<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="cqif-questionnaire" />
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>The narrative has been removed to reduce the size of the distribution of the Hl7.Fhir.Specification library</p>
    </div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/cqif-questionnaire" />
  <name value="CQIF-Questionnaire" />
  <status value="draft" />
  <experimental value="false" />
  <publisher value="Health Level Seven, Inc. - CDS WG" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://hl7.org/special/committees/dss" />
    </telecom>
  </contact>
  <description value="A questionnaire with the ability to specify behavior associated with questions or groups of questions" />
  <fhirVersion value="3.0.0" />
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <mapping>
    <identity value="w5" />
    <uri value="http://hl7.org/fhir/w5" />
    <name value="W5 Mapping" />
  </mapping>
  <mapping>
    <identity value="objimpl" />
    <uri value="http://hl7.org/fhir/object-implementation" />
    <name value="Object Implementation Information" />
  </mapping>
  <mapping>
    <identity value="v2" />
    <uri value="http://hl7.org/v2" />
    <name value="HL7 v2 Mapping" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="Questionnaire" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
  <derivation value="constraint" />
  <snapshot>
    <element id="Questionnaire">
      <path value="Questionnaire" />
      <short value="A questionnaire with the ability to specify behavior associated with questions or groups of questions" />
      <definition value="A CQIF questionnaire is a questionnaire with the added ability to describe behavior associated with questions. For example, whether or not to display a particular question or group of questions, or automatically calculating the value of an answer based on the answers to previous questions." />
      <alias value="Form" />
      <alias value="CRF" />
      <alias value="Survey" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Resource" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <xpath value="not(parent::f:contained and f:contained)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-1" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" />
        <expression value="contained.text.empty()" />
        <xpath value="not(parent::f:contained and f:text)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-3" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource" />
        <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()" />
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="que-2" />
        <severity value="error" />
        <human value="The link ids for groups and questions must be unique within the questionnaire" />
        <expression value="descendants().linkId.isDistinct()" />
        <xpath value="count(descendant::f:linkId/@value)=count(distinct-values(descendant::f:linkId/@value))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Observation[moodCode=DEF]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="infrastructure.information" />
      </mapping>
    </element>
    <element id="Questionnaire.id">
      <path value="Questionnaire.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <isSummary value="true" />
    </element>
    <element id="Questionnaire.meta">
      <path value="Questionnaire.meta" />
      <short value="Metadata about the resource" />
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <isSummary value="true" />
    </element>
    <element id="Questionnaire.implicitRules">
      <path value="Questionnaire.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content." />
      <comment value="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. &#xA;&#xA;This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
    </element>
    <element id="Questionnaire.language">
      <path value="Questionnaire.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comment value="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)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages" />
          </valueReference>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <strength value="extensible" />
        <description value="A human language." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages" />
        </valueSetReference>
      </binding>
    </element>
    <element id="Questionnaire.text">
      <path value="Questionnaire.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="A human-readable narrative that contains a summary of the resource, and may 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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
      <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="dom-1" />
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element id="Questionnaire.contained">
      <path value="Questionnaire.contained" />
      <short value="Contained, inline Resources" />
      <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
      <comment value="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." />
      <alias value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Questionnaire.extension">
      <path value="Questionnaire.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order 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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Questionnaire.extension:library">
      <path value="Questionnaire.extension" />
      <sliceName value="library" />
      <short value="A library containing logic referenced by the questionnaire" />
      <definition value="A CQL or ELM library containing any logic referenced by the questionnaire." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="library" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-library" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Questionnaire.modifierExtension">
      <path value="Questionnaire.modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored" />
      <definition value="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. Usually modifier elements provide negation or qualification. In order 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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Questionnaire.url">
      <path value="Questionnaire.url" />
      <short value="Logical URI to reference this questionnaire (globally unique)" />
      <definition value="An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this questionnaire is (or will be) published. The URL SHOULD include the major version of the questionnaire. For more information see [Technical and Business Versions](resource.html#versions)." />
      <comment value="Can be a urn:uuid: or a urn:oid:, but real http: addresses are preferred.  Multiple instances may share the same url if they have a distinct version." />
      <requirements value="…  This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.url" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".identifier[scope=BUSN;reliability=ISS]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element id="Questionnaire.identifier">
      <path value="Questionnaire.identifier" />
