Smart Forms
0.1.0 - ci-build

This page is part of the Smart Forms (v0.1.0-draft: Releases Draft) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

Questionnaire: Aboriginal and Torres Strait Islander Health Check

Official URL: http://www.health.gov.au/assessments/mbs/715 Version: 0.1.0-assembled
Draft as of 2022-05-24 Realm: Australia flag Computable Name: AboriginalTorresStraitIslanderHealthCheck

Copyright/Legal: CSIRO © 2022+; Licensed under Apache License, Version 2.0

Aboriginal and Torres Strait Islander Health Check assessment form.

Background

The long-term vision for effective Aboriginal and Torres Strait Islander health checks is of a standards-based health check template that is consistent and interoperable across different systems and applications whilst allowing for local adaptation.

The NACCHO and RACGP established a working group to review the Aboriginal and Torres Strait Islander annual health check templates and have produced five new templates that span the life course:

  1. Infants and preschool (birth-5 years)
  2. Primary school age (5-12 years)
  3. Adolescents and young people (12-24 years)
  4. Adults (25-49 years)
  5. Older people (50+ years)

These example templates can be downloaded from the RACGP.

This resource is FHIR Questionnaire representation of the templates above.

Structure
LinkIdTextCardinalityTypeFlagsDescription & Constraintsdoco
.. AboriginalTorresStraitIslanderHealthCheckAboriginal and Torres Strait Islander Health Check assessment form.Questionnairehttp://www.health.gov.au/assessments/mbs/715#0.1.0-assembled
... fd5af92e-c248-497a-8007-ee0952ccd4d9null0..1group
.... 2e82032a-dc28-45f2-916e-862303d39fe5About the health check0..1groupExpressions:
..... CD-in-progress-1In progress0..1displayEnable When: MarkComplete-1 = false
..... CD-complete-1Complete0..1displayEnable When: MarkComplete-1 = true
..... RecordUpdate-AboutImportant: The patient record may not be updated with information entered here. Information intended for the patient record should be entered there first.0..1display
..... 3da318f1-a5dd-4c8f-b258-99d83872a4f2Eligible for health check0..1choiceiconiconValue Set: Yes/No/NA
...... 04f00512-888b-424e-ba76-9bd6fd8da682not claimed 715 or 228 in past nine months0..1displayiconicon
..... 5960c096-d5f7-4745-bd74-44ff2775bde9Health check already in progress?0..1booleaniconiconExpressions:
  • Initial Value: %QuestionnaireResponseLatest.entry.resource.where(status='in-progress').exists()
..... 01418489-1ec4-4c3b-b96a-7c14c3e21cfeDate of last completed health check0..1dateExpressions:
  • Initial Value: %QuestionnaireResponseLatestCompleted.entry.resource.authored
..... 63fe14f3-2374-4382-bce7-180e2747c97fDate this health check commenced0..1dateExpressions:
..... MarkComplete-1Mark section as complete0..1boolean
.... 1016f79d-9756-4daf-b6ee-29add134b34fConsent0..1groupExpressions:
..... CD-in-progress-30In progress0..1displayEnable When: MarkComplete-30 = false
..... CD-complete-30Complete0..1displayEnable When: MarkComplete-30 = true
..... d1e1ab3d-1c6c-430b-8ae7-af56b8f0af55Consent given after discussion of process and benefits of a health check0..1choiceiconiconValue Set: Yes/No/NA
Expressions:
..... 7fa8bc57-f3f9-4ddc-bf9b-12a9b9885dbdConsent given by parent/primary carer after discussion of process and benefits of a health check0..1choiceiconiconValue Set: Yes/No/NA
Expressions:
..... 80a6a405-49a4-44fb-bff3-212902096b95Parent/primary caregiver present0..1groupExpressions:
...... c72933c7-349f-4fef-94ff-c424c69da6f3Parent/primary caregiver is present for health check?0..1choiceiconiconValue Set: Yes/No/NA
...... b7d116f9-0425-4cf1-8cde-fbf4dfaee550Relationship to child0..*stringEnable When: c72933c7-349f-4fef-94ff-c424c69da6f3 = Yes (v2 Y/N Indicator#Y)
..... d8c88bff-75ea-476f-8f83-e9b72fc9e1a0Consent for sharing of information0..1group
...... 057483ce-f265-46df-a1c5-7a18d492c1baConsent given for sharing of information with relevant healthcare providers?0..1choiceiconiconValue Set: Yes/No/NA
...... 43517c44-5cd2-4d9a-9f18-d6bf8124f4aeWho/details0..*textEnable When: 057483ce-f265-46df-a1c5-7a18d492c1ba = Yes (v2 Y/N Indicator#Y)
..... 84162f36-f4af-4509-b178-ef2a3849d0b6Date1..1dateExpressions:
..... 0f92eb2d-4629-4215-96f8-46722a2efa73Doctor0..1string
..... 8b94a129-3aab-4d13-bb6d-7a748f5c41e5Nurse0..1string
..... 2a517291-e2f1-4f66-ad1f-ae5b091d2f8aAboriginal and/or Torres Strait Islander Health Worker / Health Practitioner0..1string
..... 5bbfb4a3-a667-4ef2-98c2-76e76da55c03Location of health check0..1open-choiceOptions: 3 options
Expressions:
..... 9a51c056-021d-445d-8eaa-2123a69aa9c2Location of health check0..1open-choiceOptions: 3 options
Expressions:
