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StructureDefinition: CQF-Questionnaire - XML

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CQF-Questionnaire

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

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="cqf-questionnaire"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="3"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fhir"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/cqf-questionnaire"/> 
  <version value="4.1.0"/> 
  <name value="CQF-Questionnaire"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2015-05-30"/> 
  <publisher value="Health Level Seven, Inc. - CDS WG"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/special/committees/dss"/> 
    </telecom> 
  </contact> 
  <description value="A questionnaire with the ability to specify behavior associated with questions or groups
   of questions"/> 
  <fhirVersion value="4.1.0"/> 
  <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> 
  <mapping> 
    <identity value="objimpl"/> 
    <uri value="http://hl7.org/fhir/object-implementation"/> 
    <name value="Object Implementation Information"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 v2 Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="Questionnaire"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <element id="Questionnaire">
      <path value="Questionnaire"/> 
      <short value="A questionnaire with the ability to specify behavior associated with questions or groups
       of questions"/> 
      <definition value="A CR (Clinical Reasoning) questionnaire is a questionnaire with the added ability to describe
       behavior associated with questions. For example, whether or not to display a particular
       question or group of questions, or automatically calculating the value of an answer based
       on the answers to previous questions."/> 
      <alias value="Form"/> 
      <alias value="CRF"/> 
      <alias value="Survey"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire"/> 
        <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="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <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:lastUpdated))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <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().as(canonica
        l) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(refer
        ence = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(c
        anonical) = '#').exists()).not()).trace('unmatched', id).empty()"/> 
        <xpath value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@va
        lue=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/> 
        <source value="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">
          <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="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="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="que-2"/> 
        <severity value="error"/> 
        <human value="The link ids for groups and questions must be unique within the questionnaire"/> 
        <expression value="descendants().linkId.isDistinct()"/> 
        <xpath value="count(descendant::f:linkId/@value)=count(distinct-values(descendant::f:linkId/@value))"/> 
        <source value="Questionnaire"/> 
      </constraint> 
      <constraint> 
        <key value="que-0"/> 
        <severity value="warning"/> 
        <human value="Name should be usable as an identifier for the module by machine processing applications
         such as code generation"/> 
        <expression value="name.matches('[A-Z]([A-Za-z0-9_]){0,254}')"/> 
        <xpath value="not(exists(f:name/@value)) or matches(f:name/@value, '[A-Z]([A-Za-z0-9_]){0,254}')"/> 
        <source value="Questionnaire"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Observation[moodCode=DEF]"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.id">
      <path value="Questionnaire.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/> 
      <comment value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="id"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Questionnaire.meta">
      <path value="Questionnaire.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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="Questionnaire.implicitRules">
      <path value="Questionnaire.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <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> 
      <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="Questionnaire.language">
      <path value="Questionnaire.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <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> 
      <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="A human language."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="Questionnaire.text">
      <path value="Questionnaire.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <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 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> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.contained">
      <path value="Questionnaire.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="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."/> 
      <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> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.extension">
      <path value="Questionnaire.extension"/> 
      <slicing id="3">
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="Questionnaire.extension:library">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/> 
      </extension> 
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/> 
      </extension> 
      <path value="Questionnaire.extension"/> 
      <sliceName value="library"/> 
      <short value="A library containing logic referenced by the questionnaire"/> 
      <definition value="A CQL or ELM library containing any logic referenced by the questionnaire."/> 
      <alias value="library"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqf-library"/> 
      </type> 
      <condition value="ele-1"/> 
      <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="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(.), 'value')])"/> 
        <source value="Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
    </element> 
    <element id="Questionnaire.modifierExtension">
      <path value="Questionnaire.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.

