Generated Narrative: Questionnaire 5-biol-monit version: 1; Last updated: 2019-04-01 20:17:53+0000 Profiles: CH ORF Questionnaire, SDCBaseQuestionnaire, Extractable Questionnaire - StructureMap Structure LinkID Text Cardinality Type Flags Description & Constraints LabOrderFormExample Questionnaire http://fhir.ch/ig/ch-lab-order/Questionnaire/5-biol-monit#3.0.0-ci-build #xD; order Auftrag 1..1 group #xD; order.placerOrderIdentifier Auftragsnummer des Auftraggebers 0..1 string #xD; order.placerOrderIdentifierDomain Identifier Domain der Auftragsnummer des Auftraggebers 0..1 string #xD; order.fillerOrderIdentifier Auftragsnummer des Auftragsempfängers 0..1 string #xD; order.fillerOrderIdentifierDomain Identifier Domain der Auftragsnummer des Auftragsempfängers 0..1 string #xD; order.precedentDocumentIdentifier Identifier des Vorgängerdokuments 0..1 string #xD; order.notificationContactDocument Dringender Benachrichtigungskontakt für dieses Dokument 0..1 group #xD; order.notificationContactDocument.practitioner Zu benachrichtigende Person 0..1 group #xD; order.notificationContactDocument.practitioner.title Titel 0..1 string #xD; order.notificationContactDocument.practitioner.familyName Name 0..1 string #xD; order.notificationContactDocument.practitioner.givenName Vorname 0..1 string #xD; order.notificationContactDocument.practitioner.phone Telefon 0..1 string #xD; order.notificationContactDocument.practitioner.email E-Mail 0..1 string #xD; order.notificationContactDocumentResponse Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument 0..1 group #xD; order.notificationContactDocumentResponse.practitioner Zu benachrichtigende Person 0..1 group #xD; order.notificationContactDocumentResponse.practitioner.title Titel 0..1 string #xD; order.notificationContactDocumentResponse.practitioner.familyName Name 0..1 string #xD; order.notificationContactDocumentResponse.practitioner.givenName Vorname 0..1 string #xD; order.notificationContactDocumentResponse.practitioner.phone Telefon 0..1 string #xD; order.notificationContactDocumentResponse.practitioner.email E-Mail 0..1 string #xD; order.priority Auftragspriorität 0..1 choice Options: 4 options #xD; receiver Empfänger 0..1 group #xD; receiver.practitioner Empfangende Person 0..1 group #xD; receiver.practitioner.title Titel 0..1 string #xD; receiver.practitioner.familyName Name 0..1 string #xD; receiver.practitioner.givenName Vorname 0..1 string #xD; receiver.practitioner.gln GLN 0..1 string #xD; receiver.practitioner.zsr ZSR 0..1 string #xD; receiver.practitioner.phone Telefon 0..1 string #xD; receiver.practitioner.email E-Mail 0..1 string #xD; receiver.organization Empfangende Organisation 0..1 group #xD; receiver.organization.name Name der Organisation 0..1 string #xD; receiver.organization.gln GLN 0..1 string Definition: #xD; receiver.organization.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string #xD; receiver.organization.postalCode PLZ 0..1 string #xD; receiver.organization.city Ort 0..1 string #xD; receiver.organization.country Land 0..1 string #xD; patient Patient 1..1 group #xD; patient.familyName Name 0..1 string #xD; patient.maidenName Ledigname 0..1 string #xD; patient.givenName Vorname 0..1 string #xD; patient.localPid Lokale Patienten-ID 0..1 string #xD; patient.birthDate Geburtsdatum 0..1 date #xD; patient.gender Geschlecht 0..1 choice Options: 3 options #xD; patient.maritalStatus Zivilstand 0..1 choice Definition: Patient.maritalStatus Options: 8 options #xD; patient.phone Telefon 0..1 string #xD; patient.email E-Mail 0..1 string #xD; patient.