Da Vinci - Coverage Requirements Discovery
1.0.0 - STU 1

This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Questionnaire Task example - JSON Representation

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{
  "resourceType" : "Task",
  "id" : "questionnaire-example",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>basedOn</b>: <a href=\"MedicationRequest-example.html\">Generated Summary: id: 12345689 (OFFICIAL); status: draft; intent: order; ?ngen-3; authoredOn: 2015-01-15; <span title=\"Codes: {http://snomed.info/sct 11840006}\">Traveler's Diarrhea (disorder)</span>; Patient told to take with food</a></p><p><b>status</b>: ready</p><p><b>intent</b>: order</p><p><b>code</b>: <span title=\"Codes: {http://hl7.org/fhir/uv/sdc/CodeSystem/temp complete-questionnaire}\">The Task is asking the owner to create a QuestionnaireResponse based on the Questionnaire identified in one of the task inputs</span></p><p><b>for</b>: <a href=\"Patient-example.html\">Generated Summary: Medical Record Number: 1032702 (USUAL); active; Amy V. Shaw , Amy V. Baxter ; Phone: 555-555-5555, amy.shaw@example.com; gender: female; birthDate: 1987-02-20</a></p><p><b>encounter</b>: <a href=\"Encounter-example.html\">Generated Summary: id: v1451 (OFFICIAL); status: in-progress; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://snomed.info/sct 270427003}\">Patient-initiated encounter</span>; <span title=\"Codes: {http://snomed.info/sct 310361003}\">Non-urgent cardiological admission</span>; <span title=\"Codes: {http://snomed.info/sct 34068001}\">Heart valve replacement</span></a></p><p><b>authoredOn</b>: 2018-08-09</p><p><b>requester</b>: <a href=\"http://example.org/fhir/Organization/payer\">http://example.org/fhir/Organization/payer</a></p><p><b>reasonCode</b>: <span title=\"Codes: {http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp reason-prior-auth}\">Needed for prior authorization</span></p><blockquote><p><b>input</b></p><p><b>type</b>: <span title=\"Codes: {http://hl7.org/fhir/uv/sdc/CodeSystem/temp questionnaire}\">A canonical reference (possibly version-specific) to the Questionnaire to be completed</span></p><p><b>value</b>: <a href=\"http://example.org/Questionnaire/XYZ\">http://example.org/Questionnaire/XYZ|2</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title=\"Codes: {http://hl7.org/fhir/uv/sdc/CodeSystem/temp response-endpoint}\">Identifies the base URL for FHIR servers to which the Questionnaire resulting from the Task should be POSTed</span></p><p><b>value</b>: <a href=\"http://example.org/somePayer\">http://example.org/somePayer</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title=\"Codes: {http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp after-completion-action}\">A task input indicating an action that should be taken after a QuestionnaireResponse has been completed on a specified Questionnaire.  (Multiple completion actions can be specified.)</span></p><p><b>value</b>: <span title=\"Codes: {http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp prior-auth}\">Include in prior authorization</span></p></blockquote></div>"
  },
  "basedOn" : [
    {
      "reference" : "MedicationRequest/example"
    }
  ],
  "status" : "ready",
  "intent" : "order",
  "code" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
        "code" : "complete-questionnaire"
      }
    ]
  },
  "for" : {
    "reference" : "Patient/example"
  },
  "encounter" : {
    "reference" : "Encounter/example"
  },
  "authoredOn" : "2018-08-09",
  "requester" : {
    "reference" : "http://example.org/fhir/Organization/payer"
  },
  "reasonCode" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
        "code" : "reason-prior-auth"
      }
    ],
    "text" : "Needed for prior authorization"
  },
  "input" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
            "code" : "questionnaire"
          }
        ]
      },
      "valueCanonical" : "http://example.org/Questionnaire/XYZ|2"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
            "code" : "response-endpoint"
          }
        ]
      },
      "valueUrl" : "http://example.org/somePayer"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
            "code" : "after-completion-action"
          }
        ]
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
            "code" : "prior-auth",
            "display" : "Include in prior authorization"
          }
        ]
      }
    }
  ]
}