Release 4B 5 Ballot

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-ballot: R5 Ballot - STU see ballot notes ). 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

Questionnaireresponse.profile.xml

Example StructureDefinition/QuestionnaireResponse (XML)

FHIR Infrastructure Work Group Maturity Level : N/A Standards Status : Informative Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Raw XML ( canonical form + also see XML Format Specification )

Jump past Narrative

StructureDefinition for questionnaireresponse

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="QuestionnaireResponse"/> 
  <meta> 
    

    <lastUpdated value="2022-09-10T04:52:37.223+10:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      
        
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            <a href="formats.html#table" title="The logical name of the element">Name</a> 
          </th> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="formats.html#table" title="Information about the use of the element">Flags</a> 
          </th> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a> 
          </th> 
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            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/> 
              </a> 
            </span> 
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        </tr> 
        
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            <span title="QuestionnaireResponse : A structured set of questions and their answers. The questions
             are ordered and grouped into coherent subsets, corresponding to the structure of the grouping
             of the questionnaire being responded to.

             are ordered and grouped into coherent subsets, corresponding to the structure of
             the grouping of the questionnaire being responded to.">QuestionnaireResponse</span> 

            <a name="QuestionnaireResponse"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold;

             color: black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a> 

          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">

            <a href="domainresource.html">DomainResource</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxA structured set of questions and their answers

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">A structured set of questions and their answers
            <br/>  
            <br/>  Elements defined in Ancestors: 
            The logical id of the resource, as used in the URL for the resource. Once assigned, this
             value never changes., 

            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned,
             this value never changes.">id</a> , 

            <a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.
             Changes to the content might not always be associated with version changes to the resource., 
            A reference to a set of rules that were followed when the resource was constructed, and
             which must be understood when processing the content. Often, this is a reference to an
             implementation guide that defines the special rules along with other profiles etc., 

             Changes to the content might not always be associated with version changes to the
             resource.">meta</a> , 
            <a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed,

             and which must be understood when processing the content. Often, this is a reference
             to an implementation guide that defines the special rules along with other profiles
             etc.">implicitRules</a> , 

            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            A human-readable narrative that contains a summary of the resource and can 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., 
            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., 

            <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can 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.">text</a> , 
            <a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that

             contains them - they cannot be identified independently, nor can they have their
             own independent transaction scope. This is allowed to be a Parameters resource
             if and only if it is referenced by a resource that provides context/meaning.">contained</a> , 

            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource. 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
             can define an extension, there is a set of requirements that SHALL be met as part of the
             definition of the extension., 

             of the resource. 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 can define an extension, there is a set of requirements that SHALL
             be met as part of the definition of the extension.">extension</a> , 

            <a href="domainresource.html#DomainResource" title="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 and/or
             the understanding of the containing element's descendants. Usually modifier elements provide
             negation or qualification. 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.

             of the resource and that modifies the understanding of the element that contains
             it and/or the understanding of the containing element's descendants. Usually modifier
             elements provide negation or qualification. 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.


Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
             (including cannot change the meaning of modifierExtension itself).

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
             DomainResource (including cannot change the meaning of modifierExtension itself).">modifierExtension</a> 

          </td> 
        </tr> 

        
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            QuestionnaireResponse.identifier : A business identifier assigned to a particular completed
             (or partially completed) questionnaire.

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            <span title="QuestionnaireResponse.identifier : A business identifier assigned to a particular

             completed (or partially completed) questionnaire.">identifier</span> 

            <a name="QuestionnaireResponse.identifier"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
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           solid; padding:0px 4px 0px 4px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px">

            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
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           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Unique id for this set of answers
            <br/>  
            <br/>  
          </td> 
        </tr> 

        
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            QuestionnaireResponse.basedOn : The order, proposal or plan that is fulfilled in whole
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            <span title="QuestionnaireResponse.basedOn : The order, proposal or plan that is fulfilled in

             whole or in part by this QuestionnaireResponse.  For example, a ServiceRequest
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             post-partum depression.">basedOn</span> 

            <a name="QuestionnaireResponse.basedOn"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">

            <a href="references.html#Reference">Reference</a> (
            <a href="careplan.html">CarePlan</a>  | 
            <a href="servicerequest.html">ServiceRequest</a> )
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxRequest fulfilled by this QuestionnaireResponse

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Request fulfilled by this QuestionnaireResponse
            <br/>  
            <br/>  
          </td> 
        </tr> 

        
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           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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            QuestionnaireResponse.partOf : A procedure or observation that this questionnaire was
             performed as part of the execution of.  For example, the surgery a checklist was executed
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            <span title="QuestionnaireResponse.partOf : A procedure or observation that this questionnaire

             was performed as part of the execution of.  For example, the surgery a checklist
             was executed as part of.">partOf</span> 

            <a name="QuestionnaireResponse.partOf"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px">

            <a href="references.html#Reference">Reference</a> (
            <a href="observation.html">Observation</a>  | 
            <a href="procedure.html">Procedure</a> )
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4pxPart of this action

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Part of this action
            <br/>  
            <br/>  
          </td> 
        </tr> 

        
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            QuestionnaireResponse.questionnaire : The Questionnaire that defines and organizes the
             questions for which answers are being provided.

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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            YAAAAB3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1

            BAACxjwv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAA
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            <span title="QuestionnaireResponse.questionnaire : The Questionnaire that defines and organizes

             the questions for which answers are being provided.">questionnaire</span> 

            <a name="QuestionnaireResponse.questionnaire"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">

            <a href="datatypes.html#canonical">canonical</a> (
            <a href="questionnaire.html">Questionnaire</a> )
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Canonical URL of Questionnaire being answered
            <br/>  
          </td> 
        </tr> 

        
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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            QuestionnaireResponse.status : The position of the questionnaire response within its overall
             lifecycle.

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw

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            <span title="QuestionnaireResponse.status : The position of the questionnaire response within

             its overall lifecycle.">status</span> 

            <a name="QuestionnaireResponse.status"> </a> 
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           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">

            <a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is a modifier element">?!</a> 
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px">

            <a href="datatypes.html#code">code</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4pxin-progress | completed | amended | entered-in-error | stopped

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">in-progress | completed | amended | entered-in-error | stopped

            <br/>  
            <a href="valueset-questionnaire-answers-status.html">QuestionnaireResponseStatus</a>  (
            )

            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value
             set.">Required</a> )
            <br/>  
          </td> 
        </tr> 

        
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            QuestionnaireResponse.subject : The subject of the questionnaire response.  This could
             be a patient, organization, practitioner, device, etc.  This is who/what the answers apply
             to, but is not necessarily the source of information.

