StructureDefinition: CQIF-Questionnaire - XML

CQIF-Questionnaire

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="cqif-questionnaire"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <url value="http://hl7.org/fhir/StructureDefinition/cqif-questionnaire"/> 
  <name value="CQIF-Questionnaire"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2015-05-30"/> 
  <publisher value="Health Level Seven, Inc. - CDS WG"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/special/committees/dss"/> 
    </telecom> 
  </contact> 
  <description value="A questionnaire with the ability to specify behavior associated with questions or groups
   of questions"/> 
  <fhirVersion value="3.0.2"/> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/w5"/> 
    <name value="W5 Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="objimpl"/> 
    <uri value="http://hl7.org/fhir/object-implementation"/> 
    <name value="Object Implementation Information"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 v2 Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="Questionnaire"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="Questionnaire">
      <path value="Questionnaire"/> 
      <short value="A questionnaire with the ability to specify behavior associated with questions or groups
       of questions"/> 
      <definition value="A CQIF questionnaire is a questionnaire with the added ability to describe behavior associated
       with questions. For example, whether or not to display a particular question or group
       of questions, or automatically calculating the value of an answer based on the answers
       to previous questions."/> 
      <alias value="Form"/> 
      <alias value="CRF"/> 
      <alias value="Survey"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <xpath value="not(parent::f:contained and f:contained)"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-1"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/> 
        <expression value="contained.text.empty()"/> 
        <xpath value="not(parent::f:contained and f:text)"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere
         in the resource"/> 
        <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()"/> 
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f
        :reference/@value=concat('#', $id))]))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="que-2"/> 
        <severity value="error"/> 
        <human value="The link ids for groups and questions must be unique within the questionnaire"/> 
        <expression value="descendants().linkId.isDistinct()"/> 
        <xpath value="count(descendant::f:linkId/@value)=count(distinct-values(descendant::f:linkId/@value))"/> 
        <source value="Questionnaire"/> 
      </constraint> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[moodCode=DEF]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="infrastructure.information"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.id">
      <path value="Questionnaire.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/> 
      <comment value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="id"/> 
      </type> 
      <isSummary value="true"/> 
    </element> 
    <element id="Questionnaire.meta">
      <path value="Questionnaire.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <isSummary value="true"/> 
    </element> 
    <element id="Questionnaire.implicitRules">
      <path value="Questionnaire.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/> 
      <comment value="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. 

This element is labelled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies it's meaning or interpretation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Questionnaire.language">
      <path value="Questionnaire.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="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)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference> 
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/> 
          </valueReference> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="A human language."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/languages"/> 
        </valueSetReference> 
      </binding> 
    </element> 
    <element id="Questionnaire.text">
      <path value="Questionnaire.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/> 
      <comment value="Contained resources do not have 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 &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded in formation is added
       later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-1"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.contained">
      <path value="Questionnaire.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/> 
      <comment value="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."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.extension">
      <path value="Questionnaire.extension"/> 
      <slicing id="6">
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
    </element> 
    <element id="Questionnaire.extension:library">
      <path value="Questionnaire.extension"/> 
      <sliceName value="library"/> 
      <short value="A library containing logic referenced by the questionnaire"/> 
      <definition value="A CQL or ELM library containing any logic referenced by the questionnaire."/> 
      <alias value="library"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-library"/> 
      </type> 
      <condition value="ele-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/> 
        <source value="Extension"/> 
      </constraint> 
    </element> 
    <element id="Questionnaire.modifierExtension">
      <path value="Questionnaire.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. In order to make the use
       of extensions safe and manageable, there is a strict set of governance applied to the
       definition and use of extensions. Though any implementer is allowed to define an extension,
       there is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.url">
      <path value="Questionnaire.url"/> 
      <short value="Logical URI to reference this questionnaire (globally unique)"/> 
      <definition value="An absolute URI that is used to identify this questionnaire when it is referenced in a
       specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique,
       and SHOULD be an address at which this questionnaire is (or will be) published. The URL
       SHOULD include the major version of the questionnaire. For more information see [Technical
       and Business Versions](resource.html#versions)."/> 
      <comment value="Can be a urn:uuid: or a urn:oid:, but real http: addresses are preferred.  Multiple instances
       may share the same url if they have a distinct version."/> 
      <requirements value="…  This is the id that will be used to link a QuestionnaireResponse to the Questionnaire
       the response is for."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.url"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".identifier[scope=BUSN;reliability=ISS]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="id"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.identifier">
