SIL HIE Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: HIE QuestionnaireResponse

R4B QuestionnaireResponse profiled for HIE capture. Emphasizes linkage to Questionnaire, subject and encounter context, authorship, and structured item answers.

Usages:

• Examples for this Profile: QuestionnaireResponse/HIEQuestionnaireResponse-example

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
QuestionnaireResponse	C	0..*	QuestionnaireResponse	A structured set of questions and their answers Constraints: qr-item-has-answer-or-children, qr-answer-has-value-or-children
QuestionnaireResponse.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
QuestionnaireResponse.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
QuestionnaireResponse.identifier	Σ This element is included in summaries.	0..1	Identifier	Unique id for this set of answers
QuestionnaireResponse.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
QuestionnaireResponse.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
QuestionnaireResponse.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
QuestionnaireResponse.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
QuestionnaireResponse.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
QuestionnaireResponse.basedOn	Σ This element is included in summaries.	0..*	HIEReference(ServiceRequest)	Request fulfilled by this QuestionnaireResponse
QuestionnaireResponse.partOf	Σ This element is included in summaries.	0..*	HIEReference(HIE Observation | Procedure)	Part of this action
QuestionnaireResponse.questionnaire	S This element must be supported. Σ This element is included in summaries.	1..1	canonical(Questionnaire)	Form being answered
QuestionnaireResponse.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	in-progress | completed | amended | entered-in-error | stopped Binding: QuestionnaireResponseStatus (required): Lifecycle status of the questionnaire response.
QuestionnaireResponse.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the questions
QuestionnaireResponse.encounter	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Encounter)	Encounter created as part of
QuestionnaireResponse.authored	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Date the answers were gathered
QuestionnaireResponse.author	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	Person who received and recorded the answers
QuestionnaireResponse.source	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	The person who answered the questions
QuestionnaireResponse.item	S This element must be supported. C	1..*	BackboneElement	Groups and questions Constraints: qrs-1
QuestionnaireResponse.item.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
QuestionnaireResponse.item.linkId	S This element must be supported.	1..1	string	Pointer to specific item from Questionnaire
QuestionnaireResponse.item.text	S This element must be supported.	0..1	string	Name for group or question text
QuestionnaireResponse.item.answer	S This element must be supported.	0..*	BackboneElement	The response(s) to the question
QuestionnaireResponse.item.answer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
QuestionnaireResponse.​identifier.use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
QuestionnaireResponse.​status	Base	required	QuestionnaireResponseStatus	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	QuestionnaireResponse.identifier.type	Text is optional, coding is required	coding.exists()
dom-2	error	QuestionnaireResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	QuestionnaireResponse	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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	QuestionnaireResponse	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	error	QuestionnaireResponse	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	QuestionnaireResponse	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
qr-answer-has-value-or-children	error	QuestionnaireResponse	Each answer must have a value or nested items	answer.exists() implies answer.all(value.exists() or item.exists())
qr-item-has-answer-or-children	warning	QuestionnaireResponse	Each item must contain an answer or nested items	item.exists() implies (item.answer.exists() or item.item.exists())
qrs-1	error	QuestionnaireResponse.item	Nested item can't be beneath both item and answer	(answer.exists() and item.exists()).not()

This structure is derived from QuestionnaireResponse

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
QuestionnaireResponse	C	0..*	QuestionnaireResponse	A structured set of questions and their answers Constraints: qr-item-has-answer-or-children, qr-answer-has-value-or-children
QuestionnaireResponse.identifier
QuestionnaireResponse.identifier.use		1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
QuestionnaireResponse.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible)
QuestionnaireResponse.identifier.system		1..1	uri	The namespace for the identifier value
QuestionnaireResponse.identifier.value	S This element must be supported.	1..1	string	The value that is unique
QuestionnaireResponse.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
QuestionnaireResponse.basedOn		0..*	HIEReference(ServiceRequest)	Request fulfilled by this QuestionnaireResponse
QuestionnaireResponse.partOf		0..*	HIEReference(HIE Observation | Procedure)	Part of this action
QuestionnaireResponse.questionnaire	S This element must be supported.	1..1	canonical(Questionnaire)	Form being answered
QuestionnaireResponse.status	S This element must be supported.	1..1	code	in-progress | completed | amended | entered-in-error | stopped
QuestionnaireResponse.subject	S This element must be supported.	1..1	HIEReference(HIE Patient)	The subject of the questions
QuestionnaireResponse.encounter	S This element must be supported.	0..1	HIEReference(HIE Encounter)	Encounter created as part of
QuestionnaireResponse.authored	S This element must be supported.	1..1	dateTime	Date the answers were gathered
QuestionnaireResponse.author		0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	Person who received and recorded the answers
QuestionnaireResponse.source		0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	The person who answered the questions
QuestionnaireResponse.item	S This element must be supported.	1..*	BackboneElement	Groups and questions
QuestionnaireResponse.item.linkId	S This element must be supported.	1..1	string	Pointer to specific item from Questionnaire
QuestionnaireResponse.item.text	S This element must be supported.	0..1	string	Name for group or question text
QuestionnaireResponse.item.answer	S This element must be supported.	0..*	BackboneElement	The response(s) to the question
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
QuestionnaireResponse.​identifier.use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
qr-answer-has-value-or-children	error	QuestionnaireResponse	Each answer must have a value or nested items	answer.exists() implies answer.all(value.exists() or item.exists())
qr-item-has-answer-or-children	warning	QuestionnaireResponse	Each item must contain an answer or nested items	item.exists() implies (item.answer.exists() or item.item.exists())

