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2.39 Resource Questionnaire - Content

FHIR Infrastructure Work GroupMaturity Level: 3 Trial UseCompartments: Not linked to any defined compartments

A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.

A Questionnaire is an organized collection of questions intended to solicit information from patients, providers or other individuals involved in the healthcare domain. They may be simple flat lists of questions or can be hierarchically organized in groups and sub-groups, each containing questions. The Questionnaire defines the questions to be asked, how they are ordered and grouped, any intervening instructional text and what the constraints are on the allowed answers. The results of a Questionnaire can be communicated using the QuestionnaireResponse resource.

Questionnaires cover the need to communicate data originating from forms used in medical history examinations, research questionnaires and sometimes full clinical specialty records. In many systems this data is collected using user-defined screens and forms. Questionnaires define specifics about data capture - exactly what questions were asked, in what order, what choices for answers were, etc. Each of these questions is part of the Questionnaire, and as such the Questionnaire is a separately identifiable Resource, whereas the individual questions are not. (Questionnaire questions can be linked to shared data elements using the Questionnaire.item.definition element.)

Examples of Questionnaires include:

  • Past medical history (PMH)
  • Family diseases
  • Social history
  • Research questionnaires/Clinical research forms (CRFs)
  • Quality and evaluation forms
  • Patient intake form (e.g. clipboard)
  • Insurance claim form

This resource is limited in scope to support the characteristics of simple questionnaires. However, common extensions have been defined to allow more sophisticated behavior. This includes:

  • Questionnaire core extensions which defines the additional descriptive characteristics for questionnaires and their groups and questions
  • Element extensions which can describe additional constraints on allowed answers for questionnaires such as string length and date and numeric ranges

Additional profiles such as the Structured Data Capture Questionnaire profile may provide additional capabilities for defining more sophisticated questionnaires and forms.

Questionnaires differ from Lists because Lists group existing resources, while Questionnaires group arbitrary questions. Questionnaires are distinct from Observations and DiagnosticReports in that both of these resources are intended to capture only certain types of information (lab, imaging, vitals, etc.) and should not be used to capture the full breadth of healthcare information (allergies, medications, care plans, etc.), while Questionnaires are able to capture any information at all. More importantly, Observation and DiagnosticReport focus on capturing the discrete information in a standardized form so that the information can be used consistently regardless of where or how it is captured. Questionnaire focuses on information capture. The same information can be captured using a wide variety of questionnaires with differently phrased questions organized in different manners. As such, the Questionnaire resource provides a means to standardize the information gathering process (how information is captured), but not the actual information collected. Observation and DiagnosticReport standardize what information is actually captured, but not how the information is gathered.

Questionnaires are similar to the notion of "logical models" supported by the StructureDefinition resource. Both support the representation of a collection of data points with labels, data types and hierarchy. It will be common to find the two of them mapped together. The primary difference is that Questionnaire is focused on user-facing data collection. It describes specific questions and includes information such as what number/label should be displayed beside each question, conditions in which questions should be displayed (or not), what instructions should be provided to the user, etc. StructureDefinition, on the other hand, merely defines a data structure with no guidance on display or rules around capture mechanism, only what data should exist in the end. As well, logical models are not intended to capture data directly. Rather, they provide a basis for mapping between data capture structures.

Groups and questions that make up a Questionnaire can use the definition element to refer to data elements in external code systems and StructureDefinitions. In this way, it's possible to leverage standard definitions of questions and their associated data types and answer sets across questionnaires. This also allows extraction of the data from a questionnaire response into other data structures (e.g. populating a ServiceRequest or CarePlan from information in a completed questionnaire response. It can also support other sorts of post-processing of the data contained in a questionnaire response. However, use of the definition element is not required and Questionnaires may be quite loosely defined. The section Questionnaire versus Resources below discusses the issues of collecting data in such loosely defined Questionnaires versus collecting data as well-defined separate Resources.

This resource is referenced by CarePlan and QuestionnaireResponse

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Questionnaire IDomainResourceA structured set of questions
+ The link ids for groups and questions must be unique within the questionnaire
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriLogical URI to reference this questionnaire (globally unique)
... identifier Σ0..*IdentifierAdditional identifier for the questionnaire
... version Σ0..1stringBusiness version of the questionnaire
... name Σ0..1stringName for this questionnaire (computer friendly)
... title Σ0..1stringName for this questionnaire (human friendly)
... derivedFrom 0..*uriInstantiates protocol or definition
... status ?!Σ1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... experimental ?!Σ0..1booleanFor testing purposes, not real usage
... subjectType Σ0..*codeResource that can be subject of QuestionnaireResponse
ResourceType (Required)
... date Σ0..1dateTimeDate this was last changed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... useContext Σ0..*UsageContextContext the content is intended to support
... jurisdiction Σ0..*CodeableConceptIntended jurisdiction for questionnaire (if applicable)
Jurisdiction ValueSet (Extensible)
... description 0..1markdownNatural language description of the questionnaire
... purpose 0..1markdownWhy this questionnaire is defined
... copyright 0..1markdownUse and/or publishing restrictions
... approvalDate 0..1dateWhen the questionnaire was approved by publisher
... lastReviewDate 0..1dateWhen the questionnaire was last reviewed
... effectivePeriod Σ0..1PeriodWhen the questionnaire is expected to be used
... code Σ0..*CodingConcept that represents the overall questionnaire
Questionnaire Question Codes (Example)
... item I0..*BackboneElementQuestions and sections within the Questionnaire
+ Read-only can't be specified for "display" items
+ Default values can't be specified for groups or display items
+ Required and repeat aren't permitted for display items
+ Only 'choice' items can have options
+ A question cannot have both option and options
+ Display items cannot have a "code" asserted
+ Maximum length can only be declared for simple question types
+ Group items must have nested items, display items cannot have nested items
.... linkId 1..1stringUnique id for item in questionnaire
.... definition 0..1uriElementDefinition - details for the item
.... code ΣI0..*CodingCorresponding concept for this item in a terminology
Questionnaire Question Codes (Example)
.... prefix 0..1stringE.g. "1(a)", "2.5.3"
.... text Σ0..1stringPrimary text for the item
.... type 1..1codegroup | display | boolean | decimal | integer | date | dateTime +
QuestionnaireItemType (Required)
.... enableWhen ?!ΣI0..*BackboneElementOnly allow data when
+ enableWhen must contain either a 'answer' or a 'hasAnswer' element
..... question 1..1stringQuestion that determines whether item is enabled
..... hasAnswer I0..1booleanEnable when answered or not
..... answer[x] I0..1Value question must have
Questionnaire Answer Codes (Example)
...... answerBooleanboolean
...... answerDecimaldecimal
...... answerIntegerinteger
...... answerDatedate
...... answerDateTimedateTime
...... answerTimetime
...... answerStringstring
...... answerUriuri
...... answerAttachmentAttachment
...... answerCodingCoding
...... answerQuantityQuantity
...... answerReferenceReference(Any)
.... required I0..1booleanWhether the item must be included in data results
.... repeats I0..1booleanWhether the item may repeat
.... readOnly I0..1booleanDon't allow human editing
.... maxLength I0..1integerNo more than this many characters
.... options I0..1Reference(ValueSet)Valueset containing permitted answers
.... option I0..*BackboneElementPermitted answer
..... value[x] 1..1Answer value
Questionnaire Answer Codes (Example)
...... valueIntegerinteger
...... valueDatedate
...... valueTimetime
...... valueStringstring
...... valueCodingCoding
.... initial[x] I0..1Default value when item is first rendered
Questionnaire Answer Codes (Example)
..... initialBooleanboolean
..... initialDecimaldecimal
..... initialIntegerinteger
..... initialDatedate
..... initialDateTimedateTime
..... initialTimetime
..... initialStringstring
..... initialUriuri
..... initialAttachmentAttachment
..... initialCodingCoding
..... initialQuantityQuantity
..... initialReferenceReference(Any)
.... item I0..*see itemNested questionnaire items

doco Documentation for this format

UML Diagram (Legend)

