This page is part of the Documentation Templates and Rules (v2.2.0-ballot: STU 2.2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 2.1.0. For a full list of available versions, see the Directory of published versions
<Parameters xmlns="http://hl7.org/fhir">
<id value="NextQuestionOutputParamsExample"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-next-question-output-parameters"/>
</meta>
<parameter>
<name value="questionnaire-response-out"/>
<resource>
<QuestionnaireResponse>
<id value="home-o2-adaptive-questionnaireresponse"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse-adapt"/>
</meta>
<contained>
<Questionnaire>
<id value="home-o2-adaptive-questionnaire"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Example adaptive questionnaire contained in a QuestionnaireResposne</div>
</text>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive">
<valueUrl value="http://example.com/fhir/R4"/>
</extension>
<url value="http://example.com/fhir/questionnaire"/>
<version value="0.1.0"/>
<name value="HomeOxygenTherapyAdaptiveQuestionnaire"/>
<title value="Adaptive Home Oxygen Therapy Order Template"/>
<derivedFrom
value="http://hl7.org/fhir/us/davinci-dtr/dtr-questionnaire"/>
<status value="draft"/>
<subjectType value="Patient"/>
<date value="2020-01-16T00:00:00+00:00"/>
<publisher value="Da Vinci DTR"/>
<contact>
<name value="Example Author"/>
</contact>
<item>
<linkId value="1"/>
<text
value="Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)"/>
<type value="text"/>
<required value="true"/>
</item>
<item>
<linkId value="2"/>
<text value="Order Reason"/>
<type value="choice"/>
<required value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org"/>
<code value="1"/>
<display
value="Initial or original order for certification"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org"/>
<code value="2"/>
<display value="Change in status"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org"/>
<code value="3"/>
<display value="Revision or change in equipment"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org"/>
<code value="4"/>
<display value="Replacement"/>
</valueCoding>
</answerOption>
</item>
</Questionnaire>
</contained>
<extension
url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-coverage">
<valueReference>🔗
<reference value="Coverage/CoverageExample"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/intendedUse">
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"/>
<code value="withorder"/>
<display value="Include with order"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context">
<valueReference>🔗
<reference value="ServiceRequest/ServiceRequestExample"/>
</valueReference>
</extension>
<questionnaire value="#home-o2-adaptive-questionnaire"/>
<status value="completed"/>
<subject>🔗
<reference value="Patient/examplepatient"/>
<display value="Vlad"/>
</subject>
<authored value="2022-01-26T20:36:57.544Z"/>
<item>
<linkId value="1"/>
<text
value="Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)"/>
<answer>
<extension
url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
<extension url="source">
<valueCode value="auto"/>
</extension>
</extension>
<valueString value="diagnosis"/>
</answer>
</item>
<item>
<linkId value="2"/>
<text value="Order Reason"/>
<answer>
<extension
url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
<extension url="source">
<valueCode value="auto"/>
</extension>
</extension>
<valueCoding>
<system value="http://example.org"/>
<code value="4"/>
<display value="Replacement"/>
</valueCoding>
</answer>
</item>
</QuestionnaireResponse>
</resource>
</parameter>
</Parameters>