      <short value="Additional identifier for the questionnaire" />
      <definition value="A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance." />
      <comment value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, e.g., to identify this questionnaire outside of FHIR, where it is not possible to use the logical URI." />
      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated with the module." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Questionnaire.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".identifier" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element id="Questionnaire.version">
      <path value="Questionnaire.version" />
      <short value="Business version of the questionnaire" />
      <definition value="The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence." />
      <comment value="There may be different questionnaire instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a refrence to a particular business version of the questionnaire with the format [url]|[version]." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A (to add?)" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id.version" />
      </mapping>
    </element>
    <element id="Questionnaire.name">
      <path value="Questionnaire.name" />
      <short value="Name for this questionnaire (computer friendly)" />
      <definition value="A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation." />
      <comment value="The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly." />
      <requirements value="Support human navigation and code generation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.name" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Questionnaire.title">
      <path value="Questionnaire.title" />
      <short value="Name for this questionnaire (human friendly)" />
      <definition value="A short, descriptive, user-friendly title for the questionnaire." />
      <comment value="This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.title" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".title" />
      </mapping>
    </element>
    <element id="Questionnaire.status">
      <path value="Questionnaire.status" />
      <short value="draft | active | retired | unknown" />
      <definition value="The status of this questionnaire. Enables tracking the life-cycle of the content." />
      <comment value="Allows filtering of questionnaires that are appropriate for use vs. not.  &#xA;This is labeled as &quot;Is Modifier&quot; because applications should not use a retired questionnaire without due consideration." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Questionnaire.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus" />
        </extension>
        <strength value="required" />
        <description value="The lifecycle status of a Value Set or Concept Map." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/publication-status" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".status" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="status" />
      </mapping>
    </element>
    <element id="Questionnaire.experimental">
      <path value="Questionnaire.experimental" />
      <short value="For testing purposes, not real usage" />
      <definition value="A boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage." />
      <comment value="Allows filtering of questionnaire that are appropriate for use vs. not. This is labeled as &quot;Is Modifier&quot; because applications should not use an experimental questionnaire in production." />
      <requirements value="Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.experimental" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="class" />
      </mapping>
    </element>
    <element id="Questionnaire.date">
      <path value="Questionnaire.date" />
      <short value="Date this was last changed" />
      <definition value="The date  (and optionally time) when the questionnaire was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes." />
      <comment value="Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource." />
      <alias value="Revision Date" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.date" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT].time" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.recorded" />
      </mapping>
    </element>
    <element id="Questionnaire.publisher">
      <path value="Questionnaire.publisher" />
      <short value="Name of the publisher (organization or individual)" />
      <definition value="The name of the individual or organization that published the questionnaire." />
      <comment value="Usually an organization, but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context." />
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the questionnaire.  May also allow for contact." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.publisher" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT].role" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.witness" />
      </mapping>
    </element>
    <element id="Questionnaire.description">
      <path value="Questionnaire.description" />
      <short value="Natural language description of the questionnaire" />
      <definition value="A free text natural language description of the questionnaire from a consumer's perspective." />
      <comment value="This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the profile is presumed to be the predominant language in the place the profile was created)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.description" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
    </element>
    <element id="Questionnaire.purpose">
      <path value="Questionnaire.purpose" />
      <short value="Why this questionnaire is defined" />
      <definition value="Explaination of why this questionnaire is needed and why it has been designed as it has." />
      <comment value="This element does not describe the usage of the questionnaire Instead  it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this questionnaire." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.purpose" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".reasonCode.text" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="why" />
      </mapping>
    </element>
    <element id="Questionnaire.approvalDate">
      <path value="Questionnaire.approvalDate" />
      <short value="When the questionnaire was approved by publisher" />
      <definition value="The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage." />
      <comment value="The 'date' element may be more recent than the approval date because of minor changes / editorial corrections." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.approvalDate" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="date" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;approval&quot;].effectiveTime" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="Questionnaire.lastReviewDate">
      <path value="Questionnaire.lastReviewDate" />
      <short value="When the questionnaire was last reviewed" />
