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 2.2.0-ballot 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: Home Oxygen Therapy Order Template

Official URL: http://hl7.org/fhir/us/davinci-dtr/Questionnaire/home-o2-std-questionnaire Version: 2.2.0-ballot
Standards status: Informative Draft as of 2020-01-13 Computable Name: HomeOxygenTherapyStdQuestionnaire

LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. HomeOxygenTherapyStdQuestionnaire Questionnaire http://hl7.org/fhir/us/davinci-dtr/Questionnaire/home-o2-std-questionnaire#2.2.0-ballot
... 1 Patient Information 0..1 group
.... 1.1 Last Name 1..1 string
.... 1.2 Fist Name 1..1 string
.... 1.3 Middle Name 0..1 string
.... 1.gender What is this person's gender? 1..1 choice Definition: Demographics.sex
Value Set: Patient relationship type
.... 1.4 Postal Code (A1A 1A1) 0..1 string
.... 1.5 Enter your weight in lb 0..1 decimal
.... 1.6 Attach latest x-ray 0..1 attachment
... 2 Calculation 0..1 group
.... 2.1 Deadline for submission (7 days from now) 0..1 date iconicon

doco Documentation for this format

Patient Information

  • linkId: 1

Last Name*

  • linkId: 1.1

Fist Name*

  • linkId: 1.2

Middle Name

  • linkId: 1.3

What is this person's gender?*

Postal Code (A1A 1A1)

  • linkId: 1.4

Enter your weight in lb

  • linkId: 1.5

Attach latest x-ray

  • linkId: 1.6

Calculation

  • linkId: 2

Deadline for submission (7 days from now)

  • linkId: 2.1

Test this Questionnaire

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    Responses for this Questionnaire