{ "resourceType": "Questionnaire", "id": "sf-3353", "meta": { "extension": [ { "url": "http://hapifhir.io/fhir/StructureDefinition/resource-meta-source", "valueUri": "#0oeSx9nhi3dXpcjM" } ], "versionId": "45", "lastUpdated": "2023-07-25T02:39:52.956+00:00", "tag": [ { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-editor-version", "code": "1.10.1" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-editor-version", "code": "1.16.0" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-editor-version", "code": "1.10.0" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-editor-version", "code": "1.8.0" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-runtime-version", "code": "11.21.0" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-runtime-version", "code": "11.25.4" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-runtime-version", "code": "11.14.2" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-editor-version", "code": "1.9.0" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/form-tags", "code": "QLD SIT and UAT release 18/07/23" }, { "system": "https://qhr-devops.health.qld.gov.au/fhir/CodeSystem/formbuilder-runtime-version", "code": "11.18.0" } ] }, "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-has-been-published", "valueBoolean": true }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-name", "valueString": "Gestational diabetes" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-value", "valueReference": { "identifier": { "value": "https://qhr-devops.health.qld.gov.au/fhir/LOINC-LFT" }, "display": "LFT" } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-value", "valueReference": { "identifier": { "value": "https://qhr-devops.health.qld.gov.au/fhir/lab_UPCR" }, "display": "Urine protein creatinine ratio" } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-value", "valueReference": { "identifier": { "value": "https://qhr-devops.health.qld.gov.au/fhir/gtt" }, "display": "OGTT" } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-value", "valueReference": { "identifier": { "value": "https://qhr-devops.health.qld.gov.au/fhir/LOINC-FastingGlucose-Glucose" }, "display": "Fasting blood glucose" } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-value", "valueReference": { "identifier": { "value": "https://qhr-devops.health.qld.gov.au/fhir/HbA1c" }, "display": "HbA1c" } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-value", "valueReference": { "identifier": { "value": "https://qhr-devops.health.qld.gov.au/fhir/LOINC-UEC-UandE" }, "display": "U&E" } } ], "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-data" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/form-data-source", "valueString": "previous-response" }, { "extension": [ { "extension": [ { "extension": [ { "url": "indexabledata.specialtycondition.specialty", "valueCoding": { "system": "https://qhr-devops.health.qld.gov.au/fhir/cs/GPSR_specialties", "code": "20.53", "display": "Obstetrics - Management of Complex Pregnancy" } }, { "url": "indexabledata.specialtycondition.condition", "valueCoding": { "system": "https://qhr-devops.health.qld.gov.au/fhir/cs/GPSR_conditions", "code": "CPC0412", "display": "Gestational Diabetes Mellitus (Antenatal) (Adult)" } } ], "url": "instance" } ], "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/indexable-data/questionnaire-specialty-condition" } ], "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/application-indexable-data" }, { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "variable-condition", "valueString": "{\"id\":\"c2c2b78b-2043-46e0-2a28-a047d83d5940\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\",\"conditions\":[{\"id\":\"f1c028e1-cf35-a047-9f79-16f29c2e3785\",\"type\":\"condition\",\"item\":{\"text\":\"Private or Clinical override\",\"value\":\"d0bd7ce7-4981-a213-97aa-bb5a86b342ac\",\"dataType\":\"boolean\",\"container\":{\"type\":\"none\",\"id\":null},\"operators\":\"boolean\",\"options\":[{\"display\":\"true\",\"value\":true},{\"display\":\"false\",\"value\":false}],\"showEligibleWhenOption\":false},\"coded\":false,\"operator\":\"=\",\"operand\":false}]}" }, { "url": "name", "valueString": "Essential" }, { "url": "expression", "valueString": "%context.descendants().select(where(linkId='d0bd7ce7-4981-a213-97aa-bb5a86b342ac')).answer.valueBoolean=false" } ], "url": "http://hl7.org/fhir/StructureDefinition/variable" } ], "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/variables" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-layout-type", "valueString": "standard" } ], "name": "QLD