This page is part of the Documentation Templates and Rules (v2.0.1: STU 2.0) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="DTRQuestionnairePackageOperationResultSimple"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:90404930-204a-4127-9c40-997b2ed7f767"/>
</identifier>
<type value="collection"/>
<timestamp value="2023-04-20T00:00:00+05:00"/>
<entry id="home-o2-adaptive-questionnaire">
<fullUrl
value="http://example.org/fhir/Questionnaire/home-o2-adaptive-questionnaire"/>
<resource>
<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">
<valueBoolean value="true"/>
</extension>
<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/Questionnaire/home-o2-std-questionnaire">🔗
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-derivationType">
<valueCodeableConcept>
<coding>
<system
value="http://hl7.org/fhir/questionnaire-derivationType"/>
<code value="compliesWith"/>
<display value="Complies with"/>
</coding>
</valueCodeableConcept>
</extension>
</derivedFrom>
<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>
</resource>
</entry>
</Bundle>