Introduction:

According to Malaysia National Health and Morbidity Survey (NHMS), one out of five adults or 3.9 million people aged 18 and above in Malaysia suffer from diabetes; three out of 10 or 6.4 million people have high blood pressure; and four out of 10 people or eight million people suffer from high cholesterol.

Background:

The National Health Screening Initiative (NHSI) is one of many initiative employed by Malaysia's Ministry of Health (MOH) to detect, prevent and alleviate the rising cases of non-communicable diseases (NCD). Health screening is considered to be an effective public health awareness program as the ministry acknowledge behavioural science to be one of best strategy employed that helped mitigate the pandemic Covid-19 outbreak crisis.

Scope:

The project aims for nationwide rollout involving both peninsula and east Malaysia with KKM collaborating with PHCorp, MH Nexus, MySejahtera and PERKESO via usage of healthcare system such as MySejahtera, BP Health and Health Information Exchange (HIE) to exchanging information. This is made available by utilising and harnessing the built in international FHIR standard inside HIE system. The FHIR standard will be the bridge that allows exchange and sharing information collected by each respective system possible, ensuring a more holistic outcome benifitting both stakeholders and the public as a whole in Malaysia.

Goals:

NHSI aims to provide 1.5 million people above the age of 40 who never had health screenings with free health screenings, including faecal occult blood stool testing (FOCB) for colorectal cancer and breast cancer screening at public and private clinics.

Project Version
National Health Screening Initiative (NHSI) 1.0.0

FHIR Artifact

Resources

The Main FHIR resources involved in this project are:

  1. Patient
  2. Questionnaire
  3. QuestionnaireResponse

Profiles

These MY Core profiles are then used to further constrained the resources to include additional required information;

  1. Patient (MY Core)
  2. QuestionnaireResponse (MY Core)

A system must declare comformance to these profile when sending a related data to HIE.

Reason

  1. Patient resource is required as it functions as a reference to whom this QuestionnaireResponse is subjected towards which is the patient/person assessed during the health assessment.
    • Patient (MY Core) profile further constrains the resource to include local information not defined in the base resource such as specific identifier (MyKad No), ethnic and religion.

  1. Questionnaire resource is capable to group and organize multiple different variables into a structured list of question using LinkId. A method which is suitable for the scope of this project. Using this resource, the health assessment questionniare response can be reference via the linkId created in the questionnaire for ease of data exchange between system.
    • No local profiling was created fro Questionnaire resource.

  1. QuestionnaireResponse resource is employed as the main FHIR resource for data entry and exchange. Data can be collected and stored in answer format that can be mapped correctly by referencing the link Id defined in questionnaire.
    • QuestionnaireResponse (MY Core) adds an extension to reference an organization and it also mandatories that any QuestionnaireResponse data must always reference a Patient resource due to reason no 1.

Resource Metadata

Each resource contains an element "meta", of type "Meta", which is a set of metadata that provides technical and workflow context to the resource. MY Core mandatories that the source and profile of the data be declared when data is sent to HIE. Further info

Metadata Item Type Usage
source (1..1) uri A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. Defined sources for this project are https://peka40.moh.gov.my, https://mysj.moh.gov.my, https://www.perkeso.gov.my
profile (1..1) canonical An assertion that the content conforms to a resource profile (a StructureDefinition). Refer this project FHIR Artifact profiles on which profiles are required to be declared when sending data to HIE for this project

API

API related to this project.

  • Refer 'Template And Sample Data' section for JSON sample.
  1. Patient
Operation API Uses
UPDATE [base]/Patient?identifier=[facility mrn identifier] API to create a Patient (MY Core) record in HIE. A unique Medical record number (MRN) identifier is required from each respective facility for unique reference. The MRN identifier value is defined in Patient.identifier.value where Patient.identifier.system value is http://fhir.hie.moh.gov.my/sid/patient-mrn
READ [base]/Patient?identifier=[facility mrn identifier] API to read existing Patient (MY Core) record in HIE by searching for its assigned unique mrn identifier
UPDATE [base]/Patient?identifier=[facility mrn identifier] API to update existing Patient (MY Core) record in HIE by its assigned unique mrn identifier

  1. QuestionnaireResponse
Operation API Uses
CREATE [base]/QuestionnaireResponse API to create QuestionnaireResponse (MY Core) in HIE. A unique identifier value should be provided in QuestionnaireResponse.identifier.value if business identifier is required for reference
READ [base]/QuestionnaireResponse?identifier=[facility business identifier] API to read existing QuestionnaireResponse (MY Core) record by searching for its assigned identifier
READ [base]/QuestionnaireResponse?patient.identifier=[facility mrn identifier]&_include=QuestionnaireResponse:patient API to request a bundle to read existing QuestionnaireResponse (MY Core) and include the patient record based on assigned patient facility MRN identifier
  1. Organization
Operation API Uses
READ [base]/Organization?_id=[organization ID] API to read existing Organization (MY Core) record in HIE by searching for its assigned organization ID based on PIK codes

Questionnaire

1 User Demographic

Link Id Item Text Item Type Remark Multiple Input
1 User Demographic Group No input no
1.1 Name String - no
1.2 MySejahtera ID String - no
1.3 Contact Number Phone Must be valid phone number e.g. +601156504217 no
1.4 Type of Identification Choice no
1.5 IC Number/Passport String - no
1.6 Gender Choice no
1.7 Nationality String - no
1.8 Address String - no
1.9 Occupation Choice no
1.10 Ethnicity Choice no
1.11 Special Category of Population Choice no
1.12 Industry Choice no
1.13 Comorbidities Present Choice no
1.14 Last Screening Date Group No input no
1.14.1 Has the patient performed health screening before? Boolean (Yes/No) - No
1.14.2 If Yes: Date FHIR Format YYYY-MM-DD e.g. 2022-07-31 no

