Extensions for Using Data Elements from FHIR R5 in FHIR R4
0.1.0 - STU
Extensions for Using Data Elements from FHIR R5 in FHIR R4
0.1.0 - STU
Extensions for Using Data Elements from FHIR R5 in FHIR R4 - Downloaded Version null See the Directory of published versions
| Page standards status: Trial-use | Maturity Level: 0 |
<ConceptMap xmlns="http://hl7.org/fhir">
<id value="R5-QuestionnaireResponse-element-map-to-R4"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ConceptMap R5-QuestionnaireResponse-element-map-to-R4</b></p><a name="R5-QuestionnaireResponse-element-map-to-R4"> </a><a name="hcR5-QuestionnaireResponse-element-map-to-R4"> </a><p>Mapping from http://hl7.org/fhir/5.0 to http://hl7.org/fhir/4.0</p><br/><p><b>Group 1 </b>Mapping from <code>http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse|5.0.0</code> to <a href="http://hl7.org/fhir/R4/questionnaireresponse.html">QuestionnaireResponseversion: 4.0.1)</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>QuestionnaireResponse.meta (meta)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.meta</td><td>Element `QuestionnaireResponse.meta` is mapped to FHIR R4 element `QuestionnaireResponse.meta` as `Equivalent`.</td></tr><tr><td>QuestionnaireResponse.implicitRules (implicitRules)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.implicitRules</td><td>Element `QuestionnaireResponse.implicitRules` is mapped to FHIR R4 element `QuestionnaireResponse.implicitRules` as `Equivalent`.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.</td></tr><tr><td>QuestionnaireResponse.language (language)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.language</td><td>Element `QuestionnaireResponse.language` is mapped to FHIR R4 element `QuestionnaireResponse.language` as `Equivalent`.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).</td></tr><tr><td>QuestionnaireResponse.text (text)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.text</td><td>Element `QuestionnaireResponse.text` is mapped to FHIR R4 element `QuestionnaireResponse.text` as `Equivalent`.
Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.</td></tr><tr><td>QuestionnaireResponse.contained (contained)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.contained</td><td>Element `QuestionnaireResponse.contained` is mapped to FHIR R4 element `QuestionnaireResponse.contained` as `Equivalent`.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.</td></tr><tr><td>QuestionnaireResponse.identifier (identifier)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.identifier</td><td>Element `QuestionnaireResponse.identifier` is mapped to FHIR R4 element `QuestionnaireResponse.identifier` as `SourceIsBroaderThanTarget`.
Note: This is a business identifier, not a resource identifier (see [discussion](https://hl7.org/fhir/resource.htm#identifiers)).</td></tr><tr><td>QuestionnaireResponse.basedOn (basedOn)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.basedOn</td><td>Element `QuestionnaireResponse.basedOn` is mapped to FHIR R4 element `QuestionnaireResponse.basedOn` as `Equivalent`.</td></tr><tr><td>QuestionnaireResponse.partOf (partOf)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.partOf</td><td>Element `QuestionnaireResponse.partOf` is mapped to FHIR R4 element `QuestionnaireResponse.partOf` as `Equivalent`.
Not to be used to link an questionnaire response to an Encounter - use 'context' for that.
Composition of questionnaire responses will be handled using the Assemble operation defined in the SDC IG. For relationships to referrals, and other types of requests, use basedOn.</td></tr><tr><td>QuestionnaireResponse.questionnaire (questionnaire)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.questionnaire</td><td>Element `QuestionnaireResponse.questionnaire` is mapped to FHIR R4 element `QuestionnaireResponse.questionnaire` as `Equivalent`.
