Smart Health Checks
0.3.0 - ci-build Australia flag

Smart Health Checks, published by AEHRC CSIRO. This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/aehrc/smart-forms-ig/ and changes regularly. See the Directory of published versions

Resource Profile: SmartHealthChecksQuestionnaireResponse - Detailed Descriptions

Draft as of 2025-09-05

Definitions for the SHCQuestionnaireResponse resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. QuestionnaireResponse
Definition

Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.


A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.

ShortStandard Questionnaire ResponseA structured set of questions and their answers
Comments

The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.

Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesForm, QuestionnaireAnswers, Form Data
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject. (subject.exists())
sdcqr-2: When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers. ((QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
sdcqr-3: Can either have source or source extension, but not both (source.count() + extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-QuestionnaireResponse.source').count() <=1)
2. QuestionnaireResponse.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control10..1
Typeidstring
Is Modifierfalse
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:populate & SHALL:persistSHC Host FHIR Server
    SHALL:populate-if-known & SHALL:processSHC App
    Summarytrue
    4. QuestionnaireResponse.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. QuestionnaireResponse.text
    Definition

    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    ShortText summary of the resource, for human interpretation
    Comments

    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

    Control0..1
    TypeNarrative
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
      SHALL:populate & SHALL:processSHC App
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. QuestionnaireResponse.extension:adheresTo
      Slice NameadheresTo
      Definition

      The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

      ShortFollows rules from
      Comments

      If changes are made to this event record, the determination must be made whether, with the change, the action still complies with the referenced Definition. Revisions may result in adheresTo assertions being removed, or - if the system has an algorithm for determining which targets are appropriate - being added. Adherence may be asserted after the fact. It is possible for a Request or Event to adhere to a Definition even if the author/performer of the action was not aware of the Definition at the time the action was taken/requested.

      Also see the notes in the workflow extensions area for more guidance on this element.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(adheres to) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. QuestionnaireResponse.extension:adheresTo.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on QuestionnaireResponse.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 12. QuestionnaireResponse.extension:adheresTo.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/workflow-adheresTo
        14. QuestionnaireResponse.extension:adheresTo.value[x]
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortValue of extension
        Control10..1
        TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. QuestionnaireResponse.extension:triggeredBy
        Slice NametriggeredBy
        Definition

        This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a 'step' dictated within the protocol/order set/etc.

        ShortCreated because of following
        Comments

        See the notes in the workflow extensions area for more guidance on this element.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Triggered by) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. QuestionnaireResponse.extension:triggeredBy.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on QuestionnaireResponse.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 20. QuestionnaireResponse.extension:triggeredBy.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/StructureDefinition/workflow-triggeredBy
          22. QuestionnaireResponse.extension:triggeredBy.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. QuestionnaireResponse.extension:signature
          Slice Namesignature
          Definition

          Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

          ShortA signature attesting to the content
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          26. QuestionnaireResponse.extension:completionMode
          Slice NamecompletionMode
          Definition

          Indicates how the individual completing the QuestionnaireResponse provided their responses.

          ShortE.g. Verbal, written, electronic
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(QuestionnaireResponse Completion Mode) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          28. QuestionnaireResponse.extension:source
          Slice Namesource
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension Definition for QuestionnaireResponse.source for Version 5.0) (Extension Type: Reference(Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson))
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          30. QuestionnaireResponse.extension:source.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..0*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on QuestionnaireResponse.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 32. QuestionnaireResponse.extension:source.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-QuestionnaireResponse.source
            34. QuestionnaireResponse.extension:source.value[x]
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control10..1
            TypeReference(Device, Organization), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. QuestionnaireResponse.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            38. QuestionnaireResponse.identifier
            Definition

            A business identifier assigned to a particular completed (or partially completed) questionnaire.

            ShortUnique id for this set of answers
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Used for tracking, registration and other business purposes.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. QuestionnaireResponse.questionnaire
            Definition

            The Questionnaire that defines and organizes the questions for which answers are being provided.

