This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2
This resource maintained by the Patient Care Work Group
A structured set of questions intended to guide the collection of answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the underlying questions.
A Questionnaire is an organized collection of questions intended to solicit information from patients, providers or other individuals involved in the healthcare domain. They may be simple flat lists of questions or can be hierarchically organized in groups and sub-groups, each containing questions. The Questionnaire defines the questions to be asked, how they are ordered and grouped and what the constraints are on the allowed answers. The results of a Questionnaire can be communicated using the QuestionnaireAnswer resource.
Questionnaires cover the need to communicate data originating from forms used in medical history examinations, research questionnaires and sometimes full clinical specialty records. In many systems this data is collected using user-defined screens and forms. Questionnaires define specifics about data capture - exactly what questions were asked, in what order, what choices for answers were, etc. Each of these questions is part of the Questionnaire, and as such the Questionnaire is a separately identifiable Resource, whereas the individual questions are not.
Examples of Questionnaires include:
This resource is limited in scope to support the characteristics of simple questionnaires. However, common extensions have been defined to allow more sophisticated behavior. This includes:
Additional profiles such as the Structured Data Capture Questionnaire profile may provide additional capabilities for defining more sophisticated questionnaires and forms.
Questionnaires differ from Lists because Lists group existing resources, while Questionnaires group arbitrary questions. In theory, a Questionnaire could be expressed as a List or Composition containing DataElement resources. However, the former would disregard the "wholeness" associated with a questionnaire where questions must generally be maintained as a single structure. The latter would focus on rendering of the data elements rather than organizing the capture of information.
Groups and questions that make up a Questionnaire can be explicitly coded to refer to externally defined numbering or identification of questions and sections on formally defined questionnaires. This allows extraction of the data on a form and post-processing of the data contained in a Questionnaire. Such coding is not required however and Questionnaires may be quite loosely defined. The section Questionnaire versus Resources below discusses the issues of collecting data in such loosely defined Questionnaires versus collecting data as well-defined separate Resources.
This resource is referenced by [QuestionnaireAnswers]
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Questionnaire | I | DomainResource | A structured set of questions The link ids for groups and questions must be unique within the questionnaire | |
identifier | Σ | 0..* | Identifier | External Ids for this questionnaire |
version | Σ | 0..1 | string | Logical id for this version of Questionnaire |
status | M Σ | 1..1 | code | draft | published | retired QuestionnaireStatus (Required) |
date | Σ | 0..1 | dateTime | Date this version was authored |
publisher | Σ | 0..1 | string | Organization/individual who designed the questionnaire |
telecom | Σ | 0..* | ContactPoint | Contact information of the publisher |
group | I | 1..1 | Element | Grouped questions Groups may either contain questions or groups but not both |
linkId | 0..1 | string | To link questionnaire with questionnaire answers | |
title | 0..1 | string | Name to be displayed for group | |
concept | 0..* | Coding | Concept that represents this section on a questionnaire | |
text | 0..1 | string | Additional text for the group | |
required | 0..1 | boolean | Must group be included in data results? | |
repeats | 0..1 | boolean | Whether the group may repeat | |
group | I | 0..* | see group | Nested questionnaire group |
question | I | 0..* | Element | Questions in this group |
linkId | 0..1 | string | To link questionnaire with questionnaire answers | |
concept | 0..* | Coding | Concept that represents this question on a questionnaire | |
text | 0..1 | string | Text of the question as it is shown to the user | |
type | 0..1 | code | boolean | decimal | integer | date | dateTime + AnswerFormat (Required) | |
required | 0..1 | boolean | Must question be answered in data results? | |
repeats | 0..1 | boolean | Can question have multiple answers? | |
options | 0..1 | ValueSet | Valueset containing the possible options | |
group | 0..* | see group | Nested questionnaire group |
UML Diagram
XML Template
