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Questionnaire "zika-virus-exposure-assessment" Version "1"

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Generated Narrative

url: http://example.org/Questionnaire/zika-virus-exposure-assessment

name: ExampleZikaVirusExposureAssessment

title: Example Zika Virus Exposure Assessment

status: draft

subjectType: Patient

date: 2016-11-14

description: Example questionnaire to assess Zika virus exposure potential.

effectivePeriod: 2016-11-14 --> (ongoing)

item

linkId: 1

code: CDE: Resident of or Frequent Traveler to Zika Area

text: Are you a resident of, or do you travel frequently to, an area with active Zika transmission?

type: boolean

item

linkId: 2

code: CDE: Recent Travel to Zika Area

text: Have you recently traveled to an area with active Zika transmission?

type: boolean

EnableWhens

-QuestionOperatorAnswer[x]
*1=false

item

linkId: 3

code: CDE: Time Since Returned From Travel

text: How long has it been since you returned?

type: quantity

EnableWhens

-QuestionOperatorAnswer[x]
*2=true

item

linkId: 4

code: CDE: Recent Sexual Encounter with Traveler to Zika Area

text: Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?

type: boolean

EnableWhens

-QuestionOperatorAnswer[x]
*2=false

item

linkId: 5

code: CDE: Time Since Sexual Encounter

text: How long has it been since your last condomless sexual encounter?

type: quantity

EnableWhens

-QuestionOperatorAnswer[x]
*4=true

item

linkId: 6

code: CDE: Planned Travel to Zika Area

text: Do you plan to travel to an area with active Zika transmission?

type: boolean

EnableWhens

-QuestionOperatorAnswer[x]
*4=false

{
  "resourceType" : "Questionnaire",
  "id" : "zika-virus-exposure-assessment",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2021-05-24T10:51:07.547Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>url</b>: <a>http://example.org/Questionnaire/zika-virus-exposure-assessment</a></p><p><b>name</b>: ExampleZikaVirusExposureAssessment</p><p><b>title</b>: Example Zika Virus Exposure Assessment</p><p><b>status</b>: draft</p><p><b>subjectType</b>: Patient</p><p><b>date</b>: 2016-11-14</p><p><b>description</b>: Example questionnaire to assess Zika virus exposure potential.</p><p><b>effectivePeriod</b>: 2016-11-14 --&gt; (ongoing)</p><blockquote><p><b>item</b></p><p><b>linkId</b>: 1</p><p><b>code</b>: <span>CDE: Resident of or Frequent Traveler to Zika Area</span></p><p><b>text</b>: Are you a resident of, or do you travel frequently to, an area with active Zika transmission?</p><p><b>type</b>: boolean</p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 2</p><p><b>code</b>: <span>CDE: Recent Travel to Zika Area</span></p><p><b>text</b>: Have you recently traveled to an area with active Zika transmission?</p><p><b>type</b>: boolean</p><h3>EnableWhens</h3><table><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>1</td><td>=</td><td>false</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 3</p><p><b>code</b>: <span>CDE: Time Since Returned From Travel</span></p><p><b>text</b>: How long has it been since you returned?</p><p><b>type</b>: quantity</p><h3>EnableWhens</h3><table><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>2</td><td>=</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 4</p><p><b>code</b>: <span>CDE: Recent Sexual Encounter with Traveler to Zika Area</span></p><p><b>text</b>: Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?</p><p><b>type</b>: boolean</p><h3>EnableWhens</h3><table><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>2</td><td>=</td><td>false</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 5</p><p><b>code</b>: <span>CDE: Time Since Sexual Encounter</span></p><p><b>text</b>: How long has it been since your last condomless sexual encounter?</p><p><b>type</b>: quantity</p><h3>EnableWhens</h3><table><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>4</td><td>=</td><td>true</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 6</p><p><b>code</b>: <span>CDE: Planned Travel to Zika Area</span></p><p><b>text</b>: Do you plan to travel to an area with active Zika transmission?</p><p><b>type</b>: boolean</p><h3>EnableWhens</h3><table><tr><td>-</td><td><b>Question</b></td><td><b>Operator</b></td><td><b>Answer[x]</b></td></tr><tr><td>*</td><td>4</td><td>=</td><td>false</td></tr></table></blockquote></div>"