            ShortForm being answered
            Comments

            For SDC, this SHALL be the version-specific URL of the form as hosted on the Form Manager.


            If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).

            Control10..1
            Typecanonical(SDC Base Questionnaire, Questionnaire)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
              SHALL:populate & SHALL:processSHC App
              Summarytrue
              Requirements

              Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.

              Alternate NamesForm
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. QuestionnaireResponse.questionnaire.extension:questionnaireDisplay
              Slice NamequestionnaireDisplay
              Definition

              The title or other name to display when referencing a resource by canonical URL.

              ShortDisplay name for canonical reference
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Display Name) (Extension Type: string)
              Is Modifierfalse
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                SHALL:populate & SHALL:processSHC App
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                44. QuestionnaireResponse.status
                Definition

                The position of the questionnaire response within its overall lifecycle.

                Shortin-progress | completed | amended | entered-in-error | stopped
                Comments

                This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                Control1..1
                BindingThe codes SHALL be taken from QuestionnaireResponseStatushttp://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1
                (required to http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1)

                Lifecycle status of the questionnaire response.

                Typecode
                Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:populate & SHALL:persistSHC Host FHIR Server
                  SHALL:populate & SHALL:processSHC App
                  Summarytrue
                  Requirements

                  The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. QuestionnaireResponse.subject
                  Definition

                  The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information.

                  ShortThe subject of the questions
                  Comments

                  If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse


                  If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.

                  Control10..1
                  TypeReference(Resource)
                  Is Modifierfalse
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:populate & SHALL:persistSHC Host FHIR Server
                    SHALL:populate & SHALL:processSHC App
                    Summarytrue
                    Requirements

                    Allows linking the answers to the individual the answers describe. May also affect access control.

                    Alternate NamesPatient, Focus
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    48. QuestionnaireResponse.encounter
                    Definition

                    The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.

                    ShortEncounter created as part of
                    Comments

                    This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.

                    Control0..1
                    TypeReference(Encounter)
                    Is Modifierfalse
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                      SHALL:populate-if-known & SHALL:processSHC App
                      Summarytrue
                      Requirements

                      Provides context for the information that was captured. May also affect access control.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      50. QuestionnaireResponse.authored
                      Definition

                      Identifies when this version of the answer set was created. Changes whenever the answers are updated.


                      The date and/or time that this set of answers were last changed.

                      ShortDate the answers were gathered
                      Comments

                      May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.

                      This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.

                      Control10..1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHALL:populate & SHALL:persistSHC Host FHIR Server
                        SHALL:populate & SHALL:processSHC App
                        Summarytrue
                        Requirements

                        Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.

                        Alternate NamesDate Created, Date published, Date Issued, Date updated
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        52. QuestionnaireResponse.author
                        Definition

                        Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.

                        ShortPerson who received and recorded the answers
                        Comments

                        Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated.

                        Control10..1
                        TypeReference(Practitioner, Device, PractitionerRole, Patient, RelatedPerson, Organization)
                        Is Modifierfalse
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                          SHALL:populate & SHALL:processSHC App
                          Summarytrue
                          Requirements

                          Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.

                          Alternate NamesLaboratory, Service, Practitioner, Department, Company, Performer
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          54. QuestionnaireResponse.item
                          Definition

                          A group or question item from the original questionnaire for which answers are provided.

