Da Vinci - Documentation Templates and Rules
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Da Vinci - Documentation Templates and Rules, published by HL7 International / Clinical Decision Support. 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-dtr/ and changes regularly. See the Directory of published versions

: $next-question Output Parameters Example - XML Representation

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<Parameters xmlns="http://hl7.org/fhir">
  <id value="NextQuestionOutputParamsExample"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-next-question-output-parameters"/>
  </meta>
  <parameter>
    <name value="out"/>
    <resource>
      <QuestionnaireResponse>
        <id value="home-o2-questionnaireresponse"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse"/>
        </meta>
        <extension
                   url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context">
          <valueReference>🔗 
            <reference value="Coverage/CoverageExample"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context">
          <valueReference>🔗 
            <reference value="ServiceRequest/ServiceRequestExample"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/intendedUse">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"/>
              <code value="withorder"/>
              <display value="Include with order"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <questionnaire
                       value="http://hl7.org/fhir/us/davinci-dtr/Questionnaire/referred-questionnaire"/>
        <status value="completed"/>
        <subject>🔗 
          <reference value="Patient/examplepatient"/>
          <display value="Vlad"/>
        </subject>
        <authored value="2023-08-21"/>
        <item>
          <linkId value="1"/>
          <text value="Patient Information"/>
          <item>
            <linkId value="1.1"/>
            <text value="Last Name but Different This Time"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="override"/>
                </extension>
                <extension url="author">
                  <extension url="role">
                    <valueCodeableConcept>
                      <coding>
                        <system
                                value="http://terminology.hl7.org/CodeSystem/practitioner-role"/>
                        <code value="doctor"/>
                        <display value="Doctor"/>
                      </coding>
                    </valueCodeableConcept>
                  </extension>
                  <extension url="practitioner">
                    <valueReference>🔗 
                      <reference value="Practitioner/PractitionerExample"/>
                      <display value="Dr. Jane Doe"/>
                    </valueReference>
                  </extension>
                </extension>
              </extension>
              <valueString value="Quinton"/>
            </answer>
          </item>
          <item>
            <linkId value="1.2"/>
            <text value="First Name"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="Vlad"/>
            </answer>
          </item>
          <item>
            <linkId value="1.3"/>
            <text value="Middle Initial"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="A, N"/>
            </answer>
          </item>
          <item>
            <linkId value="1.4"/>
            <text value="Date Of Birth"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueDate value="1956-12-01"/>
            </answer>
          </item>
          <item>
            <linkId value="1.5"/>
            <text value="Gender"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueCoding>
                <system value="http://hl7.org/fhir/administrative-gender"/>
                <code value="male"/>
                <display value="Male"/>
              </valueCoding>
            </answer>
          </item>
          <item>
            <linkId value="1.6"/>
            <text value="Medicare ID"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="10A3D58WH22"/>
            </answer>
          </item>
        </item>
        <item>
          <linkId value="2"/>
          <text value="Provider who is performing face-to-face evaluation"/>
          <item>
            <linkId value="2.1"/>
            <text value="Last Name"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="Doe"/>
            </answer>
          </item>
          <item>
            <linkId value="2.2"/>
            <text value="First Name"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="Jane"/>
            </answer>
          </item>
          <item>
            <linkId value="2.3"/>
            <text value="Middle Initial"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="B"/>
            </answer>
          </item>
          <item>
            <linkId value="2.4"/>
            <text value="NPI"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="1122334455"/>
            </answer>
          </item>
          <item>
            <linkId value="2.5"/>
            <text value="Date of Face-To-Face Evaluation"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="override"/>
                </extension>
                <extension url="author">
                  <extension url="role">
                    <valueCodeableConcept>
                      <coding>
                        <system
                                value="http://terminology.hl7.org/CodeSystem/practitioner-role"/>
                        <code value="doctor"/>
                        <display value="Doctor"/>
                      </coding>
                    </valueCodeableConcept>
                  </extension>
                  <extension url="practitioner">
                    <valueReference>🔗 
                      <reference value="Practitioner/PractitionerExample"/>
                      <display value="Dr. Jane Doe"/>
                    </valueReference>
                  </extension>
                </extension>
              </extension>
              <valueDate value="2019-07-18"/>
            </answer>
          </item>
          <item>
            <linkId value="2.6"/>
            <text value="Record"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/containedReference">
                <valueBoolean value="false"/>
              </extension>
              <valueReference>🔗 
                <reference value="Patient/examplepatient"/>
                <display value="Mr. Saul Moki"/>
              </valueReference>
            </answer>
          </item>
        </item>
        <item>
          <linkId value="3"/>
          <text value="Coverage Requirements"/>
          <item>
            <linkId value="3.1"/>