If a QuestionnaireResponse references a Questionnaire that can be resolved, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.). It is possible to have a QuestionnaireResponse whose 'questionnaire' element does not resolve. It is also possible for the questionnaire element to not have a value but only extensions (e.g. conveying the title or identifier for the questionnaire). This may happen for legacy data. If there is no formally defined Questionnaire, it is undefined what the 'correct' values for the linkId elements should be and it is possible that linkIds might be inconsistent for QuestionnaireResponses for the same form if captured by distinct systems.</td></tr><tr><td>QuestionnaireResponse.status (status)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.status</td><td>Element `QuestionnaireResponse.status` is mapped to FHIR R4 element `QuestionnaireResponse.status` as `Equivalent`.
Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.</td></tr><tr><td>QuestionnaireResponse.subject (subject)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.subject</td><td>Element `QuestionnaireResponse.subject` is mapped to FHIR R4 element `QuestionnaireResponse.subject` as `Equivalent`.
If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.</td></tr><tr><td>QuestionnaireResponse.encounter (encounter)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.encounter</td><td>Element `QuestionnaireResponse.encounter` is mapped to FHIR R4 element `QuestionnaireResponse.encounter` as `Equivalent`.
This will typically be the encounter the questionnaire response was created during, but some questionnaire responses may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission forms). A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.</td></tr><tr><td>QuestionnaireResponse.authored (authored)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.authored</td><td>Element `QuestionnaireResponse.authored` is mapped to FHIR R4 element `QuestionnaireResponse.authored` as `Equivalent`.
May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.
This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.</td></tr><tr><td>QuestionnaireResponse.author (author)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.author</td><td>Element `QuestionnaireResponse.author` is mapped to FHIR R4 element `QuestionnaireResponse.author` as `Equivalent`.
Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance.</td></tr><tr><td>QuestionnaireResponse.source (source)</td><td><a href="CodeSystem-concept-map-relationship.html#wider" title="wider">maps to wider concept</a></td><td>QuestionnaireResponse.source</td><td>Element `QuestionnaireResponse.source` is mapped to FHIR R4 element `QuestionnaireResponse.source` as `SourceIsBroaderThanTarget`.
The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `QuestionnaireResponse.source` with unmapped reference targets: Device, Organization.
If not specified, no inference can be made about who provided the data. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance.</td></tr><tr><td>QuestionnaireResponse.item (item)</td><td><a href="CodeSystem-concept-map-relationship.html#wider" title="wider">maps to wider concept</a></td><td>QuestionnaireResponse.item</td><td>Element `QuestionnaireResponse.item` is mapped to FHIR R4 element `QuestionnaireResponse.item` as `Equivalent`.
Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).\nWhen dealing with repeating items, each group repetition will be handled by a separate item. However, repeating questions are handled with a single question item and potentially multiple answers.</td></tr><tr><td>QuestionnaireResponse.item.linkId (linkId)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.item.linkId</td><td>Element `QuestionnaireResponse.item.linkId` is mapped to FHIR R4 element `QuestionnaireResponse.item.linkId` as `Equivalent`.</td></tr><tr><td>QuestionnaireResponse.item.definition (definition)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.item.definition</td><td>Element `QuestionnaireResponse.item.definition` is mapped to FHIR R4 element `QuestionnaireResponse.item.definition` as `Equivalent`.
The ElementDefinition must be in a [StructureDefinition](https://hl7.org/fhir/s.html#), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].
There is no need for this element if the item pointed to by the linkId has a definition listed.</td></tr><tr><td>QuestionnaireResponse.item.text (text)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.item.text</td><td>Element `QuestionnaireResponse.item.text` is mapped to FHIR R4 element `QuestionnaireResponse.item.text` as `Equivalent`.
The text for an item SHOULD be identical to the text from the corresponding Questionnaire.item. This can't be strictly enforced because it's possible for the Questionnaire to be updated subsequent to the QuestionnaireResponse having been created, however the intention is that the text in the QuestionnaireResponse reflects what the user saw when completing the Questionnaire.</td></tr><tr><td>QuestionnaireResponse.item.answer (answer)</td><td><a href="CodeSystem-concept-map-relationship.html#wider" title="wider">maps to wider concept</a></td><td>QuestionnaireResponse.item.answer</td><td>Element `QuestionnaireResponse.item.answer` is mapped to FHIR R4 element `QuestionnaireResponse.item.answer` as `Equivalent`.
