{
  "description": "This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Denominator for Procedure. This report records date on each patient having one of the NHSN procedures selected for monitoring.\\n\\nFor further details on reporting healthcare-associated infections see the specific protocols and data collection forms on the NHSN website [https://www.cdc.gov/nhsn/](https://www.cdc.gov/nhsn/).\\n",
  "_filename": "example/Questionnaire-hai-questionnaire-opc-proc-denom.json",
  "package_name": "hl7.fhir.us.hai",
  "subjectType": [ "Patient" ],
  "date": "2019-04-01",
  "meta": {
    "source": "#QYbd8C4welZ3TEoO",
    "profile": [ "http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire" ],
    "versionId": "11",
    "lastUpdated": "2023-02-24T01:35:54.128+00:00"
  },
  "publisher": "HL7 International - Structured Documents Work Group",
  "jurisdiction": [ {
    "text": "United States of America",
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166",
      "display": "United States of America"
    } ]
  } ],
  "name": "HAI_questionnaire_opc_proc_denom",
  "item": [ {
    "text": "Facility ID",
    "type": "url",
    "linkId": "facility-id",
    "repeats": false,
    "required": true
  }, {
    "text": "Date of encounter",
    "type": "date",
    "linkId": "encounter-date",
    "repeats": false,
    "required": true
  }, {
    "code": [ {
      "code": "51898-5",
      "system": "http://loinc.org",
      "display": "Risk factors Document"
    } ],
    "item": [ {
      "text": "This group contains procedure risk factors such as ASA class, diabetes mellitus, height, and weight.",
      "type": "display",
      "linkId": "risk-factors-group-description"
    }, {
      "code": [ {
        "code": "420089007",
        "system": "http://snomed.info/sct",
        "display": "CDC wound classification category"
      } ],
      "text": "Risk Factor: Wound class",
      "type": "choice",
      "linkId": "risk-factor-wound-class",
      "repeats": false,
      "required": false,
      "answerValueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.9"
    }, {
      "code": [ {
        "code": "423827005",
        "system": "http://snomed.info/sct",
        "display": "Endoscopy"
      } ],
      "text": "Risk Factor: Endoscopy used",
      "type": "boolean",
      "linkId": "risk-factor-endoscopy",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "73211009",
        "system": "http://snomed.info/sct",
        "display": "Diabetes mellitus"
      } ],
      "text": "Risk Factor: Diabetes mellitus",
      "type": "boolean",
      "linkId": "risk-factor-diabetes-mellitus",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "50373000",
        "system": "http://snomed.info/sct",
        "display": "Body Height"
      } ],
      "text": "Risk Factor: height",
      "type": "quantity",
      "linkId": "risk-factor-height",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "27113001",
        "system": "http://snomed.info/sct",
        "display": "Body Weight"
      } ],
      "text": "Risk Factor: weight",
      "type": "quantity",
      "linkId": "risk-factor-weight",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "273270000",
        "system": "http://snomed.info/sct",
        "display": "American Society of Anesthesiologists physical status classification (assessment scale)"
      } ],
      "text": "Risk Factor: ASA Class",
      "type": "choice",
      "linkId": "risk-factor-asa-class",
      "repeats": false,
      "required": true,
      "answerValueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.10"
    } ],
    "text": "Risk Factors",
    "type": "group",
    "linkId": "risk-factors",
    "repeats": false,
    "required": true
  }, {
    "code": [ {
      "code": "51899-3",
      "system": "http://loinc.org",
      "display": "Details Document"
    } ],
    "item": [ {
      "text": "This group contains details about the procedure.",
      "type": "display",
      "linkId": "procedure-details-group-description"
    }, {
      "text": "Procedure ID",
      "type": "url",
      "linkId": "procedure-id",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "29300-1",
        "system": "http://loinc.org",
        "display": "Procedure type"
      } ],
      "text": "NHSN Procedure Code Category",
      "type": "choice",
      "linkId": "nhsn-procedure-code-category",
      "repeats": false,
      "required": true,
      "answerValueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.10.20.5.9.34"
    }, {
      "code": [ {
        "code": "76448-0",
        "system": "http://loinc.org",
        "display": "CPT billing code"
      } ],
      "text": "CPT Procedure Code",
      "type": "choice",
      "linkId": "cpt-procedure-code",
      "repeats": false,
      "required": true,
      "answerValueSet": "http://hl7.org/fhir/ValueSet/cpt-all"
    }, {
      "code": [ {
        "code": "89875-9",
        "system": "http://loinc.org",
        "display": "Procedure duration"
      } ],
      "text": "Procedure duration (in minutes)",
      "type": "quantity",
      "linkId": "procedure-duration",
      "repeats": false,
      "required": true,
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
        "valueCoding": {
          "code": "min",
          "system": "http://unitsofmeasure.org",
          "display": "min"
        }
      } ]
    } ],
    "text": "Procedure Details",
    "type": "group",
    "linkId": "procedure-details",
    "repeats": false,
    "required": true
  }, {
    "text": "General anesthesia",
    "type": "boolean",
    "linkId": "general-anesthesia",
    "repeats": false,
    "required": true
  }, {
    "text": "Surgeon code",
    "type": "url",
    "linkId": "surgeon-code",
    "repeats": false,
    "required": true
  }, {
    "code": [ {
      "code": "86468-6",
      "system": "http://loinc.org",
      "display": "Report Comment Section"
    } ],
    "text": "Comments",
    "type": "text",
    "linkId": "nhsn-comment",
    "repeats": false,
    "required": false,
    "maxLength": 2000
  } ],
  "type": null,
  "experimental": "false",
  "resourceType": "Questionnaire",
  "title": "Outpatient Procedure Component Denominator for Procedure",
  "package_version": "2.1.0",
  "status": "active",
  "language": "en-US",
  "id": "fd2b866d-dd31-4874-9467-3fd137500964",
  "kind": null,
  "url": "http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-proc-denom",
  "code": [ {
    "code": "51897-7",
    "system": "http://loinc.org",
    "display": "Healthcare Associated Infection report Document"
  } ],
  "identifier": [ {
    "value": "hai-questionnaire-opc-proc-denom-v1"
  } ],
  "version": null,
  "contact": [ {
    "name": "HL7 International - Structured Documents",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/structure",
      "system": "url"
    } ]
  } ]
}