This
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is
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of
the
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Specification
(v4.0.1:
R4
(v5.0.0-draft-final:
Final
QA
Preview
for
R5
-
Mixed
Normative
and
STU
see
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notes
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).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
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versions
.
Page
versions:
R5
R4B
R4
R3
R2
| FHIR Infrastructure Work Group |
Maturity
Level
:
|
|
Structure
Name
Flags
Card.
Type
Description
&
Constraints
QuestionnaireResponse
TU
DomainResource
A
structured
set
of
questions
and
their
answers
Elements
defined
in
Ancestors:
id
,
meta
,
implicitRules
,
language
,
text
,
contained
,
extension
,
modifierExtension
identifier
Σ
0..1
Identifier
Unique
id
for
this
set
of
answers
basedOn
Σ
0..*
Reference
(
CarePlan
|
ServiceRequest
)
Request
fulfilled
by
this
QuestionnaireResponse
partOf
Σ
0..*
Reference
(
Observation
|
Procedure
)
Part
of
this
action
questionnaire
Σ
0..1
canonical
(
Questionnaire
)
Form
being
answered
status
?!
Σ
1..1
code
in-progress
|
completed
|
amended
|
entered-in-error
|
stopped
QuestionnaireResponseStatus
(
Required
)
subject
Σ
0..1
Reference
(
Any
)
The
subject
of
the
questions
encounter
Σ
0..1
Reference
(
Encounter
)
Encounter
created
as
part
of
authored
Σ
0..1
dateTime
Date
the
answers
were
gathered
author
Σ
0..1
Reference
(
Device
|
Practitioner
|
PractitionerRole
|
Patient
|
RelatedPerson
|
Organization
)
Person
who
received
and
recorded
the
answers
source
Σ
0..1
Reference
(
Patient
|
Practitioner
|
PractitionerRole
|
RelatedPerson
)
The
person
who
answered
the
questions
item
I
0..*
BackboneElement
Groups
and
questions
+
Rule:
Nested
item
can't
be
beneath
both
item
and
answer
linkId
1..1
string
Pointer
to
specific
item
from
Questionnaire
definition
0..1
uri
ElementDefinition
-
details
for
the
item
text
0..1
string
Name
for
group
or
question
text
answer
0..*
BackboneElement
The
response(s)
to
the
question
value[x]
0..1
Single-valued
answer
to
the
question
Questionnaire
Answer
Codes
(
Example
)
valueBoolean
boolean
valueDecimal
decimal
valueInteger
integer
valueDate
date
valueDateTime
dateTime
valueTime
time
valueString
string
valueUri
uri
valueAttachment
Attachment
valueCoding
Coding
valueQuantity
Quantity
valueReference
Reference
(
Any
)
item
0..*
see
item
Nested
groups
and
questions
item
0..*
see
item
Nested
questionnaire
response
items
Documentation
for
this
format
UML
Diagram
(
Legend
)
QuestionnaireResponse
(
DomainResource
)
A
business
identifier
assigned
to
a
particular
completed
(or
partially
completed)
questionnaire
identifier
:
Identifier
[0..1]
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
basedOn
:
Reference
[0..*]
«
CarePlan
|
ServiceRequest
»
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
:
Reference
[0..*]
«
Observation
|
Procedure
»
The
Questionnaire
that
defines
and
organizes
the
questions
for
which
answers
are
being
provided
questionnaire
:
canonical
[0..1]
«
Questionnaire
»
The
position
of
the
questionnaire
response
within
its
overall
lifecycle
(this
element
modifies
the
meaning
of
other
elements)
status
:
code
[1..1]
«
Lifecycle
status
of
the
questionnaire
response.
(Strength=Required)
QuestionnaireResponseStatus
!