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.ht
      ml#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> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.url">
      <path value="Questionnaire.url"/> 
      <short value="Canonical identifier for this questionnaire, represented as a URI (globally unique)"/> 
      <definition value="An absolute URI that is used to identify this questionnaire when it is referenced in a
       specification, model, design or an instance; also called its canonical identifier. This
       SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative
       instance of this questionnaire is (or will be) published. This URL can be the target of
       a canonical reference. It SHALL remain the same when the questionnaire is stored on different
       servers."/> 
      <comment value="The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefi
      nition/display extension."/> 
      <requirements value="…  This is the id that will be used to link a QuestionnaireResponse to the Questionnaire
       the response is for."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.url"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.url"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".identifier[scope=BUSN;reliability=ISS]"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.identifier">
      <path value="Questionnaire.identifier"/> 
      <short value="Additional identifier for the questionnaire"/> 
      <definition value="A formal identifier that is used to identify this questionnaire when it is represented
       in other formats, or referenced in a specification, model, design or an instance."/> 
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)
       data type, and can then identify this questionnaire outside of FHIR, where it is not possible
       to use the logical URI."/> 
      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated
       with the module."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.version">
      <path value="Questionnaire.version"/> 
      <short value="Business version of the questionnaire"/> 
      <definition value="The identifier that is used to identify this version of the questionnaire when it is referenced
       in a specification, model, design or instance. This is an arbitrary value managed by the
       questionnaire author and is not expected to be globally unique. For example, it might
       be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no
       expectation that versions can be placed in a lexicographical sequence."/> 
      <comment value="There may be different questionnaire instances that have the same identifier but different
       versions.  The version can be appended to the url in a reference to allow a reference
       to a particular business version of the questionnaire with the format [url]|[version]."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.version"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.version"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.name">
      <path value="Questionnaire.name"/> 
      <short value="Name for this questionnaire (computer friendly)"/> 
      <definition value="A natural language name identifying the questionnaire. This name should be usable as an
       identifier for the module by machine processing applications such as code generation."/> 
      <comment value="The name is not expected to be globally unique. The name should be a simple alphanumeric
       type name to ensure that it is machine-processing friendly."/> 
      <requirements value="Support human navigation and code generation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.name"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <condition value="inv-0"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.title">
      <path value="Questionnaire.title"/> 
      <short value="Name for this questionnaire (human friendly)"/> 
      <definition value="A short, descriptive, user-friendly title for the questionnaire."/> 
      <comment value="This name does not need to be machine-processing friendly and may contain punctuation,
       white-space, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.title"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.title"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".title"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.derivedFrom">
      <path value="Questionnaire.derivedFrom"/> 
      <short value="Instantiates protocol or definition"/> 
      <definition value="The URL of a Questionnaire that this Questionnaire is based on."/> 
      <requirements value="Allows a Questionnaire to be created based on another Questionnaire."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.derivedFrom"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.derivedFrom"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=DRIV].target[classCode=OBS, moodCode=DEFN]"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.status">
      <path value="Questionnaire.status"/> 
      <short value="draft | active | retired | unknown"/> 
      <definition value="The status of this questionnaire. Enables tracking the life-cycle of the content."/> 
      <comment value="Allows filtering of questionnaires that are appropriate for use versus not."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="true"/> 
      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not use a retired
       {{title}} without due consideration"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The lifecycle status of an artifact."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/publication-status|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".status"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.experimental">
      <path value="Questionnaire.experimental"/> 
      <short value="For testing purposes, not real usage"/> 
      <definition value="A Boolean value to indicate that this questionnaire is authored for testing purposes (or
       education/evaluation/marketing) and is not intended to be used for genuine usage."/> 
      <comment value="Allows filtering of questionnaires that are appropriate for use versus not."/> 
      <requirements value="Enables experimental content to be developed following the same lifecycle that would be
       used for a production-level questionnaire."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.experimental"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.experimental"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.subjectType">
      <path value="Questionnaire.subjectType"/> 
      <short value="Resource that can be subject of QuestionnaireResponse"/> 
      <definition value="The types of subjects that can be the subject of responses created for the questionnaire."/> 
      <comment value="If none are specified, then the subject is unlimited."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.subjectType"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ResourceType"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="required"/> 
        <description value="One of the resource types defined as part of this version of FHIR."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=META].target[classCode=OBS, moodCode=DEFN, isCriterion=true].particip
        ation.role.classCode"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.date">
      <path value="Questionnaire.date"/> 
      <short value="Date last changed"/> 
      <definition value="The date  (and optionally time) when the questionnaire was published. The date must change
       when the business version changes and it must change if the status code changes. In addition,
       it should change when the substantive content of the questionnaire changes."/> 