Questionnaire (DomainResource)An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this questionnaire is (or will be) published. The URL SHOULD include the major version of the questionnaire. For more information see [Technical and Business Versions](resource.html#versions)url : uri [0..1]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 instanceidentifier : Identifier [0..*]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 sequenceversion : string [0..1]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 generationname : string [0..1]A short, descriptive, user-friendly title for the questionnairetitle : string [0..1]The URL of a Questionnaire that this Questionnaire is based onderivedFrom : uri [0..*]The status of this questionnaire. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « The lifecycle status of a Value Set or Concept Map. (Strength=Required)PublicationStatus! »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 (this element modifies the meaning of other elements)experimental : boolean [0..1]The types of subjects that can be the subject of responses created for the questionnairesubjectType : code [0..*] « One of the resource types defined as part of FHIR. (Strength=Required)ResourceType! »The date (and optionally time) when the questionnaire was published. The date must change if and 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 changesdate : dateTime [0..1]The name of the individual or organization that published the questionnairepublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate questionnaire instancesuseContext : UsageContext [0..*]A legal or geographic region in which the questionnaire is intended to be usedjurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible)Jurisdiction ValueSet+ »A free text natural language description of the questionnaire from a consumer's perspectivedescription : markdown [0..1]Explaination of why this questionnaire is needed and why it has been designed as it haspurpose : markdown [0..1]A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnairecopyright : markdown [0..1]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval, but doesn't change the original approval datelastReviewDate : date [0..1]The period during which the questionnaire content was or is planned to be in active useeffectivePeriod : Period [0..1]An identifier for this question or group of questions in a particular terminology such as LOINCcode : Coding [0..*] « Codes for questionnaires, groups and individual questions (Strength=Example)Questionnaire Question ?? »ItemAn identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resourcelinkId : string [1..1]A reference to an [[[ElementDefinition]]] that provides the details for the item. If a definition is provided, then the following element values can be inferred from the definition: * code (ElementDefinition.code) * type (ElementDefinition.type) * required (ElementDefinition.min) * repeats (ElementDefinition.max) * maxLength (ElementDefinition.maxLength) * options (ElementDefinition.binding) Any information provided in these elements on a Questionnaire Item overrides the information from the definitiondefinition : uri [0..1]A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers)code : Coding [0..*] « Codes for questionnaires, groups and individual questions (Strength=Example)Questionnaire Question ?? »A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaireprefix : string [0..1]The name of a section, the text of a question or text content for a display itemtext : string [0..1]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.)type : code [1..1] « Distinguishes groups from questions and display text and indicates data type for questions (Strength=Required)QuestionnaireItemType! »An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnairerequired : boolean [0..1]An indication, if true, that the item may occur multiple times in the response, collecting multiple answers answers for questions or multiple sets of answers for groupsrepeats : boolean [0..1]An indication, when true, that the value cannot be changed by a human respondent to the QuestionnairereadOnly : boolean [0..1]The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponsemaxLength : integer [0..1]A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" questionoptions : Reference [0..1] « ValueSet »The value that should be defaulted when initially rendering the questionnaire for user inputinitial[x] : Type [0..1] « boolean|decimal|integer|date|dateTime| time|string|uri|Attachment|Coding|Quantity|Reference(Any); Allowed values to answer questions. (Strength=Example) Questionnaire Answer ?? »EnableWhenThe linkId for the question whose answer (or lack of answer) governs whether this item is enabledquestion : string [1..1]An indication that this item should be enabled only if the specified question is answered (hasAnswer=true) or not answered (hasAnswer=false)hasAnswer : boolean [0..1]An answer that the referenced question must match in order for the item to be enabledanswer[x] : Type [0..1] « boolean|decimal|integer|date|dateTime|time| string|uri|Attachment|Coding|Quantity|Reference(Any); Allowed values to answer questions. (Strength=Example) Questionnaire Answer ?? »OptionA potential answer that's allowed as the answer to this questionvalue[x] : Type [1..1] « integer|date|time|string|Coding; Allowed values to answer questions. (Strength=Example) Questionnaire Answer ?? »A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true (this element modifies the meaning of other elements)enableWhen[0..*]One of the permitted answers for a "choice" or "open-choice" questionoption[0..*]Text, questions and other groups to be nested beneath a question or groupitem[0..*]A particular question, question grouping or display text that is part of the questionnaireitem[0..*]

XML Template

<Questionnaire xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Logical URI to reference this questionnaire (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the questionnaire --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the questionnaire -->
 <name value="[string]"/><!-- 0..1 Name for this questionnaire (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this questionnaire (human friendly) -->
 <derivedFrom value="[uri]"/><!-- 0..* Instantiates protocol or definition -->
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <subjectType value="[code]"/><!-- 0..* Resource that can be subject of QuestionnaireResponse -->
 <date value="[dateTime]"/><!-- 0..1 Date this was last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <useContext><!-- 0..* UsageContext Context the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for questionnaire (if applicable) --></jurisdiction>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the questionnaire -->
 <purpose value="[markdown]"/><!-- 0..1 Why this questionnaire is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the questionnaire was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the questionnaire was last reviewed -->
 <effectivePeriod><!-- 0..1 Period When the questionnaire is expected to be used --></effectivePeriod>
 <code><!-- 0..* Coding Concept that represents the overall questionnaire --></code>
 <item>  <!-- ?? 0..* Questions and sections within the Questionnaire -->
  <linkId value="[string]"/><!-- 1..1 Unique id for item in questionnaire -->
  <definition value="[uri]"/><!-- 0..1 ElementDefinition - details for the item -->
  <code><!-- ?? 0..* Coding Corresponding concept for this item in a terminology --></code>
  <prefix value="[string]"/><!-- 0..1 E.g. "1(a)", "2.5.3" -->
  <text value="[string]"/><!-- 0..1 Primary text for the item -->
  <type value="[code]"/><!-- 1..1 group | display | boolean | decimal | integer | date | dateTime + -->
  <enableWhen>  <!-- 0..* Only allow data when -->
   <question value="[string]"/><!-- 1..1 Question that determines whether item is enabled -->
   <hasAnswer value="[boolean]"/><!-- ?? 0..1 Enable when answered or not -->
   <answer[x]><!-- ?? 0..1 boolean|decimal|integer|date|dateTime|time|string|uri|
     Attachment|Coding|Quantity|Reference(Any) Value question must have --></answer[x]>
  </enableWhen>
  <required value="[boolean]"/><!-- ?? 0..1 Whether the item must be included in data results -->
  <repeats value="[boolean]"/><!-- ?? 0..1 Whether the item may repeat -->
  <readOnly value="[boolean]"/><!-- ?? 0..1 Don't allow human editing -->
  <maxLength value="[integer]"/><!-- ?? 0..1 No more than this many characters -->
  <options><!-- ?? 0..1 Reference(ValueSet) Valueset containing permitted answers --></options>
  <option>  <!-- ?? 0..* Permitted answer -->
   <value[x]><!-- 1..1 integer|date|time|string|Coding Answer value --></value[x]>
  </option>
  <initial[x]><!-- ?? 0..1 boolean|decimal|integer|date|dateTime|time|string|uri|
    Attachment|Coding|Quantity|Reference(Any) Default value when item is first rendered --></initial[x]>
  <item><!-- ?? 0..* Content as for Questionnaire.item Nested questionnaire items --></item>
 </item>
</Questionnaire>