      <definition value="The date on which the resource content was last reviewed. Review happens periodically after approval, but doesn't change the original approval date." />
      <comment value="If specified, this is usually after the approval date." />
      <requirements value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.lastReviewDate" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="date" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;; subsetCode=&quot;RECENT&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;review&quot;].effectiveTime" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="Questionnaire.effectivePeriod">
      <path value="Questionnaire.effectivePeriod" />
      <short value="When the questionnaire is expected to be used" />
      <definition value="The period during which the questionnaire content was or is planned to be in active use." />
      <comment value="The effective period for a questionnaire  determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015." />
      <requirements value="Allows establishing a transition before a resource comes into effect and also allows for a sunsetting  process when new versions of a the questionnaire are or are expected to be used instead." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.effectivePeriod" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A (to add?)" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="Questionnaire.useContext">
      <path value="Questionnaire.useContext" />
      <short value="Context the content is intended to support" />
      <definition value="The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate questionnaire instances." />
      <comment value="When multiple useContexts are specified, there is no expectation whether all or any of the contexts apply." />
      <requirements value="Assist in searching for appropriate content." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Questionnaire.useContext" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="UsageContext" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A (to add?)" />
      </mapping>
    </element>
    <element id="Questionnaire.jurisdiction">
      <path value="Questionnaire.jurisdiction" />
      <short value="Intended jurisdiction for questionnaire (if applicable)" />
      <definition value="A legal or geographic region in which the questionnaire is intended to be used." />
      <comment value="It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Questionnaire.jurisdiction" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction" />
        </extension>
        <strength value="extensible" />
        <description value="Countries and regions within which this artifact is targeted for use" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/jurisdiction" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="N/A (to add?)" />
      </mapping>
    </element>
    <element id="Questionnaire.contact">
      <path value="Questionnaire.contact" />
      <short value="Contact details for the publisher" />
      <definition value="Contact details to assist a user in finding and communicating with the publisher." />
      <comment value="May be a web site, an email address, a telephone number, etc." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Questionnaire.contact" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="ContactDetail" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=CALLBCK].role" />
      </mapping>
    </element>
    <element id="Questionnaire.copyright">
      <path value="Questionnaire.copyright" />
      <short value="Use and/or publishing restrictions" />
      <definition value="A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire." />
      <requirements value="Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content." />
      <alias value="License" />
      <alias value="Restrictions" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Questionnaire.copyright" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="markdown" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="N/A (to add?)" />
      </mapping>
      <mapping>
        <identity value="objimpl" />
        <map value="no-gen-base" />
      </mapping>
    </element>
    <element id="Questionnaire.code">
      <path value="Questionnaire.code" />
      <short value="Concept that represents the overall questionnaire" />
      <definition value="An identifier for this question or group of questions in a particular terminology such as LOINC." />
      <requirements value="Allows linking of the complete Questionnaire resources to formal terminologies.  It's common for &quot;panels&quot; of questions to be identified by a code." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Questionnaire.code" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireConcept" />
        </extension>
        <strength value="example" />
        <description value="Codes for questionnaires, groups and individual questions" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/questionnaire-questions" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".code" />
      </mapping>
    </element>
    <element id="Questionnaire.subjectType">
      <path value="Questionnaire.subjectType" />
      <short value="Resource that can be subject of QuestionnaireResponse" />
      <definition value="The types of subjects that can be the subject of responses created for the questionnaire." />
      <comment value="If none are specified, then the subject is unlimited." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Questionnaire.subjectType" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ResourceType" />
        </extension>
        <strength value="required" />
        <description value="One of the resource types defined as part of FHIR." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/resource-types" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=META].target[classCode=OBS, moodCode=DEFN, isCriterion=true].participation.role.classCode" />
      </mapping>
    </element>
    <element id="Questionnaire.item">
      <path value="Questionnaire.item" />
      <short value="Questions and sections within the Questionnaire" />
      <definition value="A particular question, question grouping or display text that is part of the questionnaire." />
      <comment value="The content of the questionnaire is constructed from an ordered, hierarchical collection of items." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Questionnaire.item" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="que-3" />
      <constraint>
        <key value="que-9" />
        <severity value="error" />
        <human value="Read-only can't be specified for &quot;display&quot; items" />
        <expression value="type!='display' or readOnly.empty()" />
        <xpath value="not(f:type/@value='display' and f:readOnly)" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <constraint>
        <key value="que-8" />
        <severity value="error" />
        <human value="Default values can't be specified for groups or display items" />