      <comment value="Note that this is not the same as the resource last-modified-date, since the resource
       may be a secondary representation of the questionnaire. Additional specific dates may
       be added as extensions or be found by consulting Provenances associated with past versions
       of the resource."/> 
      <alias value="Revision Date"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.date"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.date"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].time"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.publisher">
      <path value="Questionnaire.publisher"/> 
      <short value="Name of the publisher (organization or individual)"/> 
      <definition value="The name of the organization or individual that published the questionnaire."/> 
      <comment value="Usually an organization but may be an individual. The publisher (or steward) of the questionnaire
       is the organization or individual primarily responsible for the maintenance and upkeep
       of the questionnaire. This is not necessarily the same individual or organization that
       developed and initially authored the content. The publisher is the primary point of contact
       for questions or issues with the questionnaire. This item SHOULD be populated unless the
       information is available from context."/> 
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the questionnaire.  May also
       allow for contact."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.publisher"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.publisher"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.witness"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].role"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.contact">
      <path value="Questionnaire.contact"/> 
      <short value="Contact details for the publisher"/> 
      <definition value="Contact details to assist a user in finding and communicating with the publisher."/> 
      <comment value="May be a web site, an email address, a telephone number, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.contact"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.contact"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=CALLBCK].role"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.description">
      <path value="Questionnaire.description"/> 
      <short value="Natural language description of the questionnaire"/> 
      <definition value="A free text natural language description of the questionnaire from a consumer's perspective."/> 
      <comment value="This description can be used to capture details such as why the questionnaire was built,
       comments about misuse, instructions for clinical use and interpretation, literature references,
       examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed
       in the 'text' field of the resource itself. This item SHOULD be populated unless the information
       is available from context (e.g. the language of the questionnaire is presumed to be the
       predominant language in the place the questionnaire was created)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.description"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.useContext">
      <path value="Questionnaire.useContext"/> 
      <short value="The context that the content is intended to support"/> 
      <definition value="The content was developed with a focus and intent of supporting the contexts that are
       listed. These contexts may be general categories (gender, age, ...) or may be references
       to specific programs (insurance plans, studies, ...) and may be used to assist with indexing
       and searching for appropriate questionnaire instances."/> 
      <comment value="When multiple useContexts are specified, there is no expectation that all or any of the
       contexts apply."/> 
      <requirements value="Assist in searching for appropriate content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.useContext"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="UsageContext"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.useContext"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.jurisdiction">
      <path value="Questionnaire.jurisdiction"/> 
      <short value="Intended jurisdiction for questionnaire (if applicable)"/> 
      <definition value="A legal or geographic region in which the questionnaire is intended to be used."/> 
      <comment value="It may be possible for the questionnaire to be used in jurisdictions other than those
       for which it was originally designed or intended."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.jurisdiction"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Countries and regions within which this artifact is targeted for use."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/jurisdiction"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.jurisdiction"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.purpose">
      <path value="Questionnaire.purpose"/> 
      <short value="Why this questionnaire is defined"/> 
      <definition value="Explanation of why this questionnaire is needed and why it has been designed as it has."/> 
      <comment value="This element does not describe the usage of the questionnaire. Instead, it provides traceability
       of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may
       be used to point to source materials or specifications that drove the structure of this
       questionnaire."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.purpose"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.purpose"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode.text"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.copyright">
      <path value="Questionnaire.copyright"/> 
      <short value="Use and/or publishing restrictions"/> 
      <definition value="A copyright statement relating to the questionnaire and/or its contents. Copyright statements
       are generally legal restrictions on the use and publishing of the questionnaire."/> 
      <requirements value="Consumers must be able to determine any legal restrictions on the use of the questionnaire
       and/or its content."/> 
      <alias value="License"/> 
      <alias value="Restrictions"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.copyright"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.copyright"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.approvalDate">
      <path value="Questionnaire.approvalDate"/> 
      <short value="When the questionnaire was approved by publisher"/> 
      <definition value="The date on which the resource content was approved by the publisher. Approval happens
       once when the content is officially approved for usage."/> 
      <comment value="The 'date' element may be more recent than the approval date because of minor changes
       or editorial corrections."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.approvalDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.approvalDate"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;approval
        &quot;].effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.lastReviewDate">
      <path value="Questionnaire.lastReviewDate"/> 
      <short value="When the questionnaire was last reviewed"/> 
      <definition value="The date on which the resource content was last reviewed. Review happens periodically
       after approval but does not change the original approval date."/> 
      <comment value="If specified, this date follows the original approval date."/> 
      <requirements value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not been