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1

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            <span title="QuestionnaireResponse.subject : The subject of the questionnaire response.  This

             could be a patient, organization, practitioner, device, etc.  This is who/what
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            <a name="QuestionnaireResponse.subject"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">

            <a href="references.html#Reference">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">The subject of the questions
            <br/>  
          </td> 
        </tr> 

        
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           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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            QuestionnaireResponse.encounter : The Encounter during which this questionnaire response
             was created or to which the creation of this record is tightly associated.

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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw

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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1

            BAACxjwv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAA
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            <span title="QuestionnaireResponse.encounter : The Encounter during which this questionnaire

             response was created or to which the creation of this record is tightly associated.">encounter</span> 

            <a name="QuestionnaireResponse.encounter"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px">

            <a href="references.html#Reference">Reference</a> (
            <a href="encounter.html">Encounter</a> )
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Encounter created as part of
            <br/>  
          </td> 
        </tr> 

        
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            QuestionnaireResponse.authored : The date and/or time that this set of answers were last
             changed.

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw

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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw

            YAAAAB3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw

            YAAAARklEQVQ4y2P8//8/AyWAhYFCMAgMuHjx4n+KXaCv+I0szW8WpCG8kFO1lGFKW/SIjAUYgxz/MzAwMDC+nqhDUTQyj
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            <span title="QuestionnaireResponse.authored : The date and/or time that this questionnaire response

             was last modified by the user - e.g. changing answers or revising status.">authored</span> 

            <a name="QuestionnaireResponse.authored"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">

            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">

            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <br/>  
          </td> 
        </tr> 

        
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            QuestionnaireResponse.author : Person who received the answers to the questions in the
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            <a name="QuestionnaireResponse.author"> </a> 
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

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           #F0F0F0 solid; padding:0px 4px 0px 4px">

            <a href="references.html#Reference">Reference</a> (
            <a href="device.html">Device</a>  | 
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a>  | 
            <a href="patient.html">Patient</a>  | 
            <a href="relatedperson.html">RelatedPerson</a>  | 
            <a href="organization.html">Organization</a> )
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">The individual or device that received and recorded the answers
            <br/>  
          </td> 
        </tr> 

        
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            <span title="QuestionnaireResponse.source : The individual or device that answered the questions

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            <a name="QuestionnaireResponse.source"> </a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

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           solid; padding:0px 4px 0px 4px">

            <a href="references.html#Reference">Reference</a> (
            <a href="device.html">Device</a>  | 
            <a href="organization.html">Organization</a>  | 
            <a href="patient.html">Patient</a>  | 
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a>  | 
            <a href="relatedperson.html">RelatedPerson</a> )
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">The individual or device that answered the questions
            <br/>  
          </td> 
        </tr> 

        
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            <span title="QuestionnaireResponse.item : A group or question item from the original questionnaire
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="conformance-rules.html#constraints" style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold;

             color: #301212; background-color: #fdf4f4;" title="This element has or is affected by some invariants">C</a> 

          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px
            

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="types.html#BackBoneElement">BackboneElement</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4pxGroups and questions

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <br/>  
            <span style="font-style: italic" title="qrs-1">+ Rule: Item cannot contain both item and answer</span> 
            <br/>  
            <span style="font-style: italic" title="qrs-2">+ Rule: Repeated answers are combined in the answers array of a single item</span> 
            <br/>  
            

            <br/>  
          </td> 
        </tr> 

        
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            QuestionnaireResponse.item.linkId : The item from the Questionnaire that corresponds to
             this item in the QuestionnaireResponse resource.

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            <span title="QuestionnaireResponse.item.answer : The respondent's answer(s) to the question.">answer</span> 
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            <a href="types.html#BackBoneElement">BackboneElement</a> 
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          vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4pxThe response(s) to the question

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <br/>  
            <br/>  
          </td> 
        </tr> 

        
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          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxSingle-valued answer to the question

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">Single-valued answer to the question

            <br/>  
            <a href="valueset-questionnaire-answers.html">Questionnaire Answer Codes</a>  (
            Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.)

            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
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            <a href="datatypes.html#boolean">boolean</a> 
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            <a href="datatypes.html#integer">integer</a> 
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            A date or partial date (e.g. just year or year + month). There is no time zone. The format
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                        Dates SHALL be valid dates.">valueDateTime</span> 

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            <a href="datatypes.html#time">time</a> 
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            <span title="A sequence of Unicode characters">valueString</span> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px

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            <a href="datatypes.html#string">string</a> 
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            QuestionnaireResponse.item.item : Questions or sub-groups nested beneath a question or
             group.

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw

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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw

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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABGdBTUEAAK/INwWK6QAAABl

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            Ha7SH9v4C8Nrl+GFh7LoAAAAASUVORK5CYII=" style="background-color: white; background-color: inherit" title="Reference to another Element"/>  
            <span title="QuestionnaireResponse.item.item : Sub-questions, sub-groups or display items nested

             beneath a group.">item</span> 

            <a name="QuestionnaireResponse.item.item"> </a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxsee 

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0

           solid; padding:0px 4px 0px 4px">see 

            <a href="#QuestionnaireResponse.item" title="QuestionnaireResponse.item">item</a> 
          </td> 
          vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4pxNested questionnaire response items

          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Child items of group item
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr> 
          <td class="hierarchy" colspan="5">
            <br/>  
            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/>  Documentation for this format
            </a> 
          </td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
    <valueString value="Clinical.Diagnostics"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="3"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fhir"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
  

  <version value="5.0.0-ballot"/> 
  <name value="QuestionnaireResponse"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  

  <date value="2022-09-10T04:52:37+10:00"/> 
  <publisher value="Health Level Seven International (FHIR Infrastructure)"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/fiwg/index.cfm"/> 
    </telecom> 
  </contact> 
  A structured set of questions and their answers. The questions are ordered and grouped
   into coherent subsets, corresponding to the structure of the grouping of the questionnaire
   being responded to.
  To support structured, hierarchical reporting of data gathered using digital forms and
   other questionnaires.
  

