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{
  "id": "PC-PoC-DEA-Allergie-Tool-06-2021___Export_aus_LHC-Forms",
  "meta": {
    "profile": [
      "http://thieme-compliance.de/fhir/StructureDefinition/Questionnaire"
    ],
    "tag": [
      {
        "code": "lformsVersion: 29.1.2"
      }
    ]
  },
  "language": "de-DE",
  "date": "2021-08-02T14:32:49.175Z",
  "version": "06/2021",
  "identifier": [
    {
      "system": "http://thieme-compliance.de/fhir/identifier/EcpBogencode",
      "value": "PC-PoC_DEA_Allergie-Tool",
      "use": "official"
    },
    {
      "system": "http://thieme-compliance.de/fhir/identifier/TcgBogencode",
      "value": "PoC_DEA_Allergie-Tool",
      "use": "usual"
    },
    {
      "system": "http://thieme-compliance.de/fhir/identifier/SapArtikelnummer",
      "value": "DE000000",
      "use": "secondary"
    }
  ],
  "subjectType": [
    "Patient"
  ],
  "status": "draft",
  "experimental": true,
  "publisher": "Thieme Compliance GmbH, Am Weichselgarten 30a, 91058 Erlangen",
  "description": "Dieser Vorlagebogen (Vorlage MF) enthält sämtliche von der Redaktion verabschiedeten Masterfragen.",
  "copyright": "© 2021 Thieme Compliance GmbH",
  "approvalDate": "2021-05-31",
  "url": "http://thieme-compliance.de/fhir/Questionnaire/PC-PoC_DEA_Allergie-Tool",
  "name": "PoC_DEA_Allergie-Tool___Export_aus_LHC-Forms",
  "title": "Proof of Concept DEA Allergie-Tool___Export_aus_LHC-Forms",
  "resourceType": "Questionnaire",
  "item": [
    {
      "type": "date",
      "code": [],
      "required": true,
      "linkId": "dateOfBirth",
      "text": "Bitte geben Sie Ihr Geburtsdatum an."
    },
    {
      "type": "group",
      "code": [],
      "required": true,
      "linkId": "baseDataDecimal",
      "text": "Bitte geben Sie Ihre Größe (in cm), Ihr Gewicht (in kg) sowie Ihr Geschlecht an.",
      "item": [
        {
          "type": "integer",
          "code": [],
          "required": true,
          "linkId": "baseDataDecimalHeight",
          "text": "Größe:"
        },
        {
          "type": "decimal",
          "code": [],
          "required": true,
          "linkId": "baseDataDecimalWeight",
          "text": "Gewicht:"
        },
        {
          "type": "choice",
          "code": [],
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ],
                "text": "Drop down"
              }
            }
          ],
          "required": true,
          "linkId": "baseDataDecimalGender",
          "text": "Geschlecht:",
          "answerOption": [
            {
              "valueCoding": {
                "display": "weiblich"
              }
            },
            {
              "valueCoding": {
                "display": "männlich"
              }
            }
          ]
        }
      ]
    },
    {
      "type": "group",
      "code": [],
      "required": true,
      "linkId": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_0",
      "text": "DEA Allergie-Tool",
      "item": [
        {
          "type": "boolean",
          "code": [],
          "required": true,
          "linkId": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.1",
          "text": "Haben Sie Allergien oder Unverträglichkeiten?",
          "prefix": "1.1"
        },
        {
          "type": "boolean",
          "code": [],
          "required": true,
          "linkId": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.2",
          "text": "Ja, ich habe einen Allergiepass",
          "prefix": "1.2",
          "enableWhen": [
            {
              "answerBoolean": true,
              "question": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.1",
              "operator": "="
            }
          ]
        },
        {
          "type": "open-choice",
          "code": [],
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ],
                "text": "Drop down"
              }
            }
          ],
          "required": true,
          "repeats": true,
          "linkId": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.3",
          "text": "Es bestehen folgende Allergien/Unverträglichkeiten",
          "prefix": "1.3",
          "enableWhen": [
            {
              "answerBoolean": true,
              "question": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.1",
              "operator": "="
            }
          ],
          "answerOption": [
            {
              "valueCoding": {
                "display": "Pollen (Heuschnupfen), Hausstaub, Tierhaare; Duftstoffe"
              }
            },
            {
              "valueCoding": {
                "display": "Jod"
              }
            },
            {
              "valueCoding": {
                "display": "Kontrastmittel"
              }
            },
            {
              "valueCoding": {
                "display": "Latex"
              }
            },
            {
              "valueCoding": {
                "display": "Pflaster"
              }
            },
            {
              "valueCoding": {
                "display": "Medikamente (z.B. Schmerzmittel, Antibiotikum, etc.)"
              }
            },
            {
              "valueCoding": {
                "display": "Nahrungsmittel (Früchte, Nüsse, Soja, etc.)"
              }
            }
          ]
        },
        {
          "type": "choice",
          "code": [],
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ],
                "text": "Drop down"
              }
            }
          ],
          "required": true,
          "linkId": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.4",
          "text": "Wie hat sich Ihre Allergie/Unverträglichkeit in der Vergangenheit schlimmstenfalls geäußert?",
          "prefix": "1.4",
          "enableWhen": [
            {
              "answerBoolean": true,
              "question": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.1",
              "operator": "="
            }
          ],
          "answerOption": [
            {
              "valueCoding": {
                "display": "Hautauschlag/Schwellung örtlich (Schweregrad I)"
              }
            },
            {
              "valueCoding": {
                "display": "Hautauschlag/Schwellung an mehreren Körperregionen oder Ausbreitung auf den gesamten Körper (Schweregrad II)"
              }
            },
            {
              "valueCoding": {
                "display": "Hautauschlag/Schwellung Augenrötung, Nasenlaufen, Luftnot, Überkeit, Erbrechen oder Kreislaufschwäche (Schweregrad III)"
              }
            },
            {
              "valueCoding": {
                "display": "schwerer Kreislaufzusammenbruch bis hin zu Atem- und Herz-Kreislauf-Stillstand (allergischer Schock, Schweregrad IV)"
              }
            }
          ]
        },
        {
          "type": "string",
          "code": [],
          "required": false,
          "linkId": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.5",
          "text": "Welche?",
          "prefix": "1.5",
          "enableWhen": [
            {
              "answerCoding": {
                "display": "Medikamente (z.B. Schmerzmittel, Antibiotikum, etc.)"
              },
              "question": "PC-PoC_DEA_Allergie-Tool_06-2021_Frage_1.3",
              "operator": "="
            }
          ]
        }
      ]
    }
  ]
}

name : PoC_DEA_Allergie-Tool___Export_aus_LHC-Forms

{

}