FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
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FHIR Infrastructure icon Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the QuestionnaireResponse resource.

QuestionnaireResponse
Element IdQuestionnaireResponse
Definition

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.

Short DisplayA structured set of questions and their answers
Cardinality0..*
TypeDomainResource
Requirements

To support structured, hierarchical reporting of data gathered using digital forms and other questionnaires.

Alternate NamesForm; QuestionnaireAnswers
Summaryfalse
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.

QuestionnaireResponse.identifier
Element IdQuestionnaireResponse.identifier
Definition

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

Short DisplayUnique id for this set of answers
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Used for tracking, registration and other business purposes.

Summarytrue
QuestionnaireResponse.basedOn
Element IdQuestionnaireResponse.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.

Short DisplayRequest fulfilled by this QuestionnaireResponse
Cardinality0..*
TypeReference(CarePlan | ServiceRequest)
Requirements

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

Alternate Namesorder
Summarytrue
QuestionnaireResponse.partOf
Element IdQuestionnaireResponse.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.

Short DisplayPart of this action
Cardinality0..*
TypeReference(Observation | Procedure)
Summarytrue
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.

QuestionnaireResponse.questionnaire
Element IdQuestionnaireResponse.questionnaire
Definition

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

Short DisplayCanonical URL of Questionnaire being answered
Cardinality1..1
Typecanonical(Questionnaire)
Requirements

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

Alternate NamesForm
Summarytrue
Comments

If a QuestionnaireResponse references a Questionnaire that can be resolved, 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.). It is possible to have a QuestionnaireResponse whose 'questionnaire' element does not resolve. It is also possible for the questionnaire element to not have a value but only extensions (e.g. conveying the title or identifier for the questionnaire). This may happen for legacy data. If there is no formally defined Questionnaire, it is undefined what the 'correct' values for the linkId elements should be and it is possible that linkIds might be inconsistent for QuestionnaireResponses for the same form if captured by distinct systems.

QuestionnaireResponse.status
Element IdQuestionnaireResponse.status
Definition

The position of the questionnaire response within its overall lifecycle.

Short Displayin-progress | completed | amended | entered-in-error | stopped
Cardinality1..1
Terminology BindingQuestionnaireResponseStatus (Required)
Typecode
Is Modifiertrue (Reason: 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)
Requirements

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

Summarytrue
Comments

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

QuestionnaireResponse.subject
Element IdQuestionnaireResponse.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.

Short DisplayThe subject of the questions
Cardinality0..1
TypeReference(Any)
Requirements

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

Alternate NamesPatient; Focus
Summarytrue
Comments

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

QuestionnaireResponse.encounter
Element IdQuestionnaireResponse.encounter
Definition

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

Short DisplayEncounter created as part of
Cardinality0..1
TypeReference(Encounter)
Requirements

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

Summarytrue
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.

QuestionnaireResponse.authored
Element IdQuestionnaireResponse.authored
Definition

The date and/or time that this questionnaire response was last modified by the user - e.g. changing answers or revising status.

Short DisplayDate the answers were gathered
Cardinality0..1
TypedateTime
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
Summarytrue
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.

QuestionnaireResponse.author
Element IdQuestionnaireResponse.author
Definition

The individual or device that received the answers to the questions in the QuestionnaireResponse and recorded them in the system.

Short DisplayThe individual or device that received and recorded the answers
Cardinality0..1
TypeReference(Device | Practitioner | PractitionerRole | Patient | RelatedPerson | Organization)
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
Summarytrue
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. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance.

QuestionnaireResponse.source
Element IdQuestionnaireResponse.source
Definition

The individual or device that answered the questions about the subject.

Short DisplayThe individual or device that answered the questions
Cardinality0..1
TypeReference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
Requirements

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

Summarytrue
Comments

If not specified, no inference can be made about who provided the data. Device should only be used if it directly determined the answers, not if it was merely used as a capture tool to record answers provided by others. In the latter case, information about the physical device, software, etc. would be captured using Provenance.

QuestionnaireResponse.item
Element IdQuestionnaireResponse.item
Definition

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

Short DisplayGroups and questions
Cardinality0..*
Summaryfalse
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).\nWhen dealing with repeating items, each group repetition will be handled by a separate item. However, repeating questions are handled with a single question item and potentially multiple answers.

Invariants
Defined on this element
qrs-1Rule Item cannot contain both item and answer(answer.exists() and item.exists()).not()
qrs-2Rule Repeated answers are combined in the answers array of a single itemrepeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()
QuestionnaireResponse.item.linkId
Element IdQuestionnaireResponse.item.linkId
Definition

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

Short DisplayPointer to specific item from Questionnaire
Cardinality1..1
Typestring
Requirements

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

Summaryfalse
QuestionnaireResponse.item.definition
Element IdQuestionnaireResponse.item.definition
Definition

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

Short DisplayElementDefinition - details for the item
Cardinality0..1
Typeuri
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.

Summaryfalse
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.

QuestionnaireResponse.item.text
Element IdQuestionnaireResponse.item.text
Definition

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

Short DisplayName for group or question text
Cardinality0..1
Typestring
Requirements

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

Summaryfalse
Comments

The text for an item SHOULD be identical to the text from the corresponding Questionnaire.item. This can't be strictly enforced because it's possible for the Questionnaire to be updated subsequent to the QuestionnaireResponse having been created, however the intention is that the text in the QuestionnaireResponse reflects what the user saw when completing the Questionnaire.

QuestionnaireResponse.item.answer
Element IdQuestionnaireResponse.item.answer
Definition

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

Short DisplayThe response(s) to the question
Cardinality0..*
Summaryfalse
Comments

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

QuestionnaireResponse.item.answer.value[x]
Element IdQuestionnaireResponse.item.answer.value[x]
Definition

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

Short DisplaySingle-valued answer to the question
Cardinality1..1
Terminology BindingQuestionnaire Answer Codes (Example)
Typeboolean|decimal|integer|date|dateTime|time|string|uri|Attachment|Coding|SimpleQuantity|Reference(Any)
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Requirements

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

Summaryfalse
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. Note that a question is answered using one of the possible choices defined with answerOption, answerValueSet or some other means and the answer has a complex data type, all elements within the answer in the QuestionnaireResponse SHOULD match the elements defined corresponding choice value in the Questionnaire. However, it is possible that not all elements will be propagated. Also, some systems might use language translations resulting in different displays. Comparison of value to the values defined in the Questionnaire (whether by answerOption, answerValueSet or answerExpression) SHALL NOT pay attention to Coding.display, Reference.display, Quantity.unit unless those are the only elements present. As well, systems are not required to check for a match on any extensions (e.g. ordinal values, translations, etc). Systems MAY enforce that if extensions such as ordinal values are present in both Questionnaire and QuestionnaireResponse, they match.

QuestionnaireResponse.item.answer.item
Element IdQuestionnaireResponse.item.answer.item
Definition

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

Short DisplayChild items of question
Cardinality0..*
TypeSee QuestionnaireResponse.item
Requirements

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

Summaryfalse
Comments

Only used when nesting beneath a question - see item.item for nesting beneath groups

QuestionnaireResponse.item.item
Element IdQuestionnaireResponse.item.item
Definition

Sub-questions, sub-groups or display items nested beneath a group.

Short DisplayChild items of group item
Cardinality0..*
TypeSee QuestionnaireResponse.item
Requirements

Reports can consist of complex nested groups.

Summaryfalse
Comments

Only used when nesting beneath a group - see item.answer.item for nesting beneath questions