SDOH Clinical Care
3.0.0-ballot - STU 3 Ballot

SDOH Clinical Care - Downloaded Version 3.0.0-ballot See the Directory of published versions

## Questionnaire: SDOHCC Questionnaire Hunger Vital Sign

Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnaireHungerVitalSign | Version: 3.0.0-ballot
Standards status: Informative Draft as of 2020-09-01 | Computable Name: SDOHCCQuestionnaireHungerVitalSign

- Tree view
- Sample Rendering
- Form Logic

Profile: Extractable Questionnaire - StructureMap

Structure

LinkID | Text | Cardinality | Type | Description & Constraints
--- | --- | --- | --- | ---
SDOHCCQuestionnaireHungerVitalSign |  |  | Questionnaire | http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnaireHungerVitalSign#3.0.0-ballot
/88122-7 | Within the past 12 months we worried whether our food would run out before we got money to buy more | 0..1 | choice | Options: 4 options
/88123-5 | Within the past 12 months the food we bought just didn't last and we didn't have money to get more | 0..1 | choice | Options: 4 options
/88124-3 | Food insecurity risk | 0..1 | choice | Options: 2 options
/88124-3-help | An answer of "often true" or "sometimes true" to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI). | 0..1 | display |
Documentation for this format

Options Sets

Answer options for /88122-7

- http://loinc.org#LA28397-0 ("Often true")
- http://loinc.org#LA6729-3 ("Sometimes true")
- http://loinc.org#LA28398-8 ("Never true")
- http://loinc.org#LA15775-2 ("Don't know/refused")

Answer options for /88123-5

- http://loinc.org#LA28397-0 ("Often true")
- http://loinc.org#LA6729-3 ("Sometimes true")
- http://loinc.org#LA28398-8 ("Never true")
- http://loinc.org#LA15775-2 ("Don't know/refused")

Answer options for /88124-3

- http://loinc.org#LA19952-3 ("At risk")
- http://loinc.org#LA19983-8 ("No risk")

Profile: Extractable Questionnaire - StructureMap

Within the past 12 months we worried whether our food would run out before we got money to buy more

- linkId: /88122-7
- Answers: 4 options

Within the past 12 months the food we bought just didn't last and we didn't have money to get more

- linkId: /88123-5
- Answers: 4 options

Food insecurity risk

- linkId: /88124-3
- Answers: 2 options

An answer of "often true" or "sometimes true" to either or both of the Hunger Vital Sign™ questions identifies a patient as at risk for food insecurity (FI).

- linkId: /88124-3-help

Profile: Extractable Questionnaire - StructureMap

LinkID | Description & Constraints
--- | ---
/88122-7 | Options: 4 options
/88123-5 | Options: 4 options
/88124-3 | Options: 2 options
/88124-3-help |
Documentation for this format

### Test this Questionnaire

Profile: Extractable Questionnaire - StructureMap

Try this questionnaire out:

### Responses for this Questionnaire

- (no description)
- (no description)