This page is part of the PACIO Cognitive Status Implementation Guide (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "QuestionnaireResponse",
"id" : "QResponse-SNF-PHQ9-1",
"meta" : {
"profile" : [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>questionnaire</b>: <a href=\"http://example.org/Questionnaire/MDS3.0-NC-1.17\">http://example.org/Questionnaire/MDS3.0-NC-1.17</a></p><p><b>status</b>: completed</p><p><b>subject</b>: <a href=\"Patient-patientBSJ1.html\">Generated Summary: Betsy Smith-Johnson</a></p><p><b>authored</b>: Jul 11, 2020 4:30:00 PM</p><p><b>author</b>: <a href=\"PractitionerRole-Role-SLP-LunaBaskins.html\">Generated Summary: active: true; <span title=\"Codes: {http://snomed.info/sct 159026005}\">Speech and language therapist</span></a></p><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-4</p><p><b>text</b>: MDS v3.0 - RAI v1.18.1 - Mood - OSA [CMS Assessment]</p><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-4/D0200</p><p><b>text</b>: Resident mood interview (PHQ-9) [Reported PHQ-9 CMS]</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-4/D0300</p><p><b>text</b>: PHQ-9 Total Score</p></blockquote></blockquote></div>"
},
"questionnaire" : "http://example.org/Questionnaire/MDS3.0-NC-1.17",
"_questionnaire" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/display",
"valueString" : "Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.17.1 [CMS Assessment]"
}
]
},
"status" : "completed",
"subject" : {
"reference" : "Patient/patientBSJ1"
},
"authored" : "2020-07-11T11:30:00-05:00",
"author" : {
"reference" : "PractitionerRole/Role-SLP-LunaBaskins"
},
"item" : [
{
"linkId" : "Section-4",
"text" : "MDS v3.0 - RAI v1.18.1 - Mood - OSA [CMS Assessment]",
"item" : [
{
"linkId" : "Section-4/D0200",
"text" : "Resident mood interview (PHQ-9) [Reported PHQ-9 CMS]",
"item" : [
{
"linkId" : "Section-4/D0200_1",
"text" : "Resident mood interview (PHQ-9) - symptom presence in the last 2 weeks [CMS Assessment]",
"item" : [
{
"linkId" : "Section-4/D0200A1",
"text" : "Little interest or pleasure in doing things",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
}
]
},
{
"linkId" : "Section-4/D0200B1",
"text" : "Feeling down",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
}
]
},
{
"linkId" : "Section-4/D0200C1",
"text" : "Trouble falling or staying asleep",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA33-6",
"display" : "Yes"
}
}
]
},
{
"linkId" : "Section-4/D0200D1",
"text" : "Feeling tired or having little energy",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
}
]
},
{
"linkId" : "Section-4/D0200E1",
"text" : "Poor appetite or overeating",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
}
]
},
{
"linkId" : "Section-4/D0200F1",
"text" : "Feeling bad about yourself - or that you are a failure or have let yourself or your family down",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
}
]
},
{
"linkId" : "Section-4/D0200G1",
"text" : "Trouble concentrating on things",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
}
]
},
{
"linkId" : "Section-4/D0200H1",
"text" : "Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA32-8",
"display" : "No"
}
}
]
},
{
"linkId" : "Section-4/D0200I1",
"text" : "Thoughts that you would be better off dead",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10996-9",
"display" : "No response"
}
}
]
}
]
},
{
"linkId" : "Section-4/D0200_2",
"text" : "Resident mood interview (PHQ-9) - symptom frequency in the last 2 weeks [CMS Assessment]",
"item" : [
{
"linkId" : "Section-4/D0200A2",
"text" : "Little interest or pleasure in doing things",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10998-5",
"display" : "2-6 days (several days)"
}
}
]
},
{
"linkId" : "Section-4/D0200B2",
"text" : "Feeling down",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10998-5",
"display" : "2-6 days (several days)"
}
}
]
},
{
"linkId" : "Section-4/D0200C2",
"text" : "Trouble falling or staying asleep",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10998-5",
"display" : "2-6 days (several days)"
}
}
]
},
{
"linkId" : "Section-4/D0200D2",
"text" : "Feeling tired or having little energy",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10997-7",
"display" : "Never or 1 day"
}
}
]
},
{
"linkId" : "Section-4/D0200E2",
"text" : "Poor appetite or overeating",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10997-7",
"display" : "Never or 1 day"
}
}
]
},
{
"linkId" : "Section-4/D0200F2",
"text" : "Feeling bad about yourself - or that you are a failure or have let yourself or your family down",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10997-7",
"display" : "Never or 1 day"
}
}
]
},
{
"linkId" : "Section-4/D0200G2",
"text" : "Trouble concentrating on things",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10997-7",
"display" : "Never or 1 day"
}
}
]
},
{
"linkId" : "Section-4/D0200H2",
"text" : "Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA10997-7",
"display" : "Never or 1 day"
}
}
]
},
{
"linkId" : "Section-4/D0200I2",
"text" : "Thoughts that you would be better off dead"
}
]
}
]
},
{
"linkId" : "Section-4/D0300",
"text" : "PHQ-9 Total Score",
"answer" : [
{
"valueQuantity" : {
"value" : 3,
"system" : "http://unitsofmeasure.org",
"code" : "{score}"
}
}
]
}
]
}
]
}