  },
  "url" : "http://example.org/Questionnaire/zika-virus-exposure-assessment",
  "name" : "ExampleZikaVirusExposureAssessment",
  "title" : "Example Zika Virus Exposure Assessment",
  "status" : "draft",
  "subjectType" : [
    "Patient"
  ],
  "date" : "2016-11-14",
  "description" : "Example questionnaire to assess Zika virus exposure potential.",
  "effectivePeriod" : {
    "start" : "2016-11-14"
  },
  "item" : [
    {
      "extension" : [
        {
          "url" : "http://example.org/additional-information",
          "valueAttachment" : {
            "url" : "http://www.cdc.gov/zika/geo/index.html",
            "title" : "Areas with active Zika virus transmission/exposure risk"
          }
        }
      ],
      "linkId" : "1",
      "code" : [
        {
          "system" : "http://example.org/questionnaires",
          "code" : "CDE: Resident of or Frequent Traveler to Zika Area"
        }
      ],
      "text" : "Are you a resident of, or do you travel frequently to, an area with active Zika transmission?",
      "type" : "boolean"
    },
    {
      "extension" : [
        {
          "url" : "http://example.org/additional-information",
          "valueAttachment" : {
            "url" : "http://www.cdc.gov/zika/geo/index.html",
            "title" : "Areas with active Zika virus transmission/exposure risk"
          }
        }
      ],
      "linkId" : "2",
      "code" : [
        {
          "system" : "http://example.org/questionnaires",
          "code" : "CDE: Recent Travel to Zika Area"
        }
      ],
      "text" : "Have you recently traveled to an area with active Zika transmission?",
      "type" : "boolean",
      "enableWhen" : [
        {
          "question" : "1",
          "operator" : "=",
          "answerBoolean" : false
        }
      ]
    },
    {
      "linkId" : "3",
      "code" : [
        {
          "system" : "http://example.org/questionnaires",
          "code" : "CDE: Time Since Returned From Travel"
        }
      ],
      "text" : "How long has it been since you returned?",
      "type" : "quantity",
      "enableWhen" : [
        {
          "question" : "2",
          "operator" : "=",
          "answerBoolean" : true
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://example.org/additional-information",
          "valueAttachment" : {
            "url" : "http://www.cdc.gov/zika/geo/index.html",
            "title" : "Areas with active Zika virus transmission/exposure risk"
          }
        }
      ],
      "linkId" : "4",
      "code" : [
        {
          "system" : "http://example.org/questionnaires",
          "code" : "CDE: Recent Sexual Encounter with Traveler to Zika Area"
        }
      ],
      "text" : "Have you recently had condomless sex with a partner that has travelled in an area with active Zika transmission?",
      "type" : "boolean",
      "enableWhen" : [
        {
          "question" : "2",
          "operator" : "=",
          "answerBoolean" : false
        }
      ]
    },
    {
      "linkId" : "5",
      "code" : [
        {
          "system" : "http://example.org/questionnaires",
          "code" : "CDE: Time Since Sexual Encounter"
        }
      ],
      "text" : "How long has it been since your last condomless sexual encounter?",
      "type" : "quantity",
      "enableWhen" : [
        {
          "question" : "4",
          "operator" : "=",
          "answerBoolean" : true
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://example.org/additional-information",
          "valueAttachment" : {
            "url" : "http://www.cdc.gov/zika/geo/index.html",
            "title" : "Areas with active Zika virus transmission/exposure risk"
          }
        }
      ],
      "linkId" : "6",
      "code" : [
        {
          "system" : "http://example.org/questionnaires",
          "code" : "CDE: Planned Travel to Zika Area"
        }
      ],
      "text" : "Do you plan to travel to an area with active Zika transmission?",
      "type" : "boolean",
      "enableWhen" : [
        {
          "question" : "4",
          "operator" : "=",
          "answerBoolean" : false
        }
      ]
    }
  ]
}

