NHSBSA Claim SuppportingInfo

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Questionnaire

{
"resourceType": "Questionnaire",
"id": "0906e705-4a97-4701-b78c-00d68064ea79",
"version": "0.0.2",
"Patient"
],
"status": "draft",
"url": "https://fhir.virtually.healthcare/Questionnaire/NHSBSA-Claim",
"title": "NHSABSA-Claim",
"item": [
{
"linkId": "REFERRAL_REFERENCE",
"required": true,
"type": "string",
"text": "The NHS 111 call centre or online reference for the referral. Size max. 255. Mandatory for types EMG_MED, MIN_ILL, EMG_MED_UEC and MIN_ILL_UEC. Should not be supplied for type FLU_VAC, COVID_VAC. For GP Referrals should be supplied as 'GP-' {Unique_identifier}. Recommended format: 'GP-' + {Caller_Identifier} + '-' + {generated_identifier}, e.g. GPNHSBSA-123456XYZ"
},
{
"linkId": "MEDICATION_SUPPLY_TYPE",
"required": false,
"type": "choice",
"text": "Over the counter/Minor Ailments Service/Patient Group Direction"
},
{
"linkId": "REFERRER_ORG_TYPE",
"required": false,
"type": "choice",
"text": "Type of referring organisation"
},
{
"linkId": "REFERRER_CASE_REF",
"required": false,
"type": "string",
"text": "The case reference number from the referring organisation. Optional if Referral Case ID (REFERRAL_REFERENCE) is present"
},
{
"linkId": "DISPOSITION_CODE",
"required": false,
"type": "choice",
"text": "Dx code from the 111 system resulting from the NHS Pathways"
},
{
"linkId": "CONSULTATION_METHOD",
"required": false,
"type": "choice",
"text": "Type of consultation conducted"
},
{
"linkId": "CONSULTATION_OUTCOME",
"required": false,
"type": "choice",
"text": "The outcome of the consultation conducted"
},
{
"linkId": "OTHER_CONSULTATION_OUTCOME",
"required": false,
"type": "string",
"text": "Free text value for other outcome of the consultation conducted and mandatory only if value of CONSULTATION_OUTCOME is selected as OTHER(Other)."
},
{
"linkId": "SIGNPOSTED_TO",
"required": false,
"type": "choice",
"text": "Details of Where patient has been signposted to"
},
{
"linkId": "OTHER_SIGNPOSTED_TO",
"required": false,
"type": "string",
"text": "Free text value for other signposted to and mandatory only if value of SIGNPOSTED_TO is selected as option OTHER"
},
{
"linkId": "ESCALATED_TO",
"required": false,
"type": "choice",
"text": "Where patient has been referred to (escalated)"
},
{
"linkId": "INCIDENT",
"required": false,
"type": "boolean",
"text": "Confirmation of whether the pharmacist would like to report an incident or send a message to CPCS commissioners."
},
{
"linkId": "PRESENTING_COMPLAINT_OR_ISSUES",
"required": false,
"type": "string",
"text": "The health problem or issue experienced by the patient. Freetext values with max size 250 chars."
},
{
"linkId": "ONWARD_REFERRAL_REASON",
"required": false,
"type": "string",
"text": "Reason (free text value) for onward referral. Max size 250."
}
]
}

Patient Registration

Example patient registration form, based on gov.uk GMS1

{
"resourceType": "Questionnaire",
"id": "0300f7e6-3a1c-4931-b7b7-e5099a883248",
"title": "Patient Registration",
"url": "https://example.nhs.uk/Questionnaire/Patient-Registration",
"Patient"
],
"name": "PatientRegistration",
"status": "draft",
"item": [
{
"text": "Title",
"type": "string",
"linkId": "prefix",
"required": true
},
{
"text": "First Name",
"linkId": "forename",
"type": "string",
"required": true
},
{
"text": "Middle Name(s)",
"linkId": "middlenames",
"type": "string",
"required": false
},
{
"text": "Last name",
"linkId": "surname",
"type": "string",
"required": true
},
{
"text": "Previous last name",
"linkId": "previous_surname",
"type": "string"
},
{
"text": "Date of Birth",
"linkId": "date_of_birth",
"type": "date",
"required": true
},
{
"text": "NHS Number (if known)",
"linkId": "nhs_number",
"type": "string",
"maxLength": 10
},
{
"text": "Your postcode used when you last registered with a UK GP",
"linkId": "previous_postcode",
"type": "string"
},
{
"text": "Your current address",
"linkId": "current_address",
"type": "string"
},
{
"text": "Contact Preference",
"linkId": "contact_group",
"type": "group",
"repeats": true,
"item": [
{
"text": "Contact Type",
"linkId": "contact_type",
"type": "choice",
"required": false,
"answerValueSet": "http://hl7.org/fhir/ValueSet/contact-point-system"
},
{
"text": "Contact Number or email",
"linkId": "contact_value",
"type": "string"
}
]
},
{
"text": "Gender assigned at Birth",
"linkId": "gender_birth",
"type": "choice",
{
"system": "http://hl7.org/fhir/administrative-gender",
"code": "female",
"display": "Female"
}
},
{
"system": "http://hl7.org/fhir/administrative-gender",
"code": "male",
"display": "Male"
}
},
{
"system": "http://hl7.org/fhir/administrative-gender",
"code": "other",
"display": "Non Binary"
}
},
{
"system": "http://hl7.org/fhir/administrative-gender",
"code": "unknown",
"display": "Prefer to self describe"
}
}
]
},
{
"text": "Ethnic Category",
"linkId": "ethnic",
"type": "choice",
"required": false,
"answerValueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-DeathNotificationStatus"
},
{
"text": "Have you ever been a member of the UK Armed Forces or are a family member registered with the Defence Medical Services?",
"linkId": "armed_forces",
"type": "boolean"
}
],
"description": "A form to be used in conjunction with patient registration workflows"
}