JSON Template

{doco
  "resourceType" : "Questionnaire",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Logical URI to reference this questionnaire (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the questionnaire
  "version" : "<string>", // Business version of the questionnaire
  "name" : "<string>", // Name for this questionnaire (computer friendly)
  "title" : "<string>", // Name for this questionnaire (human friendly)
  "derivedFrom" : ["<uri>"], // Instantiates protocol or definition
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "subjectType" : ["<code>"], // Resource that can be subject of QuestionnaireResponse
  "date" : "<dateTime>", // Date this was last changed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "useContext" : [{ UsageContext }], // Context the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for questionnaire (if applicable)
  "description" : "<markdown>", // Natural language description of the questionnaire
  "purpose" : "<markdown>", // Why this questionnaire is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the questionnaire was approved by publisher
  "lastReviewDate" : "<date>", // When the questionnaire was last reviewed
  "effectivePeriod" : { Period }, // When the questionnaire is expected to be used
  "code" : [{ Coding }], // Concept that represents the overall questionnaire
  "item" : [{ // C? Questions and sections within the Questionnaire
    "linkId" : "<string>", // R!  Unique id for item in questionnaire
    "definition" : "<uri>", // ElementDefinition - details for the item
    "code" : [{ Coding }], // C? Corresponding concept for this item in a terminology
    "prefix" : "<string>", // E.g. "1(a)", "2.5.3"
    "text" : "<string>", // Primary text for the item
    "type" : "<code>", // R!  group | display | boolean | decimal | integer | date | dateTime +
    "enableWhen" : [{ // Only allow data when
      "question" : "<string>", // R!  Question that determines whether item is enabled
      "hasAnswer" : <boolean>, // C? Enable when answered or not
      // answer[x]: Value question must have. One of these 12:
      "answerBoolean" : <boolean>
      "answerDecimal" : <decimal>
      "answerInteger" : <integer>
      "answerDate" : "<date>"
      "answerDateTime" : "<dateTime>"
      "answerTime" : "<time>"
      "answerString" : "<string>"
      "answerUri" : "<uri>"
      "answerAttachment" : { Attachment }
      "answerCoding" : { Coding }
      "answerQuantity" : { Quantity }
      "answerReference" : { Reference(Any) }
    }],
    "required" : <boolean>, // C? Whether the item must be included in data results
    "repeats" : <boolean>, // C? Whether the item may repeat
    "readOnly" : <boolean>, // C? Don't allow human editing
    "maxLength" : <integer>, // C? No more than this many characters
    "options" : { Reference(ValueSet) }, // C? Valueset containing permitted answers
    "option" : [{ // C? Permitted answer
      // value[x]: Answer value. One of these 5:
      "valueInteger" : <integer>
      "valueDate" : "<date>"
      "valueTime" : "<time>"
      "valueString" : "<string>"
      "valueCoding" : { Coding }
    }],
    // initial[x]: Default value when item is first rendered. One of these 12:
    "initialBoolean" : <boolean>,
    "initialDecimal" : <decimal>,
    "initialInteger" : <integer>,
    "initialDate" : "<date>",
    "initialDateTime" : "<dateTime>",
    "initialTime" : "<time>",
    "initialString" : "<string>",
    "initialUri" : "<uri>",
    "initialAttachment" : { Attachment },
    "initialCoding" : { Coding },
    "initialQuantity" : { Quantity },
    "initialReference" : { Reference(Any) },
    "item" : [{ Content as for Questionnaire.item }] // C? Nested questionnaire items
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Questionnaire;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Questionnaire.url [ uri ]; # 0..1 Logical URI to reference this questionnaire (globally unique)
  fhir:Questionnaire.identifier [ Identifier ], ... ; # 0..* Additional identifier for the questionnaire
  fhir:Questionnaire.version [ string ]; # 0..1 Business version of the questionnaire
  fhir:Questionnaire.name [ string ]; # 0..1 Name for this questionnaire (computer friendly)
  fhir:Questionnaire.title [ string ]; # 0..1 Name for this questionnaire (human friendly)
  fhir:Questionnaire.derivedFrom [ uri ], ... ; # 0..* Instantiates protocol or definition
  fhir:Questionnaire.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:Questionnaire.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  fhir:Questionnaire.subjectType [ code ], ... ; # 0..* Resource that can be subject of QuestionnaireResponse
  fhir:Questionnaire.date [ dateTime ]; # 0..1 Date this was last changed
  fhir:Questionnaire.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Questionnaire.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:Questionnaire.useContext [ UsageContext ], ... ; # 0..* Context the content is intended to support
  fhir:Questionnaire.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for questionnaire (if applicable)
  fhir:Questionnaire.description [ markdown ]; # 0..1 Natural language description of the questionnaire
  fhir:Questionnaire.purpose [ markdown ]; # 0..1 Why this questionnaire is defined
  fhir:Questionnaire.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions
  fhir:Questionnaire.approvalDate [ date ]; # 0..1 When the questionnaire was approved by publisher
  fhir:Questionnaire.lastReviewDate [ date ]; # 0..1 When the questionnaire was last reviewed
  fhir:Questionnaire.effectivePeriod [ Period ]; # 0..1 When the questionnaire is expected to be used
  fhir:Questionnaire.code [ Coding ], ... ; # 0..* Concept that represents the overall questionnaire
  fhir:Questionnaire.item [ # 0..* Questions and sections within the Questionnaire
    fhir:Questionnaire.item.linkId [ string ]; # 1..1 Unique id for item in questionnaire
    fhir:Questionnaire.item.definition [ uri ]; # 0..1 ElementDefinition - details for the item
    fhir:Questionnaire.item.code [ Coding ], ... ; # 0..* Corresponding concept for this item in a terminology
    fhir:Questionnaire.item.prefix [ string ]; # 0..1 E.g. "1(a)", "2.5.3"
    fhir:Questionnaire.item.text [ string ]; # 0..1 Primary text for the item
    fhir:Questionnaire.item.type [ code ]; # 1..1 group | display | boolean | decimal | integer | date | dateTime +
    fhir:Questionnaire.item.enableWhen [ # 0..* Only allow data when
      fhir:Questionnaire.item.enableWhen.question [ string ]; # 1..1 Question that determines whether item is enabled
      fhir:Questionnaire.item.enableWhen.hasAnswer [ boolean ]; # 0..1 Enable when answered or not
      # Questionnaire.item.enableWhen.answer[x] : 0..1 Value question must have. One of these 12
        fhir:Questionnaire.item.enableWhen.answerBoolean [ boolean ]
        fhir:Questionnaire.item.enableWhen.answerDecimal [ decimal ]
        fhir:Questionnaire.item.enableWhen.answerInteger [ integer ]
        fhir:Questionnaire.item.enableWhen.answerDate [ date ]
        fhir:Questionnaire.item.enableWhen.answerDateTime [ dateTime ]
        fhir:Questionnaire.item.enableWhen.answerTime [ time ]
        fhir:Questionnaire.item.enableWhen.answerString [ string ]
        fhir:Questionnaire.item.enableWhen.answerUri [ uri ]
        fhir:Questionnaire.item.enableWhen.answerAttachment [ Attachment ]
        fhir:Questionnaire.item.enableWhen.answerCoding [ Coding ]
        fhir:Questionnaire.item.enableWhen.answerQuantity [ Quantity ]
        fhir:Questionnaire.item.enableWhen.answerReference [ Reference(Any) ]
    ], ...;
    fhir:Questionnaire.item.required [ boolean ]; # 0..1 Whether the item must be included in data results
    fhir:Questionnaire.item.repeats [ boolean ]; # 0..1 Whether the item may repeat
    fhir:Questionnaire.item.readOnly [ boolean ]; # 0..1 Don't allow human editing
    fhir:Questionnaire.item.maxLength [ integer ]; # 0..1 No more than this many characters
    fhir:Questionnaire.item.options [ Reference(ValueSet) ]; # 0..1 Valueset containing permitted answers
    fhir:Questionnaire.item.option [ # 0..* Permitted answer
      # Questionnaire.item.option.value[x] : 1..1 Answer value. One of these 5
        fhir:Questionnaire.item.option.valueInteger [ integer ]
        fhir:Questionnaire.item.option.valueDate [ date ]
        fhir:Questionnaire.item.option.valueTime [ time ]
        fhir:Questionnaire.item.option.valueString [ string ]
        fhir:Questionnaire.item.option.valueCoding [ Coding ]
    ], ...;
    # Questionnaire.item.initial[x] : 0..1 Default value when item is first rendered. One of these 12
      fhir:Questionnaire.item.initialBoolean [ boolean ]
      fhir:Questionnaire.item.initialDecimal [ decimal ]
      fhir:Questionnaire.item.initialInteger [ integer ]
      fhir:Questionnaire.item.initialDate [ date ]
      fhir:Questionnaire.item.initialDateTime [ dateTime ]
      fhir:Questionnaire.item.initialTime [ time ]
      fhir:Questionnaire.item.initialString [ string ]
      fhir:Questionnaire.item.initialUri [ uri ]
      fhir:Questionnaire.item.initialAttachment [ Attachment ]
      fhir:Questionnaire.item.initialCoding [ Coding ]
      fhir:Questionnaire.item.initialQuantity [ Quantity ]
      fhir:Questionnaire.item.initialReference [ Reference(Any) ]
    fhir:Questionnaire.item.item [ See Questionnaire.item ], ... ; # 0..* Nested questionnaire items
  ], ...;
]