<Questionnaire xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier External Ids for this questionnaire --></identifier> <version value="[string]"/><!-- 0..1 Logical id for this version of Questionnaire --> <status value="[code]"/><!-- 1..1 draft | published | retired --> <date value="[dateTime]"/><!-- 0..1 Date this version was authored --> <publisher value="[string]"/><!-- 0..1 Organization/individual who designed the questionnaire --> <telecom><!-- 0..* ContactPoint Contact information of the publisher --></telecom> <group> <!-- 1..1 Grouped questions --> <linkId value="[string]"/><!-- 0..1 To link questionnaire with questionnaire answers --> <title value="[string]"/><!-- 0..1 Name to be displayed for group --> <concept><!-- 0..* Coding Concept that represents this section on a questionnaire --></concept> <text value="[string]"/><!-- 0..1 Additional text for the group --> <required value="[boolean]"/><!-- 0..1 Must group be included in data results? --> <repeats value="[boolean]"/><!-- 0..1 Whether the group may repeat --> <group><!-- 0..* Content as for Questionnaire.group Nested questionnaire group --></group> <question> <!-- 0..* Questions in this group --> <linkId value="[string]"/><!-- 0..1 To link questionnaire with questionnaire answers --> <concept><!-- 0..* Coding Concept that represents this question on a questionnaire --></concept> <text value="[string]"/><!-- 0..1 Text of the question as it is shown to the user --> <type value="[code]"/><!-- 0..1 boolean | decimal | integer | date | dateTime + --> <required value="[boolean]"/><!-- 0..1 Must question be answered in data results? --> <repeats value="[boolean]"/><!-- 0..1 Can question have multiple answers? --> <options><!-- 0..1 Reference(ValueSet) Valueset containing the possible options --></options> <group><!-- 0..* Content as for Questionnaire.group Nested questionnaire group --></group> </question> </group> </Questionnaire>
JSON Template
{ "resourceType" : "Questionnaire", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // External Ids for this questionnaire "version" : "<string>", // Logical id for this version of Questionnaire "status" : "<code>", // R! draft | published | retired "date" : "<dateTime>", // Date this version was authored "publisher" : "<string>", // Organization/individual who designed the questionnaire "telecom" : [{ ContactPoint }], // Contact information of the publisher "group" : { // R! Grouped questions "linkId" : "<string>", // To link questionnaire with questionnaire answers "title" : "<string>", // Name to be displayed for group "concept" : [{ Coding }], // Concept that represents this section on a questionnaire "text" : "<string>", // Additional text for the group "required" : <boolean>, // Must group be included in data results? "repeats" : <boolean>, // Whether the group may repeat "group" : [{ Content as for Questionnaire.group }], // C? Nested questionnaire group "question" : [{ // C? Questions in this group "linkId" : "<string>", // To link questionnaire with questionnaire answers "concept" : [{ Coding }], // Concept that represents this question on a questionnaire "text" : "<string>", // Text of the question as it is shown to the user "type" : "<code>", // boolean | decimal | integer | date | dateTime + "required" : <boolean>, // Must question be answered in data results? "repeats" : <boolean>, // Can question have multiple answers? "options" : { Reference(ValueSet) }, // Valueset containing the possible options "group" : [{ Content as for Questionnaire.group }] // Nested questionnaire group }] } }
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Questionnaire | I | DomainResource | A structured set of questions The link ids for groups and questions must be unique within the questionnaire | |
identifier | Σ | 0..* | Identifier | External Ids for this questionnaire |
version | Σ | 0..1 | string | Logical id for this version of Questionnaire |
status | M Σ | 1..1 | code | draft | published | retired QuestionnaireStatus (Required) |
date | Σ | 0..1 | dateTime | Date this version was authored |
publisher | Σ | 0..1 | string | Organization/individual who designed the questionnaire |
telecom | Σ | 0..* | ContactPoint | Contact information of the publisher |
group | I | 1..1 | Element | Grouped questions Groups may either contain questions or groups but not both |
linkId | 0..1 | string | To link questionnaire with questionnaire answers | |
title | 0..1 | string | Name to be displayed for group | |
concept | 0..* | Coding | Concept that represents this section on a questionnaire | |
text | 0..1 | string | Additional text for the group | |
required | 0..1 | boolean | Must group be included in data results? | |
repeats | 0..1 | boolean | Whether the group may repeat | |
group | I | 0..* | see group | Nested questionnaire group |
question | I | 0..* | Element | Questions in this group |
linkId | 0..1 | string | To link questionnaire with questionnaire answers | |
concept | 0..* | Coding | Concept that represents this question on a questionnaire | |
text | 0..1 | string | Text of the question as it is shown to the user | |
type | 0..1 | code | boolean | decimal | integer | date | dateTime + AnswerFormat (Required) | |