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
QuestionnaireResponse	C	0..*	QuestionnaireResponse	A structured set of questions and their answers Constraints: qr-item-has-answer-or-children, qr-answer-has-value-or-children
QuestionnaireResponse.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
QuestionnaireResponse.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
QuestionnaireResponse.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
QuestionnaireResponse.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
QuestionnaireResponse.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
QuestionnaireResponse.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
QuestionnaireResponse.extension		0..*	Extension	Additional content defined by implementations
QuestionnaireResponse.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
QuestionnaireResponse.identifier	Σ This element is included in summaries.	0..1	Identifier	Unique id for this set of answers
QuestionnaireResponse.identifier.id		0..1	id	Unique id for inter-element referencing
QuestionnaireResponse.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
QuestionnaireResponse.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
QuestionnaireResponse.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
QuestionnaireResponse.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
QuestionnaireResponse.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
QuestionnaireResponse.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
QuestionnaireResponse.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
QuestionnaireResponse.basedOn	Σ This element is included in summaries.	0..*	HIEReference(ServiceRequest)	Request fulfilled by this QuestionnaireResponse
QuestionnaireResponse.partOf	Σ This element is included in summaries.	0..*	HIEReference(HIE Observation | Procedure)	Part of this action
QuestionnaireResponse.questionnaire	S This element must be supported. Σ This element is included in summaries.	1..1	canonical(Questionnaire)	Form being answered
QuestionnaireResponse.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	in-progress | completed | amended | entered-in-error | stopped Binding: QuestionnaireResponseStatus (required): Lifecycle status of the questionnaire response.
QuestionnaireResponse.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the questions
QuestionnaireResponse.encounter	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Encounter)	Encounter created as part of
QuestionnaireResponse.authored	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Date the answers were gathered
QuestionnaireResponse.author	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	Person who received and recorded the answers
QuestionnaireResponse.source	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	The person who answered the questions
QuestionnaireResponse.item	S This element must be supported. C	1..*	BackboneElement	Groups and questions Constraints: qrs-1
QuestionnaireResponse.item.id		0..1	string	Unique id for inter-element referencing
QuestionnaireResponse.item.extension		0..*	Extension	Additional content defined by implementations
QuestionnaireResponse.item.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
QuestionnaireResponse.item.linkId	S This element must be supported.	1..1	string	Pointer to specific item from Questionnaire
QuestionnaireResponse.item.definition		0..1	uri	ElementDefinition - details for the item
QuestionnaireResponse.item.text	S This element must be supported.	0..1	string	Name for group or question text
QuestionnaireResponse.item.answer	S This element must be supported.	0..*	BackboneElement	The response(s) to the question
QuestionnaireResponse.item.answer.id		0..1	string	Unique id for inter-element referencing
QuestionnaireResponse.item.answer.extension		0..*	Extension	Additional content defined by implementations
QuestionnaireResponse.item.answer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
QuestionnaireResponse.item.answer.value[x]		0..1		Single-valued answer to the question Binding: QuestionnaireAnswerCodes (example): Binding this is problematic because one value set can't apply to both codes and quantities.
QuestionnaireResponse.item.answer.value[x].valueBoolean			boolean
QuestionnaireResponse.item.answer.value[x].valueDecimal			decimal
QuestionnaireResponse.item.answer.value[x].valueInteger			integer
QuestionnaireResponse.item.answer.value[x].valueDate			date
QuestionnaireResponse.item.answer.value[x].valueDateTime			dateTime
QuestionnaireResponse.item.answer.value[x].valueTime			time
QuestionnaireResponse.item.answer.value[x].valueString			string
QuestionnaireResponse.item.answer.value[x].valueUri			uri
QuestionnaireResponse.item.answer.value[x].valueAttachment			Attachment
QuestionnaireResponse.item.answer.value[x].valueCoding			Coding
QuestionnaireResponse.item.answer.value[x].valueQuantity			Quantity
QuestionnaireResponse.item.answer.value[x].valueReference			Reference(Resource)
QuestionnaireResponse.item.answer.item		0..*	See item (QuestionnaireResponse)	Nested groups and questions
QuestionnaireResponse.item.item		0..*	See item (QuestionnaireResponse)	Nested questionnaire response items
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
QuestionnaireResponse.​language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
QuestionnaireResponse.​status	Base	required	QuestionnaireResponseStatus	📍4.3.0	FHIR Std.
QuestionnaireResponse.​item.answer.value[x]	Base	example	Questionnaire Answer Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	QuestionnaireResponse.identifier.type	Text is optional, coding is required	coding.exists()
dom-2	error	QuestionnaireResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	QuestionnaireResponse	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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	QuestionnaireResponse	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	error	QuestionnaireResponse	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	QuestionnaireResponse	A resource should have narrative for robust management	text.`div`.exists()
dom-r4b	warning	QuestionnaireResponse.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
qr-answer-has-value-or-children	error	QuestionnaireResponse	Each answer must have a value or nested items	answer.exists() implies answer.all(value.exists() or item.exists())
qr-item-has-answer-or-children	warning	QuestionnaireResponse	Each item must contain an answer or nested items	item.exists() implies (item.answer.exists() or item.item.exists())
qrs-1	error	QuestionnaireResponse.item	Nested item can't be beneath both item and answer	(answer.exists() and item.exists()).not()