The value is nested because we cannot have a repeating structure that has variable type.</td></tr><tr><td>QuestionnaireResponse.item.answer.value[x] (value[x])</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.item.answer.value[x]</td><td>Element `QuestionnaireResponse.item.answer.value[x]` is mapped to FHIR R4 element `QuestionnaireResponse.item.answer.value[x]` as `RelatedTo`.
The target context `QuestionnaireResponse.item.answer.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `QuestionnaireResponse.item.answer`.
More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse **SHOULD** match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) **SHALL NOT** pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems **MAY** enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match.</td></tr><tr><td>QuestionnaireResponse.item.answer.item (item)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.item.answer.item</td><td>Element `QuestionnaireResponse.item.answer.item` is mapped to FHIR R4 element `QuestionnaireResponse.item.answer.item` as `Equivalent`.
Only used when nesting beneath a question - see item.item for nesting beneath groups</td></tr><tr><td>QuestionnaireResponse.item.item (item)</td><td><a href="CodeSystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>QuestionnaireResponse.item.item</td><td>Element `QuestionnaireResponse.item.item` is mapped to FHIR R4 element `QuestionnaireResponse.item.item` as `Equivalent`.
Only used when nesting beneath a group - see item.answer.item for nesting beneath questions</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="fhir"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="0">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"/>
</extension>
</valueInteger>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"/>
</extension>
</valueCode>
</extension>
<url
value="http://hl7.org/fhir/uv/xver/ConceptMap/R5-QuestionnaireResponse-element-map-to-R4"/>
<version value="0.1.0"/>
<name value="R5QuestionnaireResponseElementMapToR4"/>
<title
value="Cross-version mapping for FHIR R5 QuestionnaireResponse to FHIR R4 QuestionnaireResponse"/>
<status value="active"/>
<experimental value="false"/>
<date value="2026-03-17T16:04:47.729107-05:00"/>
<contact>
<name value="FHIR Infrastructure"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/fiwg"/>
</telecom>
</contact>
<description
value="This ConceptMap represents cross-version mappings for elements from a FHIR R5 QuestionnaireResponse to FHIR R4."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
<display value="World"/>
</coding>
</jurisdiction>
<sourceCanonical value="http://hl7.org/fhir/5.0"/>
<targetUri value="http://hl7.org/fhir/4.0"/>
<group>
<source
value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/>
<sourceVersion value="5.0.0"/>
<target
value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/>
<targetVersion value="4.0.1"/>
<element>
<code value="QuestionnaireResponse.meta"/>
<display value="meta"/>
<target>
<code value="QuestionnaireResponse.meta"/>
<display value="QuestionnaireResponse.meta"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.meta` is mapped to FHIR R4 element `QuestionnaireResponse.meta` as `Equivalent`."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.implicitRules"/>
<display value="implicitRules"/>
<target>
<code value="QuestionnaireResponse.implicitRules"/>
<display value="QuestionnaireResponse.implicitRules"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.implicitRules` is mapped to FHIR R4 element `QuestionnaireResponse.implicitRules` as `Equivalent`.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.language"/>
<display value="language"/>
<target>
<code value="QuestionnaireResponse.language"/>
<display value="QuestionnaireResponse.language"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.language` is mapped to FHIR R4 element `QuestionnaireResponse.language` as `Equivalent`.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.text"/>
<display value="text"/>
<target>
<code value="QuestionnaireResponse.text"/>
<display value="QuestionnaireResponse.text"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.text` is mapped to FHIR R4 element `QuestionnaireResponse.text` as `Equivalent`.
Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.contained"/>
<display value="contained"/>
<target>
<code value="QuestionnaireResponse.contained"/>
<display value="QuestionnaireResponse.contained"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.contained` is mapped to FHIR R4 element `QuestionnaireResponse.contained` as `Equivalent`.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.identifier"/>
<display value="identifier"/>
<target>
<code value="QuestionnaireResponse.identifier"/>
<display value="QuestionnaireResponse.identifier"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.identifier` is mapped to FHIR R4 element `QuestionnaireResponse.identifier` as `SourceIsBroaderThanTarget`.
Note: This is a business identifier, not a resource identifier (see [discussion](https://hl7.org/fhir/resource.htm#identifiers))."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.basedOn"/>
<display value="basedOn"/>
<target>
<code value="QuestionnaireResponse.basedOn"/>
<display value="QuestionnaireResponse.basedOn"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.basedOn` is mapped to FHIR R4 element `QuestionnaireResponse.basedOn` as `Equivalent`."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.partOf"/>
<display value="partOf"/>
<target>
<code value="QuestionnaireResponse.partOf"/>
<display value="QuestionnaireResponse.partOf"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.partOf` is mapped to FHIR R4 element `QuestionnaireResponse.partOf` as `Equivalent`.
Not to be used to link an questionnaire response to an Encounter - use 'context' for that.
Composition of questionnaire responses will be handled using the Assemble operation defined in the SDC IG. For relationships to referrals, and other types of requests, use basedOn."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.questionnaire"/>
<display value="questionnaire"/>
<target>
<code value="QuestionnaireResponse.questionnaire"/>
<display value="QuestionnaireResponse.questionnaire"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.questionnaire` is mapped to FHIR R4 element `QuestionnaireResponse.questionnaire` as `Equivalent`.
If a QuestionnaireResponse references a Questionnaire that can be resolved, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.). It is possible to have a QuestionnaireResponse whose 'questionnaire' element does not resolve. It is also possible for the questionnaire element to not have a value but only extensions (e.g. conveying the title or identifier for the questionnaire). This may happen for legacy data. If there is no formally defined Questionnaire, it is undefined what the 'correct' values for the linkId elements should be and it is possible that linkIds might be inconsistent for QuestionnaireResponses for the same form if captured by distinct systems."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.status"/>
<display value="status"/>
<target>
<code value="QuestionnaireResponse.status"/>
<display value="QuestionnaireResponse.status"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.status` is mapped to FHIR R4 element `QuestionnaireResponse.status` as `Equivalent`.
Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.subject"/>
<display value="subject"/>
<target>
<code value="QuestionnaireResponse.subject"/>
<display value="QuestionnaireResponse.subject"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.subject` is mapped to FHIR R4 element `QuestionnaireResponse.subject` as `Equivalent`.
If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.encounter"/>
<display value="encounter"/>
<target>
<code value="QuestionnaireResponse.encounter"/>
<display value="QuestionnaireResponse.encounter"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.encounter` is mapped to FHIR R4 element `QuestionnaireResponse.encounter` as `Equivalent`.
This will typically be the encounter the questionnaire response was created during, but some questionnaire responses may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission forms). A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.authored"/>
<display value="authored"/>
<target>
<code value="QuestionnaireResponse.authored"/>
<display value="QuestionnaireResponse.authored"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.authored` is mapped to FHIR R4 element `QuestionnaireResponse.authored` as `Equivalent`.
May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.
This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.author"/>
<display value="author"/>
<target>
<code value="QuestionnaireResponse.author"/>
<display value="QuestionnaireResponse.author"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.author` is mapped to FHIR R4 element `QuestionnaireResponse.author` as `Equivalent`.
Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.source"/>
<display value="source"/>
<target>
<code value="QuestionnaireResponse.source"/>
<display value="QuestionnaireResponse.source"/>
<equivalence value="wider"/>
<comment
value="Element `QuestionnaireResponse.source` is mapped to FHIR R4 element `QuestionnaireResponse.source` as `SourceIsBroaderThanTarget`.
The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `QuestionnaireResponse.source` with unmapped reference targets: Device, Organization.