Changes since DSTU2

Questionnaire
Questionnaire.url
  • Added Element
Questionnaire.name
  • Added Element
Questionnaire.title
  • Added Element
Questionnaire.derivedFrom
  • Added Element
Questionnaire.status
  • Change value set from http://hl7.org/fhir/ValueSet/questionnaire-status to http://hl7.org/fhir/ValueSet/publication-status
Questionnaire.experimental
  • Added Element
Questionnaire.contact
  • Added Element
Questionnaire.useContext
  • Added Element
Questionnaire.jurisdiction
  • Added Element
Questionnaire.description
  • Added Element
Questionnaire.purpose
  • Added Element
Questionnaire.copyright
  • Added Element
Questionnaire.approvalDate
  • Added Element
Questionnaire.lastReviewDate
  • Added Element
Questionnaire.effectivePeriod
  • Added Element
Questionnaire.code
  • Added Element
Questionnaire.item
  • Renamed from group to item
  • Min Cardinality changed from 1 to 0
  • Max Cardinality changed from 1 to *
Questionnaire.item.linkId
  • Min Cardinality changed from 0 to 1
Questionnaire.item.definition
  • Added Element
Questionnaire.item.code
  • Added Element
Questionnaire.item.prefix
  • Added Element
Questionnaire.item.type
  • Added Element
Questionnaire.item.enableWhen
  • Added Element
Questionnaire.item.enableWhen.question
  • Added Element
Questionnaire.item.enableWhen.hasAnswer
  • Added Element
Questionnaire.item.enableWhen.answer[x]
  • Added Element
Questionnaire.item.readOnly
  • Added Element
Questionnaire.item.maxLength
  • Added Element
Questionnaire.item.options
  • Added Element
Questionnaire.item.option
  • Added Element
Questionnaire.item.option.value[x]
  • Added Element
Questionnaire.item.initial[x]
  • Added Element
Questionnaire.item.item
  • Added Element
Questionnaire.telecom
  • deleted
Questionnaire.group.title
  • deleted
Questionnaire.group.concept
  • deleted
Questionnaire.group.group
  • deleted
Questionnaire.group.question
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 6 tests that all execute ok. 4 fail round-trip testing and 5 r3 resources are invalid (109 errors).).

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Questionnaire IDomainResourceA structured set of questions
+ The link ids for groups and questions must be unique within the questionnaire
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriLogical URI to reference this questionnaire (globally unique)
... identifier Σ0..*IdentifierAdditional identifier for the questionnaire
... version Σ0..1stringBusiness version of the questionnaire
... name Σ0..1stringName for this questionnaire (computer friendly)
... title Σ0..1stringName for this questionnaire (human friendly)
... derivedFrom 0..*uriInstantiates protocol or definition
... status ?!Σ1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... experimental ?!Σ0..1booleanFor testing purposes, not real usage
... subjectType Σ0..*codeResource that can be subject of QuestionnaireResponse
ResourceType (Required)
... date Σ0..1dateTimeDate this was last changed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... useContext Σ0..*UsageContextContext the content is intended to support
... jurisdiction Σ0..*CodeableConceptIntended jurisdiction for questionnaire (if applicable)
Jurisdiction ValueSet (Extensible)
... description 0..1markdownNatural language description of the questionnaire
... purpose 0..1markdownWhy this questionnaire is defined
... copyright 0..1markdownUse and/or publishing restrictions
... approvalDate 0..1dateWhen the questionnaire was approved by publisher
... lastReviewDate 0..1dateWhen the questionnaire was last reviewed
... effectivePeriod Σ0..1PeriodWhen the questionnaire is expected to be used
... code Σ0..*CodingConcept that represents the overall questionnaire
Questionnaire Question Codes (Example)
... item I0..*BackboneElementQuestions and sections within the Questionnaire
+ Read-only can't be specified for "display" items
+ Default values can't be specified for groups or display items
+ Required and repeat aren't permitted for display items
+ Only 'choice' items can have options
+ A question cannot have both option and options
+ Display items cannot have a "code" asserted
+ Maximum length can only be declared for simple question types
+ Group items must have nested items, display items cannot have nested items
.... linkId 1..1stringUnique id for item in questionnaire
.... definition 0..1uriElementDefinition - details for the item
.... code ΣI0..*CodingCorresponding concept for this item in a terminology
Questionnaire Question Codes (Example)
.... prefix 0..1stringE.g. "1(a)", "2.5.3"
.... text Σ0..1stringPrimary text for the item
.... type 1..1codegroup | display | boolean | decimal | integer | date | dateTime +
QuestionnaireItemType (Required)
.... enableWhen ?!ΣI0..*BackboneElementOnly allow data when
+ enableWhen must contain either a 'answer' or a 'hasAnswer' element
..... question 1..1stringQuestion that determines whether item is enabled
..... hasAnswer I0..1booleanEnable when answered or not
..... answer[x] I0..1Value question must have
Questionnaire Answer Codes (Example)
...... answerBooleanboolean
...... answerDecimaldecimal
...... answerIntegerinteger
...... answerDatedate
...... answerDateTimedateTime
...... answerTimetime
...... answerStringstring
...... answerUriuri
...... answerAttachmentAttachment
...... answerCodingCoding
...... answerQuantityQuantity
...... answerReferenceReference(Any)
.... required I0..1booleanWhether the item must be included in data results
.... repeats I0..1booleanWhether the item may repeat
.... readOnly I0..1booleanDon't allow human editing
.... maxLength I0..1integerNo more than this many characters
.... options I0..1Reference(ValueSet)Valueset containing permitted answers
.... option I0..*BackboneElementPermitted answer
..... value[x] 1..1Answer value
Questionnaire Answer Codes (Example)
...... valueIntegerinteger
...... valueDatedate
...... valueTimetime
...... valueStringstring
...... valueCodingCoding
.... initial[x] I0..1Default value when item is first rendered
Questionnaire Answer Codes (Example)
..... initialBooleanboolean
..... initialDecimaldecimal
..... initialIntegerinteger
..... initialDatedate
..... initialDateTimedateTime
..... initialTimetime
..... initialStringstring
..... initialUriuri
..... initialAttachmentAttachment
..... initialCodingCoding
..... initialQuantityQuantity
..... initialReferenceReference(Any)
.... item I0..*see itemNested questionnaire items

doco Documentation for this format

UML Diagram (Legend)

