NHS Digital FHIR Implementation Guide

{
    "resourceType": "Questionnaire",
    "id": "c624f57d-347a-4f82-b92f-d0bf420cb813",
    "url": "https://fhir.nhs.uk/Questionnaire/COVIDVaccinationMedicalExemption",
    "version": "0.0.2",
    "name": "COVIDVaccinnationMedicalExemption",
    "title": "COVID Vaccinnation Medical Exemption",
    "status": "draft",
    "subjectType":  [
        "Patient"
    ],
    "item":  [
        {
            "type": "choice",
            "code":  [
            ],
            "extension":  [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                    "valueCodeableConcept": {
                        "coding":  [
                            {
                                "system": "http://hl7.org/fhir/questionnaire-item-control",
                                "code": "drop-down",
                                "display": "Drop down"
                            }
                        ],
                        "text": "Drop down"
                    }
                }
            ],
            "required": true,
            "linkId": "exemptionStatus",
            "text": "Exemption status",
            "answerOption":  [
                {
                    "valueCoding": {
                        "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
                        "code": "1",
                        "display": "Approved: Exemption from COVID vaccination"
                    }
                },
                {
                    "valueCoding": {
                        "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
                        "code": "2",
                        "display": "Approved: Exemption from COVID vaccination and testing"
                    }
                },
                {
                    "valueCoding": {
                        "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
                        "code": "3",
                        "display": "Rejected: Exemption from COVID vaccination"
                    }
                },
                {
                    "valueCoding": {
                        "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
                        "code": "4",
                        "display": "Rejected: Exemption from COVID vaccination and testing"
                    }
                }
            ],
            "item":  [
                {
                    "text": "This will be the code associated with the option selected by the user.",
                    "type": "display",
                    "linkId": "exemption-Status-help"
                }
            ]
        },
        {
            "type": "dateTime",
            "required": true,
            "linkId": "exemptionPeriodStart",
            "text": "Exemption Period Start",
            "item":  [
                {
                    "text": "The date upon which the exemption outcome is recorded in SCRa. .",
                    "type": "display",
                    "linkId": "exemptionPeriodStart-help"
                }
            ]
        },
        {
            "type": "dateTime",
            "required": false,
            "linkId": "exemptionPeriodEnd",
            "text": "Exemption Period End",
            "item":  [
                {
                    "text": "The date upon which the exemption outcome is moved to history (i.e. removed/deleted).",
                    "type": "display",
                    "linkId": "exemptionPeriodEnd-help"
                }
            ]
        },
        {
            "extension":  [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
                    "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole"
                }
            ],
            "type": "reference",
            "required": false,
            "linkId": "exemptionRecordedByUser",
            "text": "Exemption by User"
        },
        {
            "type": "string",
            "required": false,
            "linkId": "exemptionRecordedByUserRole",
            "text": "Exemption Recorded by user role",
            "item":  [
                {
                    "text": "The RBAC role associated with the user’s selected User Role Profile when the exemption outcome was recorded.",
                    "type": "display",
                    "linkId": "exemptionRecordedByUserRole-help"
                }
            ]
        },
        {
            "extension":  [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
                    "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization"
                }
            ],
            "type": "reference",
            "required": false,
            "linkId": "exemptionRecordedByOrganisation",
            "text": "Exemption by Organization"
        },
        {
            "type": "group",
            "required": false,
            "linkId": "removalReason",
            "text": "Removal Reason",
            "item":  [
                {
                    "type": "choice",
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                            "valueCodeableConcept": {
                                "coding":  [
                                    {
                                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                                        "code": "drop-down",
                                        "display": "Drop down"
                                    }
                                ],
                                "text": "Drop down"
                            }
                        