This structure is derived from QuestionnaireResponse

Summary

Mandatory: 4 elements(4 nested mandatory elements)
Must-Support: 11 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE Observation (https://nshr.dha.go.ke/fhir/StructureDefinition/observation)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)
• HIE Encounter (https://nshr.dha.go.ke/fhir/StructureDefinition/encounter)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)
• HIE PractitionerRole (https://nshr.dha.go.ke/fhir/StructureDefinition/practitionerrole)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
QuestionnaireResponse	C	0..*	QuestionnaireResponse	A structured set of questions and their answers Constraints: qr-item-has-answer-or-children, qr-answer-has-value-or-children
QuestionnaireResponse.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
QuestionnaireResponse.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
QuestionnaireResponse.identifier	Σ This element is included in summaries.	0..1	Identifier	Unique id for this set of answers
QuestionnaireResponse.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
QuestionnaireResponse.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
QuestionnaireResponse.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
QuestionnaireResponse.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
QuestionnaireResponse.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
QuestionnaireResponse.basedOn	Σ This element is included in summaries.	0..*	HIEReference(ServiceRequest)	Request fulfilled by this QuestionnaireResponse
QuestionnaireResponse.partOf	Σ This element is included in summaries.	0..*	HIEReference(HIE Observation | Procedure)	Part of this action
QuestionnaireResponse.questionnaire	S This element must be supported. Σ This element is included in summaries.	1..1	canonical(Questionnaire)	Form being answered
QuestionnaireResponse.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	in-progress | completed | amended | entered-in-error | stopped Binding: QuestionnaireResponseStatus (required): Lifecycle status of the questionnaire response.
QuestionnaireResponse.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the questions
QuestionnaireResponse.encounter	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Encounter)	Encounter created as part of
QuestionnaireResponse.authored	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Date the answers were gathered
QuestionnaireResponse.author	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	Person who received and recorded the answers
QuestionnaireResponse.source	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	The person who answered the questions
QuestionnaireResponse.item	S This element must be supported. C	1..*	BackboneElement	Groups and questions Constraints: qrs-1
QuestionnaireResponse.item.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
QuestionnaireResponse.item.linkId	S This element must be supported.	1..1	string	Pointer to specific item from Questionnaire
QuestionnaireResponse.item.text	S This element must be supported.	0..1	string	Name for group or question text
QuestionnaireResponse.item.answer	S This element must be supported.	0..*	BackboneElement	The response(s) to the question
QuestionnaireResponse.item.answer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
QuestionnaireResponse.​identifier.use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
QuestionnaireResponse.​status	Base	required	QuestionnaireResponseStatus	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	QuestionnaireResponse.identifier.type	Text is optional, coding is required	coding.exists()
dom-2	error	QuestionnaireResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	QuestionnaireResponse	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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	QuestionnaireResponse	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	error	QuestionnaireResponse	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	QuestionnaireResponse	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
qr-answer-has-value-or-children	error	QuestionnaireResponse	Each answer must have a value or nested items	answer.exists() implies answer.all(value.exists() or item.exists())
qr-item-has-answer-or-children	warning	QuestionnaireResponse	Each item must contain an answer or nested items	item.exists() implies (item.answer.exists() or item.item.exists())
qrs-1	error	QuestionnaireResponse.item	Nested item can't be beneath both item and answer	(answer.exists() and item.exists()).not()