Antenatal - Gestational Diabetes Mellitus 3353", "title": "QLD Antenatal - Gestational Diabetes Mellitus 3353", "status": "active", "publisher": "qhRefer Template Manager", "useContext": [ { "code": { "code": "R1", "display": "Referral form" }, "valueCodeableConcept": { "coding": [ { "code": "R1", "display": "Referral form" } ] } } ], "jurisdiction": [ { "coding": [ { "code": "PHN306", "display": "Central Queensland and Sunshine Coast PHN" } ] } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "list" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"875ce591-3bab-fd21-da46-65efda151c13\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" } ], "linkId": "34e7e29c-f6d6-6a1e-d2c6-3ff332078e91", "type": "group", "enableWhen": [ { "id": "08659acf-dbb9-8679-7cb2-45e6f46ab60c", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "3976b0fa-3f13-8745-b9be-b32e8251e84c", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "button-bar" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"37e6cc80-1f2d-a8e9-a684-16356354e0f9\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"3ee6a54e-a0ff-143e-6a49-5eaa64a44685\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable-text", "valueString": "Clear selection" } ], "linkId": "5087b504-d9cb-56f6-7d51-4aa15fef0c65", "text": "Show emergency referral criteria", "type": "choice", "required": false, "option": [ { "valueString": "Show" }, { "valueString": "Hide" } ], "initialString": "Hide" }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "21b58439-8183-8680-c59f-b7abcc911f78", "type": "display", "enableWhen": [ { "id": "51ac323f-682e-3ac6-b63e-abacd1d4682e", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "5087b504-d9cb-56f6-7d51-4aa15fef0c65", "hasAnswer": false, "answerString": "Show" } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region**\n\n* Diabetic ketoacidosis\n* Diabetes and severe vomiting\n* Acute severe hyperglycaemia\n* Acute severe hypoglycaemia", "type": "display" } ] } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "list" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"36565275-e3b0-e184-856f-3a9040330d17\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" } ], "linkId": "c1cf9c5d-ac72-1ffe-8746-d14a25ed4cfb", "text": "Minimum Referral Criteria", "type": "group", "enableWhen": [ { "id": "ced21bdd-9f3e-4777-3833-709123bdc834", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "b34a1f8f-5364-799f-8009-b1f1981275c9", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "check-box" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/choice-list-orientation", "code": "vertical" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"4575f651-6dcb-8ac2-89ee-350f626d67e1\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"582ec602-2d96-b882-3727-b54889d9291e\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "http://hl7.org/fhir/layout-columns", "valueString": "3-columns" } ], "linkId": "70271412-10e2-8bef-f441-99241915f74d", "text": "Minimum referral criteria", "type": "choice", "required": true, "option": [ { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/option/none-of-the-above", "valueBoolean": false } ], "valueString": "Gestational diabetes (GDM), or diabetes first recognised during pregnancy" }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/option/none-of-the-above", "valueBoolean": true } ], "valueString": "Request clinical override of minimum referral criteria" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "text-area" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"d5c8da9e-a9b1-4fef-e836-86f4a97a126d\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"71aee3ba-edf8-b589-a1ae-4986d801c4ff\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/rows", "valueInteger": 4 }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/max-rows", "valueInteger": 16 } ], "linkId": "8826a3af-bcd2-040e-e68a-919e29276b64", "text": "Please describe reason(s) for clinical override request", "type": "text", "enableWhen": [ { "id": "73367e7d-6a9f-8159-debe-539acad1588d", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "70271412-10e2-8bef-f441-99241915f74d", "hasAnswer": false, "answerString": "Request clinical override of minimum referral criteria" } ], "required": true }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": false }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "9dbe4178-06cf-acff-09f8-def6b16bde96", "definition": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/specialty-form-question-definition#cpcUrgency30Days", "text": "CPC Clinical Urgency", "type": "display", "enableWhen": [ { "id": "4cf36b76-5e09-aa8d-89a9-f4a70703c53e", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "b9a11e57-9aed-5d2f-5b3e-854255bc344a", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/alternative-text", "valueMarkdown": "Category 1 (appointment within 30 calendar days)" } ], "text": "**For optimum care, the patient should be seen within 1 week at maternity service. Please review your 'priority' selection.