       reviewed in a long time may have a risk of being less appropriate/relevant."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.lastReviewDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.lastReviewDate"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;; subsetCode=&quot;RECENT&quot;].act[classCode=CACT;m
        oodCode=EVN;code=&quot;review&quot;].effectiveTime"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.effectivePeriod">
      <path value="Questionnaire.effectivePeriod"/> 
      <short value="When the questionnaire is expected to be used"/> 
      <definition value="The period during which the questionnaire content was or is planned to be in active use."/> 
      <comment value="The effective period for a questionnaire  determines when the content is applicable for
       usage and is independent of publication and review dates. For example, a measure intended
       to be used for the year 2016 might be published in 2015."/> 
      <requirements value="Allows establishing a transition before a resource comes into effect and also allows for
       a sunsetting  process when new versions of the questionnaire are or are expected to be
       used instead."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.effectivePeriod"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Period"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Definition.effectivePeriod"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A (to add?)"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.code">
      <path value="Questionnaire.code"/> 
      <short value="Concept that represents the overall questionnaire"/> 
      <definition value="An identifier for this question or group of questions in a particular terminology such
       as LOINC."/> 
      <requirements value="Allows linking of the complete Questionnaire resources to formal terminologies.  It's
       common for &quot;panels&quot; of questions to be identified by a code."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.code"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireConcept"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes for questionnaires, groups and individual questions."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-questions"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item">
      <path value="Questionnaire.item"/> 
      <short value="Questions and sections within the Questionnaire"/> 
      <definition value="A particular question, question grouping or display text that is part of the questionnaire."/> 
      <comment value="The content of the questionnaire is constructed from an ordered, hierarchical collection
       of items."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="que-3"/> 
      <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="Element"/> 
      </constraint> 
      <constraint> 
        <key value="que-9"/> 
        <severity value="error"/> 
        <human value="Read-only can't be specified for &quot;display&quot; items"/> 
        <expression value="type!='display' or readOnly.empty()"/> 
        <xpath value="not(f:type/@value=('group', 'display') and f:*[starts-with(local-name(.), 'initial')])"/> 
      </constraint> 
      <constraint> 
        <key value="que-8"/> 
        <severity value="error"/> 
        <human value="Initial values can't be specified for groups or display items"/> 
        <expression value="(type!='group' and type!='display') or initial.empty()"/> 
        <xpath value="not(f:type/@value=('group', 'display') and f:*[starts-with(local-name(.), 'initial')])"/> 
      </constraint> 
      <constraint> 
        <key value="que-6"/> 
        <severity value="error"/> 
        <human value="Required and repeat aren't permitted for display items"/> 
        <expression value="type!='display' or (required.empty() and repeats.empty())"/> 
        <xpath value="not(f:type/@value='display' and (f:required or f:repeats))"/> 
      </constraint> 
      <constraint> 
        <key value="que-5"/> 
        <severity value="error"/> 
        <human value="Only 'choice' and 'open-choice' items can have answerValueSet"/> 
        <expression value="(type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type
         = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity')
         or (answerValueSet.empty() and answerOption.empty())"/> 
        <xpath value="f:type/@value=('choice','open-choice','decimal','integer','date','dateTime','time','string','quantit
        y',') or not(f:answerOption or f:answerValueSet)"/> 
      </constraint> 
      <constraint> 
        <key value="que-4"/> 
        <severity value="error"/> 
        <human value="A question cannot have both answerOption and answerValueSet"/> 
        <expression value="answerOption.empty() or answerValueSet.empty()"/> 
        <xpath value="not(f:answerValueSet and f:answerOption)"/> 
      </constraint> 
      <constraint> 
        <key value="que-3"/> 
        <severity value="error"/> 
        <human value="Display items cannot have a &quot;code&quot; asserted"/> 
        <expression value="type!='display' or code.empty()"/> 
        <xpath value="not(f:type/@value='display' and f:code)"/> 
      </constraint> 
      <constraint> 
        <key value="que-10"/> 
        <severity value="error"/> 
        <human value="Maximum length can only be declared for simple question types"/> 
        <expression value="(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice'))
         or maxLength.empty()"/> 
        <xpath value="f:type/@value=('boolean', 'decimal', 'integer', 'open-choice', 'string', 'text', 'url')
         or not(f:maxLength)"/> 
      </constraint> 
      <constraint> 
        <key value="que-1"/> 
        <severity value="error"/> 
        <human value="Group items must have nested items, display items cannot have nested items"/> 
        <expression value="(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item
        ').empty())"/> 
        <xpath value="not((f:type/@value='group' and not(f:item)) or (f:type/@value='display' and f:item))"/> 
      </constraint> 
      <constraint> 
        <key value="que-13"/> 
        <severity value="error"/> 
        <human value="Can only have multiple initial values for repeating items"/> 
        <expression value="repeats=true or initial.count() &lt;= 1"/> 
        <xpath value="f:repeats/@value='true' or count(f:initial)&lt;=1"/> 
      </constraint> 
      <constraint> 
        <key value="que-11"/> 
        <severity value="error"/> 
        <human value="If one or more answerOption is present, initial[x] must be missing"/> 
        <expression value="answerOption.empty() or initial.empty()"/> 
        <xpath value="not(f:answerOption) or not(count(f:*[starts-with(local-name(.), 'initial')]))"/> 
      </constraint> 
      <constraint> 
        <key value="que-12"/> 
        <severity value="error"/> 
        <human value="If there are more than one enableWhen, enableBehavior must be specified"/> 
        <expression value="enableWhen.count() &gt; 2 implies enableBehavior.exists()"/> 
        <xpath value="not(f:answerOption) or not(count(f:*[starts-with(local-name(.), 'initial')]))"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=DEF]"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.id">
      <path value="Questionnaire.item.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <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> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.extension">
      <path value="Questionnaire.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."/> 
      <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> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.modifierExtension">
      <path value="Questionnaire.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.