                          ShortGroups and questions
                          Comments

                          Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                            SHALL:populate-if-known & SHALL:processSHC App
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                            qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                            qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                            56. QuestionnaireResponse.item.extension:itemMedia
                            Slice NameitemMedia
                            Definition

                            Media to render/make available as an accompaniment to the question being asked

                            ShortMedia to display
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Item Media) (Extension Type: Attachment)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            58. QuestionnaireResponse.item.extension:ItemSignature
                            Slice NameItemSignature
                            Definition

                            Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                            ShortA signature attesting to the content
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            60. QuestionnaireResponse.item.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            62. QuestionnaireResponse.item.linkId
                            Definition

                            The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                            ShortPointer to specific item from Questionnaire
                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                              SHALL:populate-if-known & SHALL:processSHC App
                              Summaryfalse
                              Requirements

                              Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              64. QuestionnaireResponse.item.text
                              Definition

                              Text that is displayed above the contents of the group or as the text of the question being answered.

                              ShortName for group or question text
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                SHALL:populate-if-known & SHALL:processSHC App
                                Summaryfalse
                                Requirements

                                Allows the questionnaire response to be read without access to the questionnaire.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                66. QuestionnaireResponse.item.answer
                                Definition

                                The respondent's answer(s) to the question.

                                ShortThe response(s) to the question
                                Comments

                                The value is nested because we cannot have a repeating structure that has variable type.

                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                  SHALL:populate-if-known & SHALL:processSHC App
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  68. QuestionnaireResponse.item.answer.extension:itemAnswerMedia
                                  Slice NameitemAnswerMedia
                                  Definition

                                  Media to render/make available as an accompaniment to a specific answer option

                                  ShortAnswer Media to display
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  70. QuestionnaireResponse.item.answer.extension:itemWeight
                                  Slice NameitemWeight
                                  Definition

                                  A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                  ShortAssigned Ordinal Value
                                  Comments

                                  Inclusion of weights in QRs can increase performance when calculating based on weights.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(Item Weight) (Extension Type: decimal)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  72. QuestionnaireResponse.item.answer.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  74. QuestionnaireResponse.item.answer.value[x]
                                  Definition

                                  The answer (or one of the answers) provided by the respondent to the question.

                                  ShortSingle-valued answer to the question
                                  Comments

                                  More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                  Control0..1
                                  BindingFor example codes, see QuestionnaireAnswerCodeshttp://hl7.org/fhir/ValueSet/questionnaire-answers
                                  (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                                  Code indicating the response provided for a question.

                                  TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                    SHALL:populate-if-known & SHALL:processSHC App
                                    Summaryfalse
                                    Requirements

                                    Ability to retain a single-valued answer to a question.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    76. QuestionnaireResponse.item.answer.item
                                    Definition

                                    Nested groups and/or questions found within this particular answer.

                                    ShortNested groups and questions
                                    Control0..*
                                    TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    78. QuestionnaireResponse.item.item
                                    Definition

                                    Questions or sub-groups nested beneath a question or group.

                                    ShortNested questionnaire response items
                                    Control0..*
                                    TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                      SHALL:populate-if-known & SHALL:processSHC App
                                      Summaryfalse
                                      Requirements

                                      Reports can consist of complex nested groups.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                                      Guidance on how to interpret the contents of this table can be foundhere