Questionnaire (DomainResource)An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this questionnaire is (or will be) published. The URL SHOULD include the major version of the questionnaire. For more information see [Technical and Business Versions](resource.html#versions)url : uri [0..1]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 instanceidentifier : Identifier [0..*]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 sequenceversion : string [0..1]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 generationname : string [0..1]A short, descriptive, user-friendly title for the questionnairetitle : string [0..1]The URL of a Questionnaire that this Questionnaire is based onderivedFrom : uri [0..*]The status of this questionnaire. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « The lifecycle status of a Value Set or Concept Map. (Strength=Required)PublicationStatus! »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 (this element modifies the meaning of other elements)experimental : boolean [0..1]The types of subjects that can be the subject of responses created for the questionnairesubjectType : code [0..*] « One of the resource types defined as part of FHIR. (Strength=Required)ResourceType! »The date (and optionally time) when the questionnaire was published. The date must change if and 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 changesdate : dateTime [0..1]The name of the individual or organization that published the questionnairepublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate questionnaire instancesuseContext : UsageContext [0..*]A legal or geographic region in which the questionnaire is intended to be usedjurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible)Jurisdiction ValueSet+ »A free text natural language description of the questionnaire from a consumer's perspectivedescription : markdown [0..1]Explaination of why this questionnaire is needed and why it has been designed as it haspurpose : markdown [0..1]A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnairecopyright : markdown [0..1]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval, but doesn't change the original approval datelastReviewDate : date [0..1]The period during which the questionnaire content was or is planned to be in active useeffectivePeriod : Period [0..1]An identifier for this question or group of questions in a particular terminology such as LOINCcode : Coding [0..*] « Codes for questionnaires, groups and individual questions (Strength=Example)Questionnaire Question ?? »ItemAn identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resourcelinkId : string [1..1]A reference to an [[[ElementDefinition]]] that provides the details for the item. If a definition is provided, then the following element values can be inferred from the definition: * code (ElementDefinition.code) * type (ElementDefinition.type) * required (ElementDefinition.min) * repeats (ElementDefinition.max) * maxLength (ElementDefinition.maxLength) * options (ElementDefinition.binding) Any information provided in these elements on a Questionnaire Item overrides the information from the definitiondefinition : uri [0..1]A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers)code : Coding [0..*] « Codes for questionnaires, groups and individual questions (Strength=Example)Questionnaire Question ?? »A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaireprefix : string [0..1]The name of a section, the text of a question or text content for a display itemtext : string [0..1]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.)type : code [1..1] « Distinguishes groups from questions and display text and indicates data type for questions (Strength=Required)QuestionnaireItemType! »An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnairerequired : boolean [0..1]An indication, if true, that the item may occur multiple times in the response, collecting multiple answers answers for questions or multiple sets of answers for groupsrepeats : boolean [0..1]An indication, when true, that the value cannot be changed by a human respondent to the QuestionnairereadOnly : boolean [0..1]The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponsemaxLength : integer [0..1]A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" questionoptions : Reference [0..1] « ValueSet »The value that should be defaulted when initially rendering the questionnaire for user inputinitial[x] : Type [0..1] « boolean|decimal|integer|date|dateTime| time|string|uri|Attachment|Coding|Quantity|Reference(Any); Allowed values to answer questions. (Strength=Example) Questionnaire Answer ?? »EnableWhenThe linkId for the question whose answer (or lack of answer) governs whether this item is enabledquestion : string [1..1]An indication that this item should be enabled only if the specified question is answered (hasAnswer=true) or not answered (hasAnswer=false)hasAnswer : boolean [0..1]An answer that the referenced question must match in order for the item to be enabledanswer[x] : Type [0..1] « boolean|decimal|integer|date|dateTime|time| string|uri|Attachment|Coding|Quantity|Reference(Any); Allowed values to answer questions. (Strength=Example) Questionnaire Answer ?? »OptionA potential answer that's allowed as the answer to this questionvalue[x] : Type [1..1] « integer|date|time|string|Coding; Allowed values to answer questions. (Strength=Example) Questionnaire Answer ?? »A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true (this element modifies the meaning of other elements)enableWhen[0..*]One of the permitted answers for a "choice" or "open-choice" questionoption[0..*]Text, questions and other groups to be nested beneath a question or groupitem[0..*]A particular question, question grouping or display text that is part of the questionnaireitem[0..*]

XML Template

<Questionnaire xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Logical URI to reference this questionnaire (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the questionnaire --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the questionnaire -->
 <name value="[string]"/><!-- 0..1 Name for this questionnaire (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this questionnaire (human friendly) -->
 <derivedFrom value="[uri]"/><!-- 0..* Instantiates protocol or definition -->
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <subjectType value="[code]"/><!-- 0..* Resource that can be subject of QuestionnaireResponse -->
 <date value="[dateTime]"/><!-- 0..1 Date this was last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <useContext><!-- 0..* UsageContext Context the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for questionnaire (if applicable) --></jurisdiction>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the questionnaire -->
 <purpose value="[markdown]"/><!-- 0..1 Why this questionnaire is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <approvalDate value="[date]"/><!-- 0..1 When the questionnaire was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the questionnaire was last reviewed -->
 <effectivePeriod><!-- 0..1 Period When the questionnaire is expected to be used --></effectivePeriod>
 <code><!-- 0..* Coding Concept that represents the overall questionnaire --></code>
 <item>  <!-- ?? 0..* Questions and sections within the Questionnaire -->
  <linkId value="[string]"/><!-- 1..1 Unique id for item in questionnaire -->
  <definition value="[uri]"/><!-- 0..1 ElementDefinition - details for the item -->
  <code><!-- ?? 0..* Coding Corresponding concept for this item in a terminology --></code>
  <prefix value="[string]"/><!-- 0..1 E.g. "1(a)", "2.5.3" -->
  <text value="[string]"/><!-- 0..1 Primary text for the item -->
  <type value="[code]"/><!-- 1..1 group | display | boolean | decimal | integer | date | dateTime + -->
  <enableWhen>  <!-- 0..* Only allow data when -->
   <question value="[string]"/><!-- 1..1 Question that determines whether item is enabled -->
   <hasAnswer value="[boolean]"/><!-- ?? 0..1 Enable when answered or not -->
   <answer[x]><!-- ?? 0..1 boolean|decimal|integer|date|dateTime|time|string|uri|
     Attachment|Coding|Quantity|Reference(Any) Value question must have --></answer[x]>
  </enableWhen>
  <required value="[boolean]"/><!-- ?? 0..1 Whether the item must be included in data results -->
  <repeats value="[boolean]"/><!-- ?? 0..1 Whether the item may repeat -->
  <readOnly value="[boolean]"/><!-- ?? 0..1 Don't allow human editing -->
  <maxLength value="[integer]"/><!-- ?? 0..1 No more than this many characters -->
  <options><!-- ?? 0..1 Reference(ValueSet) Valueset containing permitted answers --></options>
  <option>  <!-- ?? 0..* Permitted answer -->
   <value[x]><!-- 1..1 integer|date|time|string|Coding Answer value --></value[x]>
  </option>
  <initial[x]><!-- ?? 0..1 boolean|decimal|integer|date|dateTime|time|string|uri|
    Attachment|Coding|Quantity|Reference(Any) Default value when item is first rendered --></initial[x]>
  <item><!-- ?? 0..* Content as for Questionnaire.item Nested questionnaire items --></item>
 </item>
</Questionnaire>