      <path value="Questionnaire.identifier"/> 
      <short value="Additional identifier for the questionnaire"/> 
      <definition value="A formal identifier that is used to identify this questionnaire when it is represented
       in other formats, or referenced in a specification, model, design or an instance."/> 
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)
       data type, e.g., to identify this questionnaire outside of FHIR, where it is not possible
       to use the logical URI."/> 
      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated
       with the module."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="id"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.version">
      <path value="Questionnaire.version"/> 
      <short value="Business version of the questionnaire"/> 
      <definition value="The identifier that is used to identify this version of the questionnaire when it is referenced
       in a specification, model, design or instance. This is an arbitrary value managed by the
       questionnaire author and is not expected to be globally unique. For example, it might
       be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no
       expectation that versions can be placed in a lexicographical sequence."/> 
      <comment value="There may be different questionnaire instances that have the same identifier but different
       versions.  The version can be appended to the url in a reference to allow a refrence to
       a particular business version of the questionnaire with the format [url]|[version]."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="id.version"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.name">
      <path value="Questionnaire.name"/> 
      <short value="Name for this questionnaire (computer friendly)"/> 
      <definition value="A natural language name identifying the questionnaire. This name should be usable as an
       identifier for the module by machine processing applications such as code generation."/> 
      <comment value="The name is not expected to be globally unique. The name should be a simple alpha-numeric
       type name to ensure that it is computable friendly."/> 
      <requirements value="Support human navigation and code generation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.name"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.title">
      <path value="Questionnaire.title"/> 
      <short value="Name for this questionnaire (human friendly)"/> 
      <definition value="A short, descriptive, user-friendly title for the questionnaire."/> 
      <comment value="This name does not need to be machine-processing friendly and may contain punctuation,
       white-space, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.title"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.status">
      <path value="Questionnaire.status"/> 
      <short value="draft | active | retired | unknown"/> 
      <definition value="The status of this questionnaire. Enables tracking the life-cycle of the content."/> 
      <comment value="Allows filtering of questionnaires that are appropriate for use vs. not.  
This is labeled as &quot;Is Modifier&quot; because applications should not use a retired
       questionnaire without due consideration."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The lifecycle status of a Value Set or Concept Map."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/publication-status"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="status"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.experimental">
      <path value="Questionnaire.experimental"/> 
      <short value="For testing purposes, not real usage"/> 
      <definition value="A boolean value to indicate that this questionnaire is authored for testing purposes (or
       education/evaluation/marketing), and is not intended to be used for genuine usage."/> 
      <comment value="Allows filtering of questionnaire that are appropriate for use vs. not. This is labeled
       as &quot;Is Modifier&quot; because applications should not use an experimental questionnaire
       in production."/> 
      <requirements value="Enables experimental content to be developed following the same lifecycle that would be
       used for a production-level questionnaire."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.experimental"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="class"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.date">
      <path value="Questionnaire.date"/> 
      <short value="Date this was last changed"/> 
      <definition value="The date  (and optionally time) when the questionnaire was published. The date must change
       if and when the business version changes and it must change if the status code changes.
       In addition, it should change when the substantive content of the questionnaire changes."/> 
      <comment value="Note that this is not the same as the resource last-modified-date, since the resource
       may be a secondary representation of the questionnaire. Additional specific dates may
       be added as extensions or be found by consulting Provenances associated with past versions
       of the resource."/> 
      <alias value="Revision Date"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.date"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].time"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="when.recorded"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.publisher">
      <path value="Questionnaire.publisher"/> 
      <short value="Name of the publisher (organization or individual)"/> 
      <definition value="The name of the individual or organization that published the questionnaire."/> 
      <comment value="Usually an organization, but may be an individual. The publisher (or steward) of the questionnaire
       is the organization or individual primarily responsible for the maintenance and upkeep
       of the questionnaire. This is not necessarily the same individual or organization that
       developed and initially authored the content. The publisher is the primary point of contact
       for questions or issues with the questionnaire. This item SHOULD be populated unless the
       information is available from context."/> 
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the questionnaire.  May also
       allow for contact."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.publisher"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="who.witness"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.description">
      <path value="Questionnaire.description"/> 
      <short value="Natural language description of the questionnaire"/> 
      <definition value="A free text natural language description of the questionnaire from a consumer's perspective."/> 
      <comment value="This description can be used to capture details such as why the questionnaire was built,