Differential View

This structure is derived from QuestionnaireResponse

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
QuestionnaireResponse	C	0..*	QuestionnaireResponse	A structured set of questions and their answers Constraints: qr-item-has-answer-or-children, qr-answer-has-value-or-children
QuestionnaireResponse.identifier
QuestionnaireResponse.identifier.use		1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
QuestionnaireResponse.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible)
QuestionnaireResponse.identifier.system		1..1	uri	The namespace for the identifier value
QuestionnaireResponse.identifier.value	S This element must be supported.	1..1	string	The value that is unique
QuestionnaireResponse.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
QuestionnaireResponse.basedOn		0..*	HIEReference(ServiceRequest)	Request fulfilled by this QuestionnaireResponse
QuestionnaireResponse.partOf		0..*	HIEReference(HIE Observation | Procedure)	Part of this action
QuestionnaireResponse.questionnaire	S This element must be supported.	1..1	canonical(Questionnaire)	Form being answered
QuestionnaireResponse.status	S This element must be supported.	1..1	code	in-progress | completed | amended | entered-in-error | stopped
QuestionnaireResponse.subject	S This element must be supported.	1..1	HIEReference(HIE Patient)	The subject of the questions
QuestionnaireResponse.encounter	S This element must be supported.	0..1	HIEReference(HIE Encounter)	Encounter created as part of
QuestionnaireResponse.authored	S This element must be supported.	1..1	dateTime	Date the answers were gathered
QuestionnaireResponse.author		0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	Person who received and recorded the answers
QuestionnaireResponse.source		0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	The person who answered the questions
QuestionnaireResponse.item	S This element must be supported.	1..*	BackboneElement	Groups and questions
QuestionnaireResponse.item.linkId	S This element must be supported.	1..1	string	Pointer to specific item from Questionnaire
QuestionnaireResponse.item.text	S This element must be supported.	0..1	string	Name for group or question text
QuestionnaireResponse.item.answer	S This element must be supported.	0..*	BackboneElement	The response(s) to the question
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
QuestionnaireResponse.​identifier.use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
qr-answer-has-value-or-children	error	QuestionnaireResponse	Each answer must have a value or nested items	answer.exists() implies answer.all(value.exists() or item.exists())
qr-item-has-answer-or-children	warning	QuestionnaireResponse	Each item must contain an answer or nested items	item.exists() implies (item.answer.exists() or item.item.exists())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
QuestionnaireResponse	C	0..*	QuestionnaireResponse	A structured set of questions and their answers Constraints: qr-item-has-answer-or-children, qr-answer-has-value-or-children
QuestionnaireResponse.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
QuestionnaireResponse.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
QuestionnaireResponse.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
QuestionnaireResponse.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
QuestionnaireResponse.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
QuestionnaireResponse.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
QuestionnaireResponse.extension		0..*	Extension	Additional content defined by implementations
QuestionnaireResponse.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
QuestionnaireResponse.identifier	Σ This element is included in summaries.	0..1	Identifier	Unique id for this set of answers
QuestionnaireResponse.identifier.id		0..1	id	Unique id for inter-element referencing
QuestionnaireResponse.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
QuestionnaireResponse.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
QuestionnaireResponse.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
QuestionnaireResponse.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
QuestionnaireResponse.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
QuestionnaireResponse.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
QuestionnaireResponse.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
QuestionnaireResponse.basedOn	Σ This element is included in summaries.	0..*	HIEReference(ServiceRequest)	Request fulfilled by this QuestionnaireResponse
QuestionnaireResponse.partOf	Σ This element is included in summaries.	0..*	HIEReference(HIE Observation | Procedure)	Part of this action
QuestionnaireResponse.questionnaire	S This element must be supported. Σ This element is included in summaries.	1..1	canonical(Questionnaire)	Form being answered
QuestionnaireResponse.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	in-progress | completed | amended | entered-in-error | stopped Binding: QuestionnaireResponseStatus (required): Lifecycle status of the questionnaire response.
QuestionnaireResponse.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the questions