JSON Template

{doco
  "resourceType" : "Questionnaire",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Logical URI to reference this questionnaire (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the questionnaire
  "version" : "<string>", // Business version of the questionnaire
  "name" : "<string>", // Name for this questionnaire (computer friendly)
  "title" : "<string>", // Name for this questionnaire (human friendly)
  "derivedFrom" : ["<uri>"], // Instantiates protocol or definition
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "subjectType" : ["<code>"], // Resource that can be subject of QuestionnaireResponse
  "date" : "<dateTime>", // Date this was last changed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "useContext" : [{ UsageContext }], // Context the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for questionnaire (if applicable)
  "description" : "<markdown>", // Natural language description of the questionnaire
  "purpose" : "<markdown>", // Why this questionnaire is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the questionnaire was approved by publisher
  "lastReviewDate" : "<date>", // When the questionnaire was last reviewed
  "effectivePeriod" : { Period }, // When the questionnaire is expected to be used
  "code" : [{ Coding }], // Concept that represents the overall questionnaire
  "item" : [{ // C? Questions and sections within the Questionnaire
    "linkId" : "<string>", // R!  Unique id for item in questionnaire
    "definition" : "<uri>", // ElementDefinition - details for the item
    "code" : [{ Coding }], // C? Corresponding concept for this item in a terminology
    "prefix" : "<string>", // E.g. "1(a)", "2.5.3"
    "text" : "<string>", // Primary text for the item
    "type" : "<code>", // R!  group | display | boolean | decimal | integer | date | dateTime +
    "enableWhen" : [{ // Only allow data when
      "question" : "<string>", // R!  Question that determines whether item is enabled
      "hasAnswer" : <boolean>, // C? Enable when answered or not
      // answer[x]: Value question must have. One of these 12:
      "answerBoolean" : <boolean>
      "answerDecimal" : <decimal>
      "answerInteger" : <integer>
      "answerDate" : "<date>"
      "answerDateTime" : "<dateTime>"
      "answerTime" : "<time>"
      "answerString" : "<string>"
      "answerUri" : "<uri>"
      "answerAttachment" : { Attachment }
      "answerCoding" : { Coding }
      "answerQuantity" : { Quantity }
      "answerReference" : { Reference(Any) }
    }],
    "required" : <boolean>, // C? Whether the item must be included in data results
    "repeats" : <boolean>, // C? Whether the item may repeat
    "readOnly" : <boolean>, // C? Don't allow human editing
    "maxLength" : <integer>, // C? No more than this many characters
    "options" : { Reference(ValueSet) }, // C? Valueset containing permitted answers
    "option" : [{ // C? Permitted answer
      // value[x]: Answer value. One of these 5:
      "valueInteger" : <integer>
      "valueDate" : "<date>"
      "valueTime" : "<time>"
      "valueString" : "<string>"
      "valueCoding" : { Coding }
    }],
    // initial[x]: Default value when item is first rendered. One of these 12:
    "initialBoolean" : <boolean>,
    "initialDecimal" : <decimal>,
    "initialInteger" : <integer>,
    "initialDate" : "<date>",
    "initialDateTime" : "<dateTime>",
    "initialTime" : "<time>",
    "initialString" : "<string>",
    "initialUri" : "<uri>",
    "initialAttachment" : { Attachment },
    "initialCoding" : { Coding },
    "initialQuantity" : { Quantity },
    "initialReference" : { Reference(Any) },
    "item" : [{ Content as for Questionnaire.item }] // C? Nested questionnaire items
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Questionnaire;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Questionnaire.url [ uri ]; # 0..1 Logical URI to reference this questionnaire (globally unique)
  fhir:Questionnaire.identifier [ Identifier ], ... ; # 0..* Additional identifier for the questionnaire
  fhir:Questionnaire.version [ string ]; # 0..1 Business version of the questionnaire
  fhir:Questionnaire.name [ string ]; # 0..1 Name for this questionnaire (computer friendly)
  fhir:Questionnaire.title [ string ]; # 0..1 Name for this questionnaire (human friendly)
  fhir:Questionnaire.derivedFrom [ uri ], ... ; # 0..* Instantiates protocol or definition
  fhir:Questionnaire.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:Questionnaire.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  fhir:Questionnaire.subjectType [ code ], ... ; # 0..* Resource that can be subject of QuestionnaireResponse
  fhir:Questionnaire.date [ dateTime ]; # 0..1 Date this was last changed
  fhir:Questionnaire.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:Questionnaire.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:Questionnaire.useContext [ UsageContext ], ... ; # 0..* Context the content is intended to support
  fhir:Questionnaire.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for questionnaire (if applicable)
  fhir:Questionnaire.description [ markdown ]; # 0..1 Natural language description of the questionnaire
  fhir:Questionnaire.purpose [ markdown ]; # 0..1 Why this questionnaire is defined
  fhir:Questionnaire.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions
  fhir:Questionnaire.approvalDate [ date ]; # 0..1 When the questionnaire was approved by publisher
  fhir:Questionnaire.lastReviewDate [ date ]; # 0..1 When the questionnaire was last reviewed
  fhir:Questionnaire.effectivePeriod [ Period ]; # 0..1 When the questionnaire is expected to be used
  fhir:Questionnaire.code [ Coding ], ... ; # 0..* Concept that represents the overall questionnaire
  fhir:Questionnaire.item [ # 0..* Questions and sections within the Questionnaire
    fhir:Questionnaire.item.linkId [ string ]; # 1..1 Unique id for item in questionnaire
    fhir:Questionnaire.item.definition [ uri ]; # 0..1 ElementDefinition - details for the item
    fhir:Questionnaire.item.code [ Coding ], ... ; # 0..* Corresponding concept for this item in a terminology
    fhir:Questionnaire.item.prefix [ string ]; # 0..1 E.g. "1(a)", "2.5.3"
    fhir:Questionnaire.item.text [ string ]; # 0..1 Primary text for the item
    fhir:Questionnaire.item.type [ code ]; # 1..1 group | display | boolean | decimal | integer | date | dateTime +
    fhir:Questionnaire.item.enableWhen [ # 0..* Only allow data when
      fhir:Questionnaire.item.enableWhen.question [ string ]; # 1..1 Question that determines whether item is enabled
      fhir:Questionnaire.item.enableWhen.hasAnswer [ boolean ]; # 0..1 Enable when answered or not
      # Questionnaire.item.enableWhen.answer[x] : 0..1 Value question must have. One of these 12
        fhir:Questionnaire.item.enableWhen.answerBoolean [ boolean ]
        fhir:Questionnaire.item.enableWhen.answerDecimal [ decimal ]
        fhir:Questionnaire.item.enableWhen.answerInteger [ integer ]
        fhir:Questionnaire.item.enableWhen.answerDate [ date ]
        fhir:Questionnaire.item.enableWhen.answerDateTime [ dateTime ]
        fhir:Questionnaire.item.enableWhen.answerTime [ time ]
        fhir:Questionnaire.item.enableWhen.answerString [ string ]
        fhir:Questionnaire.item.enableWhen.answerUri [ uri ]
        fhir:Questionnaire.item.enableWhen.answerAttachment [ Attachment ]
        fhir:Questionnaire.item.enableWhen.answerCoding [ Coding ]
        fhir:Questionnaire.item.enableWhen.answerQuantity [ Quantity ]
        fhir:Questionnaire.item.enableWhen.answerReference [ Reference(Any) ]
    ], ...;
    fhir:Questionnaire.item.required [ boolean ]; # 0..1 Whether the item must be included in data results
    fhir:Questionnaire.item.repeats [ boolean ]; # 0..1 Whether the item may repeat
    fhir:Questionnaire.item.readOnly [ boolean ]; # 0..1 Don't allow human editing
    fhir:Questionnaire.item.maxLength [ integer ]; # 0..1 No more than this many characters
    fhir:Questionnaire.item.options [ Reference(ValueSet) ]; # 0..1 Valueset containing permitted answers
    fhir:Questionnaire.item.option [ # 0..* Permitted answer
      # Questionnaire.item.option.value[x] : 1..1 Answer value. One of these 5
        fhir:Questionnaire.item.option.valueInteger [ integer ]
        fhir:Questionnaire.item.option.valueDate [ date ]
        fhir:Questionnaire.item.option.valueTime [ time ]
        fhir:Questionnaire.item.option.valueString [ string ]
        fhir:Questionnaire.item.option.valueCoding [ Coding ]
    ], ...;
    # Questionnaire.item.initial[x] : 0..1 Default value when item is first rendered. One of these 12
      fhir:Questionnaire.item.initialBoolean [ boolean ]
      fhir:Questionnaire.item.initialDecimal [ decimal ]
      fhir:Questionnaire.item.initialInteger [ integer ]
      fhir:Questionnaire.item.initialDate [ date ]
      fhir:Questionnaire.item.initialDateTime [ dateTime ]
      fhir:Questionnaire.item.initialTime [ time ]
      fhir:Questionnaire.item.initialString [ string ]
      fhir:Questionnaire.item.initialUri [ uri ]
      fhir:Questionnaire.item.initialAttachment [ Attachment ]
      fhir:Questionnaire.item.initialCoding [ Coding ]
      fhir:Questionnaire.item.initialQuantity [ Quantity ]
      fhir:Questionnaire.item.initialReference [ Reference(Any) ]
    fhir:Questionnaire.item.item [ See Questionnaire.item ], ... ; # 0..* Nested questionnaire items
  ], ...;
]