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string #xD; patient.postalCode PLZ 0..1 string #xD; patient.city Ort 0..1 string #xD; patient.country Land 0..1 string #xD; patient.languageOfCorrespondance Korrespondenssprache 0..1 choice Definition: Patient.communication:languageOfCorrespondance Value Set: DocumentEntry.languageCode #xD; patient.contactperson Kontaktperson 0..1 group Definition: Patient.contact #xD; patient.contactperson.relationship Beziehung 0..1 string Definition: Patient.contact.relationship.text #xD; patient.contactperson.familyName Name 0..1 string Definition: Patient.contact.name.family #xD; patient.contactperson.givenName Vorname 0..1 string Definition: Patient.contact.name.given #xD; patient.contactperson.phone Telefon 0..* string Definition: Patient.contact.telecom.value #xD; patient.contactperson.email E-Mail 0..1 string Definition: Patient.contact.telecom.value #xD; sender Absender 1..1 group #xD; sender.author Verantwortlicher 1..1 group #xD; sender.author.practitioner Verantwortliche Person 0..1 group #xD; sender.author.practitioner.title Titel 0..1 string #xD; sender.author.practitioner.familyName Name 0..1 string #xD; sender.author.practitioner.givenName Vorname 0..1 string #xD; sender.author.practitioner.gln GLN 0..1 string #xD; sender.author.practitioner.zsr ZSR 0..1 string #xD; sender.author.practitioner.phone Telefon 0..1 string #xD; sender.author.practitioner.email E-Mail 0..1 string #xD; sender.author.organization Verantwortliche Organisation 0..1 group #xD; sender.author.organization.name Name der Organisation 0..1 string #xD; sender.author.organization.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string #xD; sender.author.organization.postalCode PLZ 0..1 string #xD; sender.author.organization.city Ort 0..1 string #xD; sender.author.organization.country Land 0..1 string #xD; sender.dataenterer Erfasser 0..1 group #xD; sender.dataenterer.practitioner Erfassende Person 0..1 group #xD; sender.dataenterer.practitioner.familyName Name 0..1 string #xD; sender.dataenterer.practitioner.givenName Vorname 0..1 string #xD; sender.dataenterer.practitioner.phone Telefon 0..1 string #xD; sender.dataenterer.practitioner.email E-Mail 0..1 string #xD; receiverCopies Kopieempfänger 0..1 group #xD; receiverCopy Kopieempfangende Organisation oder Person 0..* group Definition: PractitionerRole #xD; receiverCopy.organization.name Name der Organisation 0..1 string Definition: PractitionerRole.practitioner #xD; receiverCopy.practitionerRole.practitioner.title Titel 0..1 string Definition: HumanName.prefix #xD; receiverCopy.practitionerRole.practitioner.familyName Name 0..1 string Definition: HumanName.family #xD; receiverCopy.practitionerRole.practitioner.givenName Vorname 0..1 string Definition: HumanName.given #xD; receiverCopy.practitionerRole.practitioner.phone Telefon 0..1 string Definition: ContactPoint.value #xD; receiverCopy.practitionerRole.practitioner.email E-Mail 0..1 string Definition: ContactPoint.value #xD; receiverCopy.title Titel 0..1 string Definition: PractitionerRole.organization #xD; receiverCopy.practitionerRole.organization.name Name der Organisation 0..1 string Definition: Organization.name #xD; receiverCopy.practitionerRole.organization.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: Address.line #xD; receiverCopy.practitionerRole.organization.postalCode PLZ 0..1 string Definition: Address.postalCode #xD; receiverCopy.practitionerRole.organization.city Ort 0..1 string Definition: Address.city #xD; receiverCopy.practitionerRole.organization.country Land 0..1 string Definition: Address.country #xD; receiverCopy.familyName Name 0..1 string #xD; receiverCopy.givenName Vorname 0..1 string #xD; receiverCopy.phone Telefon 0..1 string #xD; receiverCopy.email E-Mail 0..1 string #xD; receiverCopy.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string #xD; receiverCopy.postalCode PLZ 0..1 string #xD; receiverCopy.city Ort 0..1 string #xD; receiverCopy.country Land 0..1 string #xD; receiverCopy.patient Patient selbst 0..1 boolean Definition: Patient #xD; receiverCopy.relatedPerson Andere Person 0..* group Definition: RelatedPerson #xD; receiverCopy.relatedPerson.familyName Name 0..1 string Definition: RelatedPerson.name.family #xD; receiverCopy.relatedPerson.givenName Vorame 0..1 string Definition: RelatedPerson.name.given #xD; receiverCopy.relatedPerson.phone Telefon 0..