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.ht
      ml#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> 
      <isModifier value="true"/> 
      <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="Questionnaire.item.linkId">
      <path value="Questionnaire.item.linkId"/> 
      <short value="Unique id for item in questionnaire"/> 
      <definition value="An identifier that is unique within the Questionnaire allowing linkage to the equivalent
       item in a QuestionnaireResponse resource."/> 
      <comment value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have
       any meaning.  GUIDs or sequential numbers are appropriate here."/> 
      <requirements value="[QuestionnaireResponse](questionnaireresponse.html#) does not require omitted items to
       be included and may have some items that repeat, so linkage based on position alone is
       not sufficient."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.linkId"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.definition">
      <path value="Questionnaire.item.definition"/> 
      <short value="ElementDefinition - details for the item"/> 
      <definition value="This element is a URI that refers to an [ElementDefinition](elementdefinition.html) that
       provides information about this item, including information that might otherwise be included
       in the instance of the Questionnaire resource. A detailed description of the construction
       of the URI is shown in Comments, below. If this element is present then the following
       element values MAY be derived from the Element Definition if the corresponding elements
       of this Questionnaire resource instance have no value:

* code (ElementDefinition.code) 
* type (ElementDefinition.type) 
* required (ElementDefinition.min) 
* repeats (ElementDefinition.max) 
* maxLength (ElementDefinition.maxLength) 
* answerValueSet (ElementDefinition.binding)
* options (ElementDefinition.binding)."/> 
      <comment value="The uri refers to an ElementDefinition in a [StructureDefinition](structuredefinition.html#)
       and always starts with the [canonical URL](references.html#canonical) for the target resource.
       When referring to a StructureDefinition, a fragment identifier is used to specify the
       element definition by its id [Element.id](element-definitions.html#Element.id). E.g. http://hl7.org/
      fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment
       identifier, the first/root element definition in the target is the matching element definition."/> 
      <requirements value="A common pattern is to define a set of data elements and then build multiple questionnaires
       for different circumstances to gather the data. This element provides traceability to
       the common definition and allows the content for the question to come from the underlying
       definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.definition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=INST].target[classCode=OBS, moodCode=DEF]"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.code">
      <path value="Questionnaire.item.code"/> 
      <short value="Corresponding concept for this item in a terminology"/> 
      <definition value="A terminology code that corresponds to this group or question (e.g. a code from LOINC,
       which defines many questions and answers)."/> 
      <comment value="The value may come from the ElementDefinition referred to by .definition."/> 
      <requirements value="Allows linking of groups of questions to formal terminologies."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.code"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <condition value="que-3"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireConcept"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Codes for questionnaires, groups and individual questions."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-questions"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.prefix">
      <path value="Questionnaire.item.prefix"/> 
      <short value="E.g. &quot;1(a)&quot;, &quot;2.5.3&quot;"/> 
      <definition value="A short label for a particular group, question or set of display text within the questionnaire
       used for reference by the individual completing the questionnaire."/> 
      <comment value="These are generally unique within a questionnaire, though this is not guaranteed. Some
       questionnaires may have multiple questions with the same label with logic to control which
       gets exposed.  Typically, these won't be used for &quot;display&quot; items, though such
       use is not prohibited.  Systems SHOULD NOT generate their own prefixes if prefixes are
       defined for any items within a Questionnaire."/> 
      <requirements value="Separating the label from the question text allows improved rendering.  Also, instructions
       will often refer to specific prefixes, so there's a need for the questionnaire design
       to have control over what labels are used."/> 
      <alias value="label"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.prefix"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Not supported"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.text">
      <path value="Questionnaire.item.text"/> 
      <short value="Primary text for the item"/> 
      <definition value="The name of a section, the text of a question or text content for a display item."/> 
      <comment value="When using this element to represent the name of a section, use group type item and also
       make sure to limit the text element to a short string suitable for display as a section
       heading.  Group item instructions should be included as a display type item within the
       group."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".text"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.type">
      <path value="Questionnaire.item.type"/> 
      <short value="group | display | boolean | decimal | integer | date | dateTime +"/> 
      <definition value="The type of questionnaire item this is - whether text for display, a grouping of other
       items or a particular type of data to be captured (string, integer, coded choice, etc.)."/> 
      <comment value="Additional constraints on the type of answer can be conveyed by extensions. The value