2 Assessments

Link Id Item Text Item Type Remark Multiple Input
2 Assessments Group No input no
2.1 Does the patient have any family history? Boolean (Yes/No) - no
2.1.1 If yes: Choice yes
2.2 Does the patient have any medical history? Boolean (Yes/No) - no
2.2.1 If yes: Choice yes

3 Mental Health Assessments

Link Id Item Text Item Type Remark Multiple Input
3.1 Do you want to perform Mental Health Assessment for this patient? Boolean (Yes/No) N/A N/A
3.2 Please rate accordingly for the following situations: Over the past one month, have you been bothered by the following problems? Group No input N/A
3.2.1 "Feeling down, depressed or hopeless? " Boolean (Yes/No) N/A FALSE
3.2.2 Having little interest or pleasure in doing things? Boolean (Yes/No) N/A FALSE
3.3 "Over the last 2 weeks, how often have you been bothered by any of the following problems?" Group No input N/A
3.3.1 Feeling nervous, anxious, or on edge. Choice FALSE
3.3.2 Not being able to stop or control worrying. Choice FALSE
3.4 Over the last 2 weeks, how often have you been bothered by any of the following problems? Group No input N/A
3.4.1 Little interest or pleasure in doing things. Choice FALSE
3.4.2 Feeling down, depressed or hopeless. Choice FALSE
3.4.3 Trouble falling asleep/ staying asleep, sleeping too much. Choice FALSE
3.4.4 Feeling tired or having little energy. Choice FALSE
3.4.5 Poor appetite or overeating. Choice FALSE
3.4.6 Feeling bad about yourself – or that you are a failure or have let yourself or your family down. Choice FALSE
3.4.7 Trouble concentrating on things, such as reading the newspaper or watching television. Choice FALSE
3.4.8 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. Choice FALSE
3.4.9 Thoughts that you would be better off dead or of hurting yourself in some way. Choice FALSE
3.5 Total Mental Health Test Score Depression: Choice FALSE
3.6 Over the last 2 weeks, how often have you been bothered by any of the following? Group No input N/A
3.6.1 Feeling nervous, anxious, or on edge. Choice FALSE
3.6.2 Not being able to stop or control worrying. Choice FALSE
3.6.3 Worrying too much about different things. Choice FALSE
3.6.4 Having trouble relaxing Choice FALSE
3.6.5 Being so restless that it is hard to sit still. Choice FALSE
3.6.6 Being easily annoyed or irritable. Choice FALSE
3.6.7 Feeling afraid as if something awful might happen. Choice FALSE
3.7 Total Mental Health Test Score Anxiety: Choice FALSE

4 Lifestyle Health Assessment

Link Id Item Text Item Type Remark Multiple Input
4 Lifestyle Health Assessment Group No input no
4.1 Alcohol consumption Group No input no
4.1.1 How often do you consume alcohol? Choice no
4.1.2 How many alcoholic beverages do you consume in a day? Choice no
4.1.3 How often within the last year, Group No input no
4.1.3.1 Do you consume 6 or more drink in a day? Choice no
4.1.3.2 Were you not able to stop drinking once started? Choice no
4.1.3.3 Were you not able to perform normal activities due to drinking? Choice no
4.1.3.4 You needed to drink first thing in the morning to get going after a heavy drinking session? Choice no
4.1.3.5 That you felt guilt or remorse after drinking? Choice no
4.1.3.6 Were you unable to remember what happened the night before due to drinking? Choice no
4.1.4 Have you or someone else been injured because of your drinking? Choice no
4.1.5 Has a relative, friend, doctor, been concerned about your drinking habits? Choice no
4.1.6 Total Alcohol Consumption Test Score Choice no
4.2 Smoking Status Group No input no
4.2.1 Does the patient smoke? Boolean (Yes/No) - no
4.2.2 Cigarettes per Day Integer Decimal number not allowed no
4.2.3 Years of Smoking Integer Decimal number not allowed no
4.2.4 Total pack-years Quantity Decimal number allowed no

5 Clinical Parameters

Link Id Item Text Item Type Remark Multiple Input
5 Clinical Parameters Group No input no
5.1 Anthropometry: Height Quantity Decimal number allowed no
5.2 Anthropometry: Weight Quantity Decimal number allowed no
5.3 Anthropometry: Waistline Quantity Decimal number allowed no
5.4 BMI calculation Quantity Decimal number allowed no
5.5 BMI Outcome Choice no
5.6 Vital Signs: Blood Pressure (systolic) Quantity Decimal number allowed no
5.7 Vital Signs: Blood Pressure (diastolic) Quantity Decimal number allowed no
5.8 Vital Signs: Pulse Rate Quantity Decimal number allowed no
5.9 Blood Pressure Outcome Choice no
5.10 Point of Care Testing: Blood Glucose Group No input no
5.10.1 Fasting Quantity Decimal number allowed no
5.10.2 Random Quantity Decimal number allowed no
5.10.3 Blood Glucose Outcome Choice no
5.11 Point of Care Testing: Blood Cholesterol Group No input no
5.11.1 Fasting Quantity Decimal number allowed no
5.11.2 Random Quantity Decimal number allowed no
5.11.3 Blood Cholesterol Outcome Choice no