**\n\n**Note: pregnancy in a patient with existing diabetes requires early referral to maternity services**", "type": "display" } ] } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "list" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"af8e44cf-abd3-b58b-4ed7-070613d2ed3b\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" } ], "linkId": "8fea745c-6a0d-3140-879d-b37dd0145f23", "text": "Referral Indication", "type": "group", "enableWhen": [ { "id": "ad6fe232-1f24-e383-30da-1712b33b19dc", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "7d15a5df-46da-53d5-482d-87c5e71b7683", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "check-box" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/choice-list-orientation", "code": "vertical" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"b22e22ea-6bf2-0237-5ef6-1729bf537c6b\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"1b7dec6a-fd38-44d9-278b-eb8b85c53a91\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "http://hl7.org/fhir/layout-columns", "valueString": "3-columns" } ], "linkId": "10a72e9a-e541-016d-0a80-c4fc3cb1e96e", "text": "Referral indication(s)", "type": "choice", "required": false, "option": [ { "valueString": "Gestational diabetes (GDM), or diabetes first recognised during pregnancy" }, { "valueString": "Antenatal care requiring review within 90 days" }, { "valueString": "Other" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "text-area" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"8812a21f-c0ee-9fcb-31fe-9573286ba816\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"a76500be-bc50-5dcb-bccd-902518d6334e\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/rows", "valueInteger": 4 }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/max-rows", "valueInteger": 16 } ], "linkId": "f1df68eb-22a8-d6e9-ca1f-329cd260467b", "text": "Please describe", "type": "text", "enableWhen": [ { "id": "68ec2473-bd95-7bdf-875c-30f293320e75", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "10a72e9a-e541-016d-0a80-c4fc3cb1e96e", "hasAnswer": false, "answerString": "Other" } ], "required": false }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "c635d7df-9c38-89bb-a4fc-9146f414d2fb", "type": "display", "enableWhen": [ { "id": "98ace7a3-801b-3b03-fe39-04ad99cb7fbf", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "10a72e9a-e541-016d-0a80-c4fc3cb1e96e", "hasAnswer": false, "answerString": "Gestational diabetes (GDM), or diabetes first recognised during pregnancy" } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**For optimum care, the patient should be seen within 1 week at maternity service**\n\n**Note: pregnancy in a patient with existing diabetes requires early referral to maternity services**", "type": "display" } ] } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "list" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"de878df6-106b-aea7-79d2-19f9417bab2e\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" } ], "linkId": "d22da621-a905-493c-6149-5750a9d8f667", "text": "History and Examination", "type": "group", "enableWhen": [ { "id": "a638e3fa-55d2-2c96-62ec-967c02a346b8", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "3976b0fa-3f13-8745-b9be-b32e8251e84c", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "80940ffb-7ac9-f26b-fb77-d4b91bf09341", "type": "display", "enableWhen": [ { "id": "f4d6f20b-a2d0-46a4-21b5-310e43857ae3", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "d0bd7ce7-4981-a213-97aa-bb5a86b342ac", "hasAnswer": false, "answerBoolean": false } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**Essential referral information:**\n\n**The most recent blood pressure and BMI recorded in the practice software (PMS) will automatically be included in the referral, please ensure that these are up to