                                      0. QuestionnaireResponse
                                      2. QuestionnaireResponse.id
                                      Control1..?
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate & SHALL:persistSHC Host FHIR Server
                                        SHALL:populate-if-known & SHALL:processSHC App
                                        4. QuestionnaireResponse.text
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                          SHALL:populate & SHALL:processSHC App
                                          6. QuestionnaireResponse.questionnaire
                                          Obligations
                                            ObligationsActor
                                            SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                            SHALL:populate & SHALL:processSHC App
                                            8. QuestionnaireResponse.questionnaire.extension:questionnaireDisplay
                                            Slice NamequestionnaireDisplay
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                              SHALL:populate & SHALL:processSHC App
                                              10. QuestionnaireResponse.status
                                              Obligations
                                                ObligationsActor
                                                SHALL:populate & SHALL:persistSHC Host FHIR Server
                                                SHALL:populate & SHALL:processSHC App
                                                12. QuestionnaireResponse.subject
                                                Control1..?
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populate & SHALL:persistSHC Host FHIR Server
                                                  SHALL:populate & SHALL:processSHC App
                                                  14. QuestionnaireResponse.encounter
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                    SHALL:populate-if-known & SHALL:processSHC App
                                                    16. QuestionnaireResponse.authored
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:populate & SHALL:persistSHC Host FHIR Server
                                                      SHALL:populate & SHALL:processSHC App
                                                      18. QuestionnaireResponse.author
                                                      Control1..?
                                                      TypeReference(Practitioner)
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                        SHALL:populate & SHALL:processSHC App
                                                        20. QuestionnaireResponse.item
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                          SHALL:populate-if-known & SHALL:processSHC App
                                                          22. QuestionnaireResponse.item.linkId
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                            SHALL:populate-if-known & SHALL:processSHC App
                                                            24. QuestionnaireResponse.item.text
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                              SHALL:populate-if-known & SHALL:processSHC App
                                                              26. QuestionnaireResponse.item.answer
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                SHALL:populate-if-known & SHALL:processSHC App
                                                                28. QuestionnaireResponse.item.answer.value[x]
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                  SHALL:populate-if-known & SHALL:processSHC App
                                                                  30. QuestionnaireResponse.item.item
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                    SHALL:populate-if-known & SHALL:processSHC App

                                                                    Guidance on how to interpret the contents of this table can be foundhere

                                                                    0. QuestionnaireResponse
                                                                    Definition

                                                                    Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.

                                                                    ShortStandard Questionnaire Response
                                                                    Comments

                                                                    The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.

                                                                    Control0..*
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate NamesForm, QuestionnaireAnswers, Form Data
                                                                    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                                    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                                    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                    dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                    sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject. (subject.exists())
                                                                    sdcqr-2: When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers. ((QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                                    sdcqr-3: Can either have source or source extension, but not both (source.count() + extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-QuestionnaireResponse.source').count() <=1)
                                                                    2. QuestionnaireResponse.id
                                                                    Definition

                                                                    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                                    ShortLogical id of this artifact
                                                                    Comments

                                                                    The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                                    Control1..1
                                                                    Typeid
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:populate & SHALL:persistSHC Host FHIR Server
                                                                      SHALL:populate-if-known & SHALL:processSHC App
                                                                      Summarytrue
                                                                      4. QuestionnaireResponse.meta
                                                                      Definition

                                                                      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                                      ShortMetadata about the resource
                                                                      Control0..1
                                                                      TypeMeta
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      6. QuestionnaireResponse.implicitRules
                                                                      Definition

                                                                      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                                      ShortA set of rules under which this content was created
                                                                      Comments

                                                                      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                                      Control0..1
                                                                      Typeuri
                                                                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      8. QuestionnaireResponse.language
                                                                      Definition

                                                                      The base language in which the resource is written.

                                                                      ShortLanguage of the resource content
                                                                      Comments

                                                                      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                                      Control0..1
                                                                      BindingThe codes SHOULD be taken from CommonLanguages
                                                                      (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                                      A human language.

                                                                      Additional BindingsPurpose
                                                                      AllLanguagesMax Binding
                                                                      Typecode
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      10. QuestionnaireResponse.text
                                                                      Definition

                                                                      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                                      ShortText summary of the resource, for human interpretation
                                                                      Comments

                                                                      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                                      Control0..1
                                                                      TypeNarrative
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                        SHALL:populate & SHALL:processSHC App
                                                                        Summaryfalse
                                                                        Alternate Namesnarrative, html, xhtml, display
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        12. QuestionnaireResponse.contained
                                                                        Definition

                                                                        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                                        ShortContained, inline Resources
                                                                        Comments

                                                                        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                                        Control0..*
                                                                        TypeResource
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesinline resources, anonymous resources, contained resources
                                                                        14. QuestionnaireResponse.extension
                                                                        Definition