  <description value="A structured set of questions and their answers. The questions are ordered and
   grouped into coherent subsets, corresponding to the structure of the grouping of
   the questionnaire being responded to."/> 
  <purpose value="To support structured, hierarchical reporting of data gathered using digital forms

   and other questionnaires."/> 
  <fhirVersion value="5.0.0-ballot"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <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/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="QuestionnaireResponse"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
  <derivation value="specialization"/> 
  <snapshot> 
    <element id="QuestionnaireResponse">
      <path value="QuestionnaireResponse"/> 
      <short value="A structured set of questions and their answers"/> 
      A structured set of questions and their answers. The questions are ordered and grouped
       into coherent subsets, corresponding to the structure of the grouping of the questionnaire
       being responded to.
      The QuestionnaireResponse contains enough information about the questions asked and their
       organization that it can be interpreted somewhat independently from the Questionnaire
       it is based on.  I.e. You don't need access to the Questionnaire in order to extract basic
       information from a QuestionnaireResponse.

      <definition value="A structured set of questions and their answers. The questions are ordered and
       grouped into coherent subsets, corresponding to the structure of the grouping of
       the questionnaire being responded to."/> 
      <comment value="The QuestionnaireResponse contains enough information about the questions asked

       and their organization that it can be interpreted somewhat independently from the
       Questionnaire it is based on.  I.e. You don't need access to the Questionnaire
       in order to extract basic information from a QuestionnaireResponse."/> 

      <alias value="Form"/> 
      <alias value="QuestionnaireAnswers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse"/> 
        <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="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        If the resource is contained in another resource, it SHALL be referred to from elsewhere
         in the resource or SHALL refer to the containing resource
        contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda
        nts().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))))

        <human value="If the resource is contained in another resource, it SHALL be referred to from
         elsewhere in the resource or SHALL refer to the containing resource"/> 
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy

        pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))

         or descendants().where(reference = '#').exists() or descendants().where(as(canonical)
         = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched',
         id).empty()
        not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:refere
        nce/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))

         = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched
        ', id).empty()"/> 
        <xpath value="not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f

        :reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@va
        lue='#']))]))"/> 

        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated

        <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:lastUpdat
        ed))"/> 

        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          When a resource has no narrative, only systems that fully understand the data can display
           the resource to a human safely. Including a human readable representation in the resource
           makes for a much more robust eco-system and cheaper handling of resources by intermediary
           systems. Some ecosystems restrict distribution of resources to only those systems that
           do fully understand the resources, and as a consequence implementers may believe that
           the narrative is superfluous. However experience shows that such eco-systems often open
           up to new participants over time.

          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
           display the resource to a human safely. Including a human readable representation
           in the resource makes for a much more robust eco-system and cheaper handling of
           resources by intermediary systems. Some ecosystems restrict distribution of resources
           to only those systems that do fully understand the resources, and as a consequence
           implementers may believe that the narrative is superfluous. However experience
           shows that such eco-systems often open up to new participants over time."/> 

        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <xpath value="exists(f:text/h:div)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="infrastructure.information"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.id">
      <path value="QuestionnaireResponse.id"/> 
      <short value="Logical id of this artifact"/> 
      The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes.
      The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation.

      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
       this value never changes."/> 
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except

       for cases like the create and conditional update. Otherwise, the use of the resouce
       id depends on the given use case."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->

      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="QuestionnaireResponse.meta">
      <path value="QuestionnaireResponse.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 might not always be associated with version changes to the resource.

       Changes to the content might 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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="QuestionnaireResponse.implicitRules">
      <path value="QuestionnaireResponse.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content. Often, this is a reference to an
       implementation guide that defines the special rules along with other profiles etc.
      Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element. Often, when used, the URL
       is a reference to an implementation guide that defines these special rules as part of
       it's narrative along with other profiles, value sets, etc.

      <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. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles
       etc."/> 
      <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. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of it's narrative along with other profiles,
       value sets, etc."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies it's meaning or interpretation"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="QuestionnaireResponse.language">
      <path value="QuestionnaireResponse.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      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).

      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </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="preferred"/> 
        <description value="IETF language tag"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="QuestionnaireResponse.text">
      <path value="QuestionnaireResponse.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      A human-readable narrative that contains a summary of the resource and can 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.
      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 information is added
       later.

      <definition value="A human-readable narrative that contains a summary of the resource and can 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 a narrative. Resources that are not contained SHOULD

       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information 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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.contained">
      <path value="QuestionnaireResponse.contained"/> 
      <short value="Contained, inline Resources"/> 
      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.
      This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again. Contained
       resources may have profiles and tags In their meta elements, but SHALL NOT have security
       labels.

      <definition value="These resources do not have an independent existence apart from the resource that
       contains them - they cannot be identified independently, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource
       if and only if it is referenced by a resource that provides context/meaning."/> 
      <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. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels."/> 

      <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> 
      
        
        
        Containing new R4B resources within R4 resources may cause interoperability issues if
         instances are shared with R4 systems
        ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable
         or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this
         is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition
         or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus
         or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence
         or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefi
        nition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition
         or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorizat
        ion or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource
         is SubscriptionTopic)
        not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:Package
        dProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedA
        uthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citatio
        n|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDe
        finition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingre
        dient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|
        f:SubscriptionStatus|f:SubscriptionTopic)
        
      

      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.extension">
      <path value="QuestionnaireResponse.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 resource. 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
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension.
      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.

       of the resource. 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 can 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="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/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(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.modifierExtension">
      <path value="QuestionnaireResponse.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 and/or
       the understanding of the containing element's descendants. Usually modifier elements provide
       negation or qualification. 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.

       of the resource and that modifies the understanding of the element that contains
       it and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. 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.


Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself).
      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.
      Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension).

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <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."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 

      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/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(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them
      

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.identifier">
      <path value="QuestionnaireResponse.identifier"/> 
      <short value="Unique id for this set of answers"/> 
      

      <definition value="A business identifier assigned to a particular completed (or partially completed)
       questionnaire."/> 

      <requirements value="Used for tracking, registration and other business purposes."/> 
      <min value="0"/> 
      

      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse.identifier"/> 
        <min value="0"/> 
        

        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.basedOn">
      <path value="QuestionnaireResponse.basedOn"/> 
      <short value="Request fulfilled by this QuestionnaireResponse"/> 
      The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.
        For example, a ServiceRequest seeking an intake assessment or a decision support recommendation
       to assess for post-partum depression.
      Supports traceability of responsibility for the action and allows linkage of an action
       to the recommendations acted upon.

