Smart Forms
0.2.0-draft - trial-use

This page is part of the Smart Forms (v0.2.0-draft: R1 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
Draft as of 2024-04-02 Computable Name: AboriginalTorresStraitIslanderHealthCheck

Copyright/Legal: Copyright © 2022+ Australian Government Department of Health and Aged Care - All rights reserved. This content is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. See https://creativecommons.org/licenses/by-sa/4.0/.

Aboriginal and Torres Strait Islander Health Check assessment form.

Generated Narrative: Questionnaire AssemblyInstructions

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. AboriginalTorresStraitIslanderHealthCheckAboriginal and Torres Strait Islander Health Check assessment form.Questionnairehttp://www.health.gov.au/assessments/mbs/715#0.1.0
... fd5af92e-c248-497a-8007-ee0952ccd4d9null0..1group
.... cd3303a6-e3b6-4732-80e8-54d2bd740bebSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/AboutTheHealthCheck|0.1.0] not available. Unable to display all questions.0..1display
.... fab52f87-22a6-4a54-9797-0bb6b0f5d2a2Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/Consent|0.1.0] not available. Unable to display all questions.0..1display
.... 1d10910d-c195-4964-bdc6-98310a44719eSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/PatientDetails|0.1.0] not available. Unable to display all questions.0..1display
.... 7692f28c-7c0a-48ea-b27d-a8489974377dSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/CurrentPriorities|0.1.0] not available. Unable to display all questions.0..1display
.... 15f83d80-f49a-4852-a20f-18db9b951e53Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/MedicalHistory|0.1.0] not available. Unable to display all questions.0..1display
.... 3a7151ef-d63b-4818-8367-03d394383a61Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/RegularMedications|0.1.0] not available. Unable to display all questions.0..1display
.... 334853dc-88d4-4cb1-a119-bb0ff6ea0516Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/AllergiesAdverseReactions|0.1.0] not available. Unable to display all questions.0..1display
.... 1ab9b519-85ce-48ee-a408-8f0b9b74d112Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/FamilyHistory|0.1.0] not available. Unable to display all questions.0..1display
.... 228b8d31-21e3-49a6-b802-984135908dcaSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/SocialAndEmotionalWellbeing|0.1.0] not available. Unable to display all questions.0..1display
.... a43517f9-538e-4a4d-8789-b6c3d44206baSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/SocialHistoryChild|0.1.0] not available. Unable to display all questions.0..1display
.... 8decf7bf-e24c-4d3d-815c-c53e269f004bSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/HomeAndFamily|0.1.0] not available. Unable to display all questions.0..1display
.... 3f554c37-7d0e-4b14-8f7f-a9ec665cc0a6Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/LearningAndDevelopment|0.1.0] not available. Unable to display all questions.0..1display
.... 362bf381-23e5-4eee-963a-3de73e584da5Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/LearningAndWork|0.1.0] not available. Unable to display all questions.0..1display
.... 51a545fa-907f-40f0-9304-36bcab5a16b8Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/Mood|0.1.0] not available. Unable to display all questions.0..1display
.... 4217646d-e8e4-4ac5-baa7-fae28937cda7Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/MemoryAndThinking|0.1.0] not available. Unable to display all questions.0..1display
.... 070eadcf-9e93-499e-8615-61991ab35b32Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/ChronicDiseaseAgeing|0.1.0] not available. Unable to display all questions.0..1display
.... 56d4bc0b-3bf1-4d47-ac34-5a1de0902de1Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/ScreeningPrograms|0.1.0] not available. Unable to display all questions.0..1display
.... e0962739-c506-41d4-afd7-ab1b90db9cb4Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/HealthyEating|0.1.0] not available. Unable to display all questions.0..1display
.... 63cfb279-cd7d-41ed-a54b-0c17b6efe609Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/PhysicalActivityAndScreenTime|0.1.0] not available. Unable to display all questions.0..1display
.... db70690e-2199-495a-9919-53697efaf913Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/RedFlagsEarlyIdentificationGuide|0.1.0] not available. Unable to display all questions.0..1display
.... d1f66f56-75fa-4498-9c51-eb98e1644243Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/SubstanceUse|0.1.0] not available. Unable to display all questions.0..1display
.... ea748251-bf77-4085-b912-e9002dfa02caSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/Gambling|0.1.0] not available. Unable to display all questions.0..1display
.... 84bd802b-b3e1-4098-aa2c-2133f0e252f4Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/SexualHealth|0.1.0] not available. Unable to display all questions.0..1display
.... 56ad8128-0e12-4779-8ff4-47dcff6b29b5Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/EyeHealth|0.1.0] not available. Unable to display all questions.0..1display
.... a8161e91-7cff-403f-85e6-982a9bc8fca6Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/EarHealthAndHearing|0.1.0] not available. Unable to display all questions.0..1display
.... fe05d868-aaed-4921-9d49-4e7746bbe143Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/OralAndDentalHealth|0.1.0] not available. Unable to display all questions.0..1display
.... 64ec4c1c-0824-4b84-8d3f-40f6e066cb80Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/Skin|0.1.0] not available. Unable to display all questions.0..1display
.... 595737cd-3a94-442b-8be6-ab461c3181d2Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/Immunisation|0.1.0] not available. Unable to display all questions.0..1display
.... 3263611d-5813-4393-a660-d10166acd728Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/Examination|0.1.0] not available. Unable to display all questions.0..1display
.... 3a3b0810-e091-48ad-af50-913b0deaf663Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/AbsoluteCVDRiskCalculation|0.1.0] not available. Unable to display all questions.0..1display
.... 302d9437-25b9-41e3-9d66-138c352d32a8Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/Investigations|0.1.0] not available. Unable to display all questions.0..1display
.... ada45623-5e86-49ea-a00b-be0699364281Sub-questionnaire [http://www.health.gov.au/assessments/mbs/715/HealthPrioritiesSummary|0.1.0] not available. Unable to display all questions.0..1display
.... a6395946-872a-4f2e-b697-c74aa1ab9b8dSub-questionnaire [http://www.health.gov.au/assessments/mbs/715/FinalisingHealthCheck|0.1.0] not available. Unable to display all questions.0..1display

