Structured Data Capture, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/sdc/ and changes regularly. See the Directory of published versions
Page standards status: Informative |
Contents:
Below are some examples that demonstrate how the elements and extensions in this implementation guide are intended to be used in a Questionnaire.
Note: The rendering of the questions in the "Sample Question" tab are not functional (i.e. no validations after entry, perform actual computations, etc). They only provide a visual presentation of the questions and do not mimic
how they will work in an actual questionnaire.
To display a question text in green. (Example Questionnaire)
Enter your First Name
{
"resourceType" : "BackboneElement",
"linkId" : "1.1",
"text" : "Enter your First Name",
"_text" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString" : "color:green;"
}
]
},
"type" : "string"
}
To allow different styles to different portions of a question text. (Example Questionnaire)
Please answer Yes or No to each of the following questions:
{
"resourceType" : "BackboneElement",
"linkId" : "1.2",
"text" : "Please answer Yes or No to each of the following questions:",
"_text" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString" : "Please answer Yes or No to each of the following questions:"
}
]
},
"type" : "display"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<linkId value="1.2"/>
<text value="Please answer Yes or No to each of the following questions:">
<extension url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="Please answer Yes or No to each of the following questions:"/>
</extension>
</text>
<type value="display"/>
</BackboneElement>
To indicate what kind of display item it is so that systems can apply differential formatting based on the purpose of the display element. (Example Questionnaire)
ALL QUESTIONS CONTAINED IN THIS QUESTIONNAIRE ARE OPTIONAL AND WILL BE KEPT STRICTLY CONFIDENTIAL.
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-display-category",
"code" : "security",
"display" : "Security"
}
],
"text" : "The text provides guidance on how the information will be handled from a security perspective."
}
}
],
"linkId" : "1.3",
"text" : "ALL QUESTIONS CONTAINED IN THIS QUESTIONNAIRE ARE OPTIONAL AND WILL BE KEPT STRICTLY CONFIDENTIAL.",
"type" : "string"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-displayCategory">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-display-category"/>
<code value="security"/>
<display value="Security"/>
</coding>
<text
value="The text provides guidance on how the information will be handled from a security perspective."/>
</valueCodeableConcept>
</extension>
<linkId value="1.3"/>
<text
value="ALL QUESTIONS CONTAINED IN THIS QUESTIONNAIRE ARE OPTIONAL AND WILL BE KEPT STRICTLY CONFIDENTIAL."/>
<type value="string"/>
</BackboneElement>
To hide an item to a user. This example has a question for Form ID that is not displayed. (Example Questionnaire)
Event ID
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean" : true
}
],
"linkId" : "1.4.1",
"text" : "Form ID",
"type" : "string"
}
To display a text box where a user can type in their answer freely. (Example Questionnaire)
If you have any other medical problems or serious injuries, please describe them here:
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "text-box",
"display" : "Text Box"
}
],
"text" : "A control where a user can type in their answer freely."
}
}
],
"linkId" : "2.1",
"text" : "If you have any other medical problems or serious injuries, please describe them here:",
"type" : "text"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="text-box"/>
<display value="Text Box"/>
</coding>
<text value="A control where a user can type in their answer freely."/>
</valueCodeableConcept>
</extension>
<linkId value="2.1"/>
<text
value="If you have any other medical problems or serious injuries, please describe them here:"/>
<type value="text"/>
</BackboneElement>
To display choices horizontally. (Example Questionnaire)
Gender: Female Male Other Unknown
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode" : "horizontal"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "radio-button",
"display" : "Radio Button"
}
],
"text" : "A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."
}
}
],
"linkId" : "2.2",
"text" : "Gender:",
"type" : "choice",
"answerOption" : [
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "female",
"display" : "Female"
},
"initialSelected" : true
},
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "male",
"display" : "Male"
}
},
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "other",
"display" : "Other"
}
},
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "unknown",
"display" : "Unknown"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation">
<valueCode value="horizontal"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="radio-button"/>
<display value="Radio Button"/>
</coding>
<text
value="A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."/>
</valueCodeableConcept>
</extension>
<linkId value="2.2"/>
<text value="Gender:"/>
<type value="choice"/>
<answerOption>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="female"/>
<display value="Female"/>
</valueCoding>
<initialSelected value="true"/>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="male"/>
<display value="Male"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="other"/>
<display value="Other"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="unknown"/>
<display value="Unknown"/>
</valueCoding>
</answerOption>
</BackboneElement>
To indicate the increment of a slider itemControl. (Example Questionnaire)
Rate your doctor: 0100%
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "slider",
"display" : "Slider"
}
],
"text" : "A control where an axis is displayed between the high and low values and the control can be visually manipulated to select a value anywhere on the axis."
