Da Vinci - Documentation Templates and Rules
2.2.0 - STU 2.2 United States of America flag

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: Home Oxygen Therapy Order Template

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

doco Documentation for this format

Patient Information

  • linkId: 1
  • Answers:

Last Name*

  • linkId: 1.1
  • Answers:

Fist Name*

  • linkId: 1.2
  • Answers:

Middle Name

  • linkId: 1.3
  • Answers:

What is this person's gender?*

Date Of Birth

  • linkId: 1.4
  • Answers:

Enter your weight in lb

  • linkId: 1.5
  • Answers:

Attach latest x-ray

  • linkId: 1.6
  • Answers:

Calculation

  • linkId: 2
  • Answers:

Deadline for submission (7 days from now)

  • linkId: 2.1
  • Answers:

LinkIDDescription & Constraintsdoco
.. 1 Value Set:
... 1.1 Value Set:
... 1.2 Value Set:
... 1.3 Value Set:
... 1.4 Value Set:
... 1.5 Value Set:
... 1.6 Value Set:
.. 2 Value Set:
... 2.1 Value Set:

doco Documentation for this format

Test this Questionnaire

Try this questionnaire out:

Responses for this Questionnaire

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