* string Definition: RelatedPerson.telecom.value #xD; receiverCopy.relatedPerson.email E-Mail 0..1 string Definition: RelatedPerson.telecom.value #xD; receiverCopy.relatedPerson.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: RelatedPerson.address.line #xD; receiverCopy.relatedPerson.postalCode PLZ 0..1 string Definition: RelatedPerson.address.postalCode #xD; receiverCopy.relatedPerson.city Ort 0..1 string Definition: RelatedPerson.address.city #xD; receiverCopy.relatedPerson.country Land 0..1 string Definition: RelatedPerson.address.country #xD; consent Einverständniserklärung 0..1 group Definition: ServiceRequest.supportingInfo #xD; consent.treatment Einverständnis des Patienten zur Behandlung 0..1 string #xD; consent.patientPrivacy Einverständnis des Patienten zum Datenschutz 0..1 string #xD; consent.research Einverständnis des Patienten zur Forschung 0..1 string #xD; consent.advancedCareDirective Patientenverfügung 0..1 string #xD; coverage Kostenträger 0..1 group Definition: insurance #xD; coverage.uvg Unfallversicherung (nach UVG) 0..1 string #xD; coverage.kvg Grundversicherung (nach KVG) 0..1 string #xD; coverage.vvg Zusatzversicherung (nach VVG) 0..1 string #xD; coverage.vvgOther Andere (nach VVG) 0..1 string #xD; previousResult Vorheriges Untersuchungsresultat 0..1 group Definition: ServiceRequest.supportingInfo #xD; previousResult.result Untersuchungsresultat 0..* string #xD; hematology Hematology 0..1 group #xD; lab Laborwerte 0..* choice Options: 5 options #xD; toxicology Toxicology 0..1 group #xD; tox Toxic Content 0..* choice Options: 3 options #xD; Documentation for this format Options Sets Answer options for order.priority http://hl7.org/fhir/request-priority#routine ("Routine") http://hl7.org/fhir/request-priority#urgent ("Urgent") http://hl7.org/fhir/request-priority#asap ("ASAP") http://hl7.org/fhir/request-priority#stat ("STAT") Answer options for patient.gender http://hl7.org/fhir/administrative-gender#male ("Male") http://hl7.org/fhir/administrative-gender#female ("Female") http://hl7.org/fhir/administrative-gender#other ("Other") Answer options for patient.maritalStatus http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#1 ("ledig") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#2 ("verheiratet") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#3 ("verwitwet") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#4 ("geschieden") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#5 ("unverheiratet") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#6 ("in eingetragener Partnerschaft") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#7 ("aufgelöste Partnerschaft") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus#9 ("unbekannt") Answer options for lab http://loinc.org#24360-0 ("Hemoglobin and Hematocrit panel - Blood") http://loinc.org#43113-0 ("Hemoglobin electrophoresis panel in Blood") http://loinc.org#57021-8 ("CBC W Auto Differential panel - Blood") http://loinc.org#58410-2 ("CBC panel - Blood by Automated count") http://loinc.org#57021-8 ("CBC W Auto Differential panel - Blood") Answer options for tox http://loinc.org#29587-3 ("Toxicology panel - Blood") http://loinc.org#54454-4 ("Arsenic fractions panel - Urine") http://loinc.org#29589-9 ("Heavy metals panel - Urine")
The practitioner that is to be used to pre-populate the form
Identifier Domain der Auftragsnummer des Auftraggebers
Identifier Domain der Auftragsnummer des Auftragsempfängers
Dringender Benachrichtigungskontakt für dieses Dokument
Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument
Kopieempfangende Organisation oder Person
Einverständnis des Patienten zur Behandlung
Einverständnis des Patienten zum Datenschutz
Einverständnis des Patienten zur Forschung
Hemoglobin electrophoresis panel in Blood