A
structured
set
of
questions
and
their
answers.
The
Questionnaire
may
contain
questions,
answers
or
both.
The
questions
are
ordered
and
grouped
into
coherent
subsets,
corresponding
to
the
structure
of
the
grouping
of
the
underlying
questions.
4.7.1
Scope
and
Usage
The
Questionnaire
may
be
a
single
list
of
questions,
or
can
be
hierarchically
organized
in
groups
and
sub-groups,
each
containing
questions.
Questions
may
contain
and
single
answer,
which
can
take
the
form
of
simple
text,
numbers,
dates
or
a
set
of
coded
choices.
Questionnaires
cover
the
need
to
communicate
data
originating
from
forms
used
in
medical
history
examinations,
research
questionnaires
and
sometimes
full
clinical
speciality
records.
In
many
systems
this
data
is
collected
using
user-defined
screens
and
forms.
Questionnaires
record
specifics
about
data
capture
-
exactly
what
questions
were
asked,
in
what
order,
what
choices
for
answers
were,
etc.
Each
of
these
questions
are
part
of
the
Questionnaire,
and
as
such
the
Questionnaire
is
a
separately
identifiable
Resource,
whereas
the
individual
questions
are
not.
Examples
of
Questionnaires
include:
Past
medical
history
(PMH)
Family
diseases
Social
history
Research
questionnaires
Quality
and
evaluation
forms
Support
for
validation
is
outside
the
scope
of
this
Resource,
although
basic
structural
features
can
be
defined
using
the
Questionnaire
core
extensions
.
4.7.2
Boundaries
and
Relationships
Questionnaires
differ
from
Lists
because
Lists
regroup
or
summarize
existing
information,
while
Questionnaires
contain
original,
clinician
collected
data.
Questionnaires
are
similar
to
Documents.
However,
the
purpose
of
a
Questionnaire
is
the
capture
of
raw
data
as
opposed
to
the
composition
and
assertion
of
information
intended
for
long
term
persistence
and
use
in
a
Document.
4.7.3
Background
and
Context
Groups
and
questions
that
make
up
a
Questionnaire
can
be
explicitly
named
to
refer
to
externally
defined
numbering
or
identification
of
questions
and
sections
on
formally
defined
questionnaires.
This
allows
extraction
of
the
data
on
a
form
and
post-processing
of
the
data
contained
in
a
Questionnaire.
Such
naming
is
not
required
however
and
Questionnaires
may
be
quite
loosely
defined.
The
section
Questionnaire
versus
Resources
below
discusses
the
issues
of
collecting
data
in
such
loosely
defined
Questionnaires
versus
collecting
data
as
well-defined
separate
Resources.
Inv-3
:
On
Questionnaire.group:
Groups
may
either
contain
questions
or
groups
but
not
both
(xpath
on
f:Questionnaire/f:group:
not(exists(f:group)
and
exists(f:question))
)
Inv-1
:
On
Questionnaire.group.question:
Must
supply
either
a
simple
answer,
a
choice,
data
or
nothing
(xpath
on
f:Questionnaire/f:group/f:question:
count(f:data)
+
count(f:choice)
+
count(f:answer)
<=
1
)
Inv-2
:
On
Questionnaire.group.question:
Must
supply
a
name,
a
question's
text
or
both
(xpath
on
f:Questionnaire/f:group/f:question:
count(f:name)
+
count(f:text)
>=
1
)
4.7.5
Notes:
Questionnaires
can
be
authored
by
clinicians,
the
patient
his/herself
or
a
patients
relatives
(or
even
owner
in
the
case
of
animals).
Clinicians
may
author
questionnaires,
where
the
answers
are
provided
by
others
on
behalf
of
the
patient
his/herself.
Additionally,
information
gathered
for
the
purpose
of
a
patient
may
be
about
the
patient's
relatives
(e.g.
in
family
anamnesis).
Therefore,
Questionnaire
makes
a
distinction
between
the
author,
the
subject
and
the
source
of
information.
Questionnaires
may
be
used
to
represent
predefined
forms,
named
using
Questionnaire.name.
Questionnaires.identifier
identify
a
specific
set
of
answers
to
the
questions
on
these
forms.