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-sliderStepValue",
"valueInteger" : 10
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/minValue",
"valueInteger" : 0
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueInteger" : 100
}
],
"linkId" : "2.3",
"text" : "Rate your doctor:",
"type" : "integer",
"initial" : [
{
"valueInteger" : 50
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="slider"/>
<display value="Slider"/>
</coding>
<text
value="A control where an axis is displayed between the high and low values and the control can be visually manipulated to select a value anywhere on the axis."/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-sliderStepValue">
<valueInteger value="10"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/minValue">
<valueInteger value="0"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxValue">
<valueInteger value="100"/>
</extension>
<linkId value="2.3"/>
<text value="Rate your doctor:"/>
<type value="integer"/>
<initial>
<valueInteger value="50"/>
</initial>
</BackboneElement>
To set the width of a column in a table. (Example Questionnaire)
Medical History
Diabetes | Other Information |
Type 1 | Hypertension |
Type 2 | Smoker |
To display child items in collapsible form. (Example Questionnaire)
Relationship to patient
Name
Gender
Female
Male
Other
Unknown
To add a a support link to a question that will provide more information to the user. (Example Questionnaire)
Have you traveled outside the country within the last 14 days?
Yes
No
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink",
"valueUri" : "http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "radio-button",
"display" : "Radio Button"
}
],
"text" : "A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."
}
}
],
"linkId" : "3.1",
"text" : "Have you traveled outside the country within the last 14 days?",
"type" : "choice",
"answerOption" : [
{
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "Y",
"display" : "Yes"
}
},
{
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "N",
"display" : "No"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink">
<valueUri
value="http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="radio-button"/>
<display value="Radio Button"/>
</coding>
<text
value="A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."/>
</valueCodeableConcept>
</extension>
<linkId value="3.1"/>
<text
value="Have you traveled outside the country within the last 14 days?"/>
<type value="choice"/>
<answerOption>
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="Y"/>
<display value="Yes"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="N"/>
<display value="No"/>
</valueCoding>
</answerOption>
</BackboneElement>
To display choices with multiple columns. (Example Questionnaire)
Select Platelet:
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "drop-down",
"display" : "Drop down"
}
]
}
},
{
"extension" : [
{
"url" : "path",
"valueString" : "code"
},
{
"url" : "label",
"valueString" : "CODE"
},
{
"url" : "width",
"valueQuantity" : {
"value" : 25,
"system" : "http://unitsofmeasure.org",
"code" : "%"
}
},
{
"url" : "forDisplay",
"valueBoolean" : false
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
},
{
"extension" : [
{
"url" : "path",
"valueString" : "display"
},
{
"url" : "label",
"valueString" : "DESCRIPTION"
},
{
"url" : "width",
"valueQuantity" : {
"value" : 75,
"system" : "http://unitsofmeasure.org",
"code" : "%"
}
},
{
"url" : "forDisplay",
"valueBoolean" : true
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId" : "3.2",
"text" : "Select Platelet:",
"type" : "choice",
"answerValueSet" : "http://loinc.org/vs/LL715-4"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="drop-down"/>
<display value="Drop down"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="code"/>
</extension>
<extension url="label">
<valueString value="CODE"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="25"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="false"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="display"/>
</extension>
<extension url="label">
<valueString value="DESCRIPTION"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="75"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="true"/>
</extension>
</extension>
<linkId value="3.2"/>
<text value="Select Platelet:"/>
<type value="choice"/>
<answerValueSet value="http://loinc.org/vs/LL715-4"/>
</BackboneElement>
To add prefixes on answer options. (Example Questionnaire)
Gender:
(a) Female
(b) Male
(c) Other
(d) Unknown
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "radio-button",
"display" : "Radio Button"
}
],
"text" : "A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."
}
}
],
"linkId" : "3.3",
"text" : "Gender:",
"type" : "choice",
"answerOption" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "(a)"
}
],
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "female",
"display" : "Female"
},
"initialSelected" : true
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "(b)"
}
],
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "male",
"display" : "Male"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "(c)"
}
],
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "other",
"display" : "Other"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix",
"valueString" : "(d)"
}
],
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "unknown",
"display" : "Unknown"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="radio-button"/>
<display value="Radio Button"/>
</coding>
<text
value="A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."/>
</valueCodeableConcept>
</extension>
<linkId value="3.3"/>
<text value="Gender:"/>
<type value="choice"/>
<answerOption>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
<valueString value="(a)"/>
</extension>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="female"/>
<display value="Female"/>
</valueCoding>
<initialSelected value="true"/>
</answerOption>
<answerOption>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
<valueString value="(b)"/>
</extension>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="male"/>
<display value="Male"/>
</valueCoding>
</answerOption>
<answerOption>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
<valueString value="(c)"/>
</extension>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="other"/>
<display value="Other"/>
</valueCoding>
</answerOption>
<answerOption>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
<valueString value="(d)"/>
</extension>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="unknown"/>
<display value="Unknown"/>
</valueCoding>
</answerOption>
</BackboneElement>
To add prefixes on a value set. (Example Questionnaire)
Enter timing of harm assessment:
A. Within 24 hours
B. After 24 hours but before 3 days
C. Three days or later
D. Unknown
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode" : "vertical"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "radio-button",
"display" : "Radio Button"
}
],
"text" : "A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."
