Da Vinci - Documentation Templates and Rules
2.2.0 - STU 2.2

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 2.2.0 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

## : home-o2-adaptive-questionnaireresponse

Page standards status: Informative

Raw json | Download

    {
      "resourceType" : "QuestionnaireResponse",
      "id" : "home-o2-adaptive-questionnaireresponse",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse-adapt"
        ]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse home-o2-adaptive-questionnaireresponse</b></p><a name=\"home-o2-adaptive-questionnaireresponse\"> </a><a name=\"hchome-o2-adaptive-questionnaireresponse\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-dtr-questionnaireresponse-adapt.html\">DTR Questionnaire Response for adaptive form</a></p></div><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Definition</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Answer</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireResponseRoot\" class=\"hierarchy\"/> home-o2-adaptive-questionnaireresponse</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire:#home-o2-adaptive-questionnaire</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">diagnosis</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Order Reason</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span>example.org: 4 (Replacement)</span></span></td></tr>\r\n<tr><td colspan=\"4\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
      },
      "contained" : [
        {
          "resourceType" : "Questionnaire",
          "id" : "home-o2-adaptive-questionnaire",
          "meta" : {
            "profile" : [
              🔗 "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt"
            ]
          },
          "text" : {
            "status" : "generated",
            "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Example adaptive questionnaire contained in a QuestionnaireResposne</div>"
          },
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive",
              "valueUrl" : "http://example.com/fhir/R4"
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/request-specific",
              "valueBoolean" : false
            }
          ],
          "url" : "http://example.com/fhir/questionnaire",
          "name" : "HomeOxygenTherapyAdaptiveQuestionnaire",
          "title" : "Adaptive Home Oxygen Therapy Order Template",
          "derivedFrom" : [
            🔗 "http://hl7.org/fhir/us/davinci-dtr/dtr-questionnaire"
          ],
          "status" : "draft",
          "subjectType" : [
            "Patient"
          ],
          "date" : "2020-01-16T00:00:00+00:00",
          "publisher" : "Da Vinci DTR",
          "contact" : [
            {
              "name" : "Example Author"
            }
          ],
          "item" : [
            {
              "linkId" : "1",
              "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
              "type" : "text",
              "required" : true
            },
            {
              "linkId" : "2",
              "text" : "Order Reason",
              "type" : "choice",
              "required" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://example.org",
                    "code" : "1",
                    "display" : "Initial or original order for certification"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://example.org",
                    "code" : "2",
                    "display" : "Change in status"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://example.org",
                    "code" : "3",
                    "display" : "Revision or change in equipment"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://example.org",
                    "code" : "4",
                    "display" : "Replacement"
                  }
                }
              ]
            }
          ]
        }
      ],
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-coverage",
          "valueReference" : {
            🔗 "reference" : "Coverage/CoverageExample"
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/intendedUse",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes",
                "code" : "withorder",
                "display" : "Include with order"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context",
          "valueReference" : {
            🔗 "reference" : "ServiceRequest/ServiceRequestExample"
          }
        }
      ],
      "questionnaire" : "#home-o2-adaptive-questionnaire",
      "status" : "completed",
      "subject" : {
        🔗 "reference" : "Patient/examplepatient",
        "display" : "Vlad"
      },
      "authored" : "2022-01-26T20:36:57.544Z",
      "item" : [
        {
          "linkId" : "1",
          "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
          "answer" : [
            {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "source",
                      "valueCode" : "auto-server"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                }
              ],
              "valueString" : "diagnosis"
            }
          ]
        },
        {
          "linkId" : "2",
          "text" : "Order Reason",
          "answer" : [
            {
              "extension" : [
                {
                  "extension" : [
                    {
                      "url" : "source",
                      "valueCode" : "auto-server"
                    }
                  ],
                  "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                }
              ],
              "valueCoding" : {
                "system" : "http://example.org",
                "code" : "4",
                "display" : "Replacement"
              }
            }
          ]
        }
      ]
    }