If
a
Questionnaire
is
used
to
just
represent
a
predefined
form
or
"template",
the
Questionnaire
need
not
contain
answers
(Question.answer,
Question.data
and
Questionnaire.question.choice
are
empty).
A
Questionnaire's
contents
are
placed
inside
its
single
nested
Group,
which
may
contain
Questions
or
subgroups
with
Questions.
These
may
or
may
not
correspond
to
the
structure
of
the
original
form.
If
they
do
correspond,
Groups
may
be
named,
so
answers
on
a
Questionnaire
can
refer
to
a
corresponding
sections
of
a
form.
Likewise,
answers
to
Questionnaires
can
be
named
to
refer
to
the
question
on
a
form.
It
is
also
possible
to
include
textual
content
on
the
form
in
Questionnaire
(see
below).
Since
sections
and
questions
may
be
answered
multiple
times,
the
same
Group.name
and
Question.name
may
appear
multiple
times.
Questionnaire
allows
for
flexible
naming
and
structuring
of
its
contents
to
reflect
the
flexible
and
varying
nature
of
forms
and
questionnaires.
It
explicitly
does
not
try
to
standardize
or
streamline
exchange
of
its
contents
outside
its
context
of
use,
although
exchanging
partners
may
further
constrain
its
structure
and
flexibility
using
profiles
to
define
standardized,
reusable
forms.
Because
of
the
lack
of
explicit
support
for
Questionnaires
in
HL7v3,
HL7
CDA
Documents
frequently
used
named
sections
with
Observations
to
model
Questionnaires.
Such
use
cases
should
now
utilize
the
Questionnaire
Resource
instead.
The
Questionnaire's
encounter
element
can
be
used
to
link
to
the
encounter
during
which
the
Questionnaire
was
taken.
This
can
be
relevant
since
the
encounter
gives
context
to
the
answers
and
can
be
used
to
relate
information
in
the
Questionnaire
to
orders
and
observations
that
were
done
during
the
same
Encounter.
The
order
of
questions
within
groups,
groups
withing
groups
and
groups
withing
questions
in
relevant
and
must
be
retained
for
display
and
capture.
4.7.5.1
Using
Questionnaires
versus
using
Resources
There
is
considerable
overlap
between
the
information
covered
by
Questionnaires
and
other
Resources
(especially
FamilyHistory,
MedicationStatement,
Observation,
Procedure,
etc.):
Questionnaire's
flexible
structure
can
easily
be
misused
to
capture
any
data,
even
data
that
should
be
captured
as
separate
Resources.
The
choice
between
using
Questionnaires
or
separate
Resources
may
be
dictated
by
the
procedure
of
collection
and
recording.
E.g.
if
the
data
is
captured
as
a
physician-agreed
(electronic)
form,
it
might
be
impossible
or
undesirable
to
distill
separate
resources
from
it,
and
the
Questionnaire
SHALL
be
stored
and
communicated
as
a
whole.
However,
data
captured
only
in
Questionnaires
can
be
difficult
to
query
after-the-fact:
queries
against
other
Resources
will
not
return
data
captured
only
in
Questionnaires,
and
querying
against
Questionnaires
directly
may
not
find
all
desired
data,
depending
on
how
the
questions
may
have
been
phrased
or
encoded
over
time
or
by
different
clinicians.
Moreover,
interoperability
of
such
Questionnaires
is
limited
as
interpretation
of
its
contents
is
only
known
to
the
circle
of
parties
that
were
involved
in
its
definition:
encoding
data
from
such
Questionnaires
using
other,
more
specific,
Resources
increases
the
ability
and
consistency
with
which
it
can
be
understood
and
queried.
To
facilitate
better
standardization
of
the
information
on
a
form,
Questionnaire
has
the
capacity
(Using
a
Question's
data
element)
to
allow
systems
to
communicate
(part
of)
the
answers
in
the
form
of
structured
FHIR
data.
This
provides
an
upgrade
path
to
the
questionnaire
designer
and
communicating
systems,
where
capable
systems
may
use
FHIR
data
to
answer
(sets
of)
questions,
whereas
other
systems
can
simply
continue
to
supply
the
direct
answers
as
input
by
the
user.
