",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
                "code" : "1309-4",
                "display" : "Active SSI Detection Method"
              }
            }
          ]
        },
        {
          "linkId" : "ssi-detection-method",
          "text" : "Surveillence method through which the SSI was detected",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
                "code" : "1321-9",
                "display" : "Review of patient's medical record"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "findings-group",
      "text" : "Findings Group",
      "item" : [
        {
          "linkId" : "pathogen-identified",
          "text" : "Pathogen Identified",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "116197008",
                "display" : "Staphylococcus, coagulase negative (organism)"
              }
            }
          ]
        },
        {
          "linkId" : "pathogen-ranking",
          "text" : "Pathogen Ranking",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "255216001",
                "display" : "First"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "findings-group",
      "text" : "Findings Group",
      "item" : [
        {
          "linkId" : "pathogen-identified",
          "text" : "Pathogen Identified",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "103535006",
                "display" : "Life form of parasite (organism)"
              }
            }
          ]
        },
        {
          "linkId" : "pathogen-ranking",
          "text" : "Pathogen Ranking",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "81170007",
                "display" : "Second"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "findings-group",
      "text" : "Findings Group",
      "item" : [
        {
          "linkId" : "pathogen-identified",
          "text" : "Pathogen Identified",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "243365003",
                "display" : "Acid-fast bacillus"
              }
            }
          ]
        },
        {
          "linkId" : "pathogen-ranking",
          "text" : "Pathogen Ranking",
          "answer" : [
            {
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "code" : "70905002",
                "display" : "Third"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "nhsn-comment",
      "text" : "Comments",
      "answer" : [
        {
          "valueString" : "NHSN text comment that is less than 2000 characters."
        }
      ]
    }
  ]
}