201809 Argonaut Questionnaire

Argonaut Questionnaire

Argonaut Zulip chat stream for this track.

Submitting WG/Project/Implementer Group

Justification

To pilot the Argonaut Questionnaire Implementation Guide

The goal of the Argonaut Questionnaire Project is to develop guidance to support interchange of:

1. Simple forms based on FHIR Version 3.0.1 and specifically the Questionnaire and QuestionnaireResponse resources. This implementation guide provides implementers with FHIR RESTful APIs and guidance to create, use and share between organizations standard assessment forms and the assessment responses.
2. Adaptive Questionnaires(1) such as PROMIS forms using a stateless model. This implementation guide provides the basic framework for using Questionnaire and QuestionnaireResponse to preserve the state of the Questionnaire as the client retrieves questions from a remote adaptive questionnaire service.

(1) Adaptive computerized questionnaire administration, where a selection of items is presented on the computer, and based on the answers on those items, the computer selects following items optimized for the testee's estimated ability or trait (https://en.wikipedia.org/wiki/Questionnaire)

Proposed Track Lead

Eric Haas

Brett Marquard

FHIR version

STU3

Expected participants

• Meditech
• Epic
• All Scripts
• Partners
• ...

Roles

1. Adaptive Questionnaire Service: A System that is capable of providing questions in response to requests and contains logic for determination of the next question and calculation of the score for an Adaptive Questionnaire. For this Implementation Guide, this service is treated as a “Black Box”
2. “Assessment-Bank“(1): A form repository for the collection of the assessments. It is accessible to both the providers and form editors as a FHIR Questionnaire endpoint.
3. (Optionally) “Answer-Bank“(2): A repository for the collection of the completed assessments (‘answers’). It is accessible to the providers as a FHIR QuestionnaireResponse endpoint. It may be internal or external to the Provider EHR.
4. Form-filler: The software application interacting with the user to get answers for a questionnaire. This is also known as the Client and may be a:
   • Patients apps that launch standalone ( i.e, a third party SMART on FHIR app )
   • Patient apps that launch from a portal
   • Provider apps that launch standalone
   • Provider apps that launch from a portal
5. Provider EHR(3): The System that is capable of retrieving, rendering and displaying the assessment to a subject or a provider to fill out.

See the Argonaut Questionnaire Implementation Guide for more details and descriptions of the Roles and Actors

(1) This is called the ‘Form Manager’ in the Structured Data Capture Initiative (SDC) ↩

(2) This is called the ‘Form Receiver/Archiver’ in the Structured Data Capture Initiative (SDC) ↩

(3) This is called the ‘Form Filler’ and/or ‘Form Response Handler’ in the Structured Data Capture Initiative (SDC) ↩

Scenarios

See the Argonaut Questionnaire Implementation Guide for the detailed deccription of API and workflow for these use cases.

Static Forms

1. Form Author Editor Creates Or Updates Assessment
2. Form Author Editor Uploads The Assessments To The Assessment Bank
3. Provider EHRSs Retrieve Standard Assessments From The Assessment Bank
4. The Provider EHR Renders And Displays The Standard Assessment To The End User
5. The End User Completes The Assessment
6. The Provider EHR Posts Responses to the Answer Bank
7. The Provider EHR Retrieves The Assessment Responses from the Answer Bank

Computer Adaptive Forms

1. Adaptive Questionnaire Discovery
2. Initiate Adaptive Questionnaire
3. Get Next Question
4. Adaptive Questionnaire is Complete
5. QuestionnaireResponse and Scoring

Test Implementations

Static files:

Questionnaires for testing:

1. [Rand 36-Item Health Survey 1.0: http://sqlonfhir-stu3.azurewebsites.net/fhir/Questionnaire/eTAtxwTlJcwLaR-aif62yGg3]
2. [The Alcohol Use Disorder Identification Test (AUDIT) Form: http://sqlonfhir-stu3.azurewebsites.net/fhir/Questionnaire/questionnaire-example-audit]
3. [Ages and Stages Questionnaire (ASQ-3: Sample 16 Month Questionnaire http://sqlonfhir-stu3.azurewebsites.net/fhir/Questionnaire/questionnaire-example-asq3]
4. [Drug Abuse Screening Test (DAST-10:) http://sqlonfhir-stu3.azurewebsites.net/fhir/Questionnaire/questionnaire-example-dast]
5. [Housing Instability Questionnaire: http://sqlonfhir-stu3.azurewebsites.net/fhir/Questionnaire/questionnaire-example-housing]
6. [Patient Health Questionnaire-9 (PHQ-9): http://sqlonfhir-stu3.azurewebsites.net/fhir/Questionnaire/questionnaire-example-phq9]
7. [Argonaut Questionnaire Sampler: http://sqlonfhir-stu3.azurewebsites.net/fhir/Questionnaire/questionnaire-example-sampler]

Reference Implementations:

1. Run in Postman
2. test rendering tool: Argonaut Project Questionnaire Test Renderer

Adaptive Questionnaire

Reference Simulation

Argonaut Project Questionnaire Test Renderer