      <definition value="The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireRespon
      se.  For example, a ServiceRequest seeking an intake assessment or a decision support
       recommendation to assess for post-partum depression."/> 
      <requirements value="Supports traceability of responsibility for the action and allows linkage of an

       action to the recommendations acted upon."/> 

      <alias value="order"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse.basedOn"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.basedOn"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=FLFS].target"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.partOf">
      <path value="QuestionnaireResponse.partOf"/> 
      <short value="Part of this action"/> 
      A procedure or observation that this questionnaire was performed as part of the execution
       of.  For example, the surgery a checklist was executed as part of.
      Composition of questionnaire responses will be handled by the parent questionnaire having
       answers that reference the child questionnaire.  For relationships to referrals, and other
       types of requests, use basedOn.

      <definition value="A procedure or observation that this questionnaire was performed as part of the
       execution of.  For example, the surgery a checklist was executed as part of."/> 
      <comment value="Composition of questionnaire responses will be handled by the parent questionnaire

       having answers that reference the child questionnaire.  For relationships to referrals,
       and other types of requests, use basedOn."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse.partOf"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.partOf"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.questionnaire">
      <path value="QuestionnaireResponse.questionnaire"/> 
      
      The Questionnaire that defines and organizes the questions for which answers are being
       provided.
      If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse
       structure must be consistent with the Questionnaire (i.e. questions must be organized
       into the same groups, nested questions must still be nested, etc.).
      Needed to allow editing of the questionnaire response in a manner that enforces the constraints
       of the original form.

      <short value="Canonical URL of Questionnaire being answered"/> 
      <definition value="The Questionnaire that defines and organizes the questions for which answers are
       being provided."/> 
      <comment value="If a QuestionnaireResponse references a Questionnaire that can be resolved, then

       the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e.
       questions must be organized into the same groups, nested questions must still be
       nested, etc.).  It is possible to have a QuestionnaireResponse whose 'questionnaire'
       element does not resolve.  It is also possible for the questionnaire element to
       not have a value but only extensions (e.g. conveying the title or identifier for
       the questionnaire).  This may happen for legacy data.  If there is no formally
       defined Questionnaire, it is undefined what the 'correct' values for the linkId
       elements should be and it is possible that linkIds might be inconsistent for QuestionnaireRes
      ponses for the same form if captured by distinct systems."/> 
      <requirements value="Needed to allow editing of the questionnaire response in a manner that enforces

       the constraints of the original form."/> 

      <alias value="Form"/> 
      

      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.questionnaire"/> 
        

        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.instantiates"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.status">
      <path value="QuestionnaireResponse.status"/> 
      <short value="in-progress | completed | amended | entered-in-error | stopped"/> 
      <definition value="The position of the questionnaire response within its overall lifecycle."/> 
      This element is labeled as a modifier because the status contains codes that mark the
       resource as not currently valid.
      The information on Questionnaire resources  may possibly be gathered during multiple sessions
       and altered after considered being finished.

      <comment value="This element is labeled as a modifier because the status contains codes that mark
       the resource as not currently valid."/> 
      <requirements value="The information on Questionnaire resources  may possibly be gathered during multiple

       sessions and altered after considered being finished."/> 

      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      This element is labelled as a modifier because it is a status element that contains status
       entered-in-error which means that the resource should not be treated as valid

      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
       status entered-in-error which means that the resource should not be treated as
       valid"/> 

      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireResponseStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Lifecycle status of the questionnaire response."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers-status|5.0.0-ballot"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish
         &quot;in-progress&quot; from &quot;published)"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.subject">
      <path value="QuestionnaireResponse.subject"/> 
      <short value="The subject of the questions"/> 
      The subject of the questionnaire response.  This could be a patient, organization, practitioner,
       device, etc.  This is who/what the answers apply to, but is not necessarily the source
       of information.
      If the Questionnaire declared a subjectType, the resource pointed to by this element must
       be an instance of one of the listed types.
      Allows linking the answers to the individual the answers describe.  May also affect access
       control.

      <definition value="The subject of the questionnaire response.  This could be a patient, organization,
       practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily
       the source of information."/> 
      <comment value="If the Questionnaire declared a subjectType, the resource pointed to by this element

       must be an instance of one of the listed types."/> 
      <requirements value="Allows linking the answers to the individual the answers describe.  May also affect

       access control."/> 

      <alias value="Patient"/> 
      <alias value="Focus"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.subject"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.encounter">
      <path value="QuestionnaireResponse.encounter"/> 
      <short value="Encounter created as part of"/> 
      The Encounter during which this questionnaire response was created or to which the creation
       of this record is tightly associated.
      This will typically be the encounter the event occurred within, but some activities may
       be initiated prior to or after the official completion of an encounter but still be tied
       to the context of the encounter. A questionnaire that was initiated during an encounter
       but not fully completed during the encounter would still generally be associated with
       the encounter.
      

      <definition value="The Encounter during which this questionnaire response was created or to which
       the creation of this record is tightly associated."/> 
      <comment value="This will typically be the encounter the event occurred within, but some activities

       may be initiated prior to or after the official completion of an encounter but
       still be tied to the context of the encounter. A questionnaire that was initiated
       during an encounter but not fully completed during the encounter would still generally
       be associated with the encounter."/> 
      <requirements value="Provides context for the information that was captured.  May also affect access

       control."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.encounter"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship(typeCode=COMP].source[classCode&lt;=PCPR, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.authored">
      <path value="QuestionnaireResponse.authored"/> 
      <short value="Date the answers were gathered"/> 
      

      <definition value="The date and/or time that this questionnaire response was last modified by the
       user - e.g. changing answers or revising status."/> 

      <comment value="May be different from the lastUpdateTime of the resource itself, because that reflects
       when the data was known to the server, not when the data was captured.

This element is optional to allow for systems that might not know the value, however it
       SHOULD be populated if possible.

This element is optional to allow for systems that might not know the value, however
       it SHOULD be populated if possible."/> 

      <requirements value="Clinicians need to be able to check the date that the information in the questionnaire
       was collected, to derive the context of the answers."/> 
      <alias value="Date Created"/> 
      <alias value="Date published"/> 
      <alias value="Date Issued"/> 
      <alias value="Date updated"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.authored"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].time"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.author">
      <path value="QuestionnaireResponse.author"/> 
      
      Person who received the answers to the questions in the QuestionnaireResponse and recorded
       them in the system.
      Mapping a subject's answers to multiple choice options and determining what to put in
       the textual answer is a matter of interpretation.  Authoring by device would indicate
       that some portion of the questionnaire had been auto-populated.