6 Advanced Health Screening (Optional)

Link Id Item Text Item Type Remark Multiple Input
6 Advanced Health Screening (Optional) Group No input no
6.1 Cardiovascular Choice yes
6.2 Gastrointestinal Choice yes
6.3 Genitourinary Choice yes
6.4 Locomotor Choice yes
6.5 Neurological Choice yes
6.6 ENT Symptoms Choice yes
6.7 Dermatology Choice yes

7 Advanced Systemic Examination (Optional)

Link Id Item Text Item Type Remark Multiple Input
Link Id Variables Item Type Remark Multiple Input
7.1 General Appearance Choice FALSE
7.1.1 If Abnormal Choice TRUE
7.2 Hands and Arms Choice FALSE
7.2.1 If Abnormal Choice TRUE
7.3 Head Choice FALSE
7.3.1 If Abnormal Choice TRUE
7.4 Neck Choice FALSE
7.4.1 If Abnormal Choice TRUE
7.5 Face Choice FALSE
7.5.1 If Abnormal Choice TRUE
7.6 Mouth Choice FALSE
7.6.1 If Abnormal, Lips Choice TRUE
7.6.2 If Abnormal, Gums Choice TRUE
7.6.3 If Abnormal, Tongue Choice TRUE
7.7 Ears, Nose and Throat Choice FALSE
7.7.1 If Abnormal Ears Choice TRUE
7.7.2 If Abnormal Nose Choice TRUE
7.7.3 If Abnormal Throat Choice TRUE
7.8 Eyes Choice FALSE
7.8.1 If Abnormal, general Choice TRUE
7.8.2 If Abnormal, conjunctiva Choice TRUE
7.8.3 If Abnormal, sclera Choice TRUE
7.8.4 If Abnormal, cornea Choice TRUE
7.9 Fundoscopy Choice FALSE
7.9.1 If Abnormal, General Choice TRUE
7.9.2 If Abnormal, Optic Disc Choice TRUE
7.9.3 If Abnormal, Retina Choice TRUE
7.9.4 If Abnormal, Macula Choice TRUE
7.10 Ishihara chart Choice FALSE
7.11 Snellen Eye Chart Score Group No input FALSE
7.11.1 Snellen Eye Chart Right eye With lens Choice FALSE
7.11.2 "Snellen Eye Chart Right eye Without lens" Choice FALSE
7.11.3 Snellen Eye Chart Left eye With lens Choice FALSE
7.11.4 "Snellen Eye Chart Left eye Without lens" Choice FALSE
7.12 Cardiorespiratory Examination Choice FALSE
7.12.1 Cardiorespiratory Examination, inspection Choice TRUE
7.12.2 Cardiorespiratory Examination, palpation Choice TRUE
7.12.3 Cardiorespiratory Examination, percussion Choice TRUE
7.12.4 Cardiorespiratory Examination, auscultation Choice TRUE
7.13 Abdominal Examination Choice FALSE
7.13.1 Abdominal Examination, inspection Choice TRUE
7.13.2 Abdominal Examination, palpation Choice TRUE
7.13.3 Abdominal Examination, percussion Choice TRUE
7.13.4 Abdominal Examination, auscultation Choice TRUE
7.13.4.1 Bowel Sound Choice FALSE
7.13.5 Abdominal Examination, other String No input TRUE
7.14 Breast Examination Choice FALSE
7.14.1 Breast Examination, inspection Choice TRUE
7.14.2 Breast Examination, palpation Group No input FALSE
7.14.2.1 lump Boolean (Yes/No) Nil FALSE
7.14.2.1.1 to state position, size, shape, consistency, overlying skin changes and mobility String No input TRUE
7.14.2.2 Breast Examination, tenderness Boolean (Yes/No) Nil FALSE
7.14.3 Breast Examination, lymph node Boolean (Yes/No) Nil FALSE
7.14.3.1 If yes, state location String No input FALSE
7.14 Breast Examination, other String No input TRUE
7.15 Genital Examination Choice FALSE
7.15.1 If abnormal, Choice TRUE
7.16 Musculoskeletal Examination Choice FALSE
7.16.1 If abnormal, Choice TRUE
7.17 Neurological Examination Choice FALSE
7.17.1 Neurological Examination, motor Choice TRUE
7.17.2 Neurological Examination, muscle tone Choice TRUE
7.17.3 Neurological Examination, muscle power Choice TRUE
7.17.4 Neurological Examination, reflexes Choice TRUE
7.17.5 Neurological Examination, hyperreflex/hyporeflex Choice TRUE
7.17.6 Neurological Examination, babinski Choice TRUE
7.17.7 Neurological Examination, sensation Choice TRUE
7.17.8 Neurological Examination, other String No input TRUE

8 Further Investigations

Link Id Item Text Item Type Remark Multiple Input
8 Further Investigations Group No input no
8.1 Urine dipstick String - no
8.2 Urine FEME String - no
8.3 ECG String - no
8.4 Haemoglobin String - no

9 Diagnosis

Link Id Item Text Item Type Remark Multiple Input
9 Diagnosis Group No input no
9.1 Normal Healthy individual? Choice no
9.2 Diagnosis Group No input no
9.2.1 Display String - no
9.2.2 Code String - no
9.2.3 Code System String - no
9.3 Provisional diagnosis Group No input yes
9.3.1 Display String - yes
9.3.2 Code String - yes
9.3.3 Code System String - yes

