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

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    <QuestionnaireResponse xmlns="http://hl7.org/fhir">
      <id value="home-o2-adaptive-questionnaireresponse"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse-adapt"/>
      </meta>
      <language value="en"/>
      <text>
        <status value="generated"/>
        <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>
    <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>
    <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>
    <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>
      </text>
      <contained>
        <Questionnaire>
          <id value="home-o2-adaptive-questionnaire"/>
          <meta>
            <profile
                     value="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaire-adapt"/>
          </meta>
          <text>
            <status value="generated"/>
            <div xmlns="http://www.w3.org/1999/xhtml">Example adaptive questionnaire contained in a QuestionnaireResposne</div>
          </text>
          <extension
                     url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive">
            <valueUrl value="http://example.com/fhir/R4"/>
          </extension>
          <extension
                     url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/request-specific">
            <valueBoolean value="false"/>
          </extension>
          <url value="http://example.com/fhir/questionnaire"/>
          <name value="HomeOxygenTherapyAdaptiveQuestionnaire"/>
          <title value="Adaptive Home Oxygen Therapy Order Template"/>
          <derivedFrom
                       value="http://hl7.org/fhir/us/davinci-dtr/dtr-questionnaire"/>
          <status value="draft"/>
          <subjectType value="Patient"/>
          <date value="2020-01-16T00:00:00+00:00"/>
          <publisher value="Da Vinci DTR"/>
          <contact>
            <name value="Example Author"/>
          </contact>
          <item>
            <linkId value="1"/>
            <text
                  value="Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)"/>
            <type value="text"/>
            <required value="true"/>
          </item>
          <item>
            <linkId value="2"/>
            <text value="Order Reason"/>
            <type value="choice"/>
            <required value="true"/>
            <answerOption>
              <valueCoding>
                <system value="http://example.org"/>
                <code value="1"/>
                <display value="Initial or original order for certification"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://example.org"/>
                <code value="2"/>
                <display value="Change in status"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://example.org"/>
                <code value="3"/>
                <display value="Revision or change in equipment"/>
              </valueCoding>
            </answerOption>
            <answerOption>
              <valueCoding>
                <system value="http://example.org"/>
                <code value="4"/>
                <display value="Replacement"/>
              </valueCoding>
            </answerOption>
          </item>
        </Questionnaire>
      </contained>
      <extension
                 url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-coverage">
        <valueReference>🔗
          <reference value="Coverage/CoverageExample"/>
        </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/coverage-information-codes"/>
            <code value="withorder"/>
            <display value="Include with order"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context">
        <valueReference>🔗
          <reference value="ServiceRequest/ServiceRequestExample"/>
        </valueReference>
      </extension>
      <questionnaire value="#home-o2-adaptive-questionnaire"/>
      <status value="completed"/>
      <subject>🔗
        <reference value="Patient/examplepatient"/>
        <display value="Vlad"/>
      </subject>
      <authored value="2022-01-26T20:36:57.544Z"/>
      <item>
        <linkId value="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-server"/>
            </extension>
          </extension>
          <valueString value="diagnosis"/>
        </answer>
      </item>
      <item>
        <linkId value="2"/>
        <text value="Order Reason"/>
        <answer>
          <extension
                     url="http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin">
            <extension url="source">
              <valueCode value="auto-server"/>
            </extension>
          </extension>
          <valueCoding>
            <system value="http://example.org"/>
            <code value="4"/>
            <display value="Replacement"/>
          </valueCoding>
        </answer>
      </item>
    </QuestionnaireResponse>