            <text
                  value="Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="313296004"/>
                <display value="Mild chronic obstructive pulmonary disease"/>
              </valueCoding>
            </answer>
          </item>
          <item>
            <linkId value="3.2"/>
            <text
                  value="Arterial oxygen saturation (Patient on room air while at rest and awake when tested)"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueQuantity>
                <value value="95"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="mm[Hg]"/>
              </valueQuantity>
            </answer>
          </item>
          <item>
            <linkId value="3.3"/>
            <text
                  value="Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueQuantity>
                <value value="83"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="mm[Hg]"/>
              </valueQuantity>
            </answer>
          </item>
          <item>
            <linkId value="3.4"/>
            <text
                  value="Arterial oxygen saturation (Patient tested during exercise)"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueQuantity>
                <value value="95"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="mm[Hg]"/>
              </valueQuantity>
            </answer>
          </item>
          <item>
            <linkId value="3.5"/>
            <text
                  value="Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueQuantity>
                <value value="78"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="mm[Hg]"/>
              </valueQuantity>
            </answer>
          </item>
          <item>
            <linkId value="3.6"/>
            <text
                  value="Is there a documented improvement of hypoxemia during exercise with oxygen?"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueBoolean value="true"/>
            </answer>
          </item>
        </item>
        <item>
          <linkId value="4"/>
          <text value="Prescribed Use"/>
          <item>
            <linkId value="4.1"/>
            <text value="Start date"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueDate value="2019-07-18"/>
            </answer>
          </item>
          <item>
            <linkId value="4.2"/>
            <text value="Length of need: (months) (99 = lifetime)"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueQuantity>
                <value value="99"/>
              </valueQuantity>
            </answer>
          </item>
          <item>
            <linkId value="4.3"/>
            <text value="Peak Flow Rate"/>
            <item>
              <linkId value="4.3.1"/>
              <text value="LPM"/>
              <answer>
                <extension
                           url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                  <extension url="source">
                    <valueCode value="auto"/>
                  </extension>
                </extension>
                <valueQuantity>
                  <value value="2"/>
                </valueQuantity>
              </answer>
            </item>
            <item>
              <linkId value="4.3.2"/>
              <text value="oxygen %"/>
              <answer>
                <extension
                           url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                  <extension url="source">
                    <valueCode value="auto"/>
                  </extension>
                </extension>
                <valueQuantity>
                  <value value="98"/>
                </valueQuantity>
              </answer>
            </item>
          </item>
          <item>
            <linkId value="4.4"/>
            <text value="Average Flow Rate"/>
            <item>
              <linkId value="4.4.1"/>
              <text value="LPM"/>
              <answer>
                <extension
                           url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                  <extension url="source">
                    <valueCode value="auto"/>
                  </extension>
                </extension>
                <valueQuantity>
                  <value value="2"/>
                </valueQuantity>
              </answer>
            </item>
            <item>
              <linkId value="4.4.2"/>
              <text value="oxygen %"/>
              <answer>
                <extension
                           url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                  <extension url="source">
                    <valueCode value="auto"/>
                  </extension>
                </extension>
                <valueQuantity>
                  <value value="97"/>
                </valueQuantity>
              </answer>
            </item>
          </item>
          <item>
            <linkId value="4.5"/>
            <text value="Frequency of use (choose all that apply)"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString value="At rest and awake"/>
            </answer>
          </item>
        </item>
        <item>
          <linkId value="5"/>
          <text value="Oxygen Supply Order Details"/>
          <item>
            <linkId value="5.1"/>
            <text value="Current Order Description"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueString
                           value="HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental"/>
            </answer>
          </item>
          <item>
            <linkId value="5.1b"/>
            <text value="Current Order Is For A Portable Device"/>
          </item>
          <item>
            <linkId value="5.2"/>
            <text value="Type"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueCoding>
                <system value="http://example.org"/>
                <code value="122"/>
                <display value="Compressed Gas"/>
              </valueCoding>
            </answer>
          </item>
          <item>
            <linkId value="5.3"/>
            <text value="Means of oxygen delivery and accessories"/>
            <answer>
              <extension
                         url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
                <extension url="source">
                  <valueCode value="auto"/>
                </extension>
              </extension>
              <valueCoding>
                <system value="http://example.org"/>
                <code value="134"/>
                <display value="Mask"/>
              </valueCoding>
            </answer>
          </item>
        </item>
      </QuestionnaireResponse>
    </resource>
  </parameter>
</Parameters>