}
}
],
"linkId" : "3.4",
"text" : "Enter timing of harm assessment:",
"type" : "choice",
"answerValueSet" : "#LL2821-8"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation">
<valueCode value="vertical"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="radio-button"/>
<display value="Radio Button"/>
</coding>
<text
value="A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."/>
</valueCodeableConcept>
</extension>
<linkId value="3.4"/>
<text value="Enter timing of harm assessment:"/>
<type value="choice"/>
<answerValueSet value="#LL2821-8"/>
</BackboneElement>
To add instructions for the user to guide their input. (Example Questionnaire)
Birth Date
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/entryFormat",
"valueString" : "mm-dd-yyyy"
}
],
"linkId" : "3.5",
"text" : "Birth Date",
"type" : "date"
}
To indicate that the style extensions on a resource is essential. (Example Questionnaire)
IMPORTANT: Please complete questionnaire.
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/rendering-styleSensitive",
"valueBoolean" : true
}
],
"linkId" : "3.6",
"text" : "IMPORTANT: Please complete questionnaire.",
"_text" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString" : "color:red;"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString" : "IMPORTANT: Please complete questionnaire."
}
]
},
"type" : "display"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/rendering-styleSensitive">
<valueBoolean value="true"/>
</extension>
<linkId value="3.6"/>
<text value="IMPORTANT: Please complete questionnaire.">
<extension url="http://hl7.org/fhir/StructureDefinition/rendering-style">
<valueString value="color:red;"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString value="IMPORTANT: Please complete questionnaire."/>
</extension>
</text>
<type value="display"/>
</BackboneElement>
To set an item for optional display. (Example Questionnaire)
Enter your Middle Name
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-shortText",
"valueString" : "Annual family income"
}
],
"linkId" : "3.8",
"text" : "During the past year, what was the total combined income for you and the family members you live with? This information will help us determine if you are eligible for any benefits.",
"type" : "decimal"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-shortText">
<valueString value="Annual family income"/>
</extension>
<linkId value="3.8"/>
<text
value="During the past year, what was the total combined income for you and the family members you live with? This information will help us determine if you are eligible for any benefits."/>
<type value="decimal"/>
</BackboneElement>
To display a shorter text for an item. (Example Questionnaire)
Annual family income
{
"resourceType" : "BackboneElement",
"linkId" : "1.2",
"text" : "Please answer Yes or No to each of the following questions:",
"_text" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/rendering-xhtml",
"valueString" : "Please answer Yes or No to each of the following questions:"
}
]
},
"type" : "display"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<linkId value="1.2"/>
<text value="Please answer Yes or No to each of the following questions:">
<extension url="http://hl7.org/fhir/StructureDefinition/rendering-xhtml">
<valueString
value="Please answer Yes or No to each of the following questions:"/>
</extension>
</text>
<type value="display"/>
</BackboneElement>
To restrict an answer to only have 50 characters. (Example Questionnaire)
Enter your First Name
{
"resourceType" : "BackboneElement",
"linkId" : "1.1",
"text" : "First Name",
"type" : "string",
"maxLength" : 50
}
To restrict an answer to have at least 2 characters. (Example Questionnaire)
Enter your Last Name
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/minLength",
"valueInteger" : 2
}
],
"linkId" : "1.2",
"text" : "Last Name",
"type" : "string"
}
To restrict an answer to range from 1 to 100, up to 2 decimal places (Example Questionnaire)
Enter your weight in kg
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/minValue",
"valueDecimal" : 1
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueDecimal" : 100
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/maxDecimalPlaces",
"valueInteger" : 2
}
],
"linkId" : "1.4",
"text" : "Enter your weight in kg",
"type" : "decimal"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension url="http://hl7.org/fhir/StructureDefinition/minValue">
<valueDecimal value="1"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxValue">
<valueDecimal value="100"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxDecimalPlaces">
<valueInteger value="2"/>
</extension>
<linkId value="1.4"/>
<text value="Enter your weight in kg"/>
<type value="decimal"/>
</BackboneElement>
To restrict the answer to range from 10 to 100 kilograms. (Example Questionnaire)
Body Weight
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet",
"valueCanonical" : "http://hl7.org/fhir/ValueSet/ucum-bodyweight"
},
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity",
"valueQuantity" : {
"value" : 10,
"system" : "http://unitsofmeasure.org",
"code" : "kg"
}
},
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity",
"valueQuantity" : {
"value" : 100,
"system" : "http://unitsofmeasure.org",
"code" : "kg"
}
}
],
"linkId" : "1.5",
"text" : "Body Weight",
"type" : "quantity"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/ucum-bodyweight"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity">
<valueQuantity>
<value value="10"/>
<system value="http://unitsofmeasure.org"/>
<code value="kg"/>
</valueQuantity>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity">
<valueQuantity>
<value value="100"/>
<system value="http://unitsofmeasure.org"/>
<code value="kg"/>
</valueQuantity>
</extension>
<linkId value="1.5"/>
<text value="Body Weight"/>
<type value="quantity"/>
</BackboneElement>
To only allow a JPG or PDF attachment, up to 1,048,576 bytes. (Example Questionnaire)
Attach Proof of Citizenship
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode" : "image/jpeg"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode" : "application/pdf"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/maxSize",
"valueDecimal" : 1048576
}
],
"linkId" : "1.6",
"text" : "Attach Proof of Citizenship",
"type" : "attachment"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension url="http://hl7.org/fhir/StructureDefinition/mimeType">
<valueCode value="image/jpeg"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/mimeType">
<valueCode value="application/pdf"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/maxSize">
<valueDecimal value="1048576"/>
</extension>
<linkId value="1.6"/>
<text value="Attach Proof of Citizenship"/>
<type value="attachment"/>
</BackboneElement>
To restrict choices from a fixed list. (Example Questionnaire)
(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more.