       comments about misuse, instructions for clinical use and interpretation, literature references,
       examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed
       in the 'text' field of the resource itself. This item SHOULD be populated unless the information
       is available from context (e.g. the language of the profile is presumed to be the predominant
       language in the place the profile was created)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.purpose">
      <path value="Questionnaire.purpose"/> 
      <short value="Why this questionnaire is defined"/> 
      <definition value="Explaination of why this questionnaire is needed and why it has been designed as it has."/> 
      <comment value="This element does not describe the usage of the questionnaire Instead  it provides traceability
       of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may
       be used to point to source materials or specifications that drove the structure of this
       questionnaire."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.purpose"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode.text"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="why"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.approvalDate">
      <path value="Questionnaire.approvalDate"/> 
      <short value="When the questionnaire was approved by publisher"/> 
      <definition value="The date on which the resource content was approved by the publisher. Approval happens
       once when the content is officially approved for usage."/> 
      <comment value="The 'date' element may be more recent than the approval date because of minor changes
       / editorial corrections."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.approvalDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;approval
        &quot;].effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.lastReviewDate">
      <path value="Questionnaire.lastReviewDate"/> 
      <short value="When the questionnaire was last reviewed"/> 
      <definition value="The date on which the resource content was last reviewed. Review happens periodically
       after approval, but doesn't change the original approval date."/> 
      <comment value="If specified, this is usually after the approval date."/> 
      <requirements value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not been
       reviewed in a long time may have a risk of being less appropriate/relevant."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.lastReviewDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;; subsetCode=&quot;RECENT&quot;].act[classCode=CACT;m
        oodCode=EVN;code=&quot;review&quot;].effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.effectivePeriod">
      <path value="Questionnaire.effectivePeriod"/> 
      <short value="When the questionnaire is expected to be used"/> 
      <definition value="The period during which the questionnaire content was or is planned to be in active use."/> 
      <comment value="The effective period for a questionnaire  determines when the content is applicable for
       usage and is independent of publication and review dates. For example, a measure intended
       to be used for the year 2016 might be published in 2015."/> 
      <requirements value="Allows establishing a transition before a resource comes into effect and also allows for
       a sunsetting  process when new versions of a the questionnaire are or are expected to
       be used instead."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.effectivePeriod"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Period"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.useContext">
      <path value="Questionnaire.useContext"/> 
      <short value="Context the content is intended to support"/> 
      <definition value="The content was developed with a focus and intent of supporting the contexts that are
       listed. These terms may be used to assist with indexing and searching for appropriate
       questionnaire instances."/> 
      <comment value="When multiple useContexts are specified, there is no expectation whether all or any of
       the contexts apply."/> 
      <requirements value="Assist in searching for appropriate content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.useContext"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="UsageContext"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.jurisdiction">
      <path value="Questionnaire.jurisdiction"/> 
      <short value="Intended jurisdiction for questionnaire (if applicable)"/> 
      <definition value="A legal or geographic region in which the questionnaire is intended to be used."/> 
      <comment value="It may be possible for the questionnaire to be used in jurisdictions other than those
       for which it was originally designed or intended."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.jurisdiction"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Countries and regions within which this artifact is targeted for use"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/jurisdiction"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.contact">
      <path value="Questionnaire.contact"/> 
      <short value="Contact details for the publisher"/> 
      <definition value="Contact details to assist a user in finding and communicating with the publisher."/> 
      <comment value="May be a web site, an email address, a telephone number, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.contact"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=CALLBCK].role"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.copyright">
      <path value="Questionnaire.copyright"/> 
      <short value="Use and/or publishing restrictions"/> 
      <definition value="A copyright statement relating to the questionnaire and/or its contents. Copyright statements
       are generally legal restrictions on the use and publishing of the questionnaire."/> 
      <requirements value="Consumers must be able to determine any legal restrictions on the use of the questionnaire
       and/or its content."/> 
      <alias value="License"/> 
      <alias value="Restrictions"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.copyright"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.code">
      <path value="Questionnaire.code"/> 
      <short value="Concept that represents the overall questionnaire"/> 
      <definition value="An identifier for this question or group of questions in a particular terminology such
       as LOINC."/> 
      <requirements value="Allows linking of the complete Questionnaire resources to formal terminologies.  It's
       common for &quot;panels&quot; of questions to be identified by a code."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.code"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireConcept"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes for questionnaires, groups and individual questions"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/questionnaire-questions"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.subjectType">