date**", "type": "display" } ] }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "f5e998fe-c21b-77f8-851b-fcdbfad1d4d7", "type": "display", "enableWhen": [ { "id": "4fbd7cfb-ca08-0233-7809-bc42bbf8423e", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "d0bd7ce7-4981-a213-97aa-bb5a86b342ac", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": 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"https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"53decdee-a936-45bd-1458-b3a0d50475af\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/data-overridable", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false } ], "linkId": "983d02b4-dbe8-62b9-19b2-765170c76247", "text": "Gravidity", "type": "quantity", "required": false, "_required": { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "expression", "valueString": "%Essential" } ], "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression" } ] } }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "number" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": false }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-selected-external-data-item", "valueString": "para" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"49aa2c6f-fc6f-5114-1845-7fb77709f5b0\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/data-overridable", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false } ], "linkId": "99b3d1c0-129c-ce65-a073-81ea0910f321", "text": "Parity", "type": "quantity", "enableWhen": [ { "id": "06ede5a9-8898-1b6e-1d6e-27353d6ef373", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": ">=" } ], "question": "983d02b4-dbe8-62b9-19b2-765170c76247", "hasAnswer": false, "answerDecimal": 1 } ], "required": false, "_required": { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "expression", "valueString": "%Essential" } ], "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression" } ] } }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "date-picker" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": false }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-selected-external-data-item", "valueString": "lnmp" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"4003b677-35d4-bf8d-1534-3b1e4aa4a046\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/data-overridable", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false } ], "linkId": "469f8b70-88c0-a091-27e2-6ae51d7fa3a9", "text": "Last normal menstrual period (LNMP)", "type": "date", "required": false, "_required": { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "expression", "valueString": "%Essential" } ], "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression" } ] } }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "date-picker" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": false }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-selected-external-data-item", "valueString": "edb" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"1be32fa2-3a9c-dcb7-1a5e-9c8dc8b7db6c\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/data-overridable", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false } ], "linkId": "c956e346-1a3e-d3e7-db22-4297c1de1a93", "text": "Estimated date of birth (EDB)", "type": "date", "required": false, "_required": { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "expression", "valueString": "%Essential" } ], "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression" } ] } }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "button-bar" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"a04886c7-b26d-9490-a1ba-2b3a01823c71\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable-text", "valueString": "Clear selection" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"6db670df-3b4e-e0c4-aa57-b38c4064e1ea\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false } ], "linkId": "f27f16b3-b1d1-36d5-3d81-45c68c3f2eef", "text": "Current pregnancy", "type": "choice", "required": false, "_required": { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "expression", "valueString": "%Essential" } ], "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression" } ] }, "option": [ { "valueString": "Single" }, { "valueString": "Multiple" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "text-area" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"93388e68-e91f-500f-8ef0-54869f4aa5d2\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"f66ad09e-0c64-8ae2-1781-09d3d12c1ad8\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/rows", "valueInteger": 