                                                                        An Extension

                                                                        ShortExtension
                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on QuestionnaireResponse.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 16. QuestionnaireResponse.extension:adheresTo
                                                                          Slice NameadheresTo
                                                                          Definition

                                                                          The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

                                                                          ShortFollows rules from
                                                                          Comments

                                                                          If changes are made to this event record, the determination must be made whether, with the change, the action still complies with the referenced Definition. Revisions may result in adheresTo assertions being removed, or - if the system has an algorithm for determining which targets are appropriate - being added. Adherence may be asserted after the fact. It is possible for a Request or Event to adhere to a Definition even if the author/performer of the action was not aware of the Definition at the time the action was taken/requested.

                                                                          Also see the notes in the workflow extensions area for more guidance on this element.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension(adheres to) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          18. QuestionnaireResponse.extension:adheresTo.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          20. QuestionnaireResponse.extension:adheresTo.extension
                                                                          Definition

                                                                          An Extension

                                                                          ShortExtension
                                                                          Control0..0
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on QuestionnaireResponse.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 22. QuestionnaireResponse.extension:adheresTo.url
                                                                            Definition

                                                                            Source of the definition for the extension code - a logical name or a URL.

                                                                            Shortidentifies the meaning of the extension
                                                                            Comments

                                                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                            Control1..1
                                                                            Typeuri
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/workflow-adheresTo
                                                                            24. QuestionnaireResponse.extension:adheresTo.value[x]
                                                                            Definition

                                                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                            ShortValue of extension
                                                                            Control1..1
                                                                            TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            26. QuestionnaireResponse.extension:triggeredBy
                                                                            Slice NametriggeredBy
                                                                            Definition

                                                                            This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a 'step' dictated within the protocol/order set/etc.

                                                                            ShortCreated because of following
                                                                            Comments

                                                                            See the notes in the workflow extensions area for more guidance on this element.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension(Triggered by) (Extension Type: Choice of: canonical(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), Reference(ActivityDefinition, Measure, ObservationDefinition, PlanDefinition, Questionnaire), uri)
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            28. QuestionnaireResponse.extension:triggeredBy.id
                                                                            Definition

                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            30. QuestionnaireResponse.extension:triggeredBy.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control0..0
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on QuestionnaireResponse.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 32. QuestionnaireResponse.extension:triggeredBy.url
                                                                              Definition

                                                                              Source of the definition for the extension code - a logical name or a URL.

                                                                              Shortidentifies the meaning of the extension
                                                                              Comments

                                                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                              Control1..1
                                                                              Typeuri
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/workflow-triggeredBy
                                                                              34. QuestionnaireResponse.extension:triggeredBy.value[x]
                                                                              Definition

                                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                              ShortValue of extension
                                                                              Control1..1
                                                                              TypeChoice of: canonical(ActivityDefinition, PlanDefinition), Reference(ActivityDefinition, PlanDefinition), uri
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              36. QuestionnaireResponse.extension:signature
                                                                              Slice Namesignature
                                                                              Definition

                                                                              Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                                              ShortA signature attesting to the content
                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              38. QuestionnaireResponse.extension:completionMode
                                                                              Slice NamecompletionMode
                                                                              Definition

                                                                              Indicates how the individual completing the QuestionnaireResponse provided their responses.

                                                                              ShortE.g. Verbal, written, electronic
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(QuestionnaireResponse Completion Mode) (Extension Type: CodeableConcept)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              40. QuestionnaireResponse.extension:source
                                                                              Slice Namesource
                                                                              Definition

                                                                              Optional Extension Element - found in all resources.