Questionnaire "3141" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

            1.Comorbidity?
              1.1 Cardial Comorbidity
                1.1.1 Angina?
                1.1.2 MI?
              1.2 Vascular Comorbidity?
              ...
            Histopathology
              Abdominal
                pT category?
              ...
          

{
  "resourceType" : "Questionnaire",
  "id" : "3141",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2021-05-24T10:51:07.422Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <pre>\n 1.Comorbidity?\n 1.1 Cardial Comorbidity\n 1.1.1 Angina?\n 1.1.2 MI?\n 1.2 Vascular Comorbidity?\n ...\n Histopathology\n Abdominal\n pT category?\n ...\n </pre>\n </div>"
  },
  "url" : "http://hl7.org/fhir/Questionnaire/3141",
  "title" : "Cancer Quality Forum Questionnaire 2012",
  "status" : "draft",
  "subjectType" : [
    "Patient"
  ],
  "date" : "2012-01",
  "item" : [
    {
      "linkId" : "1",
      "code" : [
        {
          "system" : "http://example.org/system/code/sections",
          "code" : "COMORBIDITY"
        }
      ],
      "type" : "group",
      "item" : [
        {
          "linkId" : "1.1",
          "code" : [
            {
              "system" : "http://example.org/system/code/questions",
              "code" : "COMORB"
            }
          ],
          "prefix" : "1",
          "type" : "coding",
          "answerValueSet" : "http://hl7.org/fhir/ValueSet/yesnodontknow",
          "item" : [
            {
              "linkId" : "1.1.1",
              "code" : [
                {
                  "system" : "http://example.org/system/code/sections",
                  "code" : "CARDIAL"
                }
              ],
              "type" : "group",
              "enableWhen" : [
                {
                  "question" : "1.1",
                  "operator" : "=",
                  "answerCoding" : {
                    "system" : "http://terminology.hl7.org/CodeSystem/v2-0136",
                    "code" : "Y"
                  }
                }
              ],
              "item" : [
                {
                  "linkId" : "1.1.1.1",
                  "code" : [
                    {
                      "system" : "http://example.org/system/code/questions",
                      "code" : "COMORBCAR"
                    }
                  ],
                  "prefix" : "1.1",
                  "type" : "coding",
                  "answerValueSet" : "http://hl7.org/fhir/ValueSet/yesnodontknow",
                  "item" : [
                    {
                      "linkId" : "1.1.1.1.1",
                      "code" : [
                        {
                          "system" : "http://example.org/system/code/questions",
                          "code" : "COMCAR00",
                          "display" : "Angina Pectoris"
                        },
                        {
                          "system" : "http://snomed.info/sct",
                          "code" : "194828000",
                          "display" : "Angina (disorder)"
                        }
                      ],
                      "prefix" : "1.1.1",
                      "type" : "coding",
                      "answerValueSet" : "http://hl7.org/fhir/ValueSet/yesnodontknow"
                    },
                    {
                      "linkId" : "1.1.1.1.2",
                      "code" : [
                        {
                          "system" : "http://snomed.info/sct",
                          "code" : "22298006",
                          "display" : "Myocardial infarction (disorder)"
                        }
                      ],
                      "prefix" : "1.1.2",
                      "type" : "coding",
                      "answerValueSet" : "http://hl7.org/fhir/ValueSet/yesnodontknow"
                    }
                  ]
                },
                {
                  "linkId" : "1.1.1.2",
                  "code" : [
                    {
                      "system" : "http://example.org/system/code/questions",
                      "code" : "COMORBVAS"
                    }
                  ],
                  "prefix" : "1.2",
                  "type" : "coding",
                  "answerValueSet" : "http://hl7.org/fhir/ValueSet/yesnodontknow"
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId" : "2",
      "code" : [
        {
          "system" : "http://example.org/system/code/sections",
          "code" : "HISTOPATHOLOGY"
        }
      ],
      "type" : "group",
      "item" : [
        {
          "linkId" : "2.1",
          "code" : [
            {
              "system" : "http://example.org/system/code/sections",
              "code" : "ABDOMINAL"
            }
          ],
          "type" : "group",
          "item" : [
            {
              "linkId" : "2.1.2",
              "code" : [
                {
                  "system" : "http://example.org/system/code/questions",
                  "code" : "STADPT",
                  "display" : "pT category"
                }
              ],
              "type" : "coding"
            }
          ]
        }
      ]
    }
  ]
}

Questionnaire "example-practitioner-info" Version "1"

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Updated: by

Generated Narrative

status: draft

item

linkId: core-props

type: group

repeats: false

Items

-
*
*
*
*
*
*

item

linkId: Practitioner.qualification

definition: http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification

text: Qualifications

type: group

repeats: true

Items

-
*
*
*
*

{
  "resourceType" : "Questionnaire",
  "id" : "example-practitioner-info",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2021-05-24T10:51:07.379Z",
    "tag" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "HTEST",
        "display" : "test health data"
      }
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: draft</p><blockquote><p><b>item</b></p><p><b>linkId</b>: core-props</p><p><b>type</b>: group</p><p><b>repeats</b>: false</p><h3>Items</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: Practitioner.qualification</p><p><b>definition</b>: <a>http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification</a></p><p><b>text</b>: Qualifications</p><p><b>type</b>: group</p><p><b>repeats</b>: true</p><h3>Items</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "status" : "draft",
  "item" : [
    {
      "linkId" : "core-props",
      "type" : "group",
      "repeats" : false,
      "item" : [
        {
          "linkId" : "Practitioner.active",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.active",
          "text" : "Active",
          "type" : "boolean"
        },
        {
          "linkId" : "Practitioner.gender",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.gender",
          "text" : "Gender",
          "type" : "coding"
        },
        {
          "linkId" : "Practitioner.birthDate",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.birthDate",
          "text" : "Birth Date",
          "type" : "date"
        },
        {
          "linkId" : "Practitioner.name.text",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.name.text",
          "text" : "Name",
          "type" : "string"
        },
        {
          "linkId" : "Practitioner.address.line",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.address.line",
          "text" : "Address",
          "type" : "string",
          "repeats" : true
        },
        {
          "linkId" : "Practitioner.address.postalCode",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.address.postalCode",
          "text" : "Post Code",
          "type" : "string"
        }
      ]
    },
    {
      "linkId" : "Practitioner.qualification",
      "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification",
      "text" : "Qualifications",
      "type" : "group",
      "repeats" : true,
      "item" : [
        {
          "linkId" : "Practitioner.qualification.code.coding.code",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.code.coding.code",
          "text" : "Code",
          "type" : "string"
        },
        {
          "linkId" : "Practitioner.qualification.code.coding.display",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.code.coding.display",
          "text" : "Display",
          "type" : "string"
        },
        {
          "linkId" : "Practitioner.qualification.period.end",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.period.end",
          "text" : "Completion Year",
          "type" : "dateTime"
        },
        {
          "linkId" : "Practitioner.qualification.issuer.display",
          "definition" : "http://hl7.org/fhir/StructureDefinition/Practitioner#Practitioner.qualification.issuer.display",
          "text" : "Issued by",
          "type" : "string"
        }
      ]
    }
  ]
}