4 }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/max-rows", "valueInteger": 16 } ], "linkId": "e39c5161-0e5f-86bf-089c-a5930fe5beef", "text": "Please give details", "type": "text", "enableWhen": [ { "id": "3fdf5b5f-04da-81b8-484c-240b3ed73a40", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "f27f16b3-b1d1-36d5-3d81-45c68c3f2eef", "hasAnswer": false, "answerString": "Multiple" } ], "required": false, "_required": { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "expression", "valueString": "%Essential" } ], "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression" } ] } }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "button-bar" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"a04886c7-b26d-9490-a1ba-2b3a01823c71\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable-text", "valueString": "Clear selection" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"0a02452d-e425-9dba-8dcb-8d6455590e85\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false } ], "linkId": "54fbacf5-1d59-2da8-daa2-df7b60338e87", "text": "Details of past obstetric history known", "type": "choice", "enableWhen": [ { "id": "1b2415d7-e53f-a587-d2f6-71fe965389a8", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": ">=" } ], "question": "983d02b4-dbe8-62b9-19b2-765170c76247", "hasAnswer": false, "answerDecimal": 1 } ], "required": false, "_required": { "extension": [ { "extension": [ { "url": "language", "valueString": "text/fhirpath" }, { "url": "expression", "valueString": "%Essential" } ], "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression" } ] }, "option": [ { "valueString": "Yes" }, { "valueString": "No" } ] }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "17ad0bc0-775c-5a50-075a-4361ed1fb7a3", "type": "display", "enableWhen": [ { "id": "2bf54d39-c964-a025-d950-2d34cd84df73", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "54fbacf5-1d59-2da8-daa2-df7b60338e87", "hasAnswer": false, "answerString": "Yes" } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**For each pregnancy, please provide details of outcome:**", "type": "display" } ] } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "repeating-list" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/minimum-repeats", "valueInteger": 1 } ], "linkId": "f8f0ad1e-520a-cc68-9280-cd2223712969", "text": "Pregnancy", "type": "group", "enableWhen": [ { "id": "e9918e20-cf34-dd9a-aaf2-d97509206d9b", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "54fbacf5-1d59-2da8-daa2-df7b60338e87", "hasAnswer": false, "answerString": "Yes" } ], "repeats": true, "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "radio-button" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/choice-list-orientation", "code": "vertical" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"009c1705-bca1-10f4-eee2-0a26ce0d4a6b\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable-text", "valueString": "Clear selection" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"43d0e94f-be07-1c71-82ae-d801aac14cd6\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false }, { "url": "http://hl7.org/fhir/layout-columns", "valueString": "3-columns" } ], "linkId": 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"extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**Essential referral information:** \n\nDiagnostic test result e.g.:\n\n* OGTT\n* Fasting blood sugar\n* HbA1c\n\n**Additional referral information:**\n* Any additional BGL data\n* LFT\n* U&E\n* Urine protein creatinine ratio\n* Any other relevant pathology (please manually attach)", "type": "display" } ] }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "5a0395e7-3f61-42c7-e314-ad259d254463", "type": "display", "enableWhen": [ { "id": "5d374b6b-23f3-5dd1-3fc7-0abbd0264b47", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "d0bd7ce7-4981-a213-97aa-bb5a86b342ac", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**Recommended referral information:** \n\nDiagnostic test result e.g.:\n\n* OGTT\n* Fasting blood sugar\n* HbA1c\n\n**Additional referral information:**\n* Any additional BGL data\n* LFT\n* U&E\n* Urine protein creatinine ratio\n* Any other relevant pathology (please manually attach)", "type": "display" } ] }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "889e6dc6-55b1-5f8a-d77f-e23d886294c9", "type": "display", "enableWhen": [ { "id": "568dad07-759b-9b14-d0cf-f14eb605a82c", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "a6476ddb-c5c4-775e-f129-e703c0ce25de", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**If any laboratory investigations are listed below, they have NOT been automatically selected by the software. Please manually select or attach**", "type": "display" } ] }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "1978f17f-006f-1928-1c54-f3a8dccffe0f", "type": "display", "enableWhen": [ { "id": "bce18429-a3af-add2-e36e-adfeaed8d038", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "d0bd7ce7-4981-a213-97aa-bb5a86b342ac", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**If any laboratory investigations are listed below, they have NOT been automatically selected by the software. Please manually select or attach if available**", "type": "display" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "auto-select-display" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-name", "valueString": "Gestational diabetes" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/auto-select-type", "valueString": "Unselected" } ], "linkId": "107ac9df-d9ee-af6d-e648-8b567ea1eb8a", "text": "Laboratory investigations NOT found by the software:", "type": "string" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "url" } ] } } ], "linkId": "1501bcbc-8360-6e0a-2c23-3651a0f8d7bd", "text": "Click link to manually select investigations", "type": "display", "initialString": "investigations" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "url" } ] } } ], "linkId": "d8844e3c-0562-cc11-6288-7033d5f9385d", "text": "Click link to manually attach investigations", "type": "display", "initialString": "attachments" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "button-bar" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"45fcb3d7-038f-8bab-421d-2a464e261a67\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": 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"http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "text-area" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"3002b990-2ddb-8b4f-3472-43bc355f223b\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"96383d03-377e-b9a0-c700-bddab285f4b9\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/rows", "valueInteger": 4 }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/max-rows", "valueInteger": 16 } ], "linkId": "21d9830b-2193-317b-c86e-c64673b7e31c", "text": "Please describe reason unable to complete investigations", "type": "text", "enableWhen": [ { "id": "afb6767a-436c-b6a2-1eb7-6047099c4093", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "0bb55b46-9630-ec70-8eb6-2e8559e4b6ae", "hasAnswer": false, "answerString": "Yes" } ], "required": true } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "list" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"9044559f-3774-2dea-49b0-7fc249b91f33\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" } ], "linkId": "0a31f22c-628c-c180-e100-3a64c48bb532", "text": "Imaging and Reports", "type": "group", "enableWhen": [ { "id": "8c87be12-2325-7a23-26ac-eec13832e8b4", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "3976b0fa-3f13-8745-b9be-b32e8251e84c", "hasAnswer": false, "answerBoolean": true } ], "item": [ { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-information-form-only", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "linkId": "383c231a-c6be-f6e3-4c4f-6dc32bcb3e13", "type": "display", "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "inline" } ] } } ], "text": "**Additional referral information:**\n* Fetal ultrasound\n* Additional relevant imaging", "type": "display" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "check-box" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/choice-list-orientation", "code": "vertical" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"0f1e6d90-783c-e08d-881f-36d4a98861ce\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"13eec616-d097-db1d-8c8c-449ca9c99513\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/clearable", "valueBoolean": false }, { "url": "http://hl7.org/fhir/layout-columns", "valueString": "3-columns" } ], "linkId": "dca57b0c-89cf-4e92-6067-aa98f0785afe", "text": "Imaging performed", "type": "choice", "required": false, "option": [ { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/option/none-of-the-above", "valueBoolean": false } ], "valueString": "Ultrasound" }, { "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/option/none-of-the-above", "valueBoolean": false } ], "valueString": "Other" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "text-area" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"9cc48fe6-df10-7f47-40cc-9f3a0005ae40\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"6a291717-3609-8555-fa72-d03bb0e5a0e1\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/rows", "valueInteger": 4 }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/max-rows", "valueInteger": 16 } ], "linkId": "73ed8691-c2c6-9080-60f7-03e9e442cd4b", "text": "Please specify other imaging", "type": "text", "enableWhen": [ { "id": "ccda4834-0387-24f9-6de3-378d6c70ae86", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "dca57b0c-89cf-4e92-6067-aa98f0785afe", "hasAnswer": false, "answerString": "Other" } ], "required": true }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "url" } ] } } ], "linkId": "a937daf7-a4d0-e229-6129-b6f01afe0537", "text": "Click link to manually select imaging", "type": "display", "initialString": "investigations" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "url" } ] } } ], "linkId": "30844639-0361-9e88-8a53-3ecbc3660d61", "text": "Click link to manually attach imaging", "type": "display", "initialString": "attachments" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "calculated-field" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/calculated-field-conditions", "valueString": "{\"id\":\"b5c33dbe-dd7b-6dfe-deba-a2bb859a0d6a\",\"operator\":\"or\",\"type\":\"group\",\"conditions\":[{\"id\":\"d6e4107f-8b7f-e26b-70ce-04ff999441ab\",\"type\":\"condition\",\"item\":{\"text\":\"Minimum referral criteria\",\"value\":\"70271412-10e2-8bef-f441-99241915f74d\",\"dataType\":\"choice\",\"container\":{\"type\":\"list\",\"id\":\"c1cf9c5d-ac72-1ffe-8746-d14a25ed4cfb\"},\"operators\":\"equality\",\"options\":[{\"display\":\"Gestational diabetes (GDM), or diabetes first recognised during pregnancy\",\"value\":\"Gestational diabetes (GDM), or diabetes first recognised during pregnancy\"},{\"display\":\"Request clinical override of minimum referral criteria\",\"value\":\"Request clinical override of minimum referral criteria\"}],\"showEligibleWhenOption\":true},\"operator\":\"has-value\",\"operand\":null,\"coded\":false}],\"returnType\":\"boolean\"}" } ], "linkId": "e39bd053-7f95-de4a-8411-9397dc7e4d46", "text": "Minimum ciriteria has value", "type": "boolean", "required": false }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "calculated-field" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/calculated-field-conditions", "valueString": "{\"id\":\"ef313dab-9ba5-6b28-1661-f569425147b3\",\"operator\":\"or\",\"type\":\"group\",\"conditions\":[{\"id\":\"b3e14169-1cd2-bff9-f995-6d5b085938c1\",\"type\":\"condition\",\"item\":{\"text\":\"Provider\",\"value\":\"8e59fb06-066d-2d00-7a90-ae55e0bc5e72\",\"dataType\":\"choice\",\"container\":{\"type\":\"none\",\"id\":null},\"operators\":\"equality\",\"options\":[{\"display\":\"Private\",\"value\":\"DDE394C1-CC0C-4A54-A1B3-3B2B1E7F82D6\"},{\"display\":\"Public\",\"value\":\"7BEEBDA2-2DD5-4812-98DB-330011333617\"},{\"display\":\"SCC\",\"value\":\"9863C554-031C-4319-92B2-A16E80A87C73\"},{\"display\":\"CCC\",\"value\":\"62F5779F-A428-4DFE-9AFA-DDEF951E17EF\"},{\"display\":\"MBS\",\"value\":\"A9A8EE09-E605-4F6E-9ABD-6EDF4D0B9E8D\"}],\"showEligibleWhenOption\":false},\"operator\":\"=\",\"operand\":\"DDE394C1-CC0C-4A54-A1B3-3B2B1E7F82D6\",\"coded\":true},{\"id\":\"817240e1-f7c9-8e88-81e4-cfe58aa24684\",\"type\":\"condition\",\"item\":{\"text\":\"Minimum referral criteria\",\"value\":\"70271412-10e2-8bef-f441-99241915f74d\",\"dataType\":\"choice\",\"container\":{\"type\":\"list\",\"id\":\"c1cf9c5d-ac72-1ffe-8746-d14a25ed4cfb\"},\"operators\":\"equality\",\"options\":[{\"display\":\"Gestational diabetes (GDM), or diabetes first recognised during pregnancy\",\"value\":\"Gestational diabetes (GDM), or diabetes first recognised during pregnancy\"},{\"display\":\"Request clinical override of minimum referral criteria\",\"value\":\"Request clinical override of minimum referral criteria\"}],\"showEligibleWhenOption\":true},\"operator\":\"=\",\"operand\":\"Request clinical override of minimum referral criteria\",\"coded\":false}],\"returnType\":\"boolean\"}" } ], "linkId": "d0bd7ce7-4981-a213-97aa-bb5a86b342ac", "text": "Private or Clinical override", "type": "boolean", "required": false }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "readonly-text" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-selected-external-data-item", "valueString": "funding" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/data-overridable", "valueBoolean": false } ], "linkId": "8e59fb06-066d-2d00-7a90-ae55e0bc5e72", "text": "Provider", "type": "string", "required": false }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "calculated-field" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/calculated-field-conditions", "valueString": "{\"id\":\"bf6cdcfb-49ad-41fe-9787-cbc45f8d598c\",\"operator\":\"or\",\"type\":\"group\",\"conditions\":[{\"id\":\"a34e8202-07b0-25e3-cf58-edc8383f74db\",\"type\":\"condition\",\"item\":{\"text\":\"Imaging performed\",\"value\":\"dca57b0c-89cf-4e92-6067-aa98f0785afe\",\"dataType\":\"choice\",\"container\":{\"type\":\"list\",\"id\":\"0a31f22c-628c-c180-e100-3a64c48bb532\"},\"operators\":\"equality\",\"options\":[{\"display\":\"Ultrasound\",\"value\":\"Ultrasound\"},{\"display\":\"Other\",\"value\":\"Other\"}],\"showEligibleWhenOption\":true},\"coded\":false,\"operator\":\"has-value\",\"operand\":null}],\"returnType\":\"boolean\"}" } ], "linkId": "7cac472b-7e56-4546-da9d-f4c57d9ff7ae", "text": "Imaging performed public has value", "type": "boolean", "required": false }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "calculated-field" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/calculated-field-conditions", "valueString": "{\"id\":\"7f719cc3-997d-b0c6-e137-b06c4a38bc39\",\"operator\":\"or\",\"type\":\"group\",\"conditions\":[{\"id\":\"a8b80522-eff2-b52f-a01c-747617a4a29b\",\"operator\":\"and\",\"type\":\"group\",\"conditions\":[{\"id\":\"cd13c968-1614-8470-c17c-efac50ba4b5a\",\"type\":\"condition\",\"item\":{\"text\":\"Minimum referral criteria\",\"value\":\"70271412-10e2-8bef-f441-99241915f74d\",\"dataType\":\"choice\",\"container\":{\"type\":\"list\",\"id\":\"c1cf9c5d-ac72-1ffe-8746-d14a25ed4cfb\"},\"operators\":\"equality\",\"options\":[{\"display\":\"Gestational diabetes (GDM), or diabetes first recognised during pregnancy\",\"value\":\"Gestational diabetes (GDM), or diabetes first recognised during pregnancy\"},{\"display\":\"Request clinical override of minimum referral 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This can be used to forced the display of text when No value has been selected." } ], "linkId": "a6476ddb-c5c4-775e-f129-e703c0ce25de", "text": "Show essential Labs/Imaging", "type": "boolean", "required": false }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "readonly-text" } ] } }, { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-selected-external-data-item", "valueString": "referralType" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/data-overridable", "valueBoolean": false } ], "linkId": "e6904c02-7ffe-ef4f-3783-d77861dc74f6", "text": "Referral type", "type": "string", "required": false }, { "extension": [ { "url": 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"http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/calculated-field-conditions", "valueString": 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"01ad97fd-2051-68d4-e9a0-5accabc802b0", "text": "Request for Advice", "type": "group", "enableWhen": [ { "id": "4bdeb8bf-9dfa-c6fb-34ce-0bdb481db45a", "extension": [ { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/questionnaire-item-enable-when-operator", "valueString": "=" } ], "question": "e6904c02-7ffe-ef4f-3783-d77861dc74f6", "hasAnswer": false, "answerCoding": { "code": "075A3553-46AE-43FB-8DE6-AC623FFF7763", "display": "Request for advice" } } ], "item": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/questionnaire-item-control", "code": "text-area" } ] } }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/eligible-when-conditions", "valueString": "{\"id\":\"c6bc8297-b474-8b97-6a5b-946663635991\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/rows", "valueInteger": 4 }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/max-rows", "valueInteger": 16 }, { "url": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/valid-when-conditions", "valueString": "{\"id\":\"1d16fb00-a11a-df7a-1d73-b3fde943eee9\",\"operator\":\"or\",\"type\":\"group\",\"returnType\":\"boolean\"}" } ], "linkId": "e3fc3f0c-ee7f-4e16-1e3e-859cbf35a307", "definition": "https://qhr-devops.health.qld.gov.au/fhir/StructureDefinition/referral-model-for-merging#referralDetails.referralManagement.replies.replyText", "text": "Request for advice - clinical question", "type": "text", "required": true } ] } ] }