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

## Questionnaire: Adaptive Home Oxygen Therapy Order Template

Standards status: Informative as of 2020-01-16 | Computable Name: HomeOxygenTherapyAdaptiveQuestionnaire

- Tree view
- Sample Rendering
- Form Logic

Profile: DTR Questionnaire for adaptive form

Structure

LinkID | Text | Cardinality | Type | Description & Constraints
--- | --- | --- | --- | ---
HomeOxygenTherapyAdaptiveQuestionnaire |  |  | Questionnaire | http://example.com/fhir/questionnaire
1 | Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy) | 1..1 | text |
2 | Order Reason | 1..1 | choice | Options: 4 options
Documentation for this format

Options Sets

Answer options for 2

- http://example.org#1 ("Initial or original order for certification")
- http://example.org#2 ("Change in status")
- http://example.org#3 ("Revision or change in equipment")
- http://example.org#4 ("Replacement")

Profile: DTR Questionnaire for adaptive form

Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)*

- linkId: 1

Order Reason*

- linkId: 2
- Answers: 4 options

Profile: DTR Questionnaire for adaptive form

LinkID | Description & Constraints
--- | ---
1 |
2 | Options: 4 options
Documentation for this format

### Test this Questionnaire

Try this questionnaire out:

- NLM Forms Library

### Responses for this Questionnaire

There are currently no QuestionnaireResponse instances for this Questionnaire defined in this IG.