      <short value="The individual or device that received and recorded the answers"/> 
      <definition value="The individual or device that received the answers to the questions in the QuestionnaireRespo
      nse and recorded them in the system."/> 
      <comment value="Mapping a subject's answers to multiple choice options and determining what to

       put in the textual answer is a matter of interpretation. Authoring by device would
       indicate that some portion of the questionnaire had been auto-populated. Device
       should only be used if it directly determined the answers, not if it was merely
       used as a capture tool to record answers provided by others. In the latter case,
       information about the physical device, software, etc. would be captured using Provenance."/> 

      <requirements value="Need to know who interpreted the subject's answers to the questions in the questionnaire,
       and selected the appropriate options for answers."/> 
      <alias value="Laboratory"/> 
      <alias value="Service"/> 
      <alias value="Practitioner"/> 
      <alias value="Department"/> 
      <alias value="Company"/> 
      <alias value="Performer"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.author"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.source">
      <path value="QuestionnaireResponse.source"/> 
      
      
      
      When answering questions about a subject that is minor, incapable of answering or an animal,
       another human source may answer the questions.

      <short value="The individual or device that answered the questions"/> 
      <definition value="The individual or device that answered the questions about the subject."/> 
      <comment value="If not specified, no inference can be made about who provided the data. Device
       should only be used if it directly determined the answers, not if it was merely
       used as a capture tool to record answers provided by others. In the latter case,
       information about the physical device, software, etc. would be captured using Provenance."/> 
      <requirements value="When answering questions about a subject that is minor, incapable of answering

       or an animal, another human source may answer the questions."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.source"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.source"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=INF].role"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item">
      <path value="QuestionnaireResponse.item"/> 
      <short value="Groups and questions"/> 
      

      <definition value="A group or question item from the original questionnaire for which answers are
       provided."/> 

      <comment value="Groups cannot have answers and therefore must nest directly within item. When dealing
       with questions, nesting must occur within each answer because some questions may have
       multiple answers (and the nesting occurs for each answer).

       with questions, nesting must occur within each answer because some questions may
       have multiple answers (and the nesting occurs for each answer).\nWhen dealing with
       repeating items, each group repetition will be handled by a separate item.  However,
       repeating questions are handled with a single question item and potentially multiple
       answers."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse.item"/> 
        <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() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="qrs-1"/> 
        <severity value="error"/> 
        

        <human value="Item cannot contain both item and answer"/> 
        <expression value="(answer.exists() and item.exists()).not()"/> 
        <xpath value="not(exists(f:answer) and exists(f:item))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
      </constraint> 
      <constraint> 
        <key value="qrs-2"/> 
        <severity value="error"/> 
        <human value="Repeated answers are combined in the answers array of a single item"/> 
        <expression value="repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()"/> 
        <xpath value="not(exists(//f:item[exists(f:answer/f:value)][preceding-sibling::f:item/f:linkId/@value=curre
        nt()/f:linkId/@value]))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.id">
      <path value="QuestionnaireResponse.item.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces.

      <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> 
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->

      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.extension">
      <path value="QuestionnaireResponse.item.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. 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
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension.
      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.

       of the element. 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 can 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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/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(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.modifierExtension">
      <path value="QuestionnaireResponse.item.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <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 in which it is contained
       and/or the understanding of the containing element's descendants. Usually modifier elements
       provide negation or qualification. 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 can 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.

       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. 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 can 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.


Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself).
      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.
      Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension).

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <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."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 

      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/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(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 

      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.linkId">
      <path value="QuestionnaireResponse.item.linkId"/> 
      <short value="Pointer to specific item from Questionnaire"/> 
      <definition value="The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse
       resource."/> 
      Items can repeat in the answers, so a direct 1..1 correspondence by position might not
       exist - requiring correspondence by identifier.

      <requirements value="Items can repeat in the answers, so a direct 1..1 correspondence by position might
       not exist - requiring correspondence by identifier."/> 

      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.item.linkId"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.definition">
      <path value="QuestionnaireResponse.item.definition"/> 
      <short value="ElementDefinition - details for the item"/> 
      A reference to an [ElementDefinition](elementdefinition.html) that provides the details
       for the item.
      The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#), and
       must have a fragment identifier that identifies the specific data element by its id (Element.id).
       E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

      <definition value="A reference to an [ElementDefinition](elementdefinition.html) that provides the
       details for the item."/> 
      <comment value="The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#),

       and must have a fragment identifier that identifies the specific data element by
       its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.val
      ue[x].


There is no need for this element if the item pointed to by the linkId has a definition
       listed."/> 
      <requirements value="A common pattern is to define a set of data elements, and then build multiple different
       questionnaires for different circumstances to gather the data. This element provides traceability
       to the common definition.

       questionnaires for different circumstances to gather the data. This element provides
       traceability to the common definition."/> 

      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.item.definition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.text">
      <path value="QuestionnaireResponse.item.text"/> 
      <short value="Name for group or question text"/> 
      <definition value="Text that is displayed above the contents of the group or as the text of the question
       being answered."/> 
      <comment value="The text for an item SHOULD be identical to the text from the corresponding Questionnaire.ite
      m. This can't be strictly enforced because it's possible for the Questionnaire to
       be updated subsequent to the QuestionnaireResponse having been created, however
       the intention is that the text in the QuestionnaireResponse reflects what the user
       saw when completing the Questionnaire."/> 

      <requirements value="Allows the questionnaire response to be read without access to the questionnaire."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.item.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer">
      <path value="QuestionnaireResponse.item.answer"/> 
      <short value="The response(s) to the question"/> 
      <definition value="The respondent's answer(s) to the question."/> 
      

      <comment value="The value is nested because we cannot have a repeating structure that has variable
       type."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse.item.answer"/> 
        <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() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".value[type=LIST_ANY]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer.id">
      <path value="QuestionnaireResponse.item.answer.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces.

      <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> 
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->

      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer.extension">
      <path value="QuestionnaireResponse.item.answer.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. 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
       can define an extension, there is a set of requirements that SHALL be met as part of the
       definition of the extension.
      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.

       of the element. 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 can 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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/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(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer.modifierExtension">
      <path value="QuestionnaireResponse.item.answer.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <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 in which it is contained
       and/or the understanding of the containing element's descendants. Usually modifier elements
       provide negation or qualification. 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 can 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.

       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. 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 can 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.


Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource
       (including cannot change the meaning of modifierExtension itself).
      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.
      Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly
       distinguished from the vast majority of extensions which can be safely ignored.  This
       promotes interoperability by eliminating the need for implementers to prohibit the presence
       of extensions. For further information, see the [definition of modifier extensions](extensibility.ht
      ml#modifierExtension).