       may come from the ElementDefinition referred to by .definition."/> 
      <requirements value="Defines the format in which the user is to be prompted for the answer."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.type"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireItemType"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Distinguishes groups from questions and display text and indicates data type for questions."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/item-type|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen">
      <path value="Questionnaire.item.enableWhen"/> 
      <short value="Only allow data when"/> 
      <definition value="A constraint indicating that this item should only be enabled (displayed/allow answers
       to be captured) when the specified condition is true."/> 
      <comment value="If multiple repetitions of this extension are present, the item should be enabled when
       the condition for *any* of the repetitions is true.  I.e. treat &quot;enableWhen&quot;s
       as being joined by an &quot;or&quot; clause.  This element is a modifier because if enableWhen
       is present for an item, &quot;required&quot; is ignored unless one of the enableWhen conditions
       is met. When an item is disabled, all of its descendants are disabled, regardless of what
       their own enableWhen logic might evaluate to."/> 
      <requirements value="Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender
       is specified as a male, no need to capture pregnancy history.  Also allows conditional
       display of instructions or groups of questions."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen"/> 
        <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="Element"/> 
      </constraint> 
      <constraint> 
        <key value="que-7"/> 
        <severity value="error"/> 
        <human value="If the operator is 'exists', the value must be a boolean"/> 
        <expression value="operator = 'exists' implies (answer is Boolean)"/> 
        <xpath value="f:operator/@value != 'exists' or exists(f:answerBoolean)"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="If enableWhen is present and the condition evaluates to false, then the Questionnaire
       behaves as though the elements weren't actually present"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.id">
      <path value="Questionnaire.item.enableWhen.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <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> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.extension">
      <path value="Questionnaire.item.enableWhen.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."/> 
      <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> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.modifierExtension">
      <path value="Questionnaire.item.enableWhen.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.

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.ht
      ml#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> 
      <isModifier value="true"/> 
      <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="Questionnaire.item.enableWhen.question">
      <path value="Questionnaire.item.enableWhen.question"/> 
      <short value="Question that determines whether item is enabled"/> 
      <definition value="The linkId for the question whose answer (or lack of answer) governs whether this item
       is enabled."/> 
      <comment value="If multiple question occurrences are present for the same question (same linkId), then
       this refers to the nearest question occurrence reachable by tracing first the &quot;ancestor&quot;
       axis and then the &quot;preceding&quot; axis and then the &quot;following&quot; axis."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen.question"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.operator">
      <path value="Questionnaire.item.enableWhen.operator"/> 
      <short value="exists | = | != | &gt; | &lt; | &gt;= | &lt;="/> 
      <definition value="Specifies the criteria by which the question is enabled."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen.operator"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireItemOperator"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The criteria by which a question is enabled."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableWhen.answer[x]">
      <path value="Questionnaire.item.enableWhen.answer[x]"/> 
      <short value="Value for question comparison based on operator"/> 
      <definition value="A value that the referenced question is tested using the specified operator in order for
       the item to be enabled."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.enableWhen.answer[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="Coding"/> 
      </type> 
      <type> 
        <code value="Quantity"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <condition value="que-7"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireQuestionOption3"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Allowed values to answer questions."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.enableBehavior">
      <path value="Questionnaire.item.enableBehavior"/> 
      <short value="all | any"/> 
      <definition value="Controls how multiple enableWhen values are interpreted -  whether all or any must be
       true."/> 
      <comment value="This element must be specified if more than one enableWhen value is provided."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.enableBehavior"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <condition value="que-12"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="EnableWhenBehavior"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Controls how multiple enableWhen values are interpreted -  whether all or any must be
         true."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.1.0"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.required">
      <path value="Questionnaire.item.required"/> 
      <short value="Whether the item must be included in data results"/> 
      <definition value="An indication, if true, that the item must be present in a &quot;completed&quot; QuestionnaireRespon