»
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
subject
:
Reference
[0..1]
«
Any
»
The
Encounter
during
which
this
questionnaire
response
was
created
or
to
which
the
creation
of
this
record
is
tightly
associated
encounter
:
Reference
[0..1]
«
Encounter
»
The
date
and/or
time
that
this
set
of
answers
were
last
changed
authored
:
dateTime
[0..1]
Person
who
received
the
answers
to
the
questions
in
the
QuestionnaireResponse
and
recorded
them
in
the
system
author
:
Reference
[0..1]
«
Device
|
Practitioner
|
PractitionerRole
|
Patient
|
RelatedPerson
|
Organization
»
The
person
who
answered
the
questions
about
the
subject
source
:
Reference
[0..1]
«
Patient
|
Practitioner
|
PractitionerRole
|
RelatedPerson
»
Item
The
item
from
the
Questionnaire
that
corresponds
to
this
item
in
the
QuestionnaireResponse
resource
linkId
:
string
[1..1]
A
reference
to
an
[[[ElementDefinition]]]
that
provides
the
details
for
the
item
definition
:
uri
[0..1]
Text
that
is
displayed
above
the
contents
of
the
group
or
as
the
text
of
the
question
being
answered
text
:
string
[0..1]
Answer
The
answer
(or
one
of
the
answers)
provided
by
the
respondent
to
the
question
value[x]
:
Type
[0..1]
«
boolean
|
decimal
|
integer
|
date
|
dateTime
|
time
|
string
|
uri
|
Attachment
|
Coding
|
Quantity
|
Reference
(
Any
);
Code
indicating
the
response
provided
for
a
question.
(Strength=Example)
QuestionnaireAnswerCodes
??
»
Nested
groups
and/or
questions
found
within
this
particular
answer
item
[0..*]
The
respondent's
answer(s)
to
the
question
answer
[0..*]
Questions
or
sub-groups
nested
beneath
a
question
or
group
item
[0..*]
A
group
or
question
item
from
the
original
questionnaire
for
which
answers
are
provided
item
[0..*]
XML
Template
<
<!-- from -->
<!-- from -->
<</identifier>
<</basedOn>
<</partOf>
<</questionnaire>
<
<</subject>
<</encounter>
<
<|
</author>
<</source>
<
<
<
<
<
<|
</value[x]>
<</item>
</answer>
<</item>
</item>
</QuestionnaireResponse>
JSON
Template
{
"resourceType" : "",
// from
// from
"
"
"
"
"
"
"
"
"|
"
"
"
"
"
"
">,
">,
">,
">",
">",
">",
">",
">",
" },
" },
" },
" },
"
}],
"
}]
}
Turtle
Template
@prefix fhir: <http://hl7.org/fhir/> .
[ a fhir:;
fhir:nodeRole fhir:treeRoot; # if this is the parser root
# from
# from
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
fhir:
# . One of these 12
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir: ]
fhir:) ]
fhir:
], ...;
fhir:
], ...;
]
Changes
since
R3
QuestionnaireResponse
QuestionnaireResponse.basedOn
Type
Reference:
Added
Target
Type
ServiceRequest
Type
Reference:
Removed
Target
Types
ReferralRequest,
ProcedureRequest
QuestionnaireResponse.partOf
Renamed
from
parent
to
partOf
QuestionnaireResponse.questionnaire
Type
changed
from
Reference(Questionnaire)
to
canonical(Questionnaire)
QuestionnaireResponse.status
Change
value
set
from
http://hl7.org/fhir/ValueSet/questionnaire-answers-status
to
http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1
QuestionnaireResponse.encounter
Added
Element
QuestionnaireResponse.author
Type
Reference:
Added
Target
Types
PractitionerRole,
Organization
QuestionnaireResponse.source
Type
Reference:
Added
Target
Type
PractitionerRole
QuestionnaireResponse.context
deleted
QuestionnaireResponse.item.subject
deleted
See
the
Full
Difference
for
further
information
This
analysis
is
available
as
XML
or
Raw
JSON
.
See
R3
<-->
R4
Conversion
Maps
(status
=
5
tests
that
all
execute
ok.
1
fail
round-trip
testing
and
5
r3
resources
are
invalid
(0
errors).
)
Structure
Name
Flags
Card.
Type
Description
&
Constraints
QuestionnaireResponse
TU
DomainResource
A
structured
set
of
questions
and
their
answers
Elements
defined
in
Ancestors:
id
,
meta
,
implicitRules
,
language
,
text
,
contained
,
extension
,
modifierExtension
identifier
Σ
0..1
Identifier
Unique
id
for
this
set
of
answers
basedOn
Σ
0..*
Reference
(
CarePlan
|
ServiceRequest
)
Request
fulfilled
by
this
QuestionnaireResponse
partOf
Σ
0..*
Reference
(
Observation
|
Procedure
)
Part
of
this
action
questionnaire
Σ
0..1
canonical
form
(
Questionnaire
)
Form
being
answered
status
?!
