IE (Ireland) Core Implementation Guide - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Screening and Assessments

Screening and Assessments Guidance

IE Core supports the recording and exchange of screening and assessment data through the IE Core Observation Screening Assessment profile.

Use Cases

Common screening and assessment scenarios in Irish healthcare include:

• Social Determinants of Health (SDOH): Housing, food security, employment status
• Mental Health Screening: PHQ-9 (depression), GAD-7 (anxiety), AUDIT-C (alcohol)
• Falls Risk Assessment: Elderly care falls risk screening
• Nutrition Screening: Malnutrition Universal Screening Tool (MUST)
• Developmental Screening: Ages and Stages Questionnaires (ASQ) for children

Structure

Screening assessments are represented using a panel structure:

1. Panel Observation: The top-level observation representing the complete screening tool
   • category: survey (and optionally sdoh for social determinants)
   • code: LOINC code for the screening instrument
   • hasMember: References to individual question observations
2. Question Observations: Individual responses to screening questions
   • derivedFrom: Reference to the QuestionnaireResponse
   • value[x]: The coded or numeric response

Linking to QuestionnaireResponse

When screening data originates from a questionnaire:

1. Record the complete questionnaire response using IE Core QuestionnaireResponse
2. Extract relevant observations and store them as Observation resources
3. Link the observations back to the QuestionnaireResponse using Observation.derivedFrom

Conditions from Screening

When a screening assessment identifies a health concern:

• Create a Condition with category health-concern
• Link the condition to the screening observation using Condition.evidence.detail