QuestionnaireResponse.encounter	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Encounter)	Encounter created as part of
QuestionnaireResponse.authored	S This element must be supported. Σ This element is included in summaries.	1..1	dateTime	Date the answers were gathered
QuestionnaireResponse.author	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	Person who received and recorded the answers
QuestionnaireResponse.source	Σ This element is included in summaries.	0..1	HIEReference(HIE Practitioner | HIE PractitionerRole | HIE Patient | RelatedPerson)	The person who answered the questions
QuestionnaireResponse.item	S This element must be supported. C	1..*	BackboneElement	Groups and questions Constraints: qrs-1
QuestionnaireResponse.item.id		0..1	string	Unique id for inter-element referencing
QuestionnaireResponse.item.extension		0..*	Extension	Additional content defined by implementations
QuestionnaireResponse.item.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
QuestionnaireResponse.item.linkId	S This element must be supported.	1..1	string	Pointer to specific item from Questionnaire
QuestionnaireResponse.item.definition		0..1	uri	ElementDefinition - details for the item
QuestionnaireResponse.item.text	S This element must be supported.	0..1	string	Name for group or question text
QuestionnaireResponse.item.answer	S This element must be supported.	0..*	BackboneElement	The response(s) to the question
QuestionnaireResponse.item.answer.id		0..1	string	Unique id for inter-element referencing
QuestionnaireResponse.item.answer.extension		0..*	Extension	Additional content defined by implementations
QuestionnaireResponse.item.answer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
QuestionnaireResponse.item.answer.value[x]		0..1		Single-valued answer to the question Binding: QuestionnaireAnswerCodes (example): Binding this is problematic because one value set can't apply to both codes and quantities.
QuestionnaireResponse.item.answer.value[x].valueBoolean			boolean
QuestionnaireResponse.item.answer.value[x].valueDecimal			decimal
QuestionnaireResponse.item.answer.value[x].valueInteger			integer
QuestionnaireResponse.item.answer.value[x].valueDate			date
QuestionnaireResponse.item.answer.value[x].valueDateTime			dateTime
QuestionnaireResponse.item.answer.value[x].valueTime			time
QuestionnaireResponse.item.answer.value[x].valueString			string
QuestionnaireResponse.item.answer.value[x].valueUri			uri
QuestionnaireResponse.item.answer.value[x].valueAttachment			Attachment
QuestionnaireResponse.item.answer.value[x].valueCoding			Coding
QuestionnaireResponse.item.answer.value[x].valueQuantity			Quantity
QuestionnaireResponse.item.answer.value[x].valueReference			Reference(Resource)
QuestionnaireResponse.item.answer.item		0..*	See item (QuestionnaireResponse)	Nested groups and questions
QuestionnaireResponse.item.item		0..*	See item (QuestionnaireResponse)	Nested questionnaire response items
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
QuestionnaireResponse.​language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
QuestionnaireResponse.​identifier.type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
QuestionnaireResponse.​status	Base	required	QuestionnaireResponseStatus	📍4.3.0	FHIR Std.
QuestionnaireResponse.​item.answer.value[x]	Base	example	Questionnaire Answer Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	QuestionnaireResponse.identifier.type	Text is optional, coding is required	coding.exists()
dom-2	error	QuestionnaireResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	QuestionnaireResponse	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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	QuestionnaireResponse	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	error	QuestionnaireResponse	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	QuestionnaireResponse	A resource should have narrative for robust management	text.`div`.exists()
dom-r4b	warning	QuestionnaireResponse.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
qr-answer-has-value-or-children	error	QuestionnaireResponse	Each answer must have a value or nested items	answer.exists() implies answer.all(value.exists() or item.exists())
qr-item-has-answer-or-children	warning	QuestionnaireResponse	Each item must contain an answer or nested items	item.exists() implies (item.answer.exists() or item.item.exists())
qrs-1	error	QuestionnaireResponse.item	Nested item can't be beneath both item and answer	(answer.exists() and item.exists()).not()

This structure is derived from QuestionnaireResponse

Summary

Mandatory: 4 elements(4 nested mandatory elements)
Must-Support: 11 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE Observation (https://nshr.dha.go.ke/fhir/StructureDefinition/observation)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)
• HIE Encounter (https://nshr.dha.go.ke/fhir/StructureDefinition/encounter)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)
• HIE PractitionerRole (https://nshr.dha.go.ke/fhir/StructureDefinition/practitionerrole)

Other representations of profile: CSV, Excel, Schematron