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <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."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be

       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 

      <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> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/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(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 

      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer.value[x]">
      <path value="QuestionnaireResponse.item.answer.value[x]"/> 
      <short value="Single-valued answer to the question"/> 
      <definition value="The answer (or one of the answers) provided by the respondent to the question."/> 
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited
       to electronic forms that can expose an appropriate user interface to capture the components
       and enforce the constraints of a complex data type.  Additional complex types can be introduced
       through extensions. Must match the datatype specified by Questionnaire.item.type in the
       corresponding Questionnaire.

       to electronic forms that can expose an appropriate user interface to capture the
       components and enforce the constraints of a complex data type.  Additional complex
       types can be introduced through extensions. Must match the datatype specified by
       Questionnaire.item.type in the corresponding Questionnaire.     Note that a question
       is answered using one of the possible choices defined with answerOption, answerValueSet
       or some other means and the answer has a complex data type, all elements within
       the answer in the QuestionnaireResponse **SHOULD** match the elements defined corresponding
       choice value in the Questionnaire.  However, it is possible that not all elements
       will be propagated.  Also, some systems might use language translations resulting
       in different displays.  Comparison of value to the values defined in the Questionnaire
       (whether by answerOption, answerValueSet or answerExpression) **SHALL NOT** pay
       attention to Coding.display, Reference.display, Quantity.unit unless those are
       the only elements present.  As well, systems are not required to check for a match
       on any extensions (e.g. ordinal values, translations, etc).  Systems **MAY** enforce
       that if extensions such as ordinal values are present in both Questionnaire and
       QuestionnaireResponse, they match."/> 

      <requirements value="Ability to retain a single-valued answer to a question."/> 
      

      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="QuestionnaireResponse.item.answer.value[x]"/> 
        

        <min value="1"/> 
        <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"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer"/> 
        </extension> 
        <strength value="example"/> 
        

        <description value="Binding this is problematic because one value set can't apply to both codes and
         quantities."/> 

        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".item"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer.item">
      <path value="QuestionnaireResponse.item.answer.item"/> 
      

      <short value="Child items of question"/> 
      <definition value="Nested groups and/or questions found within this particular answer."/> 
      It is useful to have &quot;sub-questions&quot;, questions which normally appear when certain
       answers are given and which collect additional details.

      <comment value="Only used when nesting beneath a question - see item.item for nesting beneath groups"/> 
      <requirements value="It is useful to have &quot;sub-questions&quot;, questions which normally appear
       when certain answers are given and which collect additional details."/> 

      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse.item.answer.item"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="#QuestionnaireResponse.item"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.item">
      <path value="QuestionnaireResponse.item.item"/> 
      
      

      <short value="Child items of group item"/> 
      <definition value="Sub-questions, sub-groups or display items nested beneath a group."/> 
      <comment value="Only used when nesting beneath a group - see item.answer.item for nesting beneath
       questions"/> 

      <requirements value="Reports can consist of complex nested groups."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="QuestionnaireResponse.item.item"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="#QuestionnaireResponse.item"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="QuestionnaireResponse">
      <path value="QuestionnaireResponse"/> 
      <short value="A structured set of questions and their answers"/> 
      A structured set of questions and their answers. The questions are ordered and grouped
       into coherent subsets, corresponding to the structure of the grouping of the questionnaire
       being responded to.
      The QuestionnaireResponse contains enough information about the questions asked and their
       organization that it can be interpreted somewhat independently from the Questionnaire
       it is based on.  I.e. You don't need access to the Questionnaire in order to extract basic
       information from a QuestionnaireResponse.

      <definition value="A structured set of questions and their answers. The questions are ordered and
       grouped into coherent subsets, corresponding to the structure of the grouping of
       the questionnaire being responded to."/> 
      <comment value="The QuestionnaireResponse contains enough information about the questions asked

       and their organization that it can be interpreted somewhat independently from the
       Questionnaire it is based on.  I.e. You don't need access to the Questionnaire
       in order to extract basic information from a QuestionnaireResponse."/> 

      <alias value="Form"/> 
      <alias value="QuestionnaireAnswers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="infrastructure.information"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.identifier">
      <path value="QuestionnaireResponse.identifier"/> 
      <short value="Unique id for this set of answers"/> 
      

      <definition value="A business identifier assigned to a particular completed (or partially completed)
       questionnaire."/> 

      <requirements value="Used for tracking, registration and other business purposes."/> 
      <min value="0"/> 
      

      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.basedOn">
      <path value="QuestionnaireResponse.basedOn"/> 
      <short value="Request fulfilled by this QuestionnaireResponse"/> 
      The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.
        For example, a ServiceRequest seeking an intake assessment or a decision support recommendation
       to assess for post-partum depression.
      Supports traceability of responsibility for the action and allows linkage of an action
       to the recommendations acted upon.

      <definition value="The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireRespon
      se.  For example, a ServiceRequest seeking an intake assessment or a decision support
       recommendation to assess for post-partum depression."/> 
      <requirements value="Supports traceability of responsibility for the action and allows linkage of an

       action to the recommendations acted upon."/> 

      <alias value="order"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.basedOn"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=FLFS].target"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.partOf">
      <path value="QuestionnaireResponse.partOf"/> 
      <short value="Part of this action"/> 
      A procedure or observation that this questionnaire was performed as part of the execution
       of.  For example, the surgery a checklist was executed as part of.
      Composition of questionnaire responses will be handled by the parent questionnaire having
       answers that reference the child questionnaire.  For relationships to referrals, and other
       types of requests, use basedOn.

      <definition value="A procedure or observation that this questionnaire was performed as part of the
       execution of.  For example, the surgery a checklist was executed as part of."/> 
      <comment value="Composition of questionnaire responses will be handled by the parent questionnaire

       having answers that reference the child questionnaire.  For relationships to referrals,
       and other types of requests, use basedOn."/> 

      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.partOf"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.questionnaire">
      <path value="QuestionnaireResponse.questionnaire"/> 
      
      The Questionnaire that defines and organizes the questions for which answers are being
       provided.
      If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse
       structure must be consistent with the Questionnaire (i.e. questions must be organized
       into the same groups, nested questions must still be nested, etc.).
      Needed to allow editing of the questionnaire response in a manner that enforces the constraints
       of the original form.