If not specified, no inference can be made about who provided the data. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item"/>
<display value="item"/>
<target>
<code value="QuestionnaireResponse.item"/>
<display value="QuestionnaireResponse.item"/>
<equivalence value="wider"/>
<comment
value="Element `QuestionnaireResponse.item` is mapped to FHIR R4 element `QuestionnaireResponse.item` as `Equivalent`.
Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).\nWhen dealing with repeating items, each group repetition will be handled by a separate item. However, repeating questions are handled with a single question item and potentially multiple answers."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item.linkId"/>
<display value="linkId"/>
<target>
<code value="QuestionnaireResponse.item.linkId"/>
<display value="QuestionnaireResponse.item.linkId"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.item.linkId` is mapped to FHIR R4 element `QuestionnaireResponse.item.linkId` as `Equivalent`."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item.definition"/>
<display value="definition"/>
<target>
<code value="QuestionnaireResponse.item.definition"/>
<display value="QuestionnaireResponse.item.definition"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.item.definition` is mapped to FHIR R4 element `QuestionnaireResponse.item.definition` as `Equivalent`.
The ElementDefinition must be in a [StructureDefinition](https://hl7.org/fhir/s.html#), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].
There is no need for this element if the item pointed to by the linkId has a definition listed."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item.text"/>
<display value="text"/>
<target>
<code value="QuestionnaireResponse.item.text"/>
<display value="QuestionnaireResponse.item.text"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.item.text` is mapped to FHIR R4 element `QuestionnaireResponse.item.text` as `Equivalent`.
The text for an item SHOULD be identical to the text from the corresponding Questionnaire.item. This can't be strictly enforced because it's possible for the Questionnaire to be updated subsequent to the QuestionnaireResponse having been created, however the intention is that the text in the QuestionnaireResponse reflects what the user saw when completing the Questionnaire."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item.answer"/>
<display value="answer"/>
<target>
<code value="QuestionnaireResponse.item.answer"/>
<display value="QuestionnaireResponse.item.answer"/>
<equivalence value="wider"/>
<comment
value="Element `QuestionnaireResponse.item.answer` is mapped to FHIR R4 element `QuestionnaireResponse.item.answer` as `Equivalent`.
The value is nested because we cannot have a repeating structure that has variable type."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item.answer.value[x]"/>
<display value="value[x]"/>
<target>
<code value="QuestionnaireResponse.item.answer.value[x]"/>
<display value="QuestionnaireResponse.item.answer.value[x]"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.item.answer.value[x]` is mapped to FHIR R4 element `QuestionnaireResponse.item.answer.value[x]` as `RelatedTo`.
The target context `QuestionnaireResponse.item.answer.value[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `QuestionnaireResponse.item.answer`.
More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse **SHOULD** match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) **SHALL NOT** pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc.). Systems **MAY** enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match."/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item.answer.item"/>
<display value="item"/>
<target>
<code value="QuestionnaireResponse.item.answer.item"/>
<display value="QuestionnaireResponse.item.answer.item"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.item.answer.item` is mapped to FHIR R4 element `QuestionnaireResponse.item.answer.item` as `Equivalent`.
Only used when nesting beneath a question - see item.item for nesting beneath groups"/>
</target>
</element>
<element>
<code value="QuestionnaireResponse.item.item"/>
<display value="item"/>
<target>
<code value="QuestionnaireResponse.item.item"/>
<display value="QuestionnaireResponse.item.item"/>
<equivalence value="equivalent"/>
<comment
value="Element `QuestionnaireResponse.item.item` is mapped to FHIR R4 element `QuestionnaireResponse.item.item` as `Equivalent`.
Only used when nesting beneath a group - see item.answer.item for nesting beneath questions"/>
</target>
</element>
</group>
</ConceptMap>
IG © 2025+ FHIR Infrastructure. Package hl7.fhir.uv.xver-r5.r4#0.1.0 based on FHIR 4.0.1. Generated 2026-03-20
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