      se.  If false, the item may be skipped when answering the questionnaire."/> 
      <comment value="Questionnaire.item.required only has meaning for elements that are conditionally enabled
       with enableWhen if the condition evaluates to true.  If an item that contains other items
       is marked as required, that does not automatically make the contained elements required
       (though required groups must contain at least one child element). The value may come from
       the ElementDefinition referred to by .definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.required"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <meaningWhenMissing value="Items are generally assumed not to be required unless explicitly specified. Systems SHOULD
       always populate this value"/> 
      <condition value="que-6"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.repeats">
      <path value="Questionnaire.item.repeats"/> 
      <short value="Whether the item may repeat"/> 
      <definition value="An indication, if true, that the item may occur multiple times in the response, collecting
       multiple answers for questions or multiple sets of answers for groups."/> 
      <comment value="If a question is marked as repeats=true, then multiple answers can be provided for the
       question in the corresponding QuestionnaireResponse.  When rendering the questionnaire,
       it is up to the rendering software whether to render the question text for each answer
       repetition (i.e. &quot;repeat the question&quot;) or to simply allow entry/selection of
       multiple answers for the question (repeat the answers).  Which is most appropriate visually
       may depend on the type of answer as well as whether there are nested items.

The resulting QuestionnaireResponse will be populated the same way regardless of rendering
       - one 'question' item with multiple answer values.

 The value may come from the ElementDefinition referred to by .definition."/> 
      <requirements value="Items may be used to create set of (related) questions that can be repeated to give multiple
       answers to such a set."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.repeats"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <meaningWhenMissing value="Items are generally assumed not to repeat unless explicitly specified. Systems SHOULD
       always populate this value"/> 
      <condition value="que-6"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.readOnly">
      <path value="Questionnaire.item.readOnly"/> 
      <short value="Don't allow human editing"/> 
      <definition value="An indication, when true, that the value cannot be changed by a human respondent to the
       Questionnaire."/> 
      <comment value="The value of readOnly elements can be established by asserting  extensions for defaultValues,
       linkages that support pre-population and/or extensions that support calculation based
       on other answers."/> 
      <requirements value="Allows certain information to be phrased (and rendered) as a question and an answer, while
       keeping users from changing it.  May also be useful for preventing changes to pre-populated
       portions of a questionnaire, for calculated values, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.readOnly"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <condition value="que-9"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.maxLength">
      <path value="Questionnaire.item.maxLength"/> 
      <short value="No more than this many characters"/> 
      <definition value="The maximum number of characters that are permitted in the answer to be considered a &quot;valid&quo
      t; QuestionnaireResponse."/> 
      <comment value="For base64binary, reflects the number of characters representing the encoded data, not
       the number of bytes of the binary data. The value may come from the ElementDefinition
       referred to by .definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.maxLength"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="integer"/> 
      </type> 
      <condition value="que-10"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="N/A"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.answerValueSet">
      <path value="Questionnaire.item.answerValueSet"/> 
      <short value="Valueset containing permitted answers"/> 
      <definition value="A reference to a value set containing a list of codes representing permitted answers for
       a &quot;choice&quot; or &quot;open-choice&quot; question."/> 
      <comment value="LOINC defines many useful value sets for questionnaire responses. See [LOINC Answer Lists](loinc.htm
      l#alist). The value may come from the ElementDefinition referred to by .definition."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.answerValueSet"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </type> 
      <condition value="que-4"/> 
      <condition value="que-5"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.answerOption">
      <path value="Questionnaire.item.answerOption"/> 
      <short value="Permitted answer"/> 
      <definition value="One of the permitted answers for a &quot;choice&quot; or &quot;open-choice&quot; question."/> 
      <comment value="This element can be used when the value set machinery of answerValueSet is deemed too
       cumbersome or when there's a need to capture possible answers that are not codes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.answerOption"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="que-4"/> 
      <condition value="que-5"/> 
      <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="Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.answerOption.id">
      <path value="Questionnaire.item.answerOption.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <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> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.answerOption.extension">
      <path value="Questionnaire.item.answerOption.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."/> 
      <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> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.answerOption.modifierExtension">
      <path value="Questionnaire.item.answerOption.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.

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.ht
      ml#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> 
      <isModifier value="true"/> 
      <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="Questionnaire.item.answerOption.value[x]">
      <path value="Questionnaire.item.answerOption.value[x]"/> 
      <short value="Answer value"/> 
      <definition value="A potential answer that's allowed as the answer to this question."/> 
      <comment value="The data type of the value must agree with the item.type."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.answerOption.value[x]"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="integer"/> 
      </type> 
      <type> 
        <code value="date"/> 
      </type> 
      <type> 
        <code value="time"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireQuestionOption"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Allowed values to answer questions."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.answerOption.initialSelected">
      <path value="Questionnaire.item.answerOption.initialSelected"/> 
      <short value="Whether option is selected by default"/> 
      <definition value="Indicates whether the answer value is selected when the list of possible answers is initially
       shown."/> 
      <comment value="Use this instead of initial[v] if answerValueSet is present."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.answerOption.initialSelected"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <meaningWhenMissing value="Only selected items explicitly marked to be selected"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.initial">
      <path value="Questionnaire.item.initial"/> 
      <short value="Initial value(s) when item is first rendered"/> 
      <definition value="One or more values that should be pre-populated in the answer when initially rendering
       the questionnaire for user input."/> 
      <comment value="The user is allowed to change the value and override the default (unless marked as read-only).
       If the user doesn't change the value, then this initial value will be persisted when the
       QuestionnaireResponse is initially created.  Note that initial values can influence results.
        The data type of initial[x] must agree with the item.type, and only repeating items can
       have more then one initial value."/> 
      <requirements value="In some workflows, having defaults saves time."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.initial"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <condition value="que-8"/> 
      <condition value="que-13"/> 
      <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="Element"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.initial.id">
      <path value="Questionnaire.item.initial.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <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> 
      <type> 
        <code value="string"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.initial.extension">
      <path value="Questionnaire.item.initial.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."/> 
      <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> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.initial.modifierExtension">
      <path value="Questionnaire.item.initial.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.

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.ht
      ml#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> 
      <isModifier value="true"/> 
      <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="Questionnaire.item.initial.value[x]">
      <path value="Questionnaire.item.initial.value[x]"/> 
      <short value="Actual value for initializing the question"/> 
      <definition value="The actual value to for an initial answer."/> 
      <comment value="The type of the initial value must be consistent with the type of the item."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="Questionnaire.item.initial.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"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireQuestionOption2"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Allowed values to answer questions."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A - MIF rather than RIM level"/> 
      </mapping> 
    </element> 
    <element id="Questionnaire.item.item">
      <path value="Questionnaire.item.item"/> 
      <short value="Nested questionnaire items"/> 
      <definition value="Text, questions and other groups to be nested beneath a question or group."/> 
      <comment value="There is no specified limit to the depth of nesting.  However, Questionnaire authors are
       encouraged to consider the impact on the user and user interface of overly deep nesting."/> 
      <requirements value="Reports can consist of complex nested groups."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Questionnaire.item.item"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="#Questionnaire.item"/> 
      <condition value="que-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="Questionnaire">
      <path value="Questionnaire"/> 
      <short value="A questionnaire with the ability to specify behavior associated with questions or groups
       of questions"/> 
      <definition value="A CR (Clinical Reasoning) questionnaire is a questionnaire with the added ability to describe
       behavior associated with questions. For example, whether or not to display a particular
       question or group of questions, or automatically calculating the value of an answer based
       on the answers to previous questions."/> 
      <min value="0"/> 
      <max value="*"/> 
    </element> 
    <element id="Questionnaire.extension:library">
      <path value="Questionnaire.extension"/> 
      <sliceName value="library"/> 
      <short value="A library containing logic referenced by the questionnaire"/> 
      <definition value="A CQL or ELM library containing any logic referenced by the questionnaire."/> 
      <alias value="library"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqf-library"/> 
      </type> 
    </element> 
  </differential> 
</StructureDefinition>