required | 0..1 | boolean | Must question be answered in data results? | |
repeats | 0..1 | boolean | Can question have multiple answers? | |
options | 0..1 | ValueSet | Valueset containing the possible options | |
group | 0..* | see group | Nested questionnaire group |
XML Template
<Questionnaire xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier External Ids for this questionnaire --></identifier> <version value="[string]"/><!-- 0..1 Logical id for this version of Questionnaire --> <status value="[code]"/><!-- 1..1 draft | published | retired --> <date value="[dateTime]"/><!-- 0..1 Date this version was authored --> <publisher value="[string]"/><!-- 0..1 Organization/individual who designed the questionnaire --> <telecom><!-- 0..* ContactPoint Contact information of the publisher --></telecom> <group> <!-- 1..1 Grouped questions --> <linkId value="[string]"/><!-- 0..1 To link questionnaire with questionnaire answers --> <title value="[string]"/><!-- 0..1 Name to be displayed for group --> <concept><!-- 0..* Coding Concept that represents this section on a questionnaire --></concept> <text value="[string]"/><!-- 0..1 Additional text for the group --> <required value="[boolean]"/><!-- 0..1 Must group be included in data results? --> <repeats value="[boolean]"/><!-- 0..1 Whether the group may repeat --> <group><!-- 0..* Content as for Questionnaire.group Nested questionnaire group --></group> <question> <!-- 0..* Questions in this group --> <linkId value="[string]"/><!-- 0..1 To link questionnaire with questionnaire answers --> <concept><!-- 0..* Coding Concept that represents this question on a questionnaire --></concept> <text value="[string]"/><!-- 0..1 Text of the question as it is shown to the user --> <type value="[code]"/><!-- 0..1 boolean | decimal | integer | date | dateTime + --> <required value="[boolean]"/><!-- 0..1 Must question be answered in data results? --> <repeats value="[boolean]"/><!-- 0..1 Can question have multiple answers? --> <options><!-- 0..1 Reference(ValueSet) Valueset containing the possible options --></options> <group><!-- 0..* Content as for Questionnaire.group Nested questionnaire group --></group> </question> </group> </Questionnaire>
JSON Template
{ "resourceType" : "Questionnaire", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // External Ids for this questionnaire "version" : "<string>", // Logical id for this version of Questionnaire "status" : "<code>", // R! draft | published | retired "date" : "<dateTime>", // Date this version was authored "publisher" : "<string>", // Organization/individual who designed the questionnaire "telecom" : [{ ContactPoint }], // Contact information of the publisher "group" : { // R! Grouped questions "linkId" : "<string>", // To link questionnaire with questionnaire answers "title" : "<string>", // Name to be displayed for group "concept" : [{ Coding }], // Concept that represents this section on a questionnaire "text" : "<string>", // Additional text for the group "required" : <boolean>, // Must group be included in data results? "repeats" : <boolean>, // Whether the group may repeat "group" : [{ Content as for Questionnaire.group }], // C? Nested questionnaire group "question" : [{ // C? Questions in this group "linkId" : "<string>", // To link questionnaire with questionnaire answers "concept" : [{ Coding }], // Concept that represents this question on a questionnaire "text" : "<string>", // Text of the question as it is shown to the user "type" : "<code>", // boolean | decimal | integer | date | dateTime + "required" : <boolean>, // Must question be answered in data results? "repeats" : <boolean>, // Can question have multiple answers? "options" : { Reference(ValueSet) }, // Valueset containing the possible options "group" : [{ Content as for Questionnaire.group }] // Nested questionnaire group }] } }
Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire
Path | Definition | Type | Reference |
---|---|---|---|
Questionnaire.status | Lifecycle status of the questionnaire | Fixed | http://hl7.org/fhir/questionnaire-status |
Questionnaire.group.concept | Codes for questionnaires and groupings of questionnaire questions | Unknown | No details provided yet |
Questionnaire.group.question.type | The expected format of an answer | Fixed | http://hl7.org/fhir/answer-format |
There is considerable overlap between the information covered by Questionnaires and other Resources (especially FamilyHistory, MedicationStatement, Observation, Procedure, etc.): Questionnaire's flexible structure can easily be misused to capture any data, even data that should be captured as separate Resources. The choice between using Questionnaires or separate Resources may be dictated by the procedure of collection and recording. E.g. if the data is captured as a physician-agreed (electronic) form, it might be impossible or undesirable to distill separate resources from it and capturing the data in a Questionnaire would be most appropriate.