Questionnaire "gcs" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative

url: http://hl7.org/fhir/Questionnaire/gcs

title: Glasgow Coma Score

status: draft

subjectType: Patient

date: 2015-08-03

publisher: FHIR Project team

code: Glasgow coma score total

item

linkId: 1.1

code: Glasgow coma score verbal

type: coding

answerValueSet: #verbal

item

linkId: 1.2

code: Glasgow coma score motor

type: coding

answerValueSet: #motor

item

linkId: 1.3

code: Glasgow coma score eye opening

type: coding

answerValueSet: #eye


{
  "resourceType" : "Questionnaire",
  "id" : "gcs",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2021-05-24T10:51:07.313Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>url</b>: <a>http://hl7.org/fhir/Questionnaire/gcs</a></p><p><b>title</b>: Glasgow Coma Score</p><p><b>status</b>: draft</p><p><b>subjectType</b>: Patient</p><p><b>date</b>: 2015-08-03</p><p><b>publisher</b>: FHIR Project team</p><p><b>code</b>: <span>Glasgow coma score total</span></p><blockquote><p><b>item</b></p><p><b>linkId</b>: 1.1</p><p><b>code</b>: <span>Glasgow coma score verbal</span></p><p><b>type</b>: coding</p><p><b>answerValueSet</b>: <code>#verbal</code></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 1.2</p><p><b>code</b>: <span>Glasgow coma score motor</span></p><p><b>type</b>: coding</p><p><b>answerValueSet</b>: <code>#motor</code></p></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: 1.3</p><p><b>code</b>: <span>Glasgow coma score eye opening</span></p><p><b>type</b>: coding</p><p><b>answerValueSet</b>: <code>#eye</code></p></blockquote></div>"
  },
  "contained" : [
    {
      "resourceType" : "ValueSet",
      "id" : "motor",
      "identifier" : [
        {
          "system" : "http://loinc.org",
          "value" : "http://loinc.org/ValueSet/LL357-5"
        }
      ],
      "name" : "GCS Motor Value Set",
      "status" : "active",
      "description" : "LOINC ANSWER LIST (LL357-5)",
      "compose" : {
        "include" : [
          {
            "system" : "http://loinc.org",
            "concept" : [
              {
                "code" : "LA6562-8",
                "display" : "No motor response"
              },
              {
                "code" : "LA6563-6",
                "display" : "Extension to pain"
              },
              {
                "code" : "LA6564-4",
                "display" : "Flexion to pain"
              },
              {
                "code" : "LA6565-1",
                "display" : "Withdrawl from pain"
              },
              {
                "code" : "LA6566-9",
                "display" : "Localizing pain"
              },
              {
                "code" : "LA6567-7",
                "display" : "Obeys commands"
              }
            ]
          }
        ]
      }
    },
    {
      "resourceType" : "ValueSet",
      "id" : "verbal",
      "identifier" : [
        {
          "system" : "http://loinc.org",
          "value" : "http://loinc.org/ValueSet/LL356-7"
        }
      ],
      "name" : "GCS Verbal Value Set",
      "status" : "active",
      "description" : "LOINC ANSWER LIST (LL356-7)",
      "compose" : {
        "include" : [
          {
            "system" : "http://loinc.org",
            "concept" : [
              {
                "code" : "LA6557-8",
                "display" : "No verbal response (>2yrs); no vocal response (<=2yrs)"
              },
              {
                "code" : "LA6558-6",
                "display" : "Incomprehensible sounds"
              },
              {
                "code" : "LA6559-4",
                "display" : "Inappropriate words"
              },
              {
                "code" : "LA6560-2",
                "display" : "Confused"
              },
              {
                "code" : "LA6561-0",
                "display" : "Oriented"
              }
            ]
          }
        ]
      }
    },
    {
      "resourceType" : "ValueSet",
      "id" : "eye",
      "identifier" : [
        {
          "system" : "http://loinc.org",
          "value" : "http://loinc.org/ValueSet/LL355-9"
        }
      ],
      "name" : "GCS Eye Value Set",
      "status" : "active",
      "description" : "LOINC ANSWER LIST (LL355-9)",
      "compose" : {
        "include" : [
          {
            "system" : "http://loinc.org",
            "concept" : [
              {
                "code" : "LA6553-7",
                "display" : "No eye opening"
              },
              {
                "code" : "LA6554-5",
                "display" : "Eye opening to pain"
              },
              {
                "code" : "LA6555-2",
                "display" : "Eye opening to verbal command"
              },
              {
                "code" : "LA6556-0",
                "display" : "Eyes open spontaneously"
              }
            ]
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/Questionnaire/gcs",
  "title" : "Glasgow Coma Score",
  "status" : "draft",
  "subjectType" : [
    "Patient"
  ],
  "date" : "2015-08-03",
  "publisher" : "FHIR Project team",
  "code" : [
    {
      "system" : "http://loinc.org",
      "code" : "9269-2"
    }
  ],
  "item" : [
    {
      "linkId" : "1.1",
      "code" : [
        {
          "system" : "http://loinc.org",
          "code" : "9270-0"
        }
      ],
      "type" : "coding",
      "answerValueSet" : "#verbal"
    },
    {
      "linkId" : "1.2",
      "code" : [
        {
          "system" : "http://loinc.org",
          "code" : "9268-4"
        }
      ],
      "type" : "coding",
      "answerValueSet" : "#motor"
    },
    {
      "linkId" : "1.3",
      "code" : [
        {
          "system" : "http://loinc.org",
          "code" : "9267-6"
        }
      ],
      "type" : "coding",
      "answerValueSet" : "#eye"
    }
  ]
}