        <expression value="(type!='group' and type!='display') or initial.empty()" />
        <xpath value="not(f:type/@value=('group', 'display') and f:*[starts-with(local-name(.), 'initial')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <constraint>
        <key value="que-6" />
        <severity value="error" />
        <human value="Required and repeat aren't permitted for display items" />
        <expression value="type!='display' or (required.empty() and repeats.empty())" />
        <xpath value="not(f:type/@value='display' and (f:required or f:repeats))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <constraint>
        <key value="que-5" />
        <severity value="error" />
        <human value="Only 'choice' items can have options" />
        <expression value="(type ='choice' or type = 'open-choice') or (options.empty() and option.empty())" />
        <xpath value="f:type/@value=('choice','open-choice') or not(f:option or f:options)" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <constraint>
        <key value="que-4" />
        <severity value="error" />
        <human value="A question cannot have both option and options" />
        <expression value="option.empty() or options.empty()" />
        <xpath value="not(f:options and f:option)" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <constraint>
        <key value="que-3" />
        <severity value="error" />
        <human value="Display items cannot have a &quot;code&quot; asserted" />
        <expression value="type!='display' or code.empty()" />
        <xpath value="not(f:type/@value='display' and f:code)" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <constraint>
        <key value="que-10" />
        <severity value="error" />
        <human value="Maximum length can only be declared for simple question types" />
        <expression value="(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url')) or maxLength.empty()" />
        <xpath value="f:type/@value=('boolean', 'decimal', 'integer', 'open-choice', 'string', 'text', 'url') or not(f:maxLength)" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <constraint>
        <key value="que-1" />
        <severity value="error" />
        <human value="Group items must have nested items, display items cannot have nested items" />
        <expression value="(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())" />
        <xpath value="not((f:type/@value='group' and not(f:item)) or (f:type/@value='display' and f:item))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=DEF]" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Questionnaire">
      <path value="Questionnaire" />
      <short value="A questionnaire with the ability to specify behavior associated with questions or groups of questions" />
      <definition value="A CQIF questionnaire is a questionnaire with the added ability to describe behavior associated with questions. For example, whether or not to display a particular question or group of questions, or automatically calculating the value of an answer based on the answers to previous questions." />
      <min value="0" />
      <max value="*" />
    </element>
    <element id="Questionnaire.extension:library">
      <path value="Questionnaire.extension" />
      <sliceName value="library" />
      <short value="A library containing logic referenced by the questionnaire" />
      <definition value="A CQL or ELM library containing any logic referenced by the questionnaire." />
      <alias value="library" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-library" />
      </type>
    </element>
    <element id="Questionnaire.item">
      <path value="Questionnaire.item" />
    </element>
    <element id="Questionnaire.item.extension:condition">
      <path value="Questionnaire.item.extension" />
      <sliceName value="condition" />
      <short value="A condition that determines whether or not the group is applicable" />
      <definition value="The name of an expression that determines whether the group on which it appears is applicable. The expression is evaluated within the current context. If the result of evaluating the expression is true, the group is applicable. The expression has access to the current value of answered questions by the linkId of the question." />
      <comment value="Note that per Lloyd this extension may not be necessary, it may be able to specified structurally using the elements already available within Questionnaire." />
      <alias value="condition" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-condition" />
      </type>
    </element>
    <element id="Questionnaire.item.extension:initialvalue">
      <path value="Questionnaire.item.extension" />
      <sliceName value="initialValue" />
      <short value="An expression that provides the initial value for the answer to the question" />
      <definition value="The name of an expression that determines the initial value for the answer to the question. This expression is evaluated once as part of displaying the form, and does not have access to the answers to other questions." />
      <alias value="initialValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-initialValue" />
      </type>
    </element>
    <element id="Questionnaire.item.extension:calculatedvalue">
      <path value="Questionnaire.item.extension" />
      <sliceName value="calculatedValue" />
      <short value="An expression that provides a calculated value for the answer to the question" />
      <definition value="The name of an expression that determines a calculated value for the answer to the question. The expression is evaluated as necessary and has access to the answers to other questions by the linkId of the question." />
      <alias value="calculatedValue" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-calculatedValue" />
      </type>
    </element>
    <element id="Questionnaire.item.option">
      <path value="Questionnaire.item.option" />
    </element>
    <element id="Questionnaire.item.option.extension:optioncode">
      <path value="Questionnaire.item.option.extension" />
      <sliceName value="optionCode" />
      <short value="Meaning of the response option" />
      <definition value="A CodeableConcept that assigns meaning to the response object on which it appears." />
      <requirements value="Need to be able to determine the semantics of each potential response in order to interpret the meaning when processing the questionnaire response.  For example, the response option &quot;Severe migraines within the past year&quot; to the question &quot;Select all that apply&quot; needs detailed coding (such as via CodeableConcept) at the option level, as well as a way to represent that an affirmation/negative response should result in (perhaps) an Observation in the QuestionnaireResponse tied to a clinical model (such as CIMI). This is key to support sophisticated CDS based on the semantics of the QuestionnaireResponse -- not just the codes." />
      <alias value="optionCode" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/cqif-optionCode" />
      </type>
    </element>
  </differential>
</StructureDefinition>