4.7.5.2
Providing
Questions
and/or
Answers
The
Questionnaire
has
been
specifically
designed
to
be
able
to
contain
both
a
form's
questions
and
answers.
The
Group
and
Question
construct
has
elements
to
carry
textual
data
of
the
form
like
headings,
explanatory
text,
actual
question
text
and
the
text
of
(multiple)choice
options.
As
such,
the
Questionnaire
can
be
used
to:
only
contain
answers
(in
which
case
the
actual
layout
and
questions
of
the
form
is
defined
in
some
external
way,
and
the
name
elements
are
used
to
relate
the
answers
to
the
questions)
contain
a
combination
of
questions
and
answers
(e.g.
when
it
is
deemed
important
to
keep
the
actual
question
text
with
the
answer)
or
only
contain
the
Questions,
in
which
case
the
Questionnaire
represents
an
empty,
predefined
form
This
third
case
can
be
useful
to
make
Questionnaire
serve
as
a
kind
of
form
"template",
where
FHIR
clients
receive
the
empty
form,
display
it
to
the
user,
get
answers
from
the
users
and
then
return
the
combined
questions
and
answers
to
the
server.
The
questionnaire
core
extensions
provide
additional
means
for
control
over
repeating
sections
and
expected
answer
format.
4.7.5.3
Structure
of
the
Questionnaire
A
Questionnaire
is
built
out
of
three
components:
The
main
component
is
Questionnaire,
which
holds
information
about
the
Questionnaire,
like
the
subject,
date
authored
etcetera.
The
Questionnaire
contains
one
"main"
Group,
which
contains
all
the
content
of
the
questionnaire.
This
Group,
can
contain
either
nested
Groups
(to
represent
sections
and
subsections
on
a
questionnaire
form)
or
Questions.
This
way,
any
form
containing
sections
or
subsections
can
be
represented,
down
to
the
actual
questions.
The
Questions
themselves
may
be
simple
questions
with
a
promp
text
and
one
expected
answer,
but
they
may
also
contain
nested
groups,
each
containing
sets
of
nested
questions.
This
way,
one
can
model
"panels"
of
questions
which
would
only
be
relevant
(and
thus
would
only
be
displayed)
depending
on
the
answers
of
a
parent
question,
e.g.
a
Question
"Did
the
patient
receive
treatment
in
the
past
six
months?",
would
contain
a
nested
group
of
questions
asking
for
further
details
about
the
treatment.
See
an
example
from
the
Australian
NSW
blue
book
4.7.6
Search
Parameters
Search
parameters
for
this
resource.
The
standard
parameters
also
apply.
See
Searching
for
more
information
about
searching
in
REST,
messaging,
and
services.
.
Page
versions:
R5
R4B
R4
R3
R2
<!-- from Resource: extension, modifierExtension, language, text, and contained --> <status value="[code]"/><!-- 1..1 draft | published | retired | in progress | completed | amended § --> <authored value="[dateTime]"/><!-- 1..1 Date this version was authored § --> <subject><!-- 0..1 Resource(Patient|RelatedPerson) The subject of the questions § --></subject> <author><!-- 0..1 Resource(Practitioner|Patient|RelatedPerson) Person who received and recorded the answers § --></author> <source><!-- 0..1 Resource(Patient|Practitioner|RelatedPerson) The person who answered the questions § --></source> <name><!-- 0..1 CodeableConcept Name/code for a predefined list of questions § --></name> <identifier><!-- 0..* Identifier External Ids for this questionnaire § --></identifier> <encounter><!-- 0..1 Resource(Encounter) Primary encounter during which the answers were collected § --></encounter> <group> <!-- 0..1 Grouped questions --> <name><!-- 0..1 CodeableConcept Code or name of the section on a questionnaire --></name> <header value="[string]"/><!-- 0..1 Text that is displayed above the contents of the group --> <text value="[string]"/><!-- 0..1 Additional text for the group --> <subject><!-- 0..1 Resource(Any) The subject this group's answers are about --></subject> <group><!--
0..* Content as for Questionnaire.group Nested questionnaire group --></group> <question> <!--
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