{ "resourceType" : "Questionnaire", "id" : "ICVP", "meta" : { "profile" : ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire ICVP

\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" Questionnaire for DVC Logical Model with the WHO ICVPQuestionnairehttp://smart.who.int/icvp/Questionnaire/ICVP#0.1.0
\".\"\".\"\".\" nameFull Name of the client1..1string
\".\"\".\"\".\" dobDate of Birth1..1date
\".\"\".\"\".\" sexSex0..1choiceValue Set: hl7VS-administrativeSex
\".\"\".\"\".\" nationalityNationality0..1choiceValue Set: Country
\".\"\".\"\".\" nidNational Identification Document0..1string
\".\"\".\"\".\" guardianParent or Guardian Details0..1group
\".\"\".\"\".\"\".\" guardianNameName of Parent or Guardian0..1string
\".\"\".\"\".\"\".\" guardianRelationshipRelationship Status0..1choiceValue Set: Relationship Status for Contact in Patient
\".\"\".\"\".\" vaccineDetailsVaccine Certificate Details1..*group
\".\"\".\"\".\"\".\" productIDVaccine or Prophylaxis ID1..1choiceValue Set: WHO ICVP Vaccine Product Ids
\".\"\".\"\".\"\".\" dateDate of Vaccination1..1date
\".\"\".\"\".\"\".\" clinicianNameName of supervising clinician0..1string
\".\"\".\"\".\"\".\" issuerRelevant authoring reponsible for issuing the certificate, or for overseeing the administration center0..1string
\".\"\".\"\".\"\".\" batchNo.textBatch Number1..1string
\".\"\".\"\".\"\".\" validityPeriodCertificate Validity Period0..1group
\".\"\".\"\".\"\".\"\".\" startDateFrom0..1date
\".\"\".\"\".\"\".\"\".\" endDateTo0..1date

\"doco\" Documentation for this format

Contained Resources

ValueSet #v3-Country

Language: en

ValueSet #ICVPProductIds

ValueSet #DVCRelationshipStatus

ValueSet #preQualVaccines

" }, "contained" : [{ "resourceType" : "ValueSet", "id" : "v3-Country", "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: ValueSet v3-Country