10 Management

Link Id Item Text Item Type Remark Multiple Input
10 Management Group No input no
10.1 General management Choice yes
10.2 Doctor’s notes Multiline text Allows markdown input no
10.3 Prescription Group No input no
10.3.1 Any medication prescribed? Choice yes

11 Verified by

Link Id Item Text Item Type Remark Multiple Input
11 Verified by Group No input no
11.1 Officer incharge String - no
11.2 Registration Number/ IC number String - no

Item List

Template And Sample Data

{
    "resourceType": "Questionnaire",
    "id": "mynhs-my-core",
    "meta": {
        "versionId": "1",
        "lastUpdated": "2022-08-03T03:26:09.844+00:00",
        "profile":  [
            "http://hl7.org/fhir/StructureDefinition/Questionnaire"
        ],
        "tag":  [
            {
                "code": "lformsVersion: 29.2.1"
            }
        ]
    },
    "url": "http://fhir.hie.moh.gov.my/Questionnaire/mynhs-my-core",
    "version": "1.0.0",
    "name": "MYNHS",
    "title": "Malaysia National Health Screening",
    "status": "active",
    "experimental": true,
    "date": "2022-11-27T03:59:23.7032719+00:00",
    "item":  [
        {
            "linkId": "1",
            "code":  [
                {
                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                    "code": "01",
                    "display": "User Demographic"
                }
            ],
            "text": "User Demographic",
            "type": "group",
            "required": false,
            "item":  [
                {
                    "linkId": "1.1",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.1",
                            "display": "Name"
                        }
                    ],
                    "text": "Name",
                    "type": "string",
                    "required": false
                },
                {
                    "linkId": "1.2",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.2",
                            "display": "MySejahtera ID"
                        }
                    ],
                    "text": "MySejahtera ID",
                    "type": "string",
                    "required": false
                },
                {
                    "linkId": "1.3",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.3",
                            "display": "Contact Number"
                        }
                    ],
                    "text": "Contact Number",
                    "type": "string",
                    "required": false,
                    "item":  [
                        {
                            "extension":  [
                                {
                                    "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                                    "valueCodeableConcept": {
                                        "coding":  [
                                            {
                                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                                "code": "help",
                                                "display": "Help-Button"
                                            }
                                        ],
                                        "text": "Help-Button"
                                    }
                                }
                            ],
                            "linkId": "1.3_helpText",
                            "text": "Must be valid phone number with +60 at start",
                            "type": "display"
                        }
                    ]
                },
                {
                    "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"
                            }
                        }
                    ],
                    "linkId": "1.4",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.4",
                            "display": "Type of Identification"
                        }
                    ],
                    "text": "Type of Identification",
                    "type": "choice",
                    "required": false,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Ic Numbers"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Passport Number"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Others"
                            }
                        }
                    ]
                },
                {
                    "linkId": "1.5",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.5",
                            "display": "IC Number/Passport"
                        }
                    ],
                    "text": "IC Number/Passport",
                    "type": "string",
                    "required": false
                },
                {
                    "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"
                            }
                        }
                    ],
                    "linkId": "1.6",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.6",
                            "display": "Gender"
                        }
                    ],
                    "text": "Gender",
                    "type": "choice",
                    "required": false,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://hl7.org/fhir/administrative-gender",
                                "code": "male",
                                "display": "Male"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://hl7.org/fhir/administrative-gender",
                                "code": "female",
                                "display": "Female"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://hl7.org/fhir/administrative-gender",
                                "code": "other",
                                "display": "Others"
                            }
                        }
                    ]
                },
                {
                    "linkId": "1.7",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.7",
                            "display": "Nationality"
                        }
                    ],
                    "text": "Nationality",
                    "type": "string",
                    "required": false
                },
                {
                    "linkId": "1.8",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.8",
                            "display": "Address"
                        }
                    ],
                    "text": "Address",
                    "type": "string",
                    "required": false
                },
                {
                    "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"
                            }
                        }
                    ],
                    "linkId": "1.9",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.9",
                            "display": "Occupation"
                        }
                    ],
                    "text": "Occupation",
                    "type": "choice",
                    "required": false,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Manager"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Professional"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Technician and Associate Professional"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "04",
                                "display": "Clerical Support Worker"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "05",
                                "display": "Services and Sales Worker"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "06",
                                "display": "Skilled Agricultural, Forestry, Livestock and Fishery Worker"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "07",
                                "display": "Craft and related Trades Worker"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "08",
                                "display": "Plant and Machine Operators and Assembler"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "09",
                                "display": "Elementary Worker"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "10",
                                "display": "Armed Forces Occupation"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "11",
                                "display": "Unemployed"
                            }
                        }
                    ]
                },
                {
                    "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"
                            }
                        }
                    ],
                    "linkId": "1.10",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "1.10",
                            "display": "Ethnicity"
                        }
                    ],
                    "text": "Ethnicity",
                    "type": "choice",
                    "required": false,
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            "text": "Mental Health Assessments",
            "type": "group",
            "required": false,
            "item":  [
                {
                    "linkId": "3.1",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "3.1",
                            "display": "In the past 2 weeks, how often does this patient:"
                        }
                    ],
                    "text": "In the past 2 weeks, how often does this patient:",
                    "type": "group",
                    "required": false,
                    "item":  [
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.1",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.1",
                                    "display": "Felt Down, depressed or hopeless"
                                }
                            ],
                            "text": "Felt Down, depressed or hopeless",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.2",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.2",
                                    "display": "Little interest to do things"
                                }
                            ],
                            "text": "Little interest to do things",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.3",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.3",
                                    "display": "Trouble falling asleep/staying asleep or sleeping too much"
                                }
                            ],
                            "text": "Trouble falling asleep/staying asleep or sleeping too much",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.4",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.4",
                                    "display": "Felt tired or having little energy"
                                }
                            ],
                            "text": "Felt tired or having little energy",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 0
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 1
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 2
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 3
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.5",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.5",
                                    "display": "Had poor appetite or over eating"
                                }
                            ],
                            "text": "Had poor appetite or over eating",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 0
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 1
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 2
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 3
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.6",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.6",
                                    "display": "Felt bad about himself/herself, felt like a failure or he/she has let his/her family down"
                                }
                            ],
                            "text": "Felt bad about himself/herself, felt like a failure or he/she has let his/her family down",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 0
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 1
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 2
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 3
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.7",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.7",
                                    "display": "Trouble concentrating (e.g. watching television or reading newspaper)"
                                }
                            ],
                            "text": "Trouble concentrating (e.g. watching television or reading newspaper)",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 0
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 1
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 2
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 3