..... MarkComplete-30Mark section as complete0..1boolean
.... 5b224753-9365-44e3-823b-9c17e7394005Patient Details0..1group
..... CD-in-progress-32In progress0..1displayEnable When: MarkComplete-32 = false
..... CD-complete-32Complete0..1displayEnable When: MarkComplete-32 = true
..... RecordUpdate-PatientImportant: The patient record may not be updated with information entered here. Information intended for the patient record should be entered there first.0..1display
..... 17596726-34cf-4133-9960-7081e1d63558Name0..1stringiconiconExpressions:
  • Initial Value: (%patient.name.where(use='official').select((family | (given | prefix).join(' ')).join(', ').where($this != '') | text) | %patient.name.select((family | (given | prefix).join(' ')).join(', ').where($this != '') | text)).first()
..... 57093a06-62f7-4b8b-8cb4-2c9f451ac851Preferred name0..1stringiconiconExpressions:
  • Initial Value: (%patient.name.where(use='usual').select((family | (given | prefix).join(' ')).join(', ').where($this != '') | text)).first()
..... 540b1034-7c9a-4aba-a9ef-afb77d445a58Preferred pronouns0..1choiceiconiconValue Set: Personal Pronouns
Expressions:
  • Initial Value: %patient.extension.where(url='http://hl7.org/fhir/StructureDefinition/individual-pronouns').extension.where(url='value').value.coding
..... f669a4fe-4818-429a-8847-d20da88d2bb3Gender identity0..1choiceiconiconValue Set: Gender Identity Response
Expressions:
  • Initial Value: %patient.extension.where(url='http://hl7.org/fhir/StructureDefinition/patient-genderIdentity').value.coding
..... 418e4a02-de77-48a0-a92a-fe8fcc52b1aaAdministrative gender0..1choiceiconiconValue Set: AdministrativeGender
Expressions:
..... 56ef44bb-3d1d-4972-aad1-834b69185d61Sex assigned at birth0..1choiceiconiconValue Set: Biological Sex
Expressions:
..... 90ad8f16-16e4-4438-a7aa-b3189f510da2Date of birth0..1dateiconiconExpressions:
..... e2a16e4d-2765-4b61-b286-82cfc6356b30Age0..1integericoniconExpressions:
  • Initial Value: iif(today().toString().select(substring(5,2) & substring(8,2)).toInteger() > %patient.birthDate.toString().select(substring(5,2) & substring(8,2)).toInteger(), today().toString().substring(0,4).toInteger() - %patient.birthDate.toString().substring(0,4).toInteger(), today().toString().substring(0,4).toInteger() - %patient.birthDate.toString().substring(0,4).toInteger() - 1)
..... 8acde9f8-7a91-4f0c-9216-38531ec984efAboriginal and/or Torres Strait Islander status0..1choiceiconiconValue Set: Aboriginal and/or Torres Strait Islander
Expressions:
  • Initial Value: %patient.extension.where(url='http://hl7.org.au/fhir/StructureDefinition/indigenous-status').value
..... c8852db9-efe9-4102-96db-cef3a8be0a5fParents/primary carer/s0..*choiceValue Set: Primary Carer Of Parent Or Grandparent
Expressions:
..... 7089c48e-4216-4089-a548-034cd585e4daOther family0..*stringExpressions:
...... 70c45932-99dc-42a3-9650-4683892a0892details0..1display
..... 42b1f5e0-bf4a-47d9-86a4-f2fe946ac01fOther0..*stringExpressions:
...... dcbd3a54-9b68-4486-bf30-f6f1723bc39cdetails0..1display
..... 06737e46-e880-4037-9a2c-bcd278cd70baParents/primary carer/s details0..*groupExpressions:
...... cc20ce96-af06-4cd7-aa9b-c2601a6169adName of parent/primary carer0..1string
...... 372d79bb-9d0b-42d2-a98c-cbe332bd3745Relationship to child0..1string
..... f1262ade-843c-4eba-a86d-51a9c97d134bHome address0..1group
...... 311d83bb-f22e-4f60-9b50-b6e38dd2059bNo fixed address0..1booleanDefinition: Address.extension:noFixedAddress
Expressions:
  • Initial Value: %HomeAddressRepeat.extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').value
...... 4e0dc185-f83e-4027-b7a8-ecb543d42c6dnull0..*groupEnable When: 311d83bb-f22e-4f60-9b50-b6e38dd2059b != true
....... 2fee2d51-7828-4178-b8c1-35edd32ba338Street address0..1stringDefinition: Address.line
Expressions:
....... ddb65ed1-f4b2-4730-af2a-2f98bc73c76fCity0..1stringDefinition: Address.city
Expressions:
....... d9a1236c-8d6e-4f20-a12a-9d5de5a1d0f6State0..1choiceDefinition: Address.state
Value Set: Australian States and Territories
Expressions:
....... 3f61a1ea-1c74-4f52-8519-432ce861a74fPostcode0..1stringDefinition: Address.postalCode
Expressions:
..... edc081ea-b5ba-4234-9234-8ee598c2f95fPostal address0..*groupiconiconExpressions:
...... 622970f1-3cf1-4f0a-bf05-b00a08046ebaPurpose of use0..1stringDefinition: Address.use
Expressions:
...... 2e8437cd-5ea0-4d44-8ab2-d2aa9ef18ba7Address0..1stringDefinition: Address.line
Expressions:
...... 2bde25e5-2c4c-4c0c-b6f3-c6859535a764City0..1stringDefinition: Address.city
Expressions:
...... b41a8b11-8dbf-4999-9d0a-71d39240fed1State0..1choiceDefinition: Address.state
Value Set: Australian States and Territories
Expressions:
...... 28b58e50-2a04-4192-9655-efc8d72f32faPostcode0..1stringDefinition: Address.postalCode
Expressions:
..... 9541f0b0-f5ba-4fe7-a8e9-ad003cef897bHome phone0..*stringExpressions:
  • Initial Value: %patient.telecom.where(system = 'phone' and use = 'home').value
..... 4037a02b-4a85-40e0-9be6-5b17df1aac56Mobile phone0..*stringExpressions:
  • Initial Value: %patient.telecom.where(system = 'phone' and use = 'mobile').value
..... c22390d3-1be6-4fd1-b775-6443b7239a6bEmergency contact0..*group
...... d7f2dd75-20c8-480f-8c22-71d604ebee8dName0..1stringExpressions:
  • Initial Value: %patient.contact.where(relationship.coding.exists(code = 'C')).name.select((family | (given | prefix).join(' ')).join(', ').where($this != '') | text)
...... aa35d559-f45b-4d35-9453-dd02e4a790f3Relationship to child0..1stringExpressions:
...... 27099697-d6d1-42c0-bb0a-5e9ff7372a96Relationship to patient0..1stringExpressions:
...... 626e3723-6310-4b99-81c1-525676b027c8Phone0..*stringExpressions:
  • Initial Value: %patient.contact.where(relationship.coding.exists(code = 'C')).telecom.value
..... df1475ea-bf7e-4bf0-a69f-7f9608c3ed3cMedicare number0..1group
...... eb2a59ed-9632-4df1-b5b1-1e85c3b4b7cfNumber0..1stringExpressions:
  • Initial Value: %patient.identifier.where(type.coding.exists(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MC')).value.substring(0,10)
...... d6253253-a124-494e-a1d8-7ce02c69ec11Reference number0..1stringExpressions:
  • Initial Value: %patient.identifier.where(type.coding.exists(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MC')).value.substring(10,1)
...... c520e213-5313-42c3-860a-d30206620290Expiry0..1stringExpressions:
  • Initial Value: %patient.identifier.where(type.coding.exists(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='MC')).period.end.toString()
..... c1e4e967-c0aa-4280-b5d4-ab1f375ed9acPensioner Card Number0..1stringMax Length: 10
Expressions:
  • Initial Value: %patient.identifier.where(type.coding.exists(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='PEN')).value
..... a7e97574-3cea-4dfa-bef2-2665e7748364Health Care Card Number0..1stringMax Length: 10
Expressions:
  • Initial Value: %patient.identifier.where(type.coding.exists(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='HC')).value
..... 83814495-3a81-43f4-88df-42186cce516aRegistered for Closing the Gap PBS Co-payment Measure (CTG)0..1choiceiconiconValue Set: Yes/No/NA
..... e63547c6-1623-412f-963f-5f1ebf23563fChild has a birth certificate0..1choiceiconiconValue Set: Yes/No/NA
Expressions:
..... a8143230-b30d-4b85-9805-5f2f73f2dffaMy Aged Care0..1groupExpressions:
...... 7165c072-e3d8-4564-9d1d-d17f6807787cRegistered for My Aged Care0..1choiceiconiconValue Set: Yes/No/NA
...... 04e50521-dc85-4744-b7ab-6f8682aacb11My Aged Care Number0..1stringEnable When: 7165c072-e3d8-4564-9d1d-d17f6807787c = Yes (v2 Y/N Indicator#Y)
..... 2bfe50cb-7913-4f31-bce2-763c17ff8b1aNational Disability Insurance Scheme0..1group
...... 924b4500-53ac-4c4e-831b-7ab5569ff981Registered for NDIS0..1choiceiconiconValue Set: Yes/No/NA
...... 7379a0fd-d95b-4ecb-a781-9f43d1394f10NDIS Number0..1stringEnable When: 924b4500-53ac-4c4e-831b-7ab5569ff981 = Yes (v2 Y/N Indicator#Y)
..... 9bc882bc-e989-4600-9587-8089fb757641Children0..1groupExpressions:
...... e90b436b-2751-4e07-a40c-adfe951b6528Do you have children?0..1choiceiconiconValue Set: Yes/No/NA
...... 241f5fca-f61a-49bd-8972-52613c0e6d15Number of children0..1integerEnable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y)
...... 74ce4c60-31d6-4e78-9056-579937379451Number of children in your care0..1integerEnable When: e90b436b-2751-4e07-a40c-adfe951b6528 = Yes (v2 Y/N Indicator#Y)
..... 2b5ae784-4341-4172-875d-1698cc8069f0Someone's carer0..1groupExpressions:
...... a08271f1-194b-4fe9-91f9-4f3398858eb0Are you responsible for caring for someone else?0..1choiceiconiconValue Set: Yes/No/NA
...... 4c14b158-3ae4-4994-8446-76e02640702cDetails0..1textEnable When: a08271f1-194b-4fe9-91f9-4f3398858eb0 = Yes (v2 Y/N Indicator#Y)
..... 6c80c675-1320-4ca3-ae3f-51ad173da741Your carer0..1groupExpressions:
...... d05558fb-a3cc-4bd6-b803-b672b36b9c51Do you have a carer?0..1choiceiconiconValue Set: Yes/No/NA
...... b9991e7e-ce03-465d-b4b0-5a1725b24e02Details0..1textEnable When: d05558fb-a3cc-4bd6-b803-b672b36b9c51 = Yes (v2 Y/N Indicator#Y)
..... 3494631c-6b56-46dc-abf7-a17bfc1d025fProviders0..1group
...... 41210be5-d441-4c44-b9c2-8dd94a44cbb4Are name and contact details of other key providers (eg case workers, support services) up to date?0..1choiceiconiconValue Set: Yes/No/NA
...... 6733d6ec-5b6b-4ee2-a21e-0e9474c2b22bDetails0..1text
..... 38f81a73-447f-4ecd-a8eb-6eccd9dee050Advance care planning0..1groupExpressions:
...... c023ef16-b554-4ed9-8993-1331e5f5a3b4Enduring Power of Attorney0..1group
....... 036eace9-ea83-46ec-9d01-f2093f710816Enduring Power of Attorney0..1choiceiconiconValue Set: Yes/No/NA
....... 83518215-7151-4365-b745-d7464bbb9528Discussed today0..1text
...... c4f68251-26af-462f-879a-a69b449066ffAdvance Health Directive0..1group
....... b0632039-c12b-4748-9e94-52073590c0baAdvance Health Directive0..1choiceiconiconValue Set: Yes/No/NA
....... c4bc2d84-e411-488d-9c0d-761f0377a026Discussed today0..1text
..... MarkComplete-32Mark section as complete0..1boolean
.... b3a3eee2-f340-452e-9d05-d1f54f677b81Current health/patient priorities0..1groupExpressions:
..... CD-in-progress-5In progress0..1displayEnable When: MarkComplete-5 = false
..... CD-complete-5Complete0..1displayEnable When: MarkComplete-5 = true
..... dcf182c0-a2bf-46ac-a19b-72e4d24ef24dWhat are the important things for you in this health check today?0..1text
...... 3ac0c629-9acc-48af-bafe-6b05dfd06281details0..1display
..... a0c06f8d-3210-480b-9031-7b5eb5bf1ddaIs there anything you are worried about?0..1textExpressions:
...... 43fb3316-64a4-41dc-b12c-2f3fcee3eb84details0..1display
..... 96f3396e-f5f8-4347-8692-9abdecb97768Is there anything that you are worried about with your child's health or wellbeing?0..1textExpressions:
...... 75b39c42-8a15-4fdf-9129-936072336456details0..1display
..... 17651f83-8476-499c-a5ef-dd4e1a6c9f13Child Health Book0..1groupExpressions:
...... 2655e0e1-fe4b-431e-87af-30d4ff1aca76Does your child have a Child Health Book?0..1choiceiconiconValue Set: Yes/No
...... a30d0101-06ce-4481-b142-9fa2c091fe4fIs it up to date?0..1choiceiconiconEnable When: 2655e0e1-fe4b-431e-87af-30d4ff1aca76 = Yes (v2 Y/N Indicator#Y)
Value Set: Yes/No
..... 35b3f6d8-2907-4134-ae55-1e321b908f70Do you have any specific health goals? Is there anything in particular about your health and wellbeing that you would like to improve?0..1textExpressions:
...... bb176839-5cc8-4fb5-a919-0904968418bedetails0..1display
..... 7cd424e5-7672-4e99-8a99-30b1fb3043fdHealth priorities, actions and follow-up0..1text
..... MarkComplete-5Mark section as complete0..1boolean
.... 28d5dbe4-1e65-487c-847a-847f544a6a91Medical history and current problems0..1groupExpressions:
..... CD-in-progress-17In progress0..1displayEnable When: MarkComplete-17 = false
..... CD-complete-17Complete0..1displayEnable When: MarkComplete-17 = true
..... RecordUpdate-MedHistoryImportant: The patient record may not be updated with information entered here. Information intended for the patient record should be entered there first.0..1display
..... a10a7375-e9d3-4e71-a47a-282e9ba38ec1Gestation at birth0..1decimalExpressions:
...... f3899852-36c4-441f-9a7d-544ef1617f08weeks0..1display
..... 29b6d8ea-23b2-4a69-98d9-899198692de7Birth weight0..1decimalExpressions:
...... 87cf1ecd-6d1b-4de1-894d-58bd77dcfde1kg0..1display
..... 92bd7d05-9b5e-4cf9-900b-703f361dad9dMedical history and current problems list0..*group
...... 59b1900a-4f85-4a8c-b9cd-3fe2fd76f27eCondition0..1open-choiceValue Set: Medical History
Expressions:
  • Initial Value: %ConditionRepeat.code.select((coding.where(system='http://snomed.info/sct') | coding.where(system!='http://snomed.info/sct').first() | text ).first())
...... 88bcfad7-386b-4d87-b34b-2e50482e4d2cClinical Status0..1choiceValue Set: Condition Clinical Status Codes
Expressions:
...... 6ae641ad-95bb-4cdc-8910-5a52077e492cOnset Date0..1dateExpressions:
...... 18b9e159-2ed7-4047-82b7-deb2a171de4fRecorded Date0..1dateExpressions:
..... 4484cacd-a260-4e5f-83c1-168ca2396c04New diagnoses list0..*group
...... 2da85994-2d5e-42f1-8a81-abf44f397468Condition0..1open-choiceValue Set: Medical History
...... a7e056be-fb6f-4f7f-b04d-5b809e1e18e3Clinical Status0..1choiceValue Set: Condition Clinical Status Codes
...... e4524654-f6de-4717-b288-34919394d46bOnset Date0..1date
...... 5bc1d8f4-6e8c-4695-916c-1ef767306e46Recorded Date0..1date
..... 62774152-8a6e-4449-af9f-87bdce8b9bf5Health priorities, actions and follow-up0..1text
..... MarkComplete-17Mark section as complete0..1boolean
.... 7dfe7c6a-ca7f-4ddf-9241-a7b918a9695aRegular medications: check if still required, appropriate dose, understanding of medication and adherence0..1groupExpressions:
..... CD-in-progress-23In progress0..1displayEnable When: MarkComplete-23 = false
..... CD-complete-23Complete0..1displayEnable When: MarkComplete-23 = true
..... 6eb59145-ed9a-4184-af83-3506d47e4d4eDoes your child take any regular medications (prescribed, over-the-counter, traditional, complementary and alternative)?0..1choiceiconiconValue Set: Yes/No
Expressions:
..... 3a2d27b6-e918-4df5-aca9-b374fcf9faadDo you take any regular medications (prescribed, over-the-counter, traditional, complementary and alternative)?0..1choiceiconiconValue Set: Yes/No
Expressions:
..... 874ec8db-95c9-4cc0-95db-e45edaa3cd12Up to date in the health record?1..1booleanEnable When:
..... 36290837-ad70-48b2-9c66-31533fec918bMedication understanding and adherence has been checked with patient1..1booleanEnable When:
..... aa9ff2ed-bcd2-406d-a9ff-89c201df2605Health priorities, actions and follow-up0..1text
..... MarkComplete-23Mark section as complete0..1boolean
.... d4e4db07-a795-4a30-bd0f-9c109f96a22bAllergies/adverse reactions0..1groupExpressions:
..... CD-in-progress-3In progress0..1displayEnable When: MarkComplete-3 = false
..... CD-complete-3Complete0..1displayEnable When: MarkComplete-3 = true
..... 8a1d70bf-a68b-4b7b-be73-ba6956fccc78Up to date in the health record?0..1boolean
..... 3e689aeb-69a1-4a9b-93bd-50377511dd9bHealth priorities, actions and follow-up0..1text
..... MarkComplete-3Mark section as complete0..1boolean
.... 01f67f0b-e3be-48d8-a2ad-4c54f469cd13Family history0..1groupExpressions:
..... CD-in-progress-9In progress0..1displayEnable When: MarkComplete-9 = false
..... CD-complete-9Complete0..1displayEnable When: MarkComplete-9 = true
..... 532e09ea-2c2d-48c6-81f8-e23380b329a0Provide relevant family history information0..1textExpressions:
...... 9bc2daf9-6d13-4747-90c3-4a1862f6199aDetails0..1display
..... df5b2081-a373-48ee-acab-96225dad3c1dProvide relevant family history information (including diabetes, heart disease, cancer, mental health)0..1textExpressions:
...... 8f801e02-bfe8-437f-ba51-07c8f3631a0eDetails0..1display
..... 49ee4583-c608-41d4-a1e9-c06cf4292369Health priorities, actions and follow-up0..1text
..... MarkComplete-9Mark section as complete0..1boolean
.... 0a3c9c93-5836-4a5b-93e5-d7de559e053aSocial and emotional wellbeing0..1groupExpressions:
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..... dfbf13b5-e9e1-4f2f-83fc-1b3b9e50c921This is based on material from the The State of Queensland, Red flags early identification guide (for children aged birth to five years). 2nd edn. South Brisbane, Qld: Child Development Program, Queensland Health, 2016. Available at www.childrens.health.qld.gov.au/wp-content/uploads/PDF/red-flags-a3.pdf [Accessed 2 December 2019]. © Developed by the Child Development Program in conjunction with Brisbane North Primary Health Network. Updated: July 2016.0..1display
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....... a005050c-ed79-46ed-ac14-2fc1496059a5Date performed0..1dateExpressions:
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  • Enable When: %HealthPrioritiesSummaryAllergiesAdverseReactions.exists()
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  • Calculated Value: %HealthPrioritiesSummaryLearningDevelopment
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  • Calculated Value: %HealthPrioritiesSummaryLearningWorkAdults
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  • Calculated Value: %HealthPrioritiesSummaryChronicDiseaseAgeing
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  • Enable When: (%age >= 50).intersect(%age <= 74) and %HealthPrioritiesSummaryScreeningPrograms.exists()
  • Calculated Value: %HealthPrioritiesSummaryScreeningPrograms
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  • Calculated Value: %HealthPrioritiesSummaryPhysicalActivityScreenTimeNotOlder
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..... 931457d4-0de0-434c-88af-eb1b17746953Gambling0..1texticoniconExpressions:
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  • Calculated Value: %HealthPrioritiesSummarySexualHealthAdolescents
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  • Calculated Value: %HealthPrioritiesSummarySexualHealthAdults
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  • Enable When: %age >= 50 and %HealthPrioritiesSummarySexualHealthOlder.exists()
  • Calculated Value: %HealthPrioritiesSummarySexualHealthOlder
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...... b4110a63-8547-4aa2-84c6-c1f64f0d24daConsider what follow-up appointments can be made at the time of the health check.0..1displayiconicon
...... c47cfd7e-0f15-4dd9-bd53-bb62851b677cReminder: MBS follow up items for clients at risk of or with chronic disease are available to support follow-up of health checks0..1displayiconicon
...... 1be25c55-2a2d-4b94-b826-bd17d9e35e92Referrals and appointments0..*group
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..... 8176151f-6d86-45eb-91b1-12458d75a181A copy of this health check has been offerered - including details of follow-up and future appointments0..1choiceOptions: 3 options
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doco Documentation for this format