      <path value="Questionnaire.subjectType"/> 
      <short value="Resource that can be subject of QuestionnaireResponse"/> 
      <definition value="The types of subjects that can be the subject of responses created for the questionnaire."/> 
      <comment value="If none are specified, then the subject is unlimited."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.subjectType"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ResourceType"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="One of the resource types defined as part of FHIR."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/resource-types"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=META].target[classCode=OBS, moodCode=DEFN, isCriterion=true].particip
        ation.role.classCode"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item">
      <path value="Questionnaire.item"/> 
      <short value="Questions and sections within the Questionnaire"/> 
      <definition value="A particular question, question grouping or display text that is part of the questionnaire."/> 
      <comment value="The content of the questionnaire is constructed from an ordered, hierarchical collection
       of items."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="que-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="que-9"/> 
        <severity value="error"/> 
        <human value="Read-only can't be specified for &quot;display&quot; items"/> 
        <expression value="type!='display' or readOnly.empty()"/> 
        <xpath value="not(f:type/@value='display' and f:readOnly)"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <constraint> 
        <key value="que-8"/> 
        <severity value="error"/> 
        <human value="Default values can't be specified for groups or display items"/> 
        <expression value="(type!='group' and type!='display') or initial.empty()"/> 
        <xpath value="not(f:type/@value=('group', 'display') and f:*[starts-with(local-name(.), 'initial')])"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <constraint> 
        <key value="que-6"/> 
        <severity value="error"/> 
        <human value="Required and repeat aren't permitted for display items"/> 
        <expression value="type!='display' or (required.empty() and repeats.empty())"/> 
        <xpath value="not(f:type/@value='display' and (f:required or f:repeats))"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <constraint> 
        <key value="que-5"/> 
        <severity value="error"/> 
        <human value="Only 'choice' items can have options"/> 
        <expression value="(type ='choice' or type = 'open-choice') or (options.empty() and option.empty())"/> 
        <xpath value="f:type/@value=('choice','open-choice') or not(f:option or f:options)"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <constraint> 
        <key value="que-4"/> 
        <severity value="error"/> 
        <human value="A question cannot have both option and options"/> 
        <expression value="option.empty() or options.empty()"/> 
        <xpath value="not(f:options and f:option)"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <constraint> 
        <key value="que-3"/> 
        <severity value="error"/> 
        <human value="Display items cannot have a &quot;code&quot; asserted"/> 
        <expression value="type!='display' or code.empty()"/> 
        <xpath value="not(f:type/@value='display' and f:code)"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <constraint> 
        <key value="que-10"/> 
        <severity value="error"/> 
        <human value="Maximum length can only be declared for simple question types"/> 
        <expression value="(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url')) or maxLength.empty()"/> 
        <xpath value="f:type/@value=('boolean', 'decimal', 'integer', 'open-choice', 'string', 'text', 'url')
         or not(f:maxLength)"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <constraint> 
        <key value="que-1"/> 
        <severity value="error"/> 
        <human value="Group items must have nested items, display items cannot have nested items"/> 
        <expression value="(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item
        ').empty())"/> 
        <xpath value="not((f:type/@value='group' and not(f:item)) or (f:type/@value='display' and f:item))"/> 
        <source value="Questionnaire.item"/> 
      </constraint> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=DEF]"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.id">
      <path value="Questionnaire.item.id"/> 
      <representation value="xmlAttr"/> 
      <short value="xml:id (or equivalent in JSON)"/> 
      <definition value="unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.extension">
      <path value="Questionnaire.item.extension"/> 
      <slicing id="7">
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
    </element> 
    <element id="Questionnaire.item.extension:condition">
      <path value="Questionnaire.item.extension"/> 
      <sliceName value="condition"/> 
      <short value="A condition that determines whether or not the group is applicable"/> 
      <definition value="The name of an expression that determines whether the group on which it appears is applicable.
       The expression is evaluated within the current context. If the result of evaluating the
       expression is true, the group is applicable. The expression has access to the current
       value of answered questions by the linkId of the question."/> 
      <comment value="Note that per Lloyd this extension may not be necessary, it may be able to specified structurally
       using the elements already available within Questionnaire."/> 
      <alias value="condition"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-condition"/> 
      </type> 
      <condition value="ele-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/> 
        <source value="Extension"/> 
      </constraint> 
    </element> 
    <element id="Questionnaire.item.extension:initialvalue">
      <path value="Questionnaire.item.extension"/> 
      <sliceName value="initialValue"/> 
      <short value="An expression that provides the initial value for the answer to the question"/> 
      <definition value="The name of an expression that determines the initial value for the answer to the question.
       This expression is evaluated once as part of displaying the form, and does not have access
       to the answers to other questions."/> 
      <alias value="initialValue"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-initialValue"/> 
      </type> 
      <condition value="ele-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/> 
        <source value="Extension"/> 
      </constraint> 
    </element> 
    <element id="Questionnaire.item.extension:calculatedvalue">
      <path value="Questionnaire.item.extension"/> 
      <sliceName value="calculatedValue"/> 
      <short value="An expression that provides a calculated value for the answer to the question"/> 
      <definition value="The name of an expression that determines a calculated value for the answer to the question.
