WHO SMART Guidelines - HIV - Local Development build (v0.4.3) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Questionnaire: Record outreach and result
Branch:Generated Narrative: Questionnaire HIV.H3RecordOutreachAndResult
Language: en
Profiles: Extractable Questionnaire - StructureMap, CRMI Shareable Questionnaire, CRMI Publishable Questionnaire
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  | Questionnaire for record outreach and result | Questionnaire | http://smart.who.int/hiv/Questionnaire/HIV.H3RecordOutreachAndResult#0.4.3 | ||
  HIV.H.DE23 | Outcome from outreach attempt | 0..1 | choice | Value Set: #HIV.H.DE23 | |
 HIV.H.DE30 | Moved from catchment area | 0..1 | boolean | ||
 HIV.H.DE31 | Date client moved from catchment area | 0..1 | date | ||
 HIV.H.DE32 | New catchment area | 0..1 | string | ||
| HIV.H.DE38 | Date of death | 0..1 | date | ||
| HIV.H.DE39 | Cause of death | 0..1 | string | ||
| HIV.H.DE40 | Place of death | 0..1 | string | ||
| HIV.H.DE41 | HIV treatment outcome | 0..1 | choice | Value Set: #HIV.H.DE41 | |
| HIV.H.DE46 | Date patient lost to follow-up | 0..1 | date | ||
| HIV.H.DE47 | On ART | 0..1 | boolean | ||
| HIV.H.DE48 | Date HIV treatment outcome changed | 0..1 | date | ||
| HIV.H.DE49 | Transfer confirmed | 0..1 | boolean | ||
| HIV.H.DE50 | Transfer to facility | 0..1 | choice | Value Set: #HIV.H.DE50 | |
| HIV.H.DE51 | Date of transfer out | 0..1 | date | ||
| HIV.H.DE52 | Adherence assessment | 0..1 | boolean | ||
| HIV.H.DE53 | Reason(s) for adherence problem | 0..1 | choice | Value Set: #HIV.H.DE53 | |
| HIV.H.DE72 | Other (specify) | 0..1 | string | ||
| HIV.H.DE73 | Date ART stopped | 0..1 | date | ||
| HIV.H.DE74 | Reason ART stopped | 0..1 | choice | Value Set: #HIV.H.DE74 | |
 HIV.H.DE81 | Other reason for stopping ART (specify) | 0..1 | string | ||
| Documentation for this format | |||||