Questionnaire "f201" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Lifelines Questionnaire 1 part 1
  1. Do you have allergies?
  2. General Questions:
    2.a) What is your gender?
    2.b) What is your date of birth?
    2.c) What is your country of birth?
    2.d) What is your marital status?
    3. Intoxications:
      3.a) Do you smoke?
      3.b) Do you drink alcohol?

{
  "resourceType" : "Questionnaire",
  "id" : "f201",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2021-05-24T10:51:07.266Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <pre>Lifelines Questionnaire 1 part 1\n 1. Do you have allergies?\n 2. General Questions:\n 2.a) What is your gender?\n 2.b) What is your date of birth?\n 2.c) What is your country of birth?\n 2.d) What is your marital status?\n 3. Intoxications:\n 3.a) Do you smoke?\n 3.b) Do you drink alcohol?</pre>\n </div>"
  },
  "url" : "http://hl7.org/fhir/Questionnaire/f201",
  "status" : "active",
  "subjectType" : [
    "Patient"
  ],
  "date" : "2010",
  "code" : [
    {
      "system" : "http://example.org/system/code/lifelines/nl",
      "code" : "VL 1-1, 18-65_1.2.2",
      "display" : "Lifelines Questionnaire 1 part 1"
    }
  ],
  "item" : [
    {
      "linkId" : "1",
      "text" : "Do you have allergies?",
      "type" : "boolean"
    },
    {
      "linkId" : "2",
      "text" : "General questions",
      "type" : "group",
      "item" : [
        {
          "linkId" : "2.1",
          "text" : "What is your gender?",
          "type" : "string"
        },
        {
          "linkId" : "2.2",
          "text" : "What is your date of birth?",
          "type" : "date"
        },
        {
          "linkId" : "2.3",
          "text" : "What is your country of birth?",
          "type" : "string"
        },
        {
          "linkId" : "2.4",
          "text" : "What is your marital status?",
          "type" : "string"
        }
      ]
    },
    {
      "linkId" : "3",
      "text" : "Intoxications",
      "type" : "group",
      "item" : [
        {
          "linkId" : "3.1",
          "text" : "Do you smoke?",
          "type" : "boolean"
        },
        {
          "linkId" : "3.2",
          "text" : "Do you drink alchohol?",
          "type" : "boolean"
        }
      ]
    }
  ]
}

Questionnaire "bb" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

        Birth details - To be completed by health professional
  Name of child: ____________________________________
            Sex: __
            
  Neonatal Information
    Birth Weight (kg): ___________
    Birth Length (cm): ___________
    Vitamin K given  : __
             1st dose: ___________
             2nd dose: ___________
    Hep B given      : __
      Date given     : ___________
    Abnormalities noted at birth:
      _______________________________________________
      