{
"resourceType" : "BackboneElement",
"linkId" : "2.1",
"text" : "(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more.",
"type" : "choice",
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA28397-0",
"display" : "Often true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA6729-3",
"display" : "Sometimes true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA28398-8",
"display" : "Never true"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA15775-2",
"display" : "Don't know/refused"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<linkId value="2.1"/>
<text
value="(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more."/>
<type value="choice"/>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA28397-0"/>
<display value="Often true"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA6729-3"/>
<display value="Sometimes true"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA28398-8"/>
<display value="Never true"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA15775-2"/>
<display value="Don't know/refused"/>
</valueCoding>
</answerOption>
</BackboneElement>
To display answer options as images using the rendering-xhtml extension.
Example shows two ways to use <img> tags to display images: (1) with embedded data and (2) using contained Binary resources. (Example Questionnaire)
How are you feeling today?
To restrict choices from a value set. (Example Questionnaire)
Activity Level
{
"resourceType" : "BackboneElement",
"linkId" : "2.3",
"text" : "Activity Level",
"type" : "choice",
"answerValueSet" : "http://loinc.org/vs/LL4882-8"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<linkId value="2.3"/>
<text value="Activity Level"/>
<type value="choice"/>
<answerValueSet value="http://loinc.org/vs/LL4882-8"/>
</BackboneElement>
To restrict choices to distinct value sets based on context.
NOTE: This example makes assumptions about the correlation between declared gender and health conditions that are not necessarily safe/clinically appropriate, so treat this as a technical example, not as an appropriate mechanism for data capture.
Applicable health conditions :
To restrict control which choices are enabled based on context. (Example Questionnaire)
NOTE: This example makes assumptions about the correlation between declared gender and health conditions that are not necessarily safe/clinically appropriate, so treat this as a technical example, not as an appropriate mechanism for data capture.
Applicable health conditions :
{
"resourceType" : "BackboneElement",
"extension" : [
{
"extension" : [
{
"url" : "option",
"valueCoding" : {
"system" : "http://example.org/CodeSystem/conditions",
"code" : "3"
}
},
{
"url" : "expression",
"valueExpression" : {
"language" : "text/fhirpath",
"expression" : "%patient.gender!='male'"
}
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression"
},
{
"extension" : [
{
"url" : "option",
"valueCoding" : {
"system" : "http://example.org/CodeSystem/conditions",
"code" : "4"
}
},
{
"url" : "expression",
"valueExpression" : {
"language" : "text/fhirpath",
"expression" : "%patient.gender!='female'"
}
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression"
}
],
"linkId" : "2.5",
"text" : "Applicable health conditions",
"type" : "choice",
"repeats" : true,
"answerValueSet" : "#vsConditionsAll"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression">
<extension url="option">
<valueCoding>
<system value="http://example.org/CodeSystem/conditions"/>
<code value="3"/>
</valueCoding>
</extension>
<extension url="expression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%patient.gender!='male'"/>
</valueExpression>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression">
<extension url="option">
<valueCoding>
<system value="http://example.org/CodeSystem/conditions"/>
<code value="4"/>
</valueCoding>
</extension>
<extension url="expression">
<valueExpression>
<language value="text/fhirpath"/>
<expression value="%patient.gender!='female'"/>
</valueExpression>
</extension>
</extension>
<linkId value="2.5"/>
<text value="Applicable health conditions"/>
<type value="choice"/>
<repeats value="true"/>
<answerValueSet value="#vsConditionsAll"/>
</BackboneElement>
To require an answer. (Example Questionnaire)
Email*
{
"resourceType" : "BackboneElement",
"linkId" : "2.6",
"text" : "Email*",
"type" : "string",
"required" : true
}
To only display a populated answer and make it non-editable. (Example Questionnaire)
Current Date:
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression" : {
"description" : "current date",
"language" : "text/fhirpath",
"expression" : "today()"
}
}
],
"linkId" : "2.7",
"text" : "Current Date:",
"type" : "date",
"readOnly" : true
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="current date"/>
<language value="text/fhirpath"/>
<expression value="today()"/>
</valueExpression>
</extension>
<linkId value="2.7"/>
<text value="Current Date:"/>
<type value="date"/>
<readOnly value="true"/>
</BackboneElement>
To allow multiple answers, no limit and to specify label for alternate answer choices. (Example Questionnaire)
Heart History (check all that applies):
Heart attack
Heart surgery
Cardiac catheterization
Coronary angioplasty (PTCA)
Cardiac pacemaker
Other event (specify):
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-openLabel",
"valueString" : "Other event (specify)"
}
],
"linkId" : "2.8",
"text" : "Heart History (check all that applies)",
"type" : "open-choice",
"repeats" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U1",
"display" : "Heart attack"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U2",
"display" : "Heart surgery"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U3",
"display" : "Cardiac catheterization"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U4",
"display" : "Coronary angioplasty (PTCA)"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U5",