       The expression is evaluated as necessary and has access to the answers to other questions
       by the linkId of the question."/> 
      <alias value="calculatedValue"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-calculatedValue"/> 
      </type> 
      <condition value="ele-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/> 
        <source value="Extension"/> 
      </constraint> 
    </element> 
    <element id="Questionnaire.item.modifierExtension">
      <path value="Questionnaire.item.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.linkId">
      <path value="Questionnaire.item.linkId"/> 
      <short value="Unique id for item in questionnaire"/> 
      <definition value="An identifier that is unique within the Questionnaire allowing linkage to the equivalent
       item in a QuestionnaireResponse resource."/> 
      <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have
       any meaning.  GUIDs or sequential numbers are appropriate here."/> 
      <requirements value="[QuestionnaireResponse](questionnaireresponse.html#) does not require omitted items to
       be included and may have some items that repeat, so linkage based on position alone is
       not sufficient."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.linkId"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.definition">
      <path value="Questionnaire.item.definition"/> 
      <short value="ElementDefinition - details for the item"/> 
      <definition value="A reference to an [ElementDefinition](elementdefinition.html) that provides the details
       for the item. If a definition is provided, then the following element values can be inferred
       from the definition: 

* code (ElementDefinition.code)
* type (ElementDefinition.type)
* required (ElementDefinition.min)
* repeats (ElementDefinition.max)
* maxLength (ElementDefinition.maxLength)
* options (ElementDefinition.binding)

Any information provided in these elements on a Questionnaire Item overrides the information
       from the definition."/> 
      <comment value="the URI refers to an ElementDefinition in either a [StructureDefinition](structuredefinition.html#)
       or a [DataElement](dataelement.html#), and always starts with the canonical URL for the
       target resource. When referring to a StructureDefinition, a fragment identifier is used
       to specify the element definition by its id [Element.id](element-definitions.html#Element.id).
       E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the
       absence of a fragment identifier, the first/root element definition in the target is the
       matching element definition. Note that [LOINC codes](loinc.html#dataelements) implicitly
       define DataElement resources."/> 
      <requirements value="A common pattern is to define a set of data elements and then build multiple questionnaires
       for different circumstances to gather the data. This element provides traceability to
       the common definition and allows the content for the question to come from the underlying
       definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.definition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=INST].target[classCode=OBS, moodCode=DEF]"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.code">
      <path value="Questionnaire.item.code"/> 
      <short value="Corresponding concept for this item in a terminology"/> 
      <definition value="A terminology code that corresponds to this group or question (e.g. a code from LOINC,
       which defines many questions and answers)."/> 
      <comment value="The value may come from the ElementDefinition referred to by .definition."/> 
      <requirements value="Allows linking of groups of questions to formal terminologies."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.code"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <condition value="que-3"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireConcept"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes for questionnaires, groups and individual questions"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/questionnaire-questions"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.prefix">
      <path value="Questionnaire.item.prefix"/> 
      <short value="E.g. &quot;1(a)&quot;, &quot;2.5.3&quot;"/> 
      <definition value="A short label for a particular group, question or set of display text within the questionnaire
       used for reference by the individual completing the questionnaire."/> 
      <comment value="These are generally unique within a questionnaire, though this is not guaranteed. Some
       questionnaires may have multiple questions with the same label with logic to control which
       gets exposed.

Typically these won't be used for &quot;display&quot; items, though such use is not prohibited.

Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within
       a Questionnaire."/> 
      <requirements value="Separating the label from the question text allows improved rendering.  Also, instructions
       will often refer to specific prefixes, so there's a need for the questionnaire design
       to have control over what labels are used."/> 
      <alias value="label"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.prefix"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Not supported"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.text">
      <path value="Questionnaire.item.text"/> 
      <short value="Primary text for the item"/> 
      <definition value="The name of a section, the text of a question or text content for a display item."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.type">
      <path value="Questionnaire.item.type"/> 
      <short value="group | display | boolean | decimal | integer | date | dateTime +"/> 
      <definition value="The type of questionnaire item this is - whether text for display, a grouping of other
       items or a particular type of data to be captured (string, integer, coded choice, etc.)."/> 
      <comment value="Additional constraints on the type of answer can be conveyed by extensions. The value
       may come from the ElementDefinition referred to by .definition."/> 
      <requirements value="Defines the format in which the user is to be prompted for the answer."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.type"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireItemType"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Distinguishes groups from questions and display text and indicates data type for questions"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/item-type"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen">
      <path value="Questionnaire.item.enableWhen"/> 
      <short value="Only allow data when"/> 
      <definition value="A constraint indicating that this item should only be enabled (displayed/allow answers
       to be captured) when the specified condition is true."/> 
      <comment value="If multiple repetitions of this extension are present, the item should be enabled when
       the condition for *any* of the repetitions is true.  I.e. treat &quot;enableWhen&quot;s
       as being joined by an &quot;or&quot; clause.