      <short value="Canonical URL of Questionnaire being answered"/> 
      <definition value="The Questionnaire that defines and organizes the questions for which answers are
       being provided."/> 
      <comment value="If a QuestionnaireResponse references a Questionnaire that can be resolved, then

       the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e.
       questions must be organized into the same groups, nested questions must still be
       nested, etc.).  It is possible to have a QuestionnaireResponse whose 'questionnaire'
       element does not resolve.  It is also possible for the questionnaire element to
       not have a value but only extensions (e.g. conveying the title or identifier for
       the questionnaire).  This may happen for legacy data.  If there is no formally
       defined Questionnaire, it is undefined what the 'correct' values for the linkId
       elements should be and it is possible that linkIds might be inconsistent for QuestionnaireRes
      ponses for the same form if captured by distinct systems."/> 
      <requirements value="Needed to allow editing of the questionnaire response in a manner that enforces

       the constraints of the original form."/> 

      <alias value="Form"/> 
      

      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.instantiates"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.status">
      <path value="QuestionnaireResponse.status"/> 
      <short value="in-progress | completed | amended | entered-in-error | stopped"/> 
      <definition value="The position of the questionnaire response within its overall lifecycle."/> 
      This element is labeled as a modifier because the status contains codes that mark the
       resource as not currently valid.
      The information on Questionnaire resources  may possibly be gathered during multiple sessions
       and altered after considered being finished.

      <comment value="This element is labeled as a modifier because the status contains codes that mark
       the resource as not currently valid."/> 
      <requirements value="The information on Questionnaire resources  may possibly be gathered during multiple

       sessions and altered after considered being finished."/> 

      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      This element is labelled as a modifier because it is a status element that contains status
       entered-in-error which means that the resource should not be treated as valid

      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
       status entered-in-error which means that the resource should not be treated as
       valid"/> 

      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireResponseStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Lifecycle status of the questionnaire response."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers-status|5.0.0-ballot"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish
         &quot;in-progress&quot; from &quot;published)"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.subject">
      <path value="QuestionnaireResponse.subject"/> 
      <short value="The subject of the questions"/> 
      The subject of the questionnaire response.  This could be a patient, organization, practitioner,
       device, etc.  This is who/what the answers apply to, but is not necessarily the source
       of information.
      If the Questionnaire declared a subjectType, the resource pointed to by this element must
       be an instance of one of the listed types.
      Allows linking the answers to the individual the answers describe.  May also affect access
       control.

      <definition value="The subject of the questionnaire response.  This could be a patient, organization,
       practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily
       the source of information."/> 
      <comment value="If the Questionnaire declared a subjectType, the resource pointed to by this element

       must be an instance of one of the listed types."/> 
      <requirements value="Allows linking the answers to the individual the answers describe.  May also affect

       access control."/> 

      <alias value="Patient"/> 
      <alias value="Focus"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.encounter">
      <path value="QuestionnaireResponse.encounter"/> 
      <short value="Encounter created as part of"/> 
      The Encounter during which this questionnaire response was created or to which the creation
       of this record is tightly associated.
      This will typically be the encounter the event occurred within, but some activities may
       be initiated prior to or after the official completion of an encounter but still be tied
       to the context of the encounter. A questionnaire that was initiated during an encounter
       but not fully completed during the encounter would still generally be associated with
       the encounter.
      

      <definition value="The Encounter during which this questionnaire response was created or to which
       the creation of this record is tightly associated."/> 
      <comment value="This will typically be the encounter the event occurred within, but some activities

       may be initiated prior to or after the official completion of an encounter but
       still be tied to the context of the encounter. A questionnaire that was initiated
       during an encounter but not fully completed during the encounter would still generally
       be associated with the encounter."/> 
      <requirements value="Provides context for the information that was captured.  May also affect access

       control."/> 

      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.encounter"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship(typeCode=COMP].source[classCode&lt;=PCPR, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.authored">
      <path value="QuestionnaireResponse.authored"/> 
      <short value="Date the answers were gathered"/> 
      

      <definition value="The date and/or time that this questionnaire response was last modified by the
       user - e.g. changing answers or revising status."/> 

      <comment value="May be different from the lastUpdateTime of the resource itself, because that reflects
       when the data was known to the server, not when the data was captured.

This element is optional to allow for systems that might not know the value, however it
       SHOULD be populated if possible.

This element is optional to allow for systems that might not know the value, however
       it SHOULD be populated if possible."/> 

      <requirements value="Clinicians need to be able to check the date that the information in the questionnaire
       was collected, to derive the context of the answers."/> 
      <alias value="Date Created"/> 
      <alias value="Date published"/> 
      <alias value="Date Issued"/> 
      <alias value="Date updated"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].time"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.author">
      <path value="QuestionnaireResponse.author"/> 
      
      Person who received the answers to the questions in the QuestionnaireResponse and recorded
       them in the system.
      Mapping a subject's answers to multiple choice options and determining what to put in
       the textual answer is a matter of interpretation.  Authoring by device would indicate
       that some portion of the questionnaire had been auto-populated.

      <short value="The individual or device that received and recorded the answers"/> 
      <definition value="The individual or device that received the answers to the questions in the QuestionnaireRespo
      nse and recorded them in the system."/> 
      <comment value="Mapping a subject's answers to multiple choice options and determining what to

       put in the textual answer is a matter of interpretation. Authoring by device would
       indicate that some portion of the questionnaire had been auto-populated. Device
       should only be used if it directly determined the answers, not if it was merely
       used as a capture tool to record answers provided by others. In the latter case,
       information about the physical device, software, etc. would be captured using Provenance."/> 

      <requirements value="Need to know who interpreted the subject's answers to the questions in the questionnaire,
       and selected the appropriate options for answers."/> 
      <alias value="Laboratory"/> 
      <alias value="Service"/> 
      <alias value="Practitioner"/> 
      <alias value="Department"/> 
      <alias value="Company"/> 
      <alias value="Performer"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.author"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.source">
      <path value="QuestionnaireResponse.source"/> 
      
      
      
      When answering questions about a subject that is minor, incapable of answering or an animal,
       another human source may answer the questions.