Σ
1..1
code
in-progress
|
completed
|
amended
|
entered-in-error
|
stopped
QuestionnaireResponseStatus
(
Required
)
subject
Σ
0..1
Reference
(
Any
)
The
subject
of
the
questions
encounter
Σ
0..1
Reference
(
Encounter
)
Encounter
created
as
part
of
authored
Σ
0..1
dateTime
Date
the
answers
were
gathered
author
Σ
0..1
Reference
(
Device
|
Practitioner
|
PractitionerRole
|
Patient
|
RelatedPerson
|
Organization
)
Person
who
received
and
recorded
the
answers
source
Σ
0..1
Reference
(
Patient
|
Practitioner
|
PractitionerRole
|
RelatedPerson
)
The
person
who
answered
the
questions
item
I
0..*
BackboneElement
Groups
and
questions
+
Rule:
Nested
item
can't
be
beneath
both
item
and
answer
linkId
1..1
string
Pointer
to
specific
item
from
Questionnaire
definition
0..1
uri
ElementDefinition
-
details
for
the
item
text
0..1
string
Name
for
group
or
question
text
answer
0..*
BackboneElement
The
response(s)
to
the
question
value[x]
0..1
Single-valued
answer
to
the
question
Questionnaire
Answer
Codes
(
Example
)
valueBoolean
boolean
valueDecimal
decimal
valueInteger
integer
valueDate
date
valueDateTime
dateTime
valueTime
time
valueString
string
valueUri
uri
valueAttachment
Attachment
valueCoding
Coding
valueQuantity
Quantity
valueReference
Reference
(
Any
)
item
0..*
see
item
Nested
groups
and
questions
item
0..*
also
see
item
Nested
questionnaire
response
items
Documentation
for
this
format
UML
Diagram
(
Legend
)
QuestionnaireResponse
(
DomainResource
JSON
Format
Specification
)
A
business
identifier
assigned
to
a
particular
completed
(or
partially
completed)
questionnaire
identifier
:
Identifier
[0..1]
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
basedOn
:
Reference
[0..*]
«
CarePlan
|
ServiceRequest
»
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
:
Reference
[0..*]
«
Observation
|
Procedure
»
The
Questionnaire
that
defines
and
organizes
the
questions
for
which
answers
are
being
provided
questionnaire
:
canonical
[0..1]
«
Questionnaire
»
The
position
of
the
questionnaire
response
within
its
overall
lifecycle
(this
element
modifies
the
meaning
of
other
elements)
status
:
code
[1..1]
«
Lifecycle
status
of
the
questionnaire
response.
(Strength=Required)
QuestionnaireResponseStatus
!
»
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
subject
:
Reference
[0..1]
«
Any
»
The
Encounter
during
which
this
questionnaire
response
was
created
or
to
which
the
creation
of
this
record
is
tightly
associated
encounter
:
Reference
[0..1]
«
Encounter
»
The
date
and/or
time
that
this
set
of
answers
were
last
changed
authored
:
dateTime
[0..1]
Person
who
received
the
answers
to
the
questions
in
the
QuestionnaireResponse
and
recorded
them
in
the
system
author
:
Reference
[0..1]
«
Device
|
Practitioner
|
PractitionerRole
|
Patient
|
RelatedPerson
|
Organization
»
The
person
who
answered
the
questions
about
the
subject
source
:
Reference
[0..1]
«
Patient
|
Practitioner
|
PractitionerRole
|
RelatedPerson
»
Item
The
item
from
the
Questionnaire
that
corresponds
to
this
item
in
the
QuestionnaireResponse
resource
linkId
:
string
[1..1]
A
reference
to
an
[[[ElementDefinition]]]
that
provides
the
details
for
the
item
definition
:
uri
[0..1]
Text
that
is
displayed
above
the
contents
of
the
group
or
as
the
text
of
the
question
being
answered
text
:
string
[0..1]
Answer
The
answer
(or
one
of
the
answers)
provided
by
the
respondent
to
the
question
value[x]
:
Type
[0..1]
«
boolean
|
decimal
|
integer
|
date
|
dateTime
|
time
|
string
|
uri
|
Attachment
|
Coding
|
Quantity
|
Reference
(
Any
);
Code
indicating
the
response
provided
for
a
question.
