Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU2 United States of America flag

Da Vinci Clinical Data Exchange (CDex), published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ecdx/ and changes regularly. See the Directory of published versions

: CDex QuestionnaireResponse Example4 - XML Representation

Page standards status: Informative

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<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="cdex-questionnaireresponse-example4"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse cdex-questionnaireresponse-example4</b></p><a name="cdex-questionnaireresponse-example4"> </a><a name="hccdex-questionnaireresponse-example4"> </a><a name="cdex-questionnaireresponse-example4-en-US"> </a><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Definition</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Answer</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireResponseRoot" class="hierarchy"/> cdex-questionnaireresponse-example4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire:<a href="Questionnaire-cdex-questionnaire-example2.html">Home Oxygen Therapy Questionnaire</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Examplitis</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Order Reason</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span>example.org 4: Replacement</span></span></td></tr>
<tr><td colspan="4" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature">
    <valueSignature>
      <type>
        <system value="urn:iso-astm:E1762-95:2013"/>
        <code value="1.2.840.10065.1.12.1.5"/>
        <display value="Verification Signature"/>
      </type>
      <when value="2022-06-17T22:42:19-07:00"/>
      <who>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="NPI"/>
              <display value="National Provider Identifier"/>
            </coding>
          </type>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="9941339108"/>
        </identifier>
        <display value="CDex example provider"/>
      </who>
      <onBehalfOf>
        <identifier>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="1184932014"/>
        </identifier>
      </onBehalfOf>
      <data
            value="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"/>
    </valueSignature>
  </extension>
  <questionnaire value="http://example.org/cdex-questionnaire-example2"/>
  <status value="completed"/>
  <subject>
    <identifier>
      <use value="usual"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="MB"/>
          <display value="Member Number"/>
        </coding>
        <text value="Member Number"/>
      </type>
      <system value="http://example.org/cdex/payer/member-ids"/>
      <value value="Member123"/>
    </identifier>
    <display value="Amy Shaw"/>
  </subject>
  <authored value="2022-06-17"/>
  <author>
    <identifier>
      <system value="http://hl7.org/fhir/sid/us-npi"/>
      <value value="9941339100"/>
    </identifier>
  </author>
  <item>
    <linkId value="1"/>
    <text
          value="Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)"/>
    <answer>
      <valueString value="Examplitis"/>
    </answer>
  </item>
  <item>
    <linkId value="2"/>
    <text value="Order Reason"/>
    <answer>
      <valueCoding>
        <system value="http://example.org"/>
        <code value="4"/>
        <display value="Replacement"/>
      </valueCoding>
    </answer>
  </item>
</QuestionnaireResponse>