This element is a modifier because if enableWhen is present for an item, &quot;required&quot;
       is ignored unless one of the enableWhen conditions is met."/> 
      <requirements value="Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender
       is specified as a male, no need to capture pregnancy history.  Also allows conditional
       display of instructions or groups of questions."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="que-7"/> 
        <severity value="error"/> 
        <human value="enableWhen must contain either a 'answer' or a 'hasAnswer' element"/> 
        <expression value="hasAnswer.exists() xor answer.exists()"/> 
        <xpath value="count(f:*[starts-with(local-name(.), 'answer')]|self::f:hasAnswer) = 1"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.id">
      <path value="Questionnaire.item.enableWhen.id"/> 
      <representation value="xmlAttr"/> 
      <short value="xml:id (or equivalent in JSON)"/> 
      <definition value="unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.extension">
      <path value="Questionnaire.item.enableWhen.extension"/> 
      <short value="Additional Content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.modifierExtension">
      <path value="Questionnaire.item.enableWhen.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.question">
      <path value="Questionnaire.item.enableWhen.question"/> 
      <short value="Question that determines whether item is enabled"/> 
      <definition value="The linkId for the question whose answer (or lack of answer) governs whether this item
       is enabled."/> 
      <comment value="If multiple question occurrences are present for the same question (same linkId), then
       this refers to the nearest question occurrence reachable by tracing first the &quot;ancestor&quot;
       axis and then the &quot;preceding&quot; axis and then the &quot;following&quot; axis."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen.question"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.hasAnswer">
      <path value="Questionnaire.item.enableWhen.hasAnswer"/> 
      <short value="Enable when answered or not"/> 
      <definition value="An indication that this item should be enabled only if the specified question is answered
       (hasAnswer=true) or not answered (hasAnswer=false)."/> 
      <comment value="If answered=false and answer values are also provided, then they are treated as &quot;or&quot;.
        I.e. &quot;Enable if the question is unanswered or the answer is one of the specified
       values&quot;.  If answered=true and answers are present, one of the specified answers
       must be met. (So there's little reason to specify answered=true if answers are present.)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen.hasAnswer"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <condition value="que-7"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.answer[x]">
      <path value="Questionnaire.item.enableWhen.answer[x]"/> 
      <short value="Value question must have"/> 
      <definition value="An answer that the referenced question must match in order for the item to be enabled."/> 
      <comment value="Multiple answers are treated as &quot;or&quot;.  E.g. Enable if question 1 = A, C or E.
        

Components not specified in the answer do not need to match.  For example, if enableWhen
       specifies code + system for a Coding, it is ok if the answer has a &quot;display&quot;
       element.  I.e. treat the answer as a 'pattern'.

The dataType of this element must be the same as the data type of the question being referenced."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen.answer[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <type> 
        <code value="integer"/> 
      </type> 
      <type> 
        <code value="date"/> 
      </type> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="time"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="uri"/> 
      </type> 
      <type> 
        <code value="Attachment"/> 
      </type> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <condition value="que-7"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireQuestionOption2"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Allowed values to answer questions."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.required">
      <path value="Questionnaire.item.required"/> 
      <short value="Whether the item must be included in data results"/> 
      <definition value="An indication, if true, that the item must be present in a &quot;completed&quot; QuestionnaireRespon
      se.  If false, the item may be skipped when answering the questionnaire."/> 
      <comment value="Questionnaire.item.required only has meaning for elements that are conditionally enabled
       with enableWhen if the condition evaluates to true.  If an item that contains other items
       is marked as required, that does not automatically make the contained elements required
       (though required groups must contain at least one child element). The value may come from
       the ElementDefinition referred to by .definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.required"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <defaultValueBoolean value="false"/> 
      <condition value="que-6"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.repeats">
      <path value="Questionnaire.item.repeats"/> 
      <short value="Whether the item may repeat"/> 
      <definition value="An indication, if true, that the item may occur multiple times in the response, collecting
       multiple answers answers for questions or multiple sets of answers for groups."/> 
      <comment value="If a question is marked as repeats=true, then multiple answers can be provided for the
       question in the corresponding QuestionnaireResponse.  When rendering the questionnaire,
       it is up to the rendering software whether to render the question text for each answer
       repetition or to simply list each of the answers beneath the question.  (Which is most
       appropriate visually may depend on the type of answer as well as whether there are nested
       items.). The value may come from the ElementDefinition referred to by .definition."/> 
      <requirements value="Items may be used to create set of (related) questions that can be repeated to give multiple