Changes since DSTU2

Questionnaire
Questionnaire.url
  • Added Element
Questionnaire.name
  • Added Element
Questionnaire.title
  • Added Element
Questionnaire.derivedFrom
  • Added Element
Questionnaire.status
  • Change value set from http://hl7.org/fhir/ValueSet/questionnaire-status to http://hl7.org/fhir/ValueSet/publication-status
Questionnaire.experimental
  • Added Element
Questionnaire.contact
  • Added Element
Questionnaire.useContext
  • Added Element
Questionnaire.jurisdiction
  • Added Element
Questionnaire.description
  • Added Element
Questionnaire.purpose
  • Added Element
Questionnaire.copyright
  • Added Element
Questionnaire.approvalDate
  • Added Element
Questionnaire.lastReviewDate
  • Added Element
Questionnaire.effectivePeriod
  • Added Element
Questionnaire.code
  • Added Element
Questionnaire.item
  • Renamed from group to item
  • Min Cardinality changed from 1 to 0
  • Max Cardinality changed from 1 to *
Questionnaire.item.linkId
  • Min Cardinality changed from 0 to 1
Questionnaire.item.definition
  • Added Element
Questionnaire.item.code
  • Added Element
Questionnaire.item.prefix
  • Added Element
Questionnaire.item.type
  • Added Element
Questionnaire.item.enableWhen
  • Added Element
Questionnaire.item.enableWhen.question
  • Added Element
Questionnaire.item.enableWhen.hasAnswer
  • Added Element
Questionnaire.item.enableWhen.answer[x]
  • Added Element
Questionnaire.item.readOnly
  • Added Element
Questionnaire.item.maxLength
  • Added Element
Questionnaire.item.options
  • Added Element
Questionnaire.item.option
  • Added Element
Questionnaire.item.option.value[x]
  • Added Element
Questionnaire.item.initial[x]
  • Added Element
Questionnaire.item.item
  • Added Element
Questionnaire.telecom
  • deleted
Questionnaire.group.title
  • deleted
Questionnaire.group.concept
  • deleted
Questionnaire.group.group
  • deleted
Questionnaire.group.question
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 6 tests that all execute ok. 4 fail round-trip testing and 5 r3 resources are invalid (109 errors).).

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron + JSON Schema, ShEx (for Turtle)

PathDefinitionTypeReference
Questionnaire.status The lifecycle status of a Value Set or Concept Map.RequiredPublicationStatus
Questionnaire.subjectType One of the resource types defined as part of FHIR.RequiredResource Types
Questionnaire.jurisdiction Countries and regions within which this artifact is targeted for useExtensibleJurisdiction ValueSet
Questionnaire.code
Questionnaire.item.code
Codes for questionnaires, groups and individual questionsExampleQuestionnaire Question Codes
Questionnaire.item.type Distinguishes groups from questions and display text and indicates data type for questionsRequiredQuestionnaireItemType
Questionnaire.item.enableWhen.answer[x]
Questionnaire.item.initial[x]
Allowed values to answer questions.ExampleQuestionnaire Answer Codes
Questionnaire.item.option.value[x] Allowed values to answer questions.ExampleQuestionnaire Answer Codes

  • que-1: On Questionnaire.item: Group items must have nested items, display items cannot have nested items (expression on Questionnaire.item: (type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty()))
  • que-10: On Questionnaire.item: Maximum length can only be declared for simple question types (expression on Questionnaire.item: (type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url')) or maxLength.empty())
  • que-2: The link ids for groups and questions must be unique within the questionnaire (expression : descendants().linkId.isDistinct())
  • que-3: On Questionnaire.item: Display items cannot have a "code" asserted (expression on Questionnaire.item: type!='display' or code.empty())
  • que-4: On Questionnaire.item: A question cannot have both option and options (expression on Questionnaire.item: option.empty() or options.empty())
  • que-5: On Questionnaire.item: Only 'choice' items can have options (expression on Questionnaire.item: (type ='choice' or type = 'open-choice') or (options.empty() and option.empty()))
  • que-6: On Questionnaire.item: Required and repeat aren't permitted for display items (expression on Questionnaire.item: type!='display' or (required.empty() and repeats.empty()))
  • que-7: On Questionnaire.item.enableWhen: enableWhen must contain either a 'answer' or a 'hasAnswer' element (expression on Questionnaire.item.enableWhen: hasAnswer.exists() xor answer.exists())
  • que-8: On Questionnaire.item: Default values can't be specified for groups or display items (expression on Questionnaire.item: (type!='group' and type!='display') or initial.empty())
  • que-9: On Questionnaire.item: Read-only can't be specified for "display" items (expression on Questionnaire.item: type!='display' or readOnly.empty())
  • Questionnaires may be used to represent predefined forms or panels, referenced using items of type "group"
  • Questions may be nested. The Questionnaire resource supports nested items beneath both items of type "group" (which doesn't capture an answer of its own) as well as beneath questions
  • Groups and Questions may have linkIds allowing groups and question answers captured in a QuestionnaireResponse to be associated with their corresponding group or question.
  • Questionnaire allows for flexible naming and structuring of its contents to reflect the flexible and varying nature of forms and questionnaires. It explicitly does not try to standardize or streamline exchange of its contents outside its context of use, although exchanging partners may further constrain its structure and flexibility using profiles to define standardized, reusable forms.
  • Because of the lack of explicit support for Questionnaires in HL7 v3 , CDA Documents frequently used named sections with Observations to model Questionnaires. Such use cases should now use the Questionnaire Resource instead.
  • The order of questions within groups, groups within groups and groups within questions is relevant and must be retained for display and capture.
  • Display items allow the inclusion of instructions, background information and similar content within a questionnaire.

There is considerable overlap between the information covered by Questionnaires and other Resources (especially FamilyMemberHistory, MedicationStatement, Observation, Procedure, etc.). Questionnaire's flexible structure can easily be misused to capture any data, even data that should be captured as separate Resources. The choice between using Questionnaires or separate Resources may be dictated by the procedure of collection and recording; e.g. if the data is captured as a physician-agreed (electronic) form, it might be impossible or undesirable to distill separate resources from it and capturing the data in a Questionnaire would be most appropriate.