doco Documentation for this format

Contained Resources


Generated Narrative: ValueSet #YesNo

Expansion based on system expandedYes-NoIndicator v2.1.0 (CodeSystem)

This value set contains 2 concepts

CodeSystemDisplayDefinition
  Yhttp://terminology.hl7.org/CodeSystem/v2-0532Yes

Yes

  Nhttp://terminology.hl7.org/CodeSystem/v2-0532No

No


Generated Narrative: ValueSet #YesNoNA

Expansion based on system expandedYes-NoIndicator v2.1.0 (CodeSystem)

This value set contains 3 concepts

CodeSystemDisplayDefinition
  Yhttp://terminology.hl7.org/CodeSystem/v2-0532Yes

Yes

  Nhttp://terminology.hl7.org/CodeSystem/v2-0532No

No

  NAhttp://terminology.hl7.org/CodeSystem/v2-0532N/A

not applicable


Generated Narrative: ValueSet #YesNoNotAskedDeclined

Expansion based on:

This value set contains 4 concepts

CodeSystemDisplayDefinition
  Yhttp://terminology.hl7.org/CodeSystem/v2-0532Yes

Yes

  Nhttp://terminology.hl7.org/CodeSystem/v2-0532No

No

  NASKhttp://terminology.hl7.org/CodeSystem/v2-0532Not Asked

not asked

  asked-declinedhttp://terminology.hl7.org/CodeSystem/data-absent-reasonAsked But Declined

The source was asked but declined to answer.


Generated Narrative: ValueSet #clinical-condition-1


Generated Narrative: ValueSet #administrative-gender

Expansion based on system AdministrativeGender v4.0.1 (CodeSystem)

This value set contains 4 concepts

CodeSystemDisplayDefinitionv2 map for AdministrativeGenderv3 map for AdministrativeGender
  femalehttp://hl7.org/fhir/administrative-genderFemale

Female.

~F~F
  malehttp://hl7.org/fhir/administrative-genderMale

Male.

~M~M
  otherhttp://hl7.org/fhir/administrative-genderOther

Other.

<A
<O
<UN
  unknownhttp://hl7.org/fhir/administrative-genderUnknown

Unknown.

~U~UNK

Generated Narrative: ValueSet #condition-clinical

Expansion based on system Condition Clinical Status Codes version4.0.1

This value set contains 6 concepts

CodeSystemDisplayDefinition
  activehttp://terminology.hl7.org/CodeSystem/condition-clinicalActive

The subject is currently experiencing the condition or situation, there is evidence of the condition or situation, or considered to be a significant risk.

  inactivehttp://terminology.hl7.org/CodeSystem/condition-clinicalInactive

The subject is no longer experiencing the condition or situation and there is no longer evidence or appreciable risk of the condition or situation.

  recurrencehttp://terminology.hl7.org/CodeSystem/condition-clinicalRecurrence

The subject is experiencing a reoccurence or repeating of a previously resolved condition or situation, e.g. urinary tract infection, food insecurity.

  relapsehttp://terminology.hl7.org/CodeSystem/condition-clinicalRelapse

The subject is experiencing a return of a condition or situation after a period of improvement or remission, e.g. relapse of cancer, alcoholism.

  remissionhttp://terminology.hl7.org/CodeSystem/condition-clinicalRemission

The subject is not presently experiencing the condition or situation, but there is a risk of the condition or situation returning.

  resolvedhttp://terminology.hl7.org/CodeSystem/condition-clinicalResolved

The subject is not presently experiencing the condition or situation and there is a negligible perceived risk of the condition or situation returning.