{
  "resourceType" : "Questionnaire",
  "id" : "bb",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2021-05-24T10:51:07.203Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <pre>\n <b>Birth details - To be completed by health professional</b>\n Name of child: ____________________________________\n Sex: __\n \n Neonatal Information\n Birth Weight (kg): ___________\n Birth Length (cm): ___________\n Vitamin K given : __\n 1st dose: ___________\n 2nd dose: ___________\n Hep B given : __\n Date given : ___________\n Abnormalities noted at birth:\n _______________________________________________\n </pre>\n </div>"
  },
  "url" : "http://hl7.org/fhir/Questionnaire/bb",
  "title" : "NSW Government My Personal Health Record",
  "status" : "draft",
  "subjectType" : [
    "Patient"
  ],
  "date" : "2013-02-19",
  "publisher" : "New South Wales Department of Health",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "AU"
        }
      ]
    }
  ],
  "item" : [
    {
      "linkId" : "birthDetails",
      "text" : "Birth details - To be completed by health professional",
      "type" : "group",
      "item" : [
        {
          "linkId" : "group",
          "type" : "group",
          "item" : [
            {
              "linkId" : "nameOfChild",
              "text" : "Name of child",
              "type" : "string"
            },
            {
              "linkId" : "sex",
              "text" : "Sex",
              "type" : "coding",
              "answerOption" : [
                {
                  "valueCoding" : {
                    "code" : "F"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "M"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "neonatalInformation",
          "text" : "Neonatal Information",
          "type" : "group",
          "item" : [
            {
              "linkId" : "birthWeight",
              "text" : "Birth weight (kg)",
              "type" : "decimal"
            },
            {
              "linkId" : "birthLength",
              "text" : "Birth length (cm)",
              "type" : "decimal"
            },
            {
              "linkId" : "vitaminKgiven",
              "text" : "Vitamin K given",
              "type" : "coding",
              "answerOption" : [
                {
                  "valueCoding" : {
                    "code" : "INJECTION"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "INTRAVENOUS"
                  }
                },
                {
                  "valueCoding" : {
                    "code" : "ORAL"
                  }
                }
              ],
              "item" : [
                {
                  "linkId" : "vitaminKgivenDoses",
                  "type" : "group",
                  "enableWhen" : [
                    {
                      "question" : "vitaminKgiven",
                      "operator" : "exists",
                      "answerBoolean" : true
                    }
                  ],
                  "item" : [
                    {
                      "linkId" : "vitaminiKDose1",
                      "text" : "1st dose",
                      "type" : "dateTime"
                    },
                    {
                      "linkId" : "vitaminiKDose2",
                      "text" : "2nd dose",
                      "type" : "dateTime"
                    }
                  ]
                }
              ]
            },
            {
              "linkId" : "hepBgiven",
              "text" : "Hep B given y / n",
              "type" : "boolean",
              "item" : [
                {
                  "linkId" : "hepBgivenDate",
                  "text" : "Date given",
                  "type" : "date"
                }
              ]
            },
            {
              "linkId" : "abnormalitiesAtBirth",
              "text" : "Abnormalities noted at birth",
              "type" : "string"
            }
          ]
        }
      ]
    }
  ]
}

Questionnaire "qs1" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: qs1

meta:

identifier: ??

version: 4.6.0

status: draft

date: 5/3/2021 9:59:52 PM

publisher: Health Level Seven International (Patient Administration)