Option Sets

Answer options for 5bbfb4a3-a667-4ef2-98c2-76e76da55c03

  • http://snomed.info/sct#257585005 ("Clinic")
  • http://snomed.info/sct#264362003 ("Home")
  • http://snomed.info/sct#257698009 ("School")

Answer options for 9a51c056-021d-445d-8eaa-2123a69aa9c2

  • http://snomed.info/sct#257585005 ("Clinic")
  • http://snomed.info/sct#264362003 ("Home")
  • http://snomed.info/sct#413817003 ("Early learning centre")

Answer options for c1cf9c00-15ef-4b98-bab0-20a5f01b4932

  • Up to date
  • Discussed today
  • Not required
  • Declined
  • Next due

Answer options for 29fada07-f981-44cf-8092-61c86365a965

  • Up to date
  • Discussed today
  • Not required
  • Declined
  • Next due

Answer options for 521df1b1-ff36-458b-8f99-e41c2b1685c8

  • Up to date
  • Discussed today
  • Not required
  • Declined
  • Next due

Answer options for 0b520b20-98df-4024-b25d-2986f6b96e77

  • 6 months
  • 9 months
  • 12 months
  • 18 months
  • 2 years
  • 3 years
  • 4 years
  • 5 years

Answer options for 9c717263-341e-416f-aad8-7aec7d2167c9

  • Does not smile or interact with people

Answer options for c10acb25-fdc3-401e-b0aa-d85b2921e5bb

  • Not sharing enjoyment with others using eye contact or facial expression

Answer options for b6bb38f6-8084-4c89-a0f2-9d77aacab61d

  • Does not notice someone new
  • Does not pay early turn taking games (eg peekaboo, rolling a ball)

Answer options for c0ad8dc5-4672-4b21-b30d-6dcc7a00109a

  • Lacks interest in playing and interacting with others

Answer options for fc0977e1-fd83-4d0b-a57a-e94c7fd41fdb

  • When playing with toys tends to bang, drop, or throw them rather than use them for their purpose (eg Cuddle doll, build blocks)

Answer options for 70f7b96f-eaae-490b-8522-1214c1b1aede

  • No interest in pretend play or interacting with other children
  • Difficulty noticing and understanding feelings in themselves and others (eg happy, sad)

Answer options for 03ff1391-f48d-4b99-894c-159f4d09eb33

  • Unwilling or unable to play cooperatively

Answer options for ee5f0a61-a8a1-473e-addf-ca5b1eaad7d3

  • Play is different than their friends

Answer options for 2b23128e-1622-4880-abd6-c9cd429b48e3

  • Not starting to babble (eg aahh, oohh)

Answer options for dfb86be5-b6ff-400e-b7d6-68701df086da

  • Not using gestures (eg pointing, showing, waving)
  • Not using two part babble (eg bubu, dada)

Answer options for 4d802a6d-c89e-4460-8091-874f855be4ad

  • No babbled phrases that sound like talking
  • No response to familiar words (eg bottle, daddy)

Answer options for b8e1a699-ed65-491f-9865-8ab855bb2d33

  • No clear words
  • Cannot understand short requests (eg 'Where is the ball?')

Answer options for 6c3637ed-4afd-45be-a15c-9d5e7d8e78e8

  • Not learning new words
  • Not putting words together (eg 'push car')

Answer options for 25d67a2f-8bbe-4f79-9488-1682d2ce49fa

  • Speech is difficult for familiar people to understand
  • Not using simple sentences (eg big car go)

Answer options for f00b5ae1-cc33-44f9-bd9b-f9b6c93cc005

  • Speech difficult to understand
  • Not able to follow directions with two steps (eg 'Put your bag away and then go play')

Answer options for 3e06438a-ee7d-4880-83aa-68d2ade997ce

  • Difficulty telling a parent what is wrong
  • Not able to answer questions in a simple conversation (eg What's your name? Who is your family?)

