Documentation Templates and Rules
1.1.0-ballot - STU 1.1 US

This page is part of the Documentation Templates and Rules (v1.1.0-ballot: STU 1.1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

: home-o2-sdc-adaptive-questionnaireresponse - JSON Representation

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{
  "resourceType" : "QuestionnaireResponse",
  "id" : "home-o2-sdc-adaptive-questionnaireresponse",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkId for the item\">LinkId</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the itemcan appear in the instance\">Definition</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Answer</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireResponseRoot\" class=\"hierarchy\"/> home-o2-sdc-adaptive-questionnaireresponse</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">QuestionnaireResponse</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">diagnosis</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Order Reason</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span>http://example.org 4: Replacement</span></span></td></tr>\r\n<tr><td colspan=\"4\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
  },
  "contained" : [
    {
      "resourceType" : "Questionnaire",
      "id" : "home-o2-sdc-adaptive-questionnaire",
      "meta" : {
        "profile" : [
          "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-sdc-questionnaire-adapt"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Example adaptive questionnaire contained in a QuestionnaireResposne</div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive",
          "valueBoolean" : true
        }
      ],
      "version" : "0.1.0",
      "name" : "HomeOxygenTherapyAdaptiveSDCQuestionnaire",
      "title" : "Adaptive Home Oxygen Therapy Order Template (SDC)",
      "derivedFrom" : [
        "http://example/basequestionnaire"
      ],
      "status" : "draft",
      "subjectType" : [
        "Patient"
      ],
      "date" : "2020-01-16T00:00:00+00:00",
      "publisher" : "Da Vinci DTR",
      "contact" : [
        {
          "name" : "Example Author"
        }
      ],
      "item" : [
        {
          "linkId" : "1",
          "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
          "type" : "text",
          "required" : true
        },
        {
          "linkId" : "2",
          "text" : "Order Reason",
          "type" : "choice",
          "required" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://example.org",
                "code" : "1",
                "display" : "Initial or original order for certification"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://example.org",
                "code" : "2",
                "display" : "Change in status"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://example.org",
                "code" : "3",
                "display" : "Revision or change in equipment"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://example.org",
                "code" : "4",
                "display" : "Replacement"
              }
            }
          ]
        }
      ]
    }
  ],
  "questionnaire" : "#home-o2-sdc-adaptive-questionnaire",
  "status" : "completed",
  "subject" : {
    "reference" : "Patient/example1",
    "display" : "Vlad"
  },
  "authored" : "2022-01-26T20:36:57.544Z",
  "author" : {
    "reference" : "Practitioner/example2"
  },
  "item" : [
    {
      "linkId" : "1",
      "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
      "answer" : [
        {
          "valueString" : "diagnosis"
        }
      ]
    },
    {
      "linkId" : "2",
      "text" : "Order Reason",
      "answer" : [
        {
          "valueCoding" : {
            "system" : "http://example.org",
            "code" : "4",
            "display" : "Replacement"
          }
        }
      ]
    }
  ]
}