{
  "resourceType" : "Questionnaire",
  "id" : "qs1",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2021-05-24T10:48:56.109Z",
    "tag" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "HTEST",
        "display" : "test health data"
      }
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: qs1</p><p><b>meta</b>: </p><p><b>identifier</b>: ??</p><p><b>version</b>: 4.6.0</p><p><b>status</b>: draft</p><p><b>date</b>: 5/3/2021 9:59:52 PM</p><p><b>publisher</b>: Health Level Seven International (Patient Administration)</p></div>"
  },
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986"
    }
  ],
  "version" : "4.6.0",
  "status" : "draft",
  "date" : "2021-05-03T21:59:52+10:00",
  "publisher" : "Health Level Seven International (Patient Administration)",
  "item" : [
    {
      "linkId" : "Account",
      "text" : "Tracks balance, charges, for patient or cost center",
      "type" : "group",
      "required" : false,
      "repeats" : true,
      "item" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/questionnaire-item-control",
                    "code" : "flyover",
                    "display" : "Fly-over"
                  }
                ]
              }
            }
          ],
          "text" : "A financial tool for tracking value accrued for a particular purpose. In the healthcare field, used to track charges for a patient, cost centers, etc.",
          "type" : "display"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "string"
            }
          ],
          "linkId" : "Account.id",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Typically, the resource has an id except for cases like the create operation, conditional updates.",
              "type" : "display"
            },
            {
              "linkId" : "Account.id.value",
              "text" : "Logical id of this artifact",
              "type" : "string",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            }
          ],
          "linkId" : "Account.meta",
          "text" : "Metadata about the resource",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "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.",
              "type" : "display"
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "uri"
            }
          ],
          "linkId" : "Account.implicitRules",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "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. 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.",
              "type" : "display"
            },
            {
              "linkId" : "Account.implicitRules.value",
              "text" : "A set of rules under which this content was created",
              "type" : "string",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "code"
            }
          ],
          "linkId" : "Account.language",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "The base language in which the resource is written. 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).",
              "type" : "display"
            },
            {
              "linkId" : "Account.language.value",
              "text" : "language",
              "type" : "coding",
              "required" : false,
              "repeats" : false,
              "answerConstraint" : "optionsOnly"
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            }
          ],
          "linkId" : "Account.text",
          "text" : "Text summary of the resource, for human interpretation",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "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. Contained resources do not have a 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.",
              "type" : "display"
            }
          ]
        },
        {
          "linkId" : "Account.contained",
          "text" : "Contained, inline Resources",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. 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.",
              "type" : "display"
            }
          ]
        },
        {
          "linkId" : "Account.extension",
          "text" : "Additional content defined by implementations",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "May be used to represent additional information that is not part of the basic definition of the resource. 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. 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.",
              "type" : "display"
            }
          ]
        },
        {
          "linkId" : "Account.modifierExtension",
          "text" : "Extensions that cannot be ignored",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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.",
              "type" : "display"
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "Identifier"
            }
          ],
          "linkId" : "Account.identifier",
          "text" : "Account number",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Unique identifier used to reference the account. Might or might not be intended for human use (e.g. credit card number).",
              "type" : "display"
            },
            {
              "linkId" : "Account.identifier.label",
              "text" : "label:",
              "type" : "string",
              "required" : false,
              "repeats" : false
            },
            {
              "linkId" : "Account.identifier.system",
              "text" : "system:",
              "type" : "string",
              "required" : false,
              "repeats" : false
            },
            {
              "linkId" : "Account.identifier.value",
              "text" : "value:",
              "type" : "string",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "code"
            }
          ],
          "linkId" : "Account.status",
          "type" : "group",
          "required" : true,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Indicates whether the account is presently used/usable or not. This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the Account as not currently valid.",
              "type" : "display"
            },
            {
              "linkId" : "Account.status.value",
              "text" : "status",
              "type" : "coding",
              "required" : false,
              "repeats" : false,
              "answerConstraint" : "optionsOrType"
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "CodeableConcept"
            }
          ],
          "linkId" : "Account.type",
          "text" : "E.g. patient, expense, depreciation",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Categorizes the account for reporting and searching purposes.",
              "type" : "display"
            },
            {
              "linkId" : "Account.type.coding",
              "text" : "code:",
              "type" : "coding",
              "required" : false,
              "repeats" : false,
              "answerConstraint" : "optionsOnly"
            },
            {
              "linkId" : "Account.type.text",
              "text" : "text:",
              "type" : "string",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "string"
            }
          ],
          "linkId" : "Account.name",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Name used for the account when displaying it to humans in reports, etc.",
              "type" : "display"
            },
            {
              "linkId" : "Account.name.value",
              "text" : "Human-readable label",
              "type" : "string",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "Reference"
            }
          ],
          "linkId" : "Account.subject",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Identifies the entity which incurs the expenses. While the immediate recipients of services or goods might be entities related to the subject, the expenses were ultimately incurred by the subject of the Account. Accounts can be applied to non-patients for tracking other non-patient related activities, such as group services (patients not tracked, and costs charged to another body), or might not be allocated.",
              "type" : "display"
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource",
                  "valueCode" : "Patient, Device, Practitioner, PractitionerRole, Location, HealthcareService, Organization"
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                  "valueString" : "subject=$subj&patient=$subj&encounter=$encounter"
                }
              ],
              "linkId" : "Account.subject.value",
              "text" : "The entity that caused the expenses",
              "type" : "reference",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "Period"
            }
          ],
          "linkId" : "Account.servicePeriod",
          "text" : "Transaction window",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "The date range of services associated with this account. It is possible for transactions to be posted outside the service period, as long as the service was provided within the defined service period.",
              "type" : "display"
            },
            {
              "linkId" : "Account.servicePeriod.low",
              "text" : "start:",
              "type" : "dateTime",
              "required" : false,
              "repeats" : false
            },
            {
              "linkId" : "Account.servicePeriod.end",
              "text" : "end:",
              "type" : "dateTime",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "Account.coverage",
          "text" : "The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "text" : "Typically. this may be some form of insurance, internal charges, or self-pay.\n\nLocal or jurisdictional business rules may determine which coverage covers which types of billable items charged to the account, and in which order.\nWhere the order is important, a local/jurisdictional extension may be defined to specify the order for the type of charge.",
              "type" : "display"
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account.",
              "type" : "display"
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
                  "valueString" : "string"
                }
              ],
              "linkId" : "Account.coverage.id",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                  "type" : "display"
                },