Language: en

" }, "url" : "http://terminology.hl7.org/ValueSet/v3-Country", "identifier" : [{ "system" : "urn:ietf:rfc:3986", "value" : "urn:oid:2.16.840.1.113883.1.11.171" }], "version" : "3.0.0", "name" : "Country", "title" : "Country", "status" : "active", "experimental" : false, "date" : "2014-03-26", "publisher" : "Health Level Seven International", "contact" : [{ "telecom" : [{ "system" : "url", "value" : "http://hl7.org" }, { "system" : "email", "value" : "hq@HL7.org" }] }], "description" : "Countries of the world. ISO 3166, part 1, alpha-3 set.", "copyright" : "This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html", "compose" : { "include" : [{ "system" : "urn:iso:std:iso:3166", "filter" : [{ "property" : "code", "op" : "regex", "value" : "[A-Z]{3}" }] }] } }, { "resourceType" : "ValueSet", "id" : "ICVPProductIds", "url" : "http://smart.who.int/icvp/ValueSet/ICVPProductIds", "name" : "ICVPProductIds", "title" : "WHO ICVP Vaccine Product Ids", "status" : "active", "experimental" : true, "description" : "WHO ICVP Vaccine Product Ids", "compose" : { "include" : [{ "system" : "http://smart.who.int/pcmt-vaxprequal/CodeSystem/PreQualProductIDs", "concept" : [{ "code" : "YellowFeverProductd2c75a15ed309658b3968519ddb31690", "display" : "26/03/2009Yellow Fevern/aAmpoule2Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation" }, { "code" : "YellowFeverProduct771d1a5c0acaee3e2dc9d56af1aba49d", "display" : "26/03/2009Yellow Fevern/aAmpoule5Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation" }, { "code" : "YellowFeverProducte929626497bdbb71adbe925f0c09c79f", "display" : "26/03/2009Yellow Fevern/aAmpoule10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation" }, { "code" : "YellowFeverProduct01a3b83cf13e87948437db11cf5c34eb", "display" : "14/10/2022Yellow FeverSinSaVac™Vial10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation" }, { "code" : "YellowFeverProductf82b015dfb3b1feeacd4c44d95b3b3ec", "display" : "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule5Institut Pasteur de DakarMinistère de la Santé publique" }, { "code" : "YellowFeverProduct223330a7c15da86b21cc363f591de002", "display" : "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule10Institut Pasteur de DakarMinistère de la Santé publique" }, { "code" : "YellowFeverProductffea8448252ee58b7a92add05f0c3431", "display" : "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule20Institut Pasteur de DakarMinistère de la Santé publique" }, { "code" : "YellowFeverProductd8a09f80301dc05e124f99ffe7711fc0", "display" : "01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé" }, { "code" : "YellowFeverProductab01f006f8b24113f4a28cb50bfe6d9d", "display" : "17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)5Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria" }, { "code" : "YellowFeverProduct5f0639d8e4d52afef089aa7148c5060c", "display" : "10/12/2007Yellow FeverYellow FeverTwo vial set (active + excipient)10Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria" }, { "code" : "YellowFeverProducte0534dbc71a6cc09f56dce25216c538c", "display" : "17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)50Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria" }] }] } }, { "resourceType" : "ValueSet", "id" : "DVCRelationshipStatus", "url" : "http://smart.who.int/icvp/ValueSet/DVCRelationshipStatus", "name" : "DVCRelationshipStatus", "title" : "Relationship Status for Contact in Patient", "status" : "draft", "description" : "Relationship Status for Contact in Patient", "compose" : { "include" : [{ "system" : "http://smart.who.int/icvp/CodeSystem/DVCRelationshipStatus" }] } }, { "resourceType" : "ValueSet", "id" : "preQualVaccines", "url" : "http://smart.who.int/icvp/ValueSet/preQualVaccines", "name" : "preQualVaccines", "title" : "preQualVaccines", "status" : "draft", "description" : "preQualVaccines value set", "compose" : { "include" : [{ "system" : "http://smart.who.int/icvp/CodeSystem/preQualVaccines" }] } }], "url" : "http://smart.who.int/icvp/Questionnaire/ICVP", "version" : "0.1.0", "title" : "ICVP Model Questionnaire", "status" : "draft", "date" : "2025-02-15T21:19:05+00:00", "publisher" : "WHO", "contact" : [{ "name" : "WHO", "telecom" : [{ "system" : "url", "value" : "http://who.int" }] }], "description" : "Questionnaire for DVC Logical Model with the WHO ICVP", "item" : [{ "linkId" : "name", "text" : "Full Name of the client", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "dob", "text" : "Date of Birth", "type" : "date", "required" : true, "repeats" : false }, { "linkId" : "sex", "text" : "Sex", "type" : "choice", "required" : false, "repeats" : false, "answerValueSet" : "http://terminology.hl7.org/ValueSet/v2-0001" }, { "linkId" : "nationality", "text" : "Nationality", "type" : "choice", "required" : false, "repeats" : false, "answerValueSet" : "http://terminology.hl7.org/ValueSet/v3-Country" }, { "linkId" : "nid", "text" : "National Identification Document", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "guardian", "text" : "Parent or Guardian Details", "type" : "group", "required" : false, "repeats" : false, "item" : [{ "linkId" : "guardianName", "text" : "Name of Parent or Guardian", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "guardianRelationship", "text" : "Relationship Status", "type" : "choice", "required" : false, "repeats" : false, "answerValueSet" : "#DVCRelationshipStatus" }] }, { "linkId" : "vaccineDetails", "text" : "Vaccine Certificate Details", "type" : "group", "required" : true, "repeats" : true, "item" : [{ "linkId" : "productID", "text" : "Vaccine or Prophylaxis ID", "type" : "choice", "required" : true, "repeats" : false, "answerValueSet" : "http://smart.who.int/icvp/ValueSet/ICVPProductIds" }, { "linkId" : "date", "text" : "Date of Vaccination", "type" : "date", "required" : true, "repeats" : false }, { "linkId" : "clinicianName", "text" : "Name of supervising clinician", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "issuer", "text" : "Relevant authoring reponsible for issuing the certificate, or for overseeing the administration center", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "batchNo.text", "text" : "Batch Number", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "validityPeriod", "text" : "Certificate Validity Period", "type" : "group", "required" : false, "repeats" : false, "item" : [{ "linkId" : "startDate", "text" : "From", "type" : "date", "required" : false, "repeats" : false }, { "linkId" : "endDate", "text" : "To", "type" : "date", "required" : false, "repeats" : false }] }] }] }