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
Draft as of 2024-04-02 |
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="FamilyHistory"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-render"/>
<profile
value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-modular"/>
<profile
value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-exp"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire FamilyHistory</b></p><a name="FamilyHistory"> </a><a name="hcFamilyHistory"> </a><a name="FamilyHistory-en-US"> </a><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> FamilyHistory</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Family History sub-questionnaire for Aboriginal and Torres Strait Islander Health Check.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://www.health.gov.au/assessments/mbs/715/FamilyHistory#0.2.0-draft</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item.01f67f0b-e3be-48d8-a2ad-4c54f469cd13" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> 01f67f0b-e3be-48d8-a2ad-4c54f469cd13</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Family history</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.CD-in-progress-9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> CD-in-progress-9</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In progress</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.MarkComplete-9">MarkComplete-9</a> != </span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.CD-complete-9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> CD-complete-9</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Complete</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Enable When: <span><a href="#item.MarkComplete-9">MarkComplete-9</a> = </span></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" id="item.532e09ea-2c2d-48c6-81f8-e23380b329a0" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> 532e09ea-2c2d-48c6-81f8-e23380b329a0</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Provide relevant family history information</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)" id="item.9bc2daf9-6d13-4747-90c3-4a1862f6199a" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> 9bc2daf9-6d13-4747-90c3-4a1862f6199a</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Details</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" id="item.df5b2081-a373-48ee-acab-96225dad3c1d" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> df5b2081-a373-48ee-acab-96225dad3c1d</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Provide relevant family history information (including diabetes, heart disease, cancer, mental health)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)" id="item.8f801e02-bfe8-437f-ba51-07c8f3631a0e" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> 8f801e02-bfe8-437f-ba51-07c8f3631a0e</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Details</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.49ee4583-c608-41d4-a1e9-c06cf4292369" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-text.png" alt="." style="background-color: white; background-color: inherit" title="text" class="hierarchy"/> 49ee4583-c608-41d4-a1e9-c06cf4292369</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Health priorities, actions and follow-up</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text">text</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" id="item.MarkComplete-9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="boolean" class="hierarchy"/> MarkComplete-9</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Mark section as complete</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assemble-expectation">
<valueCode value="assemble-child"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext">
<extension url="name">
<valueCoding>
<system value="http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"/>
<code value="patient"/>
</valueCoding>
</extension>
<extension url="type">
<valueCode value="Patient"/>
</extension>
<extension url="description">
<valueString
value="The patient that is to be used to pre-populate the form"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext">
<extension url="name">
<valueCoding>
<system value="http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"/>
<code value="user"/>
</valueCoding>
</extension>
<extension url="type">
<valueCode value="Practitioner"/>
</extension>
<extension url="description">
<valueString
value="The practitioner user that is to be used to pre-populate the form"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext">
<extension url="name">
<valueCoding>
<system value="http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"/>
<code value="encounter"/>
</valueCoding>
</extension>
<extension url="type">
<valueCode value="Encounter"/>
</extension>
<extension url="description">
<valueString