                {
                  "linkId" : "Account.coverage.id.value",
                  "text" : "Unique id for inter-element referencing",
                  "type" : "string",
                  "required" : false,
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "Account.coverage.extension",
              "text" : "Additional content defined by implementations",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "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. 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.",
                  "type" : "display"
                }
              ]
            },
            {
              "linkId" : "Account.coverage.modifierExtension",
              "text" : "Extensions that cannot be ignored even if unrecognized",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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.",
                  "type" : "display"
                }
              ]
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
                  "valueString" : "Reference"
                }
              ],
              "linkId" : "Account.coverage.coverage",
              "type" : "group",
              "required" : true,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "The party(s) that contribute to payment (or part of) of the charges applied to this account (including self-pay).\n\nA coverage may only be responsible for specific types of charges, and the sequence of the coverages in the account could be important when processing billing.",
                  "type" : "display"
                },
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource",
                      "valueCode" : "Coverage"
                    },
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                      "valueString" : "subject=$subj&patient=$subj&encounter=$encounter"
                    }
                  ],
                  "linkId" : "Account.coverage.coverage.value",
                  "text" : "The party(s), such as insurances, that may contribute to the payment of this account",
                  "type" : "reference",
                  "required" : false,
                  "repeats" : false
                }
              ]
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
                  "valueString" : "integer"
                }
              ],
              "linkId" : "Account.coverage.priority",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "The priority of the coverage in the context of this account. It is common in some jurisdictions for there to be multiple coverages allocated to an account, and a sequence is required to order the settling of the account (often with insurance claiming).",
                  "type" : "display"
                },
                {
                  "linkId" : "Account.coverage.priority.value",
                  "text" : "The priority of the coverage in the context of this account",
                  "type" : "integer",
                  "required" : false,
                  "repeats" : false
                }
              ]
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "Reference"
            }
          ],
          "linkId" : "Account.owner",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Indicates the service area, hospital, department, etc. with responsibility for managing the Account.",
              "type" : "display"
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource",
                  "valueCode" : "Organization"
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                  "valueString" : "subject=$subj&patient=$subj&encounter=$encounter"
                }
              ],
              "linkId" : "Account.owner.value",
              "text" : "Entity managing the Account",
              "type" : "reference",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "string"
            }
          ],
          "linkId" : "Account.description",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Provides additional information about what the account tracks and how it is used.",
              "type" : "display"
            },
            {
              "linkId" : "Account.description.value",
              "text" : "Explanation of purpose/use",
              "type" : "string",
              "required" : false,
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "Account.guarantor",
          "text" : "The parties ultimately responsible for balancing the Account",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "The parties responsible for balancing the account if other payment options fall short.",
              "type" : "display"
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
                  "valueString" : "string"
                }
              ],
              "linkId" : "Account.guarantor.id",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                  "type" : "display"
                },
                {
                  "linkId" : "Account.guarantor.id.value",
                  "text" : "Unique id for inter-element referencing",
                  "type" : "string",
                  "required" : false,
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "Account.guarantor.extension",
              "text" : "Additional content defined by implementations",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "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. 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.",
                  "type" : "display"
                }
              ]
            },
            {
              "linkId" : "Account.guarantor.modifierExtension",
              "text" : "Extensions that cannot be ignored even if unrecognized",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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.",
                  "type" : "display"
                }
              ]
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
                  "valueString" : "Reference"
                }
              ],
              "linkId" : "Account.guarantor.party",
              "type" : "group",
              "required" : true,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "The entity who is responsible.",
                  "type" : "display"
                },
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource",
                      "valueCode" : "Patient, RelatedPerson, Organization"
                    },
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                      "valueString" : "subject=$subj&patient=$subj&encounter=$encounter"
                    }
                  ],
                  "linkId" : "Account.guarantor.party.value",
                  "text" : "Responsible entity",
                  "type" : "reference",
                  "required" : false,
                  "repeats" : false
                }
              ]
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
                  "valueString" : "boolean"
                }
              ],
              "linkId" : "Account.guarantor.onHold",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "A guarantor may be placed on credit hold or otherwise have their role temporarily suspended.",
                  "type" : "display"
                },
                {
                  "linkId" : "Account.guarantor.onHold.value",
                  "text" : "Credit or other hold applied",
                  "type" : "boolean",
                  "required" : false,
                  "repeats" : false
                }
              ]
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
                  "valueInteger" : 1
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
                  "valueString" : "Period"
                }
              ],
              "linkId" : "Account.guarantor.period",
              "text" : "Guarantee account during",
              "type" : "group",
              "required" : false,
              "repeats" : true,
              "item" : [
                {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                      "valueCodeableConcept" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/questionnaire-item-control",
                            "code" : "flyover",
                            "display" : "Fly-over"
                          }
                        ]
                      }
                    }
                  ],
                  "text" : "The timeframe during which the guarantor accepts responsibility for the account.",
                  "type" : "display"
                },
                {
                  "linkId" : "Account.guarantor.period.low",
                  "text" : "start:",
                  "type" : "dateTime",
                  "required" : false,
                  "repeats" : false
                },
                {
                  "linkId" : "Account.guarantor.period.end",
                  "text" : "end:",
                  "type" : "dateTime",
                  "required" : false,
                  "repeats" : false
                }
              ]
            }
          ]
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
              "valueInteger" : 1
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
              "valueString" : "Reference"
            }
          ],
          "linkId" : "Account.partOf",
          "type" : "group",
          "required" : false,
          "repeats" : true,
          "item" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/questionnaire-item-control",
                        "code" : "flyover",
                        "display" : "Fly-over"
                      }
                    ]
                  }
                }
              ],
              "text" : "Reference to a parent Account.",
              "type" : "display"
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource",
                  "valueCode" : "Account"
                },
                {
                  "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
                  "valueString" : "subject=$subj&patient=$subj&encounter=$encounter"
                }
              ],
              "linkId" : "Account.partOf.value",
              "text" : "Reference to a parent Account",
              "type" : "reference",
              "required" : false,
              "repeats" : false
            }
          ]
        }
      ]
    }
  ]
}