However, data captured only in Questionnaires can be difficult to query after-the-fact. Queries against other Resources will not return data captured only in Questionnaires, and querying against Questionnaires directly may not find all desired data, depending on how the questions may have been phrased or encoded over time or by different clinicians. Moreover, interoperability of such Questionnaires is limited as interpretation of its contents is only known to the circle of parties that were involved in its definition: encoding data from such Questionnaires using other, more specific, Resources increases the ability and consistency with which it can be understood and queried.
A Questionnaire is built out of three components:
title
for the questionnaire, the concept
that represents the meaning
of the overall questionnaire (e.g. a code for "family history"), the text
to display at the top of the questionnaire, etc. (In most cases, required
would be 'true' and repeats
would be false for the root groupQuestionnaires can be crafted using any questions the author can conceive phrased in whatever manner is appropriate or convenient. However, standardization of questions and the constraints enforced on the accompanying answers increases the ability to compare data gathered across questionnaires. There are two mechanisms defined in the specification for linking a Question (or Group) to a standardized definition:
concept
element on both Group and Question allows an individual question, a group of questions or even the questionnaire as a whole to be associated
with a pre-defined terminology of questions and question groups such as LOINCLinking to formal definitions of a question allows data captured by distinct questionnaires to be compared. If systems have the necessary mappings to the formal definition, linkages to formal definitions may also be used to automatically pre-populate or extract data from a corresponding QuestionnaireAnswers resource.
NOTE: Even if standard question definitions are referenced using concept
or the deReference
extension, information such as the question text,
data type and value set SHOULD still be declared for the question. Systems processing the questionnaire may not have access to or support the ability to look
up the question definitions from external sources. If the information is not included in-line within the questionnaire, other systems may not be able to to render
or use the Questionnaire.
If an external reference (concept
or deReference
extension) is included along with question information such as question text, data type or
value set, it is expected that the content for the question and the referenced definition would be in alignment. However, FHIR does not dictate what degree of
alignment is required. E.g. Does the question text need to match exactly? Is it legitimate for a question to constrain the allowed value set of possible answers?
These rules will need to be established within implementation environments.
The codes for the data type for each question is slightly different than the data types allowed in the QuestionnaireAnswers resource. Where the names are the same (ignoring case), the "answer" must use the specified type. Where the names are different, the mappings are as follows:
Questionnaire AnswerFormat code | QuestionnaireAnswers data type |
---|---|
text | string |
url | uri |
choice | Coding |
open-choice | Coding |
The core elements defined in the questionnaire resource are sufficient for simple questionnaires. For more sophisticated capabilities, a number of "common" extensions are defined in the Questionnaire Core extensions and the Element extensions profiles. For example, strict control over allowed number of conditions, conditional display of questionnaire content, etc.
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
Name | Type | Description | Paths |
code | token | A code that corresponds to the questionnaire or one of its groups | Questionnaire.group.concept |
date | date | When the questionnaire was last changed | Questionnaire.date |
identifier | token | An identifier for the questionnaire | Questionnaire.identifier |
publisher | string | The author of the questionnaire | Questionnaire.publisher |
status | token | The status of the questionnaire | Questionnaire.status |
title | string | All or part of the name of the questionnaire (title for the root group of the questionnaire) | |
version | string | The business version of the questionnaire | Questionnaire.version |