Answer options for 49d172b4-bc2f-46cd-95a8-2f3ecba8e852

  • Not reaching for and holding (grasping) toys
  • Hands frequently clenched
  • Does not explore objects with hand and mouth
  • Does not bring hands together at midline

Answer options for 785ec313-7b25-4d0d-9421-382981286cbc

  • Does not hold objects
  • Does not 'give' objects on request
  • Cannot move toy from one hand to another

Answer options for 2c2b263e-41a5-4dae-94e1-814f5bfca20a

  • Does not feed self finger foods or hold own bottle/cup
  • Unable to pick up small items using index finger and thumb

Answer options for d6d7d675-0fee-466d-85e8-5dae46adac40

  • Does not scribble with a crayon
  • Does not attempt to stack blocks after demonstration

Answer options for c48e4138-0952-49a7-9c77-14b3e6d1dad3

  • Does not attempt to feed self using a spoon and/or help with dressing

Answer options for 433e768c-8458-476a-8330-3f59a4aa94b4

  • Does not attempt everyday care skills (such as feeding or dressing)
  • Difficulty in manipulating small objects (eg threading beads)

Answer options for 06d96181-2b2d-48de-b80f-bd5ccb2fb3c1

  • Not toilet trained by day
  • Not able to draw lines and circles

Answer options for e08345d3-a919-4bf0-8775-5df84a173832

  • Concerns from teacher about school readiness
  • Not independently able to complete everyday routines such as feeding and dressing
  • Cannot draw simple pictures (eg stick person)

Answer options for 7f3861fd-b9f0-489d-8a39-5fdd18eeaf0e

  • Not holding head and shoulders up with good control when lying on tummy
  • Not holding head with good control in supported sitting

Answer options for 68809920-fbf4-48e5-89f7-c0b49a8b8f78

  • Not rolling
  • Not sitting independently/ without support
  • Not moving (eg creeping, crawling)
  • Not taking weight on legs when held in standing

Answer options for 5cf7c9bc-b3ec-43ac-8de8-65078f57a82b

  • No form of independent mobility (eg crawling, commando crawling, bottom shuffle)
  • Not pulling to stand independently and holding on for support

Answer options for a1137862-767c-49fb-883b-92bee7588edc

  • Not standing independently
  • Not attempting to walk without support

Answer options for dd83d558-6a7f-4b94-b677-7c2b31ccc52f

  • Not able to walk independently
  • Not able to walk up and down stairs holding on

Answer options for 5ea4460c-a4c5-4025-bf85-64884a66458f

  • Not able to walk up and down stairs independently
  • Not able to run or jump

Answer options for 75b597b4-3b38-4efd-aeb2-ab1551d83c3c

  • Not able to walk, run, climb, jump and uses stairs confidently
  • Cannot catch, throw or kick a ball

Answer options for f23ac52c-2064-4032-b283-6ce09fc306fa

  • Not able to walk, run, climb, jump and use stairs confidently
  • Not able to hop five times on one leg and stand on one leg for five seconds

Answer options for 758d4109-363a-48c9-95f3-8a8d8b1b32ec

  • Strong parental concerns
  • Significant loss of skills
  • Lack of response to sound or visual stimuli
  • Poor interaction with adults or other children
  • Lack of, or limited eye contact
  • Differences between right and left sides of body in strength, movement or tone
  • Marked low tone (floppy) or high tone (stiff and tense) and significantly impacting on development and functional motor skills

Answer options for b639a3a8-f476-4cc8-b5c7-f5d2abb23511

  • http://snomed.info/sct#266919005 ("Never smoked")
  • http://snomed.info/sct#77176002 ("Smoker")
  • http://snomed.info/sct#8517006 ("Ex-Smoker")
  • http://snomed.info/sct#16090371000119103 ("Environmental exposure to tobacco smoke (home, car, etc)")
  • Wants to quit
  • Other tobacco use

Answer options for 96dc7c22-d003-459c-8a56-f6cd182fc077

  • http://snomed.info/sct#48031000119106 ("Quit >=12 months")
  • http://snomed.info/sct#735128000 ("Quit <12 months")

Answer options for 37dbd343-6d02-477c-89bf-59ba022efbb7

  • http://snomed.info/sct#736595007 ("Declined")
  • http://snomed.info/sct#410527000 ("Offered")
  • http://snomed.info/sct#171154002 ("Not required")
  • http://snomed.info/sct#171155001 ("Up to date")

Answer options for 202b5b91-541e-4a72-b1f6-1d474b59b7a3

  • http://snomed.info/sct#60332004 ("Trichiasis")
  • http://snomed.info/sct#95726001 ("Corneal scarring")

Answer options for 6ae69487-345e-46a0-a8db-b1356671ee59

  • http://snomed.info/sct#60332004 ("Trichiasis")
  • http://snomed.info/sct#95726001 ("Corneal scarring")

Answer options for dedfc83e-7451-404d-bd24-97b1254304eb

  • Clear and intact
  • Dull and intact
  • Discharge
  • Retracted
  • Unable to view eardrum
  • Wax
  • Grommet in canal
  • Grommet in eardrum
  • Perforation
  • Red/bulging

Answer options for 23daa784-4476-447f-8aa2-42933b4490d9

  • Clear and intact
  • Dull and intact
  • Discharge
  • Retracted
  • Unable to view eardrum
  • Wax
  • Grommet in canal
  • Grommet in eardrum
  • Perforation
  • Red/bulging

Answer options for 079df9c5-234c-4129-8769-800dab47a59a

  • Clear and intact
  • Dull and intact
  • Discharge
  • Retracted
  • Unable to view eardrum
  • Wax

Answer options for ce1fc869-a412-4aea-aa53-36e794a14519

  • Clear and intact
  • Dull and intact
  • Discharge
  • Retracted
  • Unable to view eardrum
  • Wax

Answer options for 99a8eb6f-a36a-4daf-99d7-27bfde0d4bb1

  • http://snomed.info/sct#271636001 ("Pulse Regular")
  • http://snomed.info/sct#61086009 ("Pulse Irregular")

Answer options for bac0f824-3784-400e-80f9-ad18d46bd8cb

  • http://snomed.info/sct#266919005 ("Never smoked")
  • http://snomed.info/sct#77176002 ("Smoker")
  • http://snomed.info/sct#8517006 ("Ex-Smoker")
  • http://snomed.info/sct#16090371000119103 ("Environmental exposure to tobacco smoke (home, car, etc)")
  • Wants to quit
  • Other tobacco use

Answer options for 28ff9463-b77f-435d-9ba7-427682a61f96

  • High Risk
  • Intermediate Risk
  • Low Risk

Answer options for 041a589e-7bb5-441d-a4ba-a22db8040b3f

  • Reclassified up
  • Reclassified down
  • Did not reclassify

Answer options for d0e58402-a08a-49ca-b2ca-9f4bbdb89da0

  • Sugary drinks
  • Screen use
  • Healthy eating, including breastfeeding
  • Environmental exposure to harmful elements eg tobacco smoke
  • Physical activity and exercise
  • Sun protection
  • Parenting advice
  • Safe sleeping practices
  • Developmental milestones - including language and hearing

Answer options for 0f70dec3-c1f2-4b36-b1f6-bd7f5743d5f8

  • Healthy eating
  • Screen use
  • Sun protection
  • Environmental exposure to harmful elements (e.g. tobacco smoke)
  • Sugary drinks
  • Physical activity and exercise
  • Parenting advice

Answer options for eaed9770-95f4-4c6a-b06c-d573427a2616

  • Healthy eating
  • Screen use
  • Physical activity and exercise
  • Mental health and wellbeing
  • Safety/risky behaviours
  • Smoking cessation
  • Substance use/harm minimisation
  • Safe sex/contraception
  • Care of teeth and gums

Answer options for 25f27e83-fcf0-49c8-86c1-e285e201a043

  • Healthy eating
  • Screen use
  • Physical activity and exercise
  • Mental health and wellbeing
  • Carer support
  • Safety/risky behaviours
  • Smoking cessation
  • Substance use/harm minimisation
  • Safe sex/contraception
  • Oral and dental health

Answer options for 2657da9c-a27e-4939-af7a-08a19b9ab6f7

  • Healthy eating
  • Physical activity and exercise
  • Mental health and wellbeing
  • Carer support
  • Smoking cessation
  • Substance use/harm minimisation
  • Social support and services
  • Oral and dental health

Answer options for 4044d0b4-94b2-4a89-b826-a14614298511

  • GP follow-up
  • Aboriginal and/or Torres Strait Islander Health Worker follow-up
  • Aboriginal and/or Torres Strait Islander Health Practitioner follow-up
  • Practice nurse follow-up
  • Child health nurse
  • Dentist
  • Paediatrician
  • Audiology
  • Speech pathology
  • Mental health
  • Early intervention (development) services
  • Parenting programs/support services

Answer options for f97f211a-ef2a-49a3-aef7-c4e9cd08aa2a

  • GP follow-up
  • Aboriginal and/or Torres Strait Islander Health Worker follow-up
  • Aboriginal and/or Torres Strait Islander Health Practitioner follow-up
  • Practice nurse follow-up
  • Dentist
  • Paediatrician
  • Audiology
  • Speech pathology
  • Mental health
  • Parenting programs/support services

Answer options for 07cfe077-ba93-4f93-b2a5-027023faa33b

  • GP follow-up
  • GP review of results of investigations
  • Aboriginal and/or Torres Strait Islander Health Worker follow-up
  • Aboriginal and/or Torres Strait Islander Health Practitioner follow-up
  • Practice nurse follow-up
  • Dentist
  • Paediatrician
  • Audiology
  • Speech pathology
  • Parenting programs/support services
  • Social and emotional wellbeing/mental health

Answer options for a525c370-d8c3-4764-ab3a-bf62081725e0

  • GP follow-up
  • GP review of results of investigations
  • Aboriginal and/or Torres Strait Islander Health Worker follow-up
  • Aboriginal and/or Torres Strait Islander Health Practitioner follow-up
  • Practice nurse follow-up
  • Dentist
  • Medication review
  • Smoking cessation
  • Audiology
  • Dietician
  • Physiotherapist or exercise program
  • Parenting programs/support services
  • Social and emotional wellbeing/mental health

Answer options for d68d9693-48d3-4663-9dbb-dd3a7aec5278

  • GP follow-up
  • GP review of results of investigations
  • Aboriginal and/or Torres Strait Islander Health Worker follow-up
  • Aboriginal and/or Torres Strait Islander Health Practitioner follow-up
  • Practice nurse follow-up
  • Dentist
  • Medication review
  • Geriatrician
  • Smoking cessation
  • Audiologist
  • Dietician
  • Physiotherapist or exercise program
  • Optometrist
  • Podiatrist
  • Social and emotional wellbeing/mental health
  • Social support and services

Answer options for 8176151f-6d86-45eb-91b1-12458d75a181

  • Yes, copy taken
  • Yes, but declined
  • Not offered. Plan to follow up and offer at a later date