value="The encounter that is to be used to pre-populate the form"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assembleContext">
<valueString value="age"/>
</extension>
<url value="http://www.health.gov.au/assessments/mbs/715/FamilyHistory"/>
<version value="0.2.0-draft"/>
<name value="FamilyHistory"/>
<title
value="Aboriginal and Torres Strait Islander Health Check - Family History"/>
<status value="draft"/>
<experimental value="false"/>
<subjectType value="Patient"/>
<date value="2024-04-02"/>
<publisher value="AEHRC CSIRO"/>
<contact>
<name value="AEHRC CSIRO"/>
<telecom>
<system value="url"/>
<value
value="https://confluence.csiro.au/display/PCDQFPhase2/Primary+Care+Data+Quality+Foundations+-+Phase+2"/>
</telecom>
</contact>
<description
value="Family History sub-questionnaire for Aboriginal and Torres Strait Islander Health Check."/>
<copyright
value="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/."/>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%age.exists()"/>
</valueExpression>
</extension>
<linkId value="01f67f0b-e3be-48d8-a2ad-4c54f469cd13"/>
<text value="Family history"/>
<type value="group"/>
<repeats value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system
value="https://smartforms.csiro.au/ig/CodeSystem/QuestionnaireItemControlExtended"/>
<code value="context-display"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="CD-in-progress-9"/>
<text value="In progress">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="<div title="In progress" xmlns="http://www.w3.org/1999/xhtml">
<div style="display: flex; flex-direction: row;">
<img width='24' height='24' src='data:image/svg+xml;base64,
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'
style="align-self: center;"/>
</div>
</div>"/>
</extension>
</text>
<type value="display"/>
<enableWhen>
<question value="MarkComplete-9"/>
<operator value="!="/>
<answerBoolean value="true"/>
</enableWhen>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system
value="https://smartforms.csiro.au/ig/CodeSystem/QuestionnaireItemControlExtended"/>
<code value="context-display"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="CD-complete-9"/>
<text value="Complete">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="<div title="Section completed" xmlns="http://www.w3.org/1999/xhtml">
<div style="display: flex; flex-direction: row;">
<img width='24' height='24' src='data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHdpZHRoPSIxZW0iIGhlaWdodD0iMWVtIiB2aWV3Qm94PSIwIDAgMjQgMjQiPjxwYXRoIGZpbGw9IiMyZTdkMzIiIGQ9Ik0yMCAxMmE4IDggMCAwIDEtOCA4YTggOCAwIDAgMS04LThhOCA4IDAgMCAxIDgtOGMuNzYgMCAxLjUuMTEgMi4yLjMxbDEuNTctMS41N0E5LjgyMiA5LjgyMiAwIDAgMCAxMiAyQTEwIDEwIDAgMCAwIDIgMTJhMTAgMTAgMCAwIDAgMTAgMTBhMTAgMTAgMCAwIDAgMTAtMTBNNy45MSAxMC4wOEw2LjUgMTEuNUwxMSAxNkwyMSA2bC0xLjQxLTEuNDJMMTEgMTMuMTdsLTMuMDktMy4wOVoiLz48L3N2Zz4='
style="align-self: center;"/>
</div>
</div>"/>
</extension>
</text>
<type value="display"/>
<enableWhen>
<question value="MarkComplete-9"/>
<operator value="="/>
<answerBoolean value="true"/>
</enableWhen>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%age <= 12"/>
</valueExpression>
</extension>
<linkId value="532e09ea-2c2d-48c6-81f8-e23380b329a0"/>
<text value="Provide relevant family history information"/>
<type value="text"/>
<repeats value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="prompt"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="9bc2daf9-6d13-4747-90c3-4a1862f6199a"/>
<text value="Details"/>
<type value="display"/>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%age > 12"/>
</valueExpression>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-shortText">
<valueString value="Provide relevant family history information"/>
</extension>
<linkId value="df5b2081-a373-48ee-acab-96225dad3c1d"/>
<text
value="Provide relevant family history information (including diabetes, heart disease, cancer, mental health)"/>
<type value="text"/>
<repeats value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="prompt"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="8f801e02-bfe8-437f-ba51-07c8f3631a0e"/>
<text value="Details"/>
<type value="display"/>
</item>
</item>
<item>
<linkId value="49ee4583-c608-41d4-a1e9-c06cf4292369"/>
<text value="Health priorities, actions and follow-up"/>
<type value="text"/>
<repeats value="false"/>
</item>
<item>
<linkId value="MarkComplete-9"/>
<text value="Mark section as complete">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="<div xmlns="http://www.w3.org/1999/xhtml">
<head>
<style type="text/css">
.alert {
padding: 0.875rem;
margin-bottom: 1rem;
font-size: 0.875rem;
color: #2E7D32;
border-radius: 0.5rem;
background-color: #d5e5d6;
font-weight: 700;
}
</style>
</head>
<body>
<div class="alert">Mark section as complete</div>
</body>
</div>"/>
</extension>
</text>
<type value="boolean"/>
<repeats value="false"/>
</item>
</item>
</Questionnaire>