                                                                              ShortOptional Extensions Element
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(Extension Definition for QuestionnaireResponse.source for Version 5.0) (Extension Type: Reference(Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson))
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              42. QuestionnaireResponse.extension:source.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              44. QuestionnaireResponse.extension:source.extension
                                                                              Definition

                                                                              An Extension

                                                                              ShortExtension
                                                                              Control0..0
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on QuestionnaireResponse.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 46. QuestionnaireResponse.extension:source.url
                                                                                Definition

                                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                                Shortidentifies the meaning of the extension
                                                                                Comments

                                                                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                Control1..1
                                                                                Typeuri
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-QuestionnaireResponse.source
                                                                                48. QuestionnaireResponse.extension:source.value[x]
                                                                                Definition

                                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                ShortValue of extension
                                                                                Control1..1
                                                                                TypeReference(Device, Organization)
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                50. QuestionnaireResponse.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                52. QuestionnaireResponse.identifier
                                                                                Definition

                                                                                A business identifier assigned to a particular completed (or partially completed) questionnaire.

                                                                                ShortUnique id for this set of answers
                                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                Control0..1
                                                                                TypeIdentifier
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Requirements

                                                                                Used for tracking, registration and other business purposes.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                54. QuestionnaireResponse.basedOn
                                                                                Definition

                                                                                The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.

                                                                                ShortRequest fulfilled by this QuestionnaireResponse
                                                                                Control0..*
                                                                                TypeReference(CarePlan, ServiceRequest)
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Requirements

                                                                                Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.

                                                                                Alternate Namesorder
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                56. QuestionnaireResponse.partOf
                                                                                Definition

                                                                                A procedure or observation that this questionnaire was performed as part of the execution of. For example, the surgery a checklist was executed as part of.

                                                                                ShortPart of this action
                                                                                Comments

                                                                                Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire. For relationships to referrals, and other types of requests, use basedOn.

                                                                                Control0..*
                                                                                TypeReference(Observation, Procedure)
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                58. QuestionnaireResponse.questionnaire
                                                                                Definition

                                                                                The Questionnaire that defines and organizes the questions for which answers are being provided.

                                                                                ShortForm being answered
                                                                                Comments

                                                                                For SDC, this SHALL be the version-specific URL of the form as hosted on the Form Manager.

                                                                                Control1..1
                                                                                Typecanonical(SDC Base Questionnaire)
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                  SHALL:populate & SHALL:processSHC App
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.

                                                                                  Alternate NamesForm
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  60. QuestionnaireResponse.questionnaire.id
                                                                                  Definition

                                                                                  unique id for the element within a resource (for internal references)

                                                                                  Shortxml:id (or equivalent in JSON)
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  62. QuestionnaireResponse.questionnaire.extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on QuestionnaireResponse.questionnaire.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 64. QuestionnaireResponse.questionnaire.extension:questionnaireDisplay
                                                                                    Slice NamequestionnaireDisplay
                                                                                    Definition

                                                                                    The title or other name to display when referencing a resource by canonical URL.

                                                                                    ShortDisplay name for canonical reference
                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension(Display Name) (Extension Type: string)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                      SHALL:populate & SHALL:processSHC App
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      66. QuestionnaireResponse.questionnaire.value
                                                                                      Definition

                                                                                      Primitive value for canonical

                                                                                      ShortPrimitive value for canonical
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      68. QuestionnaireResponse.status
                                                                                      Definition

                                                                                      The position of the questionnaire response within its overall lifecycle.

                                                                                      Shortin-progress | completed | amended | entered-in-error | stopped
                                                                                      Comments

                                                                                      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                                                      Control1..1
                                                                                      BindingThe codes SHALL be taken from QuestionnaireResponseStatus
                                                                                      (required to http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1)

                                                                                      Lifecycle status of the questionnaire response.

                                                                                      Typecode
                                                                                      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:populate & SHALL:persistSHC Host FHIR Server
                                                                                        SHALL:populate & SHALL:processSHC App
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        70. QuestionnaireResponse.subject
                                                                                        Definition

                                                                                        The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information.