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.8",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.8",
                                    "display": "Moved slowly or fidgeted excessively that is noticeable by people around him/her"
                                }
                            ],
                            "text": "Moved slowly or fidgeted excessively that is noticeable by people around him/her",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 0
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 1
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 2
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 3
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.9",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.9",
                                    "display": "Had thoughts that he/she would be better dead, or hurting yourself"
                                }
                            ],
                            "text": "Had thoughts that he/she would be better dead, or hurting yourself",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 0
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not At All"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 1
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Several Days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 2
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "> 7 days"
                                    }
                                },
                                {
                                    "extension":  [
                                        {
                                            "url": "http://hl7.org/fhir/StructureDefinition/ordinalValue",
                                            "valueDecimal": 3
                                        }
                                    ],
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Almost everyday"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.1.10",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.1.10",
                                    "display": "Total Mental Health Test Score"
                                }
                            ],
                            "text": "Total Mental Health Test Score",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "0-4 : None-minimal depression"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "5-9 : Mild Depression"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "10-14 : Moderate Depression"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "15-19 :Moderate severe depression"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "04",
                                        "display": "20-27 : Severe Depression"
                                    }
                                }
                            ]
                        }
                    ]
                },
                {
                    "linkId": "3.2",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "3.2",
                            "display": "In the last 2 weeks, indicate how difficult these problems made it for this patient"
                        },
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "3,2",
                            "display": "In the last 2 weeks, indicate how difficult these problems made it for this patient"
                        }
                    ],
                    "text": "In the last 2 weeks, indicate how difficult these problems made it for this patient",
                    "type": "group",
                    "required": false,
                    "item":  [
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "3.2.1",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "3.2.1",
                                    "display": "Do your work, take care of things at home, or get along with others"
                                }
                            ],
                            "text": "Do your work, take care of things at home, or get along with others",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Not Difficult"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Somewhat difficult"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "Very difficult"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Extreme difficult"
                                    }
                                }
                            ]
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "4",
            "code":  [
                {
                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                    "code": "04",
                    "display": "Lifestyle Health Assessment"
                }
            ],
            "text": "Lifestyle Health Assessment",
            "type": "group",
            "required": false,
            "item":  [
                {
                    "linkId": "4.1",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "4.1",
                            "display": "Alcohol consumption"
                        }
                    ],
                    "text": "Alcohol consumption",
                    "type": "group",
                    "required": false,
                    "item":  [
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "4.1.1",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.1.1",
                                    "display": "How often do you consume alcohol?"
                                }
                            ],
                            "text": "How often do you consume alcohol?",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Never"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Once a month"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "2-4 times a month"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "2-3 times week"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "04",
                                        "display": "> 4 times a weeks"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "4.1.2",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.1.2",
                                    "display": "How many alcoholic beverages do you consume in a day?"
                                }
                            ],
                            "text": "How many alcoholic beverages do you consume in a day?",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "<2"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "3-4"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "5-6"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "7-9"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "04",
                                        "display": ">10"
                                    }
                                }
                            ]
                        },
                        {
                            "linkId": "4.1.3",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.1.3",
                                    "display": "How often within the last year,"
                                }
                            ],
                            "text": "How often within the last year,",
                            "type": "group",
                            "required": false,
                            "item":  [
                                {
                                    "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"
                                            }
                                        }
                                    ],
                                    "linkId": "4.1.3.1",
                                    "code":  [
                                        {
                                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                            "code": "4.1.3.1",
                                            "display": "Do you consume 6 or more drink in a day?"
                                        }
                                    ],
                                    "text": "Do you consume 6 or more drink in a day?",
                                    "type": "choice",
                                    "required": false,
                                    "answerOption":  [
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "00",
                                                "display": "Never"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "01",
                                                "display": "< Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "02",
                                                "display": "Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "03",
                                                "display": "Weekly"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "04",
                                                "display": "Almost daily"
                                            }
                                        }
                                    ]
                                },
                                {
                                    "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"
                                            }
                                        }
                                    ],
                                    "linkId": "4.1.3.2",
                                    "code":  [
                                        {
                                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                            "code": "4.1.3.2",
                                            "display": "Were you not able to stop drinking once started?"
                                        }
                                    ],
                                    "text": "Were you not able to stop drinking once started?",
                                    "type": "choice",
                                    "required": false,
                                    "answerOption":  [
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "00",
                                                "display": "Never"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "01",
                                                "display": "< Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "02",
                                                "display": "Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "03",
                                                "display": "Weekly"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "code": "04",
                                                "display": "Almost daily"
                                            }
                                        }
                                    ]
                                },
                                {
                                    "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"
                                            }
                                        }
                                    ],
                                    "linkId": "4.1.3.3",
                                    "code":  [
                                        {
                                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                            "code": "4.1.3.3",
                                            "display": "Were you not able to perform normal activities due to drinking?"
                                        }
                                    ],
                                    "text": "Were you not able to perform normal activities due to drinking?",
                                    "type": "choice",
                                    "required": false,
                                    "answerOption":  [
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "00",
                                                "display": "Never"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "01",
                                                "display": "< Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "02",
                                                "display": "Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "03",
                                                "display": "Weekly"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "code": "04",
                                                "display": "Almost daily"
                                            }
                                        }
                                    ]
                                },
                                {
                                    "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"
                                            }
                                        }
                                    ],
                                    "linkId": "4.1.3.4",
                                    "code":  [
                                        {
                                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                            "code": "4.1.3.4",
                                            "display": "You needed to drink first thing in the morning to get going after a heavy drinking session?"
                                        }
                                    ],
                                    "text": "You needed to drink first thing in the morning to get going after a heavy drinking session?",
                                    "type": "choice",
                                    "required": false,
                                    "answerOption":  [
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "00",
                                                "display": "Never"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "01",
                                                "display": "< Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "02",
                                                "display": "Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "03",
                                                "display": "Weekly"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "04",
                                                "display": "Almost daily"
                                            }
                                        }
                                    ]
                                },
                                {
                                    "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"
                                            }
                                        }
                                    ],
                                    "linkId": "4.1.3.5",
                                    "code":  [
                                        {
                                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                            "code": "4.1.3.5",
                                            "display": "That you felt guilt or remorse after drinking?"
                                        }
                                    ],
                                    "text": "That you felt guilt or remorse after drinking?",
                                    "type": "choice",
                                    "required": false,
                                    "answerOption":  [
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "00",
                                                "display": "Never"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "01",
                                                "display": "< Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "02",
                                                "display": "Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "03",
                                                "display": "Weekly"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "04",
                                                "display": "Almost daily"
                                            }
                                        }
                                    ]
                                },
                                {
                                    "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"
                                            }
                                        }
                                    ],
                                    "linkId": "4.1.3.6",
                                    "code":  [
                                        {
                                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                            "code": "4.1.3.6",
                                            "display": "Were you unable to remember what happened the night before due to drinking?"
                                        }
                                    ],
                                    "text": "Were you unable to remember what happened the night before due to drinking?",
                                    "type": "choice",
                                    "required": false,
                                    "answerOption":  [
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "00",
                                                "display": "Never"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "01",
                                                "display": "< Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "02",
                                                "display": "Once a month"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "03",
                                                "display": "Weekly"
                                            }
                                        },
                                        {
                                            "valueCoding": {
                                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                                "code": "04",
                                                "display": "Almost daily"
                                            }
                                        }
                                    ]
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "4.1.4",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.1.4",
                                    "display": "Have you or someone else been injured because of your drinking?"
                                }
                            ],
                            "text": "Have you or someone else been injured because of your drinking?",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "No"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Yes, but not last year"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "Yes, during last year"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "4.1.5",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.1.5",
                                    "display": "Has a relative, friend, doctor, been concerned about your drinking habits?"
                                }
                            ],
                            "text": "Has a relative, friend, doctor, been concerned about your drinking habits?",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "No"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Yes, but not last year"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "Yes, during last year"
                                    }
                                }
                            ]
                        },
                        {
                            "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"
                                    }
                                }
                            ],
                            "linkId": "4.1.6",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.1.6",
                                    "display": "Total Alcohol Consumption Test Score"
                                }
                            ],
                            "text": "Total Alcohol Consumption Test Score",
                            "type": "choice",
                            "required": false,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "1-7 Low Risk"
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                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "8-12 Moderate Risk"
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                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": ">13 High Risk"
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                                }
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                    ]
                },
                {
                    "linkId": "4.2",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                            "display": "Smoking Status"
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                    ],
                    "text": "Smoking Status",
                    "type": "group",
                    "required": false,
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                            "linkId": "4.2.1",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.2.1",
                                    "display": "Does the patient smoke?"
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                            ],
                            "text": "Does the patient smoke?",
                            "type": "boolean",
                            "required": false
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                        {
                            "linkId": "4.2.2",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.2.2",
                                    "display": "Cigarettes per Day"
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                            ],
                            "text": "Cigarettes per Day",
                            "type": "integer",
                            "required": false
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                        {
                            "linkId": "4.2.3",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.2.3",
                                    "display": "Years of Smoking"
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                            ],
                            "text": "Years of Smoking",
                            "type": "integer",
                            "required": false
                        },
                        {
                            "linkId": "4.2.4",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "4.2.4",
                                    "display": "Total pack-years"
                                }
                            ],
                            "text": "Total pack-years",
                            "type": "quantity",
                            "required": false
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                    ]
                }
            ]
        },
        {
            "linkId": "5",
            "code":  [
                {
                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                    "code": "05",
                    "display": "Clinical Parameters"
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            ],
            "text": "Clinical Parameters",
            "type": "group",
            "required": false,
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                {
                    "extension":  [
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                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
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                                "display": "cm"
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                    ],
                    "linkId": "5.1",
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                        {
                            "system": "http://loinc.org",
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                            "display": "Anthropometry: Height"
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                    ],
                    "text": "Anthropometry: Height",
                    "type": "quantity",
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                {
                    "extension":  [
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                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
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                        {
                            "system": "http://loinc.org",
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                            "display": "Anthropometry: Weight"
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                    ],
                    "text": "Anthropometry: Weight",
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                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
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                                "display": "cm"
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                        }
                    ],
                    "linkId": "5.3",
                    "code":  [
                        {
                            "system": "http://loinc.org",
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                            "display": "Anthropometry: Waistline"
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "5.3",
                            "display": "Anthropometry: Waistline"
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                    ],
                    "text": "Anthropometry: Waistline",
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                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
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                                "display": "kg/m2"
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                    ],
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                        {
                            "system": "http://loinc.org",
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "5.4",
                            "display": "BMI calculation"
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                    ],
                    "text": "BMI calculation",
                    "type": "quantity",
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                {
                    "extension":  [
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                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                                "text": "Drop down"
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                    "linkId": "5.5",
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                    "text": "BMI Outcome",
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                "display": "Obese (≥30)"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                            "display": "Vital Signs: Blood Pressure (systolic)"
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                    ],
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                {
                    "extension":  [
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                    "linkId": "5.7",
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "5.7",
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                    ],
                    "text": "Vital Signs: Blood Pressure (diastolic)",
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                {
                    "extension":  [
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                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                },
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                                    "valueCoding": {
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                                    "valueCoding": {
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                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                    "text": "Point of Care Testing: Blood Cholesterol",
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                    "required": false,
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                        {
                            "extension":  [
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                                    "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
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                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                        "text": "Drop down"
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                            "linkId": "5.11.3",
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                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                    "display": "Blood Cholesterol Outcome"
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                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "5.13",
                                    "display": "Blood Cholesterol Outcome"
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                            ],
                            "text": "Blood Cholesterol Outcome",
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                                    "valueCoding": {
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                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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        {
            "linkId": "6",
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                {
                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                    "display": "Advanced Health Screening (Optional)"
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            ],
            "text": "Advanced Health Screening (Optional)",
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                {
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                                        "system": "http://hl7.org/fhir/questionnaire-item-control",
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                                "text": "Drop down"
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                    "linkId": "6.1",
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                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                    "text": "Cardiovascular",
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                    "required": false,
                    "repeats": true,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                "display": "Chest Pain"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Ankle Swelling"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Shortness of breath"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "04",
                                "display": "Intermittent claudication"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "05",
                                "display": "Orthopnoea"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "06",
                                "display": "Cough with or without sputum"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "07",
                                "display": "Palpitation"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "08",
                                "display": "Nocturnal dyspnoea"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "09",
                                "display": "Haemoptysis"
                            }
                        }
                    ]
                },
                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                                        "system": "http://hl7.org/fhir/questionnaire-item-control",
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                                        "display": "Drop down"
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                                "text": "Drop down"
                            }
                        }
                    ],
                    "linkId": "6.2",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                            "display": "Gastrointestinal"
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                    ],
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                    "required": false,
                    "repeats": true,
                    "answerOption":  [
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                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                "display": "Abdominal pain"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Nausea and/or vomiting"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Bowel pattern and any changes"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "04",
                                "display": "Dyspepsia"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "05",
                                "display": "Degree of appetide"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "06",
                                "display": "Cough with or without sputum"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "07",
                                "display": "Dysphagia"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "08",
                                "display": "Weight loss or gain"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "09",
                                "display": "Haemoptyis"
                            }
                        }
                    ]
                },
                {
                    "extension":  [
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                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                            "valueCodeableConcept": {
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                                        "system": "http://hl7.org/fhir/questionnaire-item-control",
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                                        "display": "Drop down"
                                    }
                                ],
                                "text": "Drop down"
                            }
                        }
                    ],
                    "linkId": "6.3",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                            "display": "Genitourinary"
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                    ],
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                    "required": false,
                    "repeats": true,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Haematuria"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Dysuria"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Menstual irregularity - women"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "04",
                                "display": "Nocturia"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "05",
                                "display": "Frequency"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "06",
                                "display": "Urethral discharge - men"
                            }
                        }
                    ]
                },
                {
                    "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"
                            }
                        }
                    ],
                    "linkId": "6.4",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "6.4",
                            "display": "Locomotor"
                        }
                    ],
                    "text": "Locomotor",
                    "type": "choice",
                    "required": false,
                    "repeats": true,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Joint pain"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Change in mobility"
                            }
                        }
                    ]
                },
                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "system": "http://hl7.org/fhir/questionnaire-item-control",
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                                        "display": "Drop down"
                                    }
                                ],
                                "text": "Drop down"
                            }
                        }
                    ],
                    "linkId": "6.5",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                            "display": "Neurological"
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                    ],
                    "text": "Neurological",
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                    "required": false,
                    "repeats": true,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Seizures"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Eyesight"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Transient loss of function (vision, speech, sight)"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "04",
                                "display": "Collapses"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "05",
                                "display": "Hearing"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "06",
                                "display": "Paresthesia"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "07",
                                "display": "Dizziness"
                            }
                        }
                    ]
                },
                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                            "valueCodeableConcept": {
                                "coding":  [
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                                        "system": "http://hl7.org/fhir/questionnaire-item-control",
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                                        "display": "Drop down"
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                                ],
                                "text": "Drop down"
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                        }
                    ],
                    "linkId": "6.6",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "6.6",
                            "display": "ENT Symptoms"
                        }
                    ],
                    "text": "ENT Symptoms",
                    "type": "choice",
                    "required": false,
                    "repeats": true,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                                "display": "Hearing loss/tinnitus"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Epistaxis"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Snoring"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "04",
                                "display": "Otalgia"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "05",
                                "display": "Dysphonia"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "06",
                                "display": "Trismus"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "07",
                                "display": "Facial pain"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "08",
                                "display": "Dysphagia"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "09",
                                "display": "Neck swelling"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "10",
                                "display": "Persistent nasal discharge"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "11",
                                "display": "Odynophagia"
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                        }
                    ]
                },
                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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                                        "system": "http://hl7.org/fhir/questionnaire-item-control",
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                                        "display": "Drop down"
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                                ],
                                "text": "Drop down"
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                        }
                    ],
                    "linkId": "6.7",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "6.7",
                            "display": "Dermatology"
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                    ],
                    "text": "Dermatology",
                    "type": "choice",
                    "required": false,
                    "repeats": true,
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Rashes"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "02",
                                "display": "Skin color changes"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "03",
                                "display": "Ulcers"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "04",
                                "display": "Skin lesions"
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                        }
                    ]
                }
            ]
        },
        {
            "linkId": "7",
            "code":  [
                {
                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                    "code": "07",
                    "display": "Advanced Systemic Examination (Optional)"
                }
            ],
            "text": "Advanced Systemic Examination (Optional)",
            "type": "group",
            "required": false,
            "item":  [
                {
                    "linkId": "7430591698512",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                    ],
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                    "answerOption":  [
                        {
                            "valueCoding": {
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
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                        }
                    ],
                    "item":  [
                        {
                            "linkId": "9491690640065",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "7.1.1"
                                }
                            ],
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                            "type": "choice",
                            "repeats": true,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Dysmorphic features"
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                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "Cyanosed"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Jaundiced"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "04",
                                        "display": "Abnormal gait"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "05",
                                        "display": "Pale"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "06",
                                        "display": "Ill-looking"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "07",
                                        "display": "Dehydrated"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "08",
                                        "display": "Cachexic"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "09",
                                        "display": "Abnormal gait"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "10",
                                        "display": "Limbs deformity"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "11",
                                        "display": "Present of vision aid (eg: Spectacles)"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "12",
                                        "display": "Skin lesion"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "13",
                                        "display": "Others"
                                    }
                                }
                            ]
                        }
                    ]
                },
                {
                    "linkId": "9385492769029",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "7.2"
                        }
                    ],
                    "text": "Hands and Arms",
                    "type": "choice",
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "00",
                                "display": "Normal"
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                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Abnormal"
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                        }
                    ],
                    "item":  [
                        {
                            "linkId": "2706469979386",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "7.2.1"
                                }
                            ],
                            "text": "If Abnormal:",
                            "type": "choice",
                            "repeats": true,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Finger Clubbing"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "Koilonychia"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Leuchonychia"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "04",
                                        "display": "Palmar erythema"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "05",
                                        "display": "Dupuytren’s contracture"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "06",
                                        "display": "Cyanosis"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "07",
                                        "display": "Tremors"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "08",
                                        "display": "Bruising"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "09",
                                        "display": "Muscle Wasting"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "10",
                                        "display": "Bruising"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "11",
                                        "display": "Splinter Haemorrhage"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "12",
                                        "display": "Osler's Node"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "13",
                                        "display": "Janeway Lesion"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "14",
                                        "display": "Onycholysis"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "15",
                                        "display": "1skin Lesion"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "16",
                                        "display": "Joint Deformity"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "17",
                                        "display": "Bony Deformity"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "18",
                                        "display": "others"
                                    }
                                }
                            ]
                        }
                    ]
                },
                {
                    "linkId": "803255584502",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "73"
                        }
                    ],
                    "text": "Head",
                    "type": "choice",
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "00",
                                "display": "Normal"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Abnormal"
                            }
                        }
                    ],
                    "item":  [
                        {
                            "linkId": "2706057387357",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "7.3.1"
                                }
                            ],
                            "text": "If Abnormal:",
                            "type": "choice",
                            "repeats": true,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Frontal Bossing"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Microcephaly"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "Macrocephaly"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Psoriatic plaque"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "04",
                                        "display": "Alopecia"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "05",
                                        "display": "Scaly Patches"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "06",
                                        "display": "Bleeding"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "07",
                                        "display": "Discharges"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "08",
                                        "display": "Fleas"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "09",
                                        "display": "Others"
                                    }
                                }
                            ]
                        }
                    ]
                },
                {
                    "linkId": "5438686906842",
                    "code":  [
                        {
                            "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                            "code": "7.4"
                        }
                    ],
                    "text": "Neck",
                    "type": "choice",
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "00",
                                "display": "Normal"
                            }
                        },
                        {
                            "valueCoding": {
                                "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                "code": "01",
                                "display": "Abnormal"
                            }
                        }
                    ],
                    "item":  [
                        {
                            "linkId": "8525967233111",
                            "code":  [
                                {
                                    "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                    "code": "7.4.1"
                                }
                            ],
                            "text": "If Abnormal:",
                            "type": "choice",
                            "repeats": true,
                            "answerOption":  [
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "00",
                                        "display": "Lymphadenopathy"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "01",
                                        "display": "Neck Lump"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "02",
                                        "display": "Trachea Deviation"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "03",
                                        "display": "Skin Lesion"
                                    }
                                },
                                {
                                    "valueCoding": {
                                        "system": "http://fhir.hie.moh.gov.my/CodeSystem/nhsi-my-core",
                                        "code": "04",
                                        "display": "Others"
                                    }
                                }
                            ]
                        }
                    ]
                },
                {
                    "