Generated Narrative: ValueSet #AboriginalTorresStraitIslander

Expansion based on system australian-indigenous-status-1 version1.0.3

This value set contains 3 concepts

CodeSystemDisplay
  1https://healthterminologies.gov.au/fhir/CodeSystem/australian-indigenous-status-1Aboriginal but not Torres Strait Islander origin
  2https://healthterminologies.gov.au/fhir/CodeSystem/australian-indigenous-status-1Torres Strait Islander but not Aboriginal origin
  3https://healthterminologies.gov.au/fhir/CodeSystem/australian-indigenous-status-1Both Aboriginal and Torres Strait Islander origin

Generated Narrative: ValueSet #PrimaryCarerParentGrandparent

Expansion based on:

  • system NullFlavor version2018-08-12
  • system RoleCode version2018-08-12

This value set contains 4 concepts

CodeSystemDisplayDefinition
  MTHhttp://terminology.hl7.org/CodeSystem/v3-RoleCodemother

The player of the role is a female who conceives, gives birth to, or raises and nurtures the scoping entity (child).

  FTHhttp://terminology.hl7.org/CodeSystem/v3-RoleCodefather

The player of the role is a male who begets or raises or nurtures the scoping entity (child).

  GRPRNhttp://terminology.hl7.org/CodeSystem/v3-RoleCodegrandparent

The player of the role is a parent of the scoping person's mother or father.

  NAhttp://terminology.hl7.org/CodeSystem/v3-NullFlavornot applicable

Known to have no proper value (e.g., last menstrual period for a male).


Generated Narrative: ValueSet #australian-pronouns-1

Expansion based on:

  • Loinc v2.77
  • system DataAbsentReason version5.0.0-ballot

This value set contains 7 concepts

CodeSystemDisplayDefinition
  LA29518-0http://loinc.orghe/him/his/his/himself
  LA29519-8http://loinc.orgshe/her/her/hers/herself
  LA29520-6http://loinc.orgthey/them/their/theirs/themselves
  asked-declinedhttp://terminology.hl7.org/CodeSystem/data-absent-reasonAsked But Declined

The source was asked but declined to answer.

  asked-unknownhttp://terminology.hl7.org/CodeSystem/data-absent-reasonAsked But Unknown

The source was asked but does not know the value.

  not-askedhttp://terminology.hl7.org/CodeSystem/data-absent-reasonNot Asked

The workflow didn't lead to this value being known.

  unknownhttp://terminology.hl7.org/CodeSystem/data-absent-reasonUnknown

The value is expected to exist but is not known.


Generated Narrative: ValueSet #australian-states-territories-2

Expansion based on system australian-states-territories-1 version1.1.3

This value set contains 9 concepts

CodeSystemDisplay
  ACThttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1Australian Capital Territory
  NSWhttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1New South Wales
  NThttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1Northern Territory
  OTHERhttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1Other territories
  QLDhttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1Queensland
  SAhttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1South Australia
  TAShttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1Tasmania
  VIChttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1Victoria
  WAhttps://healthterminologies.gov.au/fhir/CodeSystem/australian-states-territories-1Western Australia

Generated Narrative: ValueSet #gender-identity-response-1

Expansion based on:

  • SNOMED CT Australian edition 31-Mar 2024
  • system DataAbsentReason version5.0.0-ballot

This value set contains 6 concepts

CodeSystemDisplayDefinition
  446151000124109http://snomed.info/sctIdentifies as male gender
  446141000124107http://snomed.info/sctIdentifies as female gender
  33791000087105http://snomed.info/sctIdentifies as nonbinary gender
  unknownhttp://terminology.hl7.org/CodeSystem/data-absent-reasonUnknown

The value is expected to exist but is not known.

  asked-declinedhttp://terminology.hl7.org/CodeSystem/data-absent-reasonAsked But Declined

The source was asked but declined to answer.

  not-askedhttp://terminology.hl7.org/CodeSystem/data-absent-reasonNot Asked

The workflow didn't lead to this value being known.


Generated Narrative: ValueSet #biological-sex-1

Expansion based on SNOMED CT Australian edition 31-Aug 2023

This value set contains 4 concepts

CodeSystemDisplay
  248152002http://snomed.info/sctFemale
  32570681000036106http://snomed.info/sctIndeterminate sex
  32570691000036108http://snomed.info/sctIntersex
  248153007http://snomed.info/sctMale

Generated Narrative: ValueSet #SmokingQuitStatus-1

Expansion based on SNOMED CT Australian edition 31-Mar 2024

This value set contains 2 concepts

CodeSystemDisplay
  48031000119106http://snomed.info/sctQuit >12 months
  735128000http://snomed.info/sctQuit <12 months

Generated Narrative: ValueSet #CervicalScreeningStatus-1

Expansion based on SNOMED CT Australian edition 31-Mar 2024

This value set contains 4 concepts

CodeSystemDisplay
  736595007http://snomed.info/sctDeclined
  410527000http://snomed.info/sctOffered
  171154002http://snomed.info/sctNot required
  171155001http://snomed.info/sctUp to date