However, data captured only in Questionnaires can be difficult to query after-the-fact. Queries against other Resources will not return data captured only in Questionnaires, and querying against Questionnaires directly may not find all desired data, depending on how the questions may have been phrased or encoded over time or by different clinicians. Moreover, interoperability of such Questionnaires is limited, as interpretation of its contents is only known to the circle of parties that were involved in its definition: encoding data from such Questionnaires using more specific resources increases the availability of the information they contain.

It is entirely possible for data to exist in both QuestionnaireResponse and in other resources. For example, data may be captured in QuestionnaireResponse as part of an intake questionnaire. That data may then be propagated into the Patient resource (demographics), FamilyMemberHistory, AllergyIntolerance, MedicationStatement and Observation resources to allow the data to be queried and analyzed. The original QuestionnaireResponse instance can be retained for traceability purposes. If desired, a Provenance resource can be used to identify the Questionnaire as the data source for the other resources. For example, if a questionnaire question asks "what is your weight", an Observation with the appropriate Observation.code and the specified answer as the Observation.valueQuantity can be created.

A Questionnaire is built out of two components, Questionnaire and item:

  • The main component is Questionnaire, which holds information about the Questionnaire, like the identifier, publisher, date authored, title, etc. The Questionnaire contains zero or more items which define the content of the questionnaire (zero items allows for the possibility of narrative-only questionnaires, though these provide little computable information).
  • Items have one of three sub-types, distinguished by the type element:
    • display items convey text to be rendered on the form that won't capture data and which won't contain nested items. This might include copyright or authorship information, instructions or other background information.
    • group items organize content of the questionnaire into sections, sub-sections, etc. Groups don't have answers associated with them directly, but generally contain child 'question' items which do.
    • question items ask a specific question to which an answer may be given. There isn't a single type for question items. Instead, the type conveys the data type of the answer for the question. If an item isn't a 'display' or a 'group', then it's a question which allows a particular type of answer to be gathered. Questions may also have nested content - groups and/or other questions. This way, one can model "panels" of questions which would only be relevant (and thus would only be displayed) depending on the answers of a parent question; e.g. a question "Did the patient receive treatment in the past six months?" would contain a nested group of questions asking for further details about the treatment. See an example from the Australian New South Wales blue book

Specific controls on dynamic display of groups, questions, etc. based on the answers to other questions is outside the scope of the base resource and are handled using extensions.

There are three different "identifying" elements within Questionnaire: identifier, id and linkId. Each serves very distinct purposes:

  • The identifier element is used to reference the overall questionnaire in business terms. It is the number printed across the top of the form or listed beside the form when making a choice between alternate forms.
  • The id attribute supported on each element is used for references within a resource, for example linking narrative to discrete elements. Ids are not generally displayed to end users
  • The linkId element on questions and groups establishes a link between elements in a QuestionnaireResponse and their definition inside a Questionnaire. This is the only way to link between the groups and questions in a Questionnaire and QuestionnaireResponse. These are also not displayed to end users

Questionnaires can be crafted using any questions the author can conceive and can be phrased in whatever manner is appropriate or convenient. However, standardization of questions and the constraints enforced on the accompanying answers increases the ability to compare data gathered across questionnaires. Items can be directly linked to an ElementDefinition using Questionnaire.item.definition which provides details for the item. If a definition is provided, then the following element values can be derived from the definition:

  • concept (from ElementDefinition.code)
  • type (from ElementDefinition.type)
  • required (from ElementDefinition.min)
  • repeats (from ElementDefinition.max)
  • maxLength (from ElementDefinition.maxLength)
  • options (from ElementDefinition.binding)

Any information provided in these elements overrides the information from the definition. The url refers to a an ElementDefinition in StructureDefinition, and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id (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.

The definitions may also be used to automatically pre-populate answers, or extract data from a corresponding QuestionnaireResponse resource.

NOTE: Even if a standard question definition is provided , information such as the question text, data type and value set SHOULD still be declared for the question. Systems processing the questionnaire may not have access to or support the ability to look up the question definitions from external sources. If the information is not included in-line within the questionnaire, other systems may not be able to render or use the Questionnaire.

If an external definition is included along with question information such as question text, data type or value set, it is expected that the content for the question and the referenced definition would be in alignment. However, FHIR does not dictate what degree of alignment is required; e.g. Does the question text need to match exactly? Is it legitimate for a question to constrain the allowed value set of possible answers? These rules will need to be established within implementation environments.

The codes for the data type for each question are slightly different than the data types allowed in the QuestionnaireResponse resource. Where the names are the same (ignoring case), the "answer" must use the specified type. Where the names are different, the mappings are as follows:

Questionnaire AnswerFormat code QuestionnaireResponse data type
text string
url uri
choice Coding
open-choice Coding (if choosing from one of the listed choices) or string (if a different value is provided)

Many questionnaires place constraints on the allowed list of values for a given question. FHIR supports this notion through the item.options or the item.option element.

The "option" mechanism is simplest - all options are listed in-line with the question using the item.option element. Maintenance of the set of permitted question answers involves maintenance of the questionnaire itself.

The "options" mechanism is more sophisticated. Rather than listing the options directly, the item.options element points to a ValueSet resource. This approach adds complexity for questionnaires having a simple list of strings as choices for a question, but provides several benefits, including:

  • Questionnaires that reference codes from externally defined code systems have a means of doing so
  • Answer sets can be shared across questions (and there are many questionnaires where this capability is useful)
  • The full capability of value sets can be brought into play, including the ability to use ConceptMap to link and translate from questionnaire-specific codes to other codes, the use of multiple display names (e.g. different languages), the ability to use coded ordinals, and the ability to allow choices from larger value sets (e.g. "all SNOMED CT procedure codes")

In many cases, the set of code choices will be specific to a given questionnaire and should be maintained as part of the questionnaire. In this case, the referenced ValueSet can be included as a contained resource. All contained ValueSets are listed together and then are referenced by the individual questions as necessary. Alternatively, the item.options element can reference the value set in a version-specific manner. This ensures that the Questionnaire will not adopt a new version of the referenced value set without revising the Questionnaire to point to that new version - putting the author of the Questionnaire in control of any changes.

Many questions have a common set of possible codes for their answer. These value sets may be useful to help, and when referenced by full URL, do not need to be provided as part of the questionnaire:

In some questionnaires, it may be possible to respond to a question with multiple types of answers. For example, capturing a coded answer plus free text, capturing a coded value plus a numeric priority, etc. In FHIR, this is handled through nested questions. Each question has a single data type. However, each question can have nested child questions. These nested child questions can have text (e.g. "Please specify") or can have no text at all if the appropriate guidance is provided by the parent question or group.

Many questionnaires involve computations on questionnaire answers, e.g. tabulating scores. To help with associating numeric values to coded answers, there are two extensions defined - one for defining the numeric weighting of a code defined in a value set - valueset-ordinalValue and the other for defining a code that can appear within a Coding itself - iso21090-CO-value.

In addition, there are extensions for defining the dynamic value of an element usings expressions. For more information, see the Using Expressions and Documentation Template topics in the Clinical Reasoning module.

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
codetokenA code that corresponds to one of its items in the questionnaireQuestionnaire.item.code
datedateThe questionnaire publication dateQuestionnaire.date
descriptionstringThe description of the questionnaireQuestionnaire.description
effectivedateThe time during which the questionnaire is intended to be in useQuestionnaire.effectivePeriod
identifiertokenExternal identifier for the questionnaireQuestionnaire.identifier
jurisdictiontokenIntended jurisdiction for the questionnaireQuestionnaire.jurisdiction
namestringComputationally friendly name of the questionnaireQuestionnaire.name
publisherstringName of the publisher of the questionnaireQuestionnaire.publisher
statustokenThe current status of the questionnaireQuestionnaire.status
titlestringThe human-friendly name of the questionnaireQuestionnaire.title
urluriThe uri that identifies the questionnaireQuestionnaire.url
versiontokenThe business version of the questionnaireQuestionnaire.version