       answers to such a set."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.repeats"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <defaultValueBoolean value="false"/> 
      <condition value="que-6"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.readOnly">
      <path value="Questionnaire.item.readOnly"/> 
      <short value="Don't allow human editing"/> 
      <definition value="An indication, when true, that the value cannot be changed by a human respondent to the
       Questionnaire."/> 
      <comment value="The value of readOnly elements can be established by asserting  extensions for defaultValues,
       linkages that support pre-population and/or extensions that support calculation based
       on other answers."/> 
      <requirements value="Allows certain information to be phrased (and rendered) as a question and an answer, while
       keeping users from changing it.  May also be useful for preventing changes to pre-populated
       portions of a questionnaire, for calculated values, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.readOnly"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <condition value="que-9"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.maxLength">
      <path value="Questionnaire.item.maxLength"/> 
      <short value="No more than this many characters"/> 
      <definition value="The maximum number of characters that are permitted in the answer to be considered a &quot;valid&quo
      t; QuestionnaireResponse."/> 
      <comment value="For base64binary, reflects the number of characters representing the encoded data, not
       the number of bytes of the binary data. The value may come from the ElementDefinition
       referred to by .definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.maxLength"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="integer"/> 
      </type> 
      <condition value="que-10"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.options">
      <path value="Questionnaire.item.options"/> 
      <short value="Valueset containing permitted answers"/> 
      <definition value="A reference to a value set containing a list of codes representing permitted answers for
       a &quot;choice&quot; or &quot;open-choice&quot; question."/> 
      <comment value="LOINC defines many useful value sets for questionnaire responses. See [LOINC Answer Lists](loinc.htm
      l#alist). The value may come from the ElementDefinition referred to by .definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.options"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </type> 
      <condition value="que-4"/> 
      <condition value="que-5"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.option">
      <path value="Questionnaire.item.option"/> 
      <short value="Permitted answer"/> 
      <definition value="One of the permitted answers for a &quot;choice&quot; or &quot;open-choice&quot; question."/> 
      <comment value="This element can be used when the value set machinery of options is deemed too cumbersome
       or when there's a need to capture options that are not codes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.option"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="que-4"/> 
      <condition value="que-5"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.option.id">
      <path value="Questionnaire.item.option.id"/> 
      <representation value="xmlAttr"/> 
      <short value="xml:id (or equivalent in JSON)"/> 
      <definition value="unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.option.extension">
      <path value="Questionnaire.item.option.extension"/> 
      <slicing id="8">
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
    </element> 
    <element id="Questionnaire.item.option.extension:optioncode">
      <path value="Questionnaire.item.option.extension"/> 
      <sliceName value="optionCode"/> 
      <short value="Meaning of the response option"/> 
      <definition value="A CodeableConcept that assigns meaning to the response object on which it appears."/> 
      <requirements value="Need to be able to determine the semantics of each potential response in order to interpret
       the meaning when processing the questionnaire response.  For example, the response option
       &quot;Severe migraines within the past year&quot; to the question &quot;Select all that
       apply&quot; needs detailed coding (such as via CodeableConcept) at the option level, as
       well as a way to represent that an affirmation/negative response should result in (perhaps)
       an Observation in the QuestionnaireResponse tied to a clinical model (such as CIMI). This
       is key to support sophisticated CDS based on the semantics of the QuestionnaireResponse
       -- not just the codes."/> 
      <alias value="optionCode"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-optionCode"/> 
      </type> 
      <condition value="ele-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/> 
        <source value="Extension"/> 
      </constraint> 
    </element> 
    <element id="Questionnaire.item.option.modifierExtension">
      <path value="Questionnaire.item.option.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.option.value[x]">
      <path value="Questionnaire.item.option.value[x]"/> 
      <short value="Answer value"/> 
      <definition value="A potential answer that's allowed as the answer to this question."/> 
      <comment value="The data type of the value must agree with the item.type."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.option.value[x]"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="integer"/> 
      </type> 
      <type> 
        <code value="date"/> 
      </type> 
      <type> 
        <code value="time"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireQuestionOption"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Allowed values to answer questions."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.initial[x]">
      <path value="Questionnaire.item.initial[x]"/> 
      <short value="Default value when item is first rendered"/> 
      <definition value="The value that should be defaulted when initially rendering the questionnaire for user
       input."/> 
      <comment value="The user is allowed to change the value and override the default (unless marked as read-only).
       If the user doesn't change the value, then this initial value will be persisted when the
       QuestionnaireResponse is initially created.  Note that default values can influence results.