      <short value="The individual or device that answered the questions"/> 
      <definition value="The individual or device that answered the questions about the subject."/> 
      <comment value="If not specified, no inference can be made about who provided the data. Device
       should only be used if it directly determined the answers, not if it was merely
       used as a capture tool to record answers provided by others. In the latter case,
       information about the physical device, software, etc. would be captured using Provenance."/> 
      <requirements value="When answering questions about a subject that is minor, incapable of answering

       or an animal, another human source may answer the questions."/> 

      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.source"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=INF].role"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item">
      <path value="QuestionnaireResponse.item"/> 
      <short value="Groups and questions"/> 
      

      <definition value="A group or question item from the original questionnaire for which answers are
       provided."/> 

      <comment value="Groups cannot have answers and therefore must nest directly within item. When dealing
       with questions, nesting must occur within each answer because some questions may have
       multiple answers (and the nesting occurs for each answer).

       with questions, nesting must occur within each answer because some questions may
       have multiple answers (and the nesting occurs for each answer).\nWhen dealing with
       repeating items, each group repetition will be handled by a separate item.  However,
       repeating questions are handled with a single question item and potentially multiple
       answers."/> 

      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="qrs-2"/> 
        <severity value="error"/> 
        <human value="Repeated answers are combined in the answers array of a single item"/> 
        <expression value="repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()"/> 
        <xpath value="not(exists(//f:item[exists(f:answer/f:value)][preceding-sibling::f:item/f:linkId/@value=curre
        nt()/f:linkId/@value]))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
      </constraint> 
      <constraint> 
        <key value="qrs-1"/> 
        <severity value="error"/> 
        

        <human value="Item cannot contain both item and answer"/> 
        <expression value="(answer.exists() and item.exists()).not()"/> 
        <xpath value="not(exists(f:answer) and exists(f:item))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.linkId">
      <path value="QuestionnaireResponse.item.linkId"/> 
      <short value="Pointer to specific item from Questionnaire"/> 
      <definition value="The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse
       resource."/> 
      Items can repeat in the answers, so a direct 1..1 correspondence by position might not
       exist - requiring correspondence by identifier.

      <requirements value="Items can repeat in the answers, so a direct 1..1 correspondence by position might
       not exist - requiring correspondence by identifier."/> 

      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.definition">
      <path value="QuestionnaireResponse.item.definition"/> 
      <short value="ElementDefinition - details for the item"/> 
      A reference to an [ElementDefinition](elementdefinition.html) that provides the details
       for the item.
      The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#), and
       must have a fragment identifier that identifies the specific data element by its id (Element.id).
       E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

      <definition value="A reference to an [ElementDefinition](elementdefinition.html) that provides the
       details for the item."/> 
      <comment value="The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#),

       and must have a fragment identifier that identifies the specific data element by
       its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.val
      ue[x].


There is no need for this element if the item pointed to by the linkId has a definition
       listed."/> 
      <requirements value="A common pattern is to define a set of data elements, and then build multiple different
       questionnaires for different circumstances to gather the data. This element provides traceability
       to the common definition.

       questionnaires for different circumstances to gather the data. This element provides
       traceability to the common definition."/> 

      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="uri"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.text">
      <path value="QuestionnaireResponse.item.text"/> 
      <short value="Name for group or question text"/> 
      <definition value="Text that is displayed above the contents of the group or as the text of the question
       being answered."/> 
      <comment value="The text for an item SHOULD be identical to the text from the corresponding Questionnaire.ite
      m. This can't be strictly enforced because it's possible for the Questionnaire to
       be updated subsequent to the QuestionnaireResponse having been created, however
       the intention is that the text in the QuestionnaireResponse reflects what the user
       saw when completing the Questionnaire."/> 

      <requirements value="Allows the questionnaire response to be read without access to the questionnaire."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer">
      <path value="QuestionnaireResponse.item.answer"/> 
      <short value="The response(s) to the question"/> 
      <definition value="The respondent's answer(s) to the question."/> 
      

      <comment value="The value is nested because we cannot have a repeating structure that has variable
       type."/> 

      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".value[type=LIST_ANY]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer.value[x]">
      <path value="QuestionnaireResponse.item.answer.value[x]"/> 
      <short value="Single-valued answer to the question"/> 
      <definition value="The answer (or one of the answers) provided by the respondent to the question."/> 
      <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited
       to electronic forms that can expose an appropriate user interface to capture the components
       and enforce the constraints of a complex data type.  Additional complex types can be introduced
       through extensions. Must match the datatype specified by Questionnaire.item.type in the
       corresponding Questionnaire.

       to electronic forms that can expose an appropriate user interface to capture the
       components and enforce the constraints of a complex data type.  Additional complex
       types can be introduced through extensions. Must match the datatype specified by
       Questionnaire.item.type in the corresponding Questionnaire.     Note that a question
       is answered using one of the possible choices defined with answerOption, answerValueSet
       or some other means and the answer has a complex data type, all elements within
       the answer in the QuestionnaireResponse **SHOULD** match the elements defined corresponding
       choice value in the Questionnaire.  However, it is possible that not all elements
       will be propagated.  Also, some systems might use language translations resulting
       in different displays.  Comparison of value to the values defined in the Questionnaire
       (whether by answerOption, answerValueSet or answerExpression) **SHALL NOT** pay
       attention to Coding.display, Reference.display, Quantity.unit unless those are
       the only elements present.  As well, systems are not required to check for a match
       on any extensions (e.g. ordinal values, translations, etc).  Systems **MAY** enforce
       that if extensions such as ordinal values are present in both Questionnaire and
       QuestionnaireResponse, they match."/> 

      <requirements value="Ability to retain a single-valued answer to a question."/> 
      

      <min value="1"/> 
      <max value="1"/> 
      <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"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer"/> 
        </extension> 
        <strength value="example"/> 
        

        <description value="Binding this is problematic because one value set can't apply to both codes and
         quantities."/> 

        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".item"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.answer.item">
      <path value="QuestionnaireResponse.item.answer.item"/> 
      

      <short value="Child items of question"/> 
      <definition value="Nested groups and/or questions found within this particular answer."/> 
      It is useful to have &quot;sub-questions&quot;, questions which normally appear when certain
       answers are given and which collect additional details.

      <comment value="Only used when nesting beneath a question - see item.item for nesting beneath groups"/> 
      <requirements value="It is useful to have &quot;sub-questions&quot;, questions which normally appear
       when certain answers are given and which collect additional details."/> 

      <min value="0"/> 
      <max value="*"/> 
      <contentReference value="#QuestionnaireResponse.item"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="QuestionnaireResponse.item.item">
      <path value="QuestionnaireResponse.item.item"/> 
      
      

      <short value="Child items of group item"/> 
      <definition value="Sub-questions, sub-groups or display items nested beneath a group."/> 
      <comment value="Only used when nesting beneath a group - see item.answer.item for nesting beneath
       questions"/> 

      <requirements value="Reports can consist of complex nested groups."/> 
      <min value="0"/> 
      <max value="*"/> 
      <contentReference value="#QuestionnaireResponse.item"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </differential> 


</

StructureDefinition

>



Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.