(Strength=Example)
QuestionnaireAnswerCodes
??
»
Nested
groups
and/or
questions
found
within
this
particular
answer
item
[0..*]
The
respondent's
answer(s)
to
the
question
answer
[0..*]
Questions
or
sub-groups
nested
beneath
a
question
or
group
item
[0..*]
A
group
or
question
item
from
the
original
questionnaire
for
which
answers
are
provided
item
[0..*]
XML
Template
JSON
Template
Logical
Model
Product
Changes
since
Release
3
QuestionnaireResponse
QuestionnaireResponse.basedOn
Type
Reference:
Added
Target
Type
ServiceRequest
Type
Reference:
Removed
Target
Types
ReferralRequest,
ProcedureRequest
QuestionnaireResponse.partOf
Renamed
from
parent
to
partOf
QuestionnaireResponse.questionnaire
Type
changed
from
Reference(Questionnaire)
to
canonical(Questionnaire)
QuestionnaireResponse.status
Change
value
set
from
http://hl7.org/fhir/ValueSet/questionnaire-answers-status
Usage
note:
every
effort
has
been
made
to
http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1
QuestionnaireResponse.encounter
Added
Element
QuestionnaireResponse.author
Type
Reference:
Added
Target
Types
PractitionerRole,
Organization
QuestionnaireResponse.source
Type
Reference:
Added
Target
Type
PractitionerRole
QuestionnaireResponse.context
deleted
QuestionnaireResponse.item.subject
deleted
See
the
Full
Difference
for
further
information
This
analysis
is
available
as
XML
or
JSON
.
See
R3
<-->
R4
Conversion
Maps
(status
=
5
tests
ensure
that
all
execute
ok.
1
fail
round-trip
testing
and
5
r3
resources
are
invalid
(0
errors).
)
See
the
Profiles
&
Extensions
and
the
alternate
definitions:
Master
Definition
XML
+
JSON
,
XML
Schema
/
Schematron
+
JSON
Schema
,
ShEx
(for
Turtle
)
+
see
the
extensions
&
the
dependency
analysis
2.38.3.1
Terminology
Bindings
Path
Definition
Type
Reference
QuestionnaireResponse.status
Lifecycle
status
of
the
questionnaire
response.
Required
QuestionnaireResponseStatus
QuestionnaireResponse.item.answer.value[x]
Code
indicating
the
response
provided
for
a
question.
Example
QuestionnaireAnswerCodes
2.38.3.2
Constraints
id
Level
Location
Description
Expression
qrs-1
Rule
QuestionnaireResponse.item
Nested
item
can't
be
beneath
both
item
and
answer
(answer.exists()
and
item.exists()).not()
2.38.4
Notes
QuestionnaireResponses
can
be
authored
by
clinicians,
patients,
or
patients'
relatives
(or
even
owners
in
the
case
of
animals).
Clinicians
may
author
questionnaire
responses,
where
the
answers
examples
are
provided
by
others
on
behalf
of
the
patient.
Additionally,
information
gathered
on
behalf
of
a
patient
may
be
about
the
patient's
relatives
(e.g.
in
family
anamnesis).
Therefore,
QuestionnaireResponse
makes
a
distinction
between
the
author,
the
subject
and
the
source
of
information.
The
QuestionnaireResponse's
encounter
element
can
be
used
to
link
to
the
encounter
when
the
questionnaire
response
was
authored.
This
can
be
relevant
since
the
encounter
gives
context
to
the
answers
and
can
be
used
to
relate
information
in
the
QuestionnaireResponse
to
orders
and
observations
that
were
done
during
the
same
Encounter.
The
QuestionnaireResponse's
language
element
can
be
used
to
indicte
the
language
in
which
the
patient
completed
the
survey/questionnaire
The
order
of
questions
within
groups,
groups
within
groups
and
groups
within
questions
is
relevant
and
must
be
retained
for
display
and
capture.
The
hierarchy
items
within
the
Questionnaire
SHALL
mirror
the
hierarchy
of
the
corresponding
Questionnaire
(if
any).
For
use
of
QuestionnaireResponse.item.definition,
see
notes
on
Questionnaire
Because
of
the
lack
of
explicit
support
for
Questionnaires
in
HL7
v3
,
CDA
Documents
frequently
used
named
sections
with
Observations
to
model
questionnaires.