                                                                                        ShortThe subject of the questions
                                                                                        Comments

                                                                                        If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse

                                                                                        Control1..1
                                                                                        TypeReference(Resource)
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:populate & SHALL:persistSHC Host FHIR Server
                                                                                          SHALL:populate & SHALL:processSHC App
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Allows linking the answers to the individual the answers describe. May also affect access control.

                                                                                          Alternate NamesPatient, Focus
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          72. QuestionnaireResponse.encounter
                                                                                          Definition

                                                                                          The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.

                                                                                          ShortEncounter created as part of
                                                                                          Comments

                                                                                          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.

                                                                                          Control0..1
                                                                                          TypeReference(Encounter)
                                                                                          Is Modifierfalse
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                            SHALL:populate-if-known & SHALL:processSHC App
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Provides context for the information that was captured. May also affect access control.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            74. QuestionnaireResponse.authored
                                                                                            Definition

                                                                                            Identifies when this version of the answer set was created. Changes whenever the answers are updated.

                                                                                            ShortDate the answers were gathered
                                                                                            Comments

                                                                                            May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.

                                                                                            This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.

                                                                                            Control1..1
                                                                                            TypedateTime
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:populate & SHALL:persistSHC Host FHIR Server
                                                                                              SHALL:populate & SHALL:processSHC App
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.

                                                                                              Alternate NamesDate Created, Date published, Date Issued, Date updated
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              76. QuestionnaireResponse.author
                                                                                              Definition

                                                                                              Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.

                                                                                              ShortPerson who received and recorded the answers
                                                                                              Comments

                                                                                              Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated.

                                                                                              Control1..1
                                                                                              TypeReference(Practitioner)
                                                                                              Is Modifierfalse
                                                                                              Must Supporttrue
                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                                SHALL:populate & SHALL:processSHC App
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.

                                                                                                Alternate NamesLaboratory, Service, Practitioner, Department, Company, Performer
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                78. QuestionnaireResponse.source
                                                                                                Definition

                                                                                                The person who answered the questions about the subject.

                                                                                                ShortThe person who answered the questions
                                                                                                Comments

                                                                                                If not specified, no inference can be made about who provided the data.

                                                                                                Control0..1
                                                                                                TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson)
                                                                                                Is Modifierfalse
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                80. QuestionnaireResponse.item
                                                                                                Definition

                                                                                                A group or question item from the original questionnaire for which answers are provided.

                                                                                                ShortGroups and questions
                                                                                                Comments

                                                                                                Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

                                                                                                Control0..*
                                                                                                TypeBackboneElement
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                                  SHALL:populate-if-known & SHALL:processSHC App
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
                                                                                                  qrs-2: Repeated answers are combined in the answers array of a single item (repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue())
                                                                                                  82. QuestionnaireResponse.item.id
                                                                                                  Definition

                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  Summaryfalse
                                                                                                  84. QuestionnaireResponse.item.extension
                                                                                                  Definition

                                                                                                  An Extension

                                                                                                  ShortExtension
                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  SlicingThis element introduces a set of slices on QuestionnaireResponse.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 86. QuestionnaireResponse.item.extension:itemMedia
                                                                                                    Slice NameitemMedia
                                                                                                    Definition

                                                                                                    Media to render/make available as an accompaniment to the question being asked

                                                                                                    ShortMedia to display
                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension(Item Media) (Extension Type: Attachment)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    88. QuestionnaireResponse.item.extension:ItemSignature
                                                                                                    Slice NameItemSignature
                                                                                                    Definition

                                                                                                    Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

                                                                                                    ShortA signature attesting to the content
                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension(QuestionnaireResponse Signature) (Extension Type: Signature)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    90. QuestionnaireResponse.item.modifierExtension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    92. QuestionnaireResponse.item.linkId
                                                                                                    Definition

                                                                                                    The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

                                                                                                    ShortPointer to specific item from Questionnaire
                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Must Supporttrue
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                                      SHALL:populate-if-known & SHALL:processSHC App
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      94. QuestionnaireResponse.item.definition
                                                                                                      Definition

                                                                                                      A reference to an ElementDefinition that provides the details for the item.

                                                                                                      ShortElementDefinition - details for the item
                                                                                                      Comments

                                                                                                      The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

                                                                                                      There is no need for this element if the item pointed to by the linkId has a definition listed.

                                                                                                      Control0..1
                                                                                                      Typeuri
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      96. QuestionnaireResponse.item.text
                                                                                                      Definition

                                                                                                      Text that is displayed above the contents of the group or as the text of the question being answered.

                                                                                                      ShortName for group or question text
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Must Supporttrue
                                                                                                      Obligations
                                                                                                        ObligationsActor
                                                                                                        SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                                        SHALL:populate-if-known & SHALL:processSHC App
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Allows the questionnaire response to be read without access to the questionnaire.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        98. QuestionnaireResponse.item.answer
                                                                                                        Definition

                                                                                                        The respondent's answer(s) to the question.

                                                                                                        ShortThe response(s) to the question
                                                                                                        Comments

                                                                                                        The value is nested because we cannot have a repeating structure that has variable type.

                                                                                                        Control0..*
                                                                                                        TypeBackboneElement
                                                                                                        Is Modifierfalse
                                                                                                        Must Supporttrue
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                                          SHALL:populate-if-known & SHALL:processSHC App
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          100. QuestionnaireResponse.item.answer.id
                                                                                                          Definition

                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                          ShortUnique id for inter-element referencing
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          Summaryfalse
                                                                                                          102. QuestionnaireResponse.item.answer.extension
                                                                                                          Definition

                                                                                                          An Extension

                                                                                                          ShortExtension
                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          SlicingThis element introduces a set of slices on QuestionnaireResponse.item.answer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 104. QuestionnaireResponse.item.answer.extension:itemAnswerMedia
                                                                                                            Slice NameitemAnswerMedia
                                                                                                            Definition

                                                                                                            Media to render/make available as an accompaniment to a specific answer option

                                                                                                            ShortAnswer Media to display
                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension(Item Answer Media) (Extension Type: Attachment)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            106. QuestionnaireResponse.item.answer.extension:itemWeight
                                                                                                            Slice NameitemWeight
                                                                                                            Definition

                                                                                                            A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

                                                                                                            ShortAssigned Ordinal Value
                                                                                                            Comments

                                                                                                            Inclusion of weights in QRs can increase performance when calculating based on weights.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension(Item Weight) (Extension Type: decimal)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            108. QuestionnaireResponse.item.answer.modifierExtension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            110. QuestionnaireResponse.item.answer.value[x]
                                                                                                            Definition

                                                                                                            The answer (or one of the answers) provided by the respondent to the question.

                                                                                                            ShortSingle-valued answer to the question
                                                                                                            Comments

                                                                                                            More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

                                                                                                            Control0..1
                                                                                                            BindingFor example codes, see QuestionnaireAnswerCodes
                                                                                                            (example to http://hl7.org/fhir/ValueSet/questionnaire-answers)

                                                                                                            Code indicating the response provided for a question.

                                                                                                            TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                                              SHALL:populate-if-known & SHALL:processSHC App
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Ability to retain a single-valued answer to a question.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              112. QuestionnaireResponse.item.answer.item
                                                                                                              Definition

                                                                                                              Nested groups and/or questions found within this particular answer.

                                                                                                              ShortNested groups and questions
                                                                                                              Control0..*
                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              114. QuestionnaireResponse.item.item
                                                                                                              Definition

                                                                                                              Questions or sub-groups nested beneath a question or group.

                                                                                                              ShortNested questionnaire response items
                                                                                                              Control0..*
                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:populate-if-known & SHALL:persistSHC Host FHIR Server
                                                                                                                SHALL:populate-if-known & SHALL:processSHC App
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Reports can consist of complex nested groups.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))