"display" : "Cardiac pacemaker"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-openLabel">
<valueString value="Other event (specify)"/>
</extension>
<linkId value="2.8"/>
<text value="Heart History (check all that applies)"/>
<type value="open-choice"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U1"/>
<display value="Heart attack"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U2"/>
<display value="Heart surgery"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U3"/>
<display value="Cardiac catheterization"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U4"/>
<display value="Coronary angioplasty (PTCA)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U5"/>
<display value="Cardiac pacemaker"/>
</valueCoding>
</answerOption>
</BackboneElement>
Must have at least to 2 answers. (Example Questionnaire)
Heart History (check at least 2):
Heart attack
Heart surgery
Cardiac catheterization
Coronary angioplasty (PTCA)
Cardiac pacemaker
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueUnsignedInt" : 2
}
],
"linkId" : "2.9",
"text" : "Heart History (check at least 2):",
"type" : "choice",
"required" : true,
"repeats" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U1",
"display" : "Heart attack"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U2",
"display" : "Heart surgery"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U3",
"display" : "Cardiac catheterization"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U4",
"display" : "Coronary angioplasty (PTCA)"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U5",
"display" : "Cardiac pacemaker"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs">
<valueUnsignedInt value="2"/>
</extension>
<linkId value="2.9"/>
<text value="Heart History (check at least 2):"/>
<type value="choice"/>
<required value="true"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U1"/>
<display value="Heart attack"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U2"/>
<display value="Heart surgery"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U3"/>
<display value="Cardiac catheterization"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U4"/>
<display value="Coronary angioplasty (PTCA)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U5"/>
<display value="Cardiac pacemaker"/>
</valueCoding>
</answerOption>
</BackboneElement>
Can only have up to 3 answers. (Example Questionnaire)
Heart History (check no more than 3):
Heart attack
Heart surgery
Cardiac catheterization
Coronary angioplasty (PTCA)
Cardiac pacemaker
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueUnsignedInt" : 3
}
],
"linkId" : "2.10",
"text" : "Heart History (check no more than 3):",
"type" : "choice",
"required" : true,
"repeats" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U1",
"display" : "Heart attack"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U2",
"display" : "Heart surgery"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U3",
"display" : "Cardiac catheterization"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U4",
"display" : "Coronary angioplasty (PTCA)"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/procedures",
"code" : "U5",
"display" : "Cardiac pacemaker"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs">
<valueUnsignedInt value="3"/>
</extension>
<linkId value="2.10"/>
<text value="Heart History (check no more than 3):"/>
<type value="choice"/>
<required value="true"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U1"/>
<display value="Heart attack"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U2"/>
<display value="Heart surgery"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U3"/>
<display value="Cardiac catheterization"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U4"/>
<display value="Coronary angioplasty (PTCA)"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/procedures"/>
<code value="U5"/>
<display value="Cardiac pacemaker"/>
</valueCoding>
</answerOption>
</BackboneElement>
To restrict other answers from being selected when an exclusive answer (like "None of the above") has been selected. (Example Questionnaire)
What treatments do you now have for heart disease? (select all that applies)
No treatment
Aspirin
Other medicines, tablets, or pills
Diet
Exercise
None of the above
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "check-box",
"display" : "Check-box"
}
]
}
}
],
"linkId" : "2.11",
"text" : "What treatments do you now have for heart disease? (select all that applies)",
"type" : "choice",
"repeats" : true,
"answerOption" : [
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/treatments",
"code" : "noTreatment",
"display" : "NoTreatment"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/treatments",
"code" : "aspirin",
"display" : "Aspirin"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/treatments",
"code" : "otherMeds",
"display" : "Other medicines, tablets, or pills"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/treatments",
"code" : "diet",
"display" : "Diet"
}
},
{
"valueCoding" : {
"system" : "http://example.org/CodeSystem/treatments",
"code" : "exercise",
"display" : "Exercise"
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-optionExclusive",
"valueBoolean" : true
}
],
"valueCoding" : {
"system" : "http://example.org/CodeSystem/treatments",
"code" : "none",
"display" : "None of the above"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="check-box"/>
<display value="Check-box"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="2.11"/>
<text
value="What treatments do you now have for heart disease? (select all that applies)"/>
<type value="choice"/>
<repeats value="true"/>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="noTreatment"/>
<display value="NoTreatment"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="aspirin"/>