The data type of initial[x] must agree with the item.type."/> 
      <requirements value="In some workflows, having defaults saves time."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.initial[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <type> 
        <code value="integer"/> 
      </type> 
      <type> 
        <code value="date"/> 
      </type> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="time"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="uri"/> 
      </type> 
      <type> 
        <code value="Attachment"/> 
      </type> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <condition value="que-8"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireQuestionOption2"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Allowed values to answer questions."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.item">
      <path value="Questionnaire.item.item"/> 
      <short value="Nested questionnaire items"/> 
      <definition value="Text, questions and other groups to be nested beneath a question or group."/> 
      <comment value="There is no specified limit to the depth of nesting.  However, Questionnaire authors are
       encouraged to consider the impact on the user and user interface of overly deep nesting."/> 
      <requirements value="Reports can consist of complex nested groups."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.item"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="#Questionnaire.item"/> 
      <condition value="que-1"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="Questionnaire">
      <path value="Questionnaire"/> 
      <short value="A questionnaire with the ability to specify behavior associated with questions or groups
       of questions"/> 
      <definition value="A CQIF questionnaire is a questionnaire with the added ability to describe behavior associated
       with questions. For example, whether or not to display a particular question or group
       of questions, or automatically calculating the value of an answer based on the answers
       to previous questions."/> 
      <min value="0"/> 
      <max value="*"/> 
    </element> 
    <element id="Questionnaire.extension:library">
      <path value="Questionnaire.extension"/> 
      <sliceName value="library"/> 
      <short value="A library containing logic referenced by the questionnaire"/> 
      <definition value="A CQL or ELM library containing any logic referenced by the questionnaire."/> 
      <alias value="library"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-library"/> 
      </type> 
    </element> 
    <element id="Questionnaire.item">
      <path value="Questionnaire.item"/> 
    </element> 
    <element id="Questionnaire.item.extension:condition">
      <path value="Questionnaire.item.extension"/> 
      <sliceName value="condition"/> 
      <short value="A condition that determines whether or not the group is applicable"/> 
      <definition value="The name of an expression that determines whether the group on which it appears is applicable.
       The expression is evaluated within the current context. If the result of evaluating the
       expression is true, the group is applicable. The expression has access to the current
       value of answered questions by the linkId of the question."/> 
      <comment value="Note that per Lloyd this extension may not be necessary, it may be able to specified structurally
       using the elements already available within Questionnaire."/> 
      <alias value="condition"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-condition"/> 
      </type> 
    </element> 
    <element id="Questionnaire.item.extension:initialvalue">
      <path value="Questionnaire.item.extension"/> 
      <sliceName value="initialValue"/> 
      <short value="An expression that provides the initial value for the answer to the question"/> 
      <definition value="The name of an expression that determines the initial value for the answer to the question.
       This expression is evaluated once as part of displaying the form, and does not have access
       to the answers to other questions."/> 
      <alias value="initialValue"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-initialValue"/> 
      </type> 
    </element> 
    <element id="Questionnaire.item.extension:calculatedvalue">
      <path value="Questionnaire.item.extension"/> 
      <sliceName value="calculatedValue"/> 
      <short value="An expression that provides a calculated value for the answer to the question"/> 
      <definition value="The name of an expression that determines a calculated value for the answer to the question.
       The expression is evaluated as necessary and has access to the answers to other questions
       by the linkId of the question."/> 
      <alias value="calculatedValue"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-calculatedValue"/> 
      </type> 
    </element> 
    <element id="Questionnaire.item.option">
      <path value="Questionnaire.item.option"/> 
    </element> 
    <element id="Questionnaire.item.option.extension:optioncode">
      <path value="Questionnaire.item.option.extension"/> 
      <sliceName value="optionCode"/> 
      <short value="Meaning of the response option"/> 
      <definition value="A CodeableConcept that assigns meaning to the response object on which it appears."/> 
      <requirements value="Need to be able to determine the semantics of each potential response in order to interpret
       the meaning when processing the questionnaire response.  For example, the response option
       &quot;Severe migraines within the past year&quot; to the question &quot;Select all that
       apply&quot; needs detailed coding (such as via CodeableConcept) at the option level, as
       well as a way to represent that an affirmation/negative response should result in (perhaps)
       an Observation in the QuestionnaireResponse tied to a clinical model (such as CIMI). This
       is key to support sophisticated CDS based on the semantics of the QuestionnaireResponse
       -- not just the codes."/> 
      <alias value="optionCode"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-optionCode"/> 
      </type> 
    </element> 
  </differential> 
</StructureDefinition>