Such
use
cases
should
now
utilize
the
QuestionnaireResponse
resource
instead.
Refer
to
additional
guidance
provided
in
the
Questionnaire
resource
dealing
with
the
design
of
questionnaires.
2.38.4.1
Links
to
Questionnaire
A
QuestionnaireResponse
may
be
stand-alone
or
may
point
to
the
definition
of
the
questions
in
Questionnaire
.
If
the
QuestionnaireResponse
refers
to
a
Questionnaire:
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.
The
linkage
between
the
questions
correct
and
groups
in
the
two
resources
is
established
using
the
linkId
element
When
a
QuestionnaireResponse
references
a
Questionnaire,
all
the
items
in
the
questionnaire
SHOULD
be
included
in
the
QuestionnaireResponse
if
useful,
but
they
are
relevant
to
the
interpretation
of
the
answers,
including
items
of
type
=
display
.
This
might
also
include
items
that
were
>not
enabled
when
the
Questionnaire
was
answered,
though
of
course
these
will
not
have
answers
2.38.4.2
Security
QuestionnaireResponse
resources
can
have
answers
with
values
of
type
Attachment.
These
attachments
will
typically
be
selected
by
the
user
answering
the
questionnaire
and
this
selection
may
be
done
in
an
uncontrolled
environment.
Systems
should
ensure
that
the
attachment
is
of
the
desired
type
and
should
take
precautions
before
rendering
or
executing
any
attached
content.
2.38.4.3
Access
Control
For
most
resources,
the
type
of
information
that
can
be
conveyed
in
the
resource
is
determined
by
the
resource,
and
the
key
attributes
that
determine
the
sensitivity
level
of
the
information
are
also
known;
e.g.,
drug,
observation
type,
clinical
trial
randomization
status,
etc.
However,
for
QuestionnaireResponse,
the
sensitivity
of
an
instance
is
dependent
on
what
type
of
Questionnaire
it
is
associated
with.
And
the
data
elements
that
determine
that
sensitivity
could
be
the
answers
to
any
of
the
questions.
This
makes
automatically
enforcing
access
control
rules
more
challenging.
Designers
should
take
these
challenges
into
account
and
may
need
to
place
stricter
access
controls
around
QuestionnaireResponse
to
ensure
that
access
to
information
is
not
granted
improperly.
2.38.5
Search
Parameters
Search
parameters
for
this
resource.
The
common
parameters
also
apply.
See
Searching
for
more
information
about
searching
in
REST,
messaging,
and
services.
Name
Type
Description
Expression
In
Common
author
reference
The
author
of
the
questionnaire
response
QuestionnaireResponse.author
(
Practitioner
,
Organization
,
Device
,
Patient
,
PractitionerRole
,
RelatedPerson
)
authored
date
When
the
questionnaire
response
was
last
changed
QuestionnaireResponse.authored
based-on
reference
Plan/proposal/order
fulfilled
by
this
questionnaire
response
QuestionnaireResponse.basedOn
(
CarePlan
,
ServiceRequest
)
encounter
reference
Encounter
associated
with
the
questionnaire
response
QuestionnaireResponse.encounter
(
Encounter
)
identifier
token
The
unique
identifier
for
the
questionnaire
response
QuestionnaireResponse.identifier
part-of
reference
Procedure
or
observation
this
questionnaire
response
was
performed
as
a
normative
part
of
QuestionnaireResponse.partOf
(
Observation
,
Procedure
)
patient
reference
The
patient
that
is
the
subject
of
the
questionnaire
response
QuestionnaireResponse.subject.where(resolve()
is
Patient)
(
Patient
)
questionnaire
reference
The
questionnaire
the
answers
are
provided
for
QuestionnaireResponse.questionnaire
(
Questionnaire
)
source
reference
The
individual
providing
the
information
reflected
in
the
questionnaire
respose
QuestionnaireResponse.source
(
Practitioner
,
Patient
,
PractitionerRole
,
RelatedPerson
)
status
token
The
status
of
the
questionnaire
response
QuestionnaireResponse.status
subject
reference
The
subject
of
the
questionnaire
response
QuestionnaireResponse.subject
(Any)
specification.