<display value="Aspirin"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="otherMeds"/>
<display value="Other medicines, tablets, or pills"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="diet"/>
<display value="Diet"/>
</valueCoding>
</answerOption>
<answerOption>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="exercise"/>
<display value="Exercise"/>
</valueCoding>
</answerOption>
<answerOption>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionExclusive">
<valueBoolean value="true"/>
</extension>
<valueCoding>
<system value="http://example.org/CodeSystem/treatments"/>
<code value="none"/>
<display value="None of the above"/>
</valueCoding>
</answerOption>
</BackboneElement>
Restrict unit choices using unit options with control over how strict and other options. (Example Questionnaire)
Dosage
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding" : {
"system" : "http://unitsofmeasure.org",
"code" : "mL",
"display" : "mL"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding" : {
"system" : "http://unitsofmeasure.org",
"code" : "L",
"display" : "L"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding" : {
"system" : "http://unitsofmeasure.org",
"code" : "g",
"display" : "g"
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding" : {
"system" : "http://unitsofmeasure.org",
"code" : "mg",
"display" : "mg"
}
},
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitOpen",
"valueCode" : "optionsOrType"
},
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitSupplementalSystem",
"valueCanonical" : "http://example.org/SomeUnitCodeSystem"
}
],
"linkId" : "2.12",
"text" : "Dosage",
"type" : "quantity"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="mL"/>
<display value="mL"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="L"/>
<display value="L"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="g"/>
<display value="g"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption">
<valueCoding>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
<display value="mg"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitOpen">
<valueCode value="optionsOrType"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitSupplementalSystem">
<valueCanonical value="http://example.org/SomeUnitCodeSystem"/>
</extension>
<linkId value="2.12"/>
<text value="Dosage"/>
<type value="quantity"/>
</BackboneElement>
Restrict unit choices from a value set. (Example Questionnaire)
Specify age:
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet",
"valueCanonical" : "http://hl7.org/fhir/ValueSet/age-units"
}
],
"linkId" : "2.13",
"text" : "Specify age:",
"type" : "quantity"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/age-units"/>
</extension>
<linkId value="2.13"/>
<text value="Specify age:"/>
<type value="quantity"/>
</BackboneElement>
Restrict an answer to a specific resource or profile.
Select your preferred practitioner:
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode" : "Practitioner"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
"valueCanonical" : "http://example.org/fhir/StructureDefinition/my-practitioner"
},
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-lookupQuestionnaire",
"valueCanonical" : "http://example.org/Questionnaire/1234"
},
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression" : {
"description" : "all active practitioners",
"language" : "application/x-fhir-query",
"expression" : "Practitioner?active=true&_sort=family,given"
}
},
{
"extension" : [
{
"url" : "path",
"valueString" : "name.where(use='official').family + ', ' + name.where(use='official').given.first()"
},
{
"url" : "forDisplay",
"valueBoolean" : true
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId" : "2.14",
"text" : "Select your preferred practitioner:",
"type" : "reference"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource">
<valueCode value="Practitioner"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
<valueCanonical
value="http://example.org/fhir/StructureDefinition/my-practitioner"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-lookupQuestionnaire">
<valueCanonical value="http://example.org/Questionnaire/1234"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression">
<valueExpression>
<description value="all active practitioners"/>
<language value="application/x-fhir-query"/>
<expression value="Practitioner?active=true&_sort=family,given"/>
</valueExpression>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString
value="name.where(use='official').family + ', ' + name.where(use='official').given.first()"/>
</extension>
<extension url="forDisplay">
<valueBoolean value="true"/>
</extension>
</extension>
<linkId value="2.14"/>
<text value="Select your preferred practitioner:"/>
<type value="reference"/>
</BackboneElement>
Example with an initial expression. (Example Questionnaire)
Deadline for submission (7 days from now)
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression" : {
"description" : "deadline for submission",
"language" : "text/fhirpath",
"expression" : "today() + 7 days"
}
}
],
"linkId" : "3.1",
"text" : "Deadline for submission (7 days from now)",
"type" : "date",
"readOnly" : true
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression">
<valueExpression>
<description value="deadline for submission"/>
<language value="text/fhirpath"/>
<expression value="today() + 7 days"/>
</valueExpression>
</extension>
<linkId value="3.1"/>
<text value="Deadline for submission (7 days from now)"/>
<type value="date"/>
<readOnly value="true"/>
</BackboneElement>
To set resources that provide context for form processing logic. (Example Questionnaire)
Last Name: Hamilton
First Name: William
Gender: male
Example with a calculated expression. (Example Questionnaire)
Note: The questions below are not functional. The BMI will not calculated and displayed after input.
Weight (kg)
Body Height (inches)
Your Body Mass Index (BMI) is
Example question with a cqf-calculatedValue for minimum and maximum weight allowed and a question using a cqf-expression to determine if a question is required based on Patient data. (Example Questionnaire)
Enter weight in kg
Enter email address
Text example with cqf-expression. (Example Questionnaire)
Your last immunization was on 2021-01-05.
{
"resourceType" : "BackboneElement",
"linkId" : "3.5",
"_text" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression" : {
"description" : "last immunization date",
"language" : "text/fhirpath",
"expression" : "'Your last immunization was on '+ %Immunization.occurrenceDateTime.substring(0,10) + '.'"
}
}
]
},
"type" : "display"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<linkId value="3.5"/>
<text>
<extension url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<description value="last immunization date"/>
<language value="text/fhirpath"/>
<expression
value="'Your last immunization was on '+ %Immunization.occurrenceDateTime.substring(0,10) + '.'"/>
</valueExpression>
</extension>
</text>
<type value="display"/>
</BackboneElement>
Example of options with initial value. (Example Questionnaire)
Marital Status
{
"resourceType" : "BackboneElement",
"linkId" : "4.1",
"text" : "Marital Status",
"type" : "choice",
"answerValueSet" : "http://hl7.org/fhir/ValueSet/marital-status",
"initial" : [
{
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
"code" : "D",
"display" : "Divorced"
}
}
]
}
<BackboneElement xmlns="http://hl7.org/fhir">
<linkId value="4.1"/>
<text value="Marital Status"/>
<type value="choice"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/marital-status"/>
<initial>
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
<code value="D"/>
<display value="Divorced"/>
</valueCoding>
</initial>
</BackboneElement>
Example of enabling behaviors. (Example Questionnaire)
Note: The questions below are not functional. Display does not show actual enabling behaviors.
Choose Gender
Are you pregnant? (enableWhen gender = Female)
Yes
No
Don't know
Are you diabetic? (enableWhen gender = Female)
Yes
No
Don't know
Have you been diagnosed with Gestational Diabetes? (enableBehavior = only when pregnant and diabetic)
Yes
No
Don't know
Enter your birthdate (MM/DD/YYYY)
Have you had mammogram before?(enableWhenExpression = only when gender is female and age > 40)
Yes
No
Don't know
Example involving ordinal value and contraints. (Example Questionnaire)
Note: The questions below are not functional. The total score will not be calculated and displayed after input.
You should answer at least three questions.
Over the last 2 weeks, how often have you been bothered by any of the following problems?
1. Little interest or pleasure in doing things
Not at all (0)
Several Days (1)
More than half the days (2)
Nearly every day (3)
2. Feeling down, depressed, or hopeless
Not at all (0)
Several Days (1)
More than half the days (2)
Nearly every day (3)
3. Trouble falling or staying asleep, or sleeping too much
Not at all (0)
Several Days (1)
More than half the days (2)
Nearly every day (3)
4. Feeling tired or having little energy
Not at all (0)
Several Days (1)
More than half the days (2)
Nearly every day (3)
Total Score: 0
To restrict an answer to be in this format: A1A 1A1 (Example Questionnaire)
Postal Code (A1A 1A1)
{
"resourceType" : "BackboneElement",
"extension" : [
{
"extension" : [
{
"url" : "key",
"valueId" : "contraint-regex1"
},
{
"url" : "severity",
"valueCode" : "error"
},
{
"url" : "expression",
"valueString" : "%resource.repeat(item).where(linkId='1.3').answer.all(value.matches('[A-Z][0-9][A-Z] [0-9][A-Z][0-9]'))"
},
{
"url" : "human",
"valueString" : "Postal code must match syntax A1A 1A1."
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-constraint"
}
],
"linkId" : "1.3",
"text" : "Postal Code (A1A 1A1)",
"type" : "string"
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-constraint">
<extension url="key">
<valueId value="contraint-regex1"/>
</extension>
<extension url="severity">
<valueCode value="error"/>
</extension>
<extension url="expression">
<valueString
value="%resource.repeat(item).where(linkId='1.3').answer.all(value.matches('[A-Z][0-9][A-Z] [0-9][A-Z][0-9]'))"/>
</extension>
<extension url="human">
<valueString value="Postal code must match syntax A1A 1A1."/>
</extension>
</extension>
<linkId value="1.3"/>
<text value="Postal Code (A1A 1A1)"/>
<type value="string"/>
</BackboneElement>
Example of a questionnaire requiring a signature. (Example Questionnaire)
Signature of Patient: [only show signature pad when capturing data]
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.8",
"display" : "Signature Witness Signature"
}
],
"text" : "the signature of a witness to any other signature."
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-usageMode",
"valueCode" : "capture"
}
],
"linkId" : "4.4",
"text" : "Signature of Patient",
"type" : "attachment",
"required" : true
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired">
<valueCodeableConcept>
<coding>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.8"/>
<display value="Signature Witness Signature"/>
</coding>
<text value="the signature of a witness to any other signature."/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-usageMode">
<valueCode value="capture"/>
</extension>
<linkId value="4.4"/>
<text value="Signature of Patient"/>
<type value="attachment"/>
<required value="true"/>
</BackboneElement>
To set an endpoint URL for the Form Receiver when the Questionnaire is completed. (Example Questionnaire)
[Not applicable to a question item - this extension is part of a base Questionnaire's metadata]
To display questions one at a time. (Example Questionnaire)
[Not applicable to a question item - this extension is part of a base Questionnaire's metadata]
To provide a list of candidate answers for the question item. (Example Questionnaire)
All the practitioners below can speak your language. Choose all preferred practioners:
Last Name | First Name | Gender | |
---|---|---|---|
Smith | John | Male | |
Moseley | Henry | Male | |
Upton | Isaac | Male | |
Williams | Amy | Female |
{
"resourceType" : "BackboneElement",
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression",
"valueExpression" : {
"description" : "active practitioners that speak at least one of the patient's language",
"language" : "application/x-fhir-query",
"expression" : "Practitioner?communication=&active=true"
}
},
{
"extension" : [
{
"url" : "path",
"valueString" : "name.first().family"
},
{
"url" : "label",
"valueString" : "LAST NAME"
},
{
"url" : "width",
"valueQuantity" : {
"value" : 40,
"system" : "http://unitsofmeasure.org",
"code" : "%"
}
},
{
"url" : "forDisplay",
"valueBoolean" : true
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
},
{
"extension" : [
{
"url" : "path",
"valueString" : "name.first().given.first()"
},
{
"url" : "label",
"valueString" : "FIRST NAME"
},
{
"url" : "width",
"valueQuantity" : {
"value" : 40,
"system" : "http://unitsofmeasure.org",
"code" : "%"
}
},
{
"url" : "forDisplay",
"valueBoolean" : true
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
},
{
"extension" : [
{
"url" : "path",
"valueString" : "gender"
},
{
"url" : "label",
"valueString" : "GENDER"
},
{
"url" : "width",
"valueQuantity" : {
"value" : 20,
"system" : "http://unitsofmeasure.org",
"code" : "%"
}
},
{
"url" : "forDisplay",
"valueBoolean" : false
}
],
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn"
}
],
"linkId" : "4.5",
"text" : "All the practitioners below can speak the patient's language. Choose all preferred practioners:",
"type" : "reference",
"repeats" : true
}
<BackboneElement xmlns="http://hl7.org/fhir">
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression">
<valueExpression>
<description
value="active practitioners that speak at least one of the patient's language"/>
<language value="application/x-fhir-query"/>
<expression value="Practitioner?communication=&active=true"/>
</valueExpression>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="name.first().family"/>
</extension>
<extension url="label">
<valueString value="LAST NAME"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="40"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="true"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="name.first().given.first()"/>
</extension>
<extension url="label">
<valueString value="FIRST NAME"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="40"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="true"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn">
<extension url="path">
<valueString value="gender"/>
</extension>
<extension url="label">
<valueString value="GENDER"/>
</extension>
<extension url="width">
<valueQuantity>
<value value="20"/>
<system value="http://unitsofmeasure.org"/>
<code value="%"/>
</valueQuantity>
</extension>
<extension url="forDisplay">
<valueBoolean value="false"/>
</extension>
</extension>
<linkId value="4.5"/>
<text
value="All the practitioners below can speak the patient's language. Choose all preferred practioners:"/>
<type value="reference"/>
<repeats value="true"/>
</BackboneElement>
To indicate the resources to make available for display to the user to aid in answering the question. (Example Questionnaire)
Instruction: Click on "Review Previous Visits" button to view all the visits of this patient in the past year.
Has the patient been admitted for this issue on any visits in the past year?
Yes
No
Don't know
To specify the resources to populate and extract a questionnaire. (Example Questionnaire)
Home Address
Address:
City:
Province:
Postal Code: