{ "resourceType": "QuestionnaireResponse", "id": "SDOHCC-QuestionnaireResponsePRAPAREExample", "meta": { "versionId": "1", "lastUpdated": "2021-06-03T00:48:30.721+00:00", "source": "#lELuFd3L32Xc9mgx", "profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse|2.7" ] }, "text": { "status": "generated", "div": "

Generated Narrative

questionnaire: http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE

status: completed

subject: COLIN ABBAS. Generated Summary: Medical Record Number: 1032702 (USUAL); active; COLIN V. ABBAS , COLIN V. BAXTER ; Phone: 555-555-5555; gender: male; birthDate: 1987-02-20

authored: Apr 26, 2021 1:56:33 PM

item

linkId: /93025-5

text: Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]

item

linkId: /93043-8

text: Personal characteristics

item

linkId: /93042-0

text: Family and home

item

linkId: /93041-2

text: Money and resources

item

linkId: /93040-4

text: Social and emotional health

item

linkId: /93039-6

text: Optional additional questions

" }, "questionnaire": "http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE", "_questionnaire": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/display", "valueString": "SDOHCC Questionnaire PRAPARE" } ] }, "status": "completed", "subject": { "reference": "Patient/pat-53234", "display": "COLIN ABBAS" }, "authored": "2021-04-26T13:56:33.747Z", "item": [ { "linkId": "/93025-5", "text": "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]", "item": [ { "linkId": "/93043-8", "text": "Personal characteristics", "item": [ { "linkId": "/93043-8/56051-6", "text": "Do you consider yourself Hispanic/Latino?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA32-8", "display": "No" } } ] }, { "linkId": "/93043-8/32624-9", "text": "Race", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA4457-3", "display": "White" } }, { "valueCoding": { "system": "http://loinc.org", "code": "LA30187-1", "display": "Pacific Islander" } } ] }, { "linkId": "/93043-8/93035-4", "text": "At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA33-6", "display": "Yes" } } ] }, { "linkId": "/93043-8/93034-7", "text": "Have you been discharged from the armed forces of the United States?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA32-8", "display": "No" } } ] }, { "linkId": "/93043-8/54899-0", "text": "Preferred language", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA43-5", "display": "English" } } ] } ] }, { "linkId": "/93042-0", "text": "Family and home", "item": [ { "linkId": "/93042-0/63512-8", "text": "How many people are living or staying at this address?", "answer": [ { "valueInteger": 6 } ] }, { "linkId": "/93042-0/71802-3", "text": "Housing status", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA30190-5", "display": "I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)" } } ] }, { "linkId": "/93042-0/93033-9", "text": "Are you worried about losing your housing?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA30122-8", "display": "I choose not to answer this question" } } ] }, { "linkId": "/93042-0/56799-0", "text": "Address", "answer": [ { "valueString": "Broadway" } ] } ] }, { "linkId": "/93041-2", "text": "Money and resources", "item": [ { "linkId": "/93041-2/82589-3", "text": "Highest level of educ", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA30191-3", "display": "Less than high school degree" } } ] }, { "linkId": "/93041-2/67875-5", "text": "Employment status current", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA17956-6", "display": "Unemployed" } } ] }, { "linkId": "/93041-2/76437-3", "text": "Primary insurance", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA17849-3", "display": "Medicaid" } } ] }, { "linkId": "/93041-2/63586-2", "text": "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?", "answer": [ { "valueDecimal": 25000 } ] }, { "linkId": "/93041-2/93031-3", "text": "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA30126-9", "display": "Clothing" } }, { "valueCoding": { "system": "http://loinc.org", "code": "LA30127-7", "display": "Child care" } } ] }, { "linkId": "/93041-2/93030-5", "text": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA30134-3", "display": "Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need" } } ] } ] }, { "linkId": "/93040-4", "text": "Social and emotional health", "item": [ { "linkId": "/93040-4/93029-7", "text": "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA30130-1", "display": "1 or 2 times a week" } } ] }, { "linkId": "/93040-4/93038-8", "text": "Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA13909-9", "display": "Somewhat" } } ] } ] }, { "linkId": "/93039-6", "text": "Optional additional questions", "item": [ { "linkId": "/93039-6/93028-9", "text": "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA32-8", "display": "No" } } ] }, { "linkId": "/93039-6/93027-1", "text": "Are you a refugee?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA32-8", "display": "No" } } ] }, { "linkId": "/93039-6/93026-3", "text": "Do you feel physically and emotionally safe where you currently live?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA32-8", "display": "No" } } ] }, { "linkId": "/93039-6/76501-6", "text": "Within the last year, have you been afraid of your partner or ex-partner?", "answer": [ { "valueCoding": { "system": "http://loinc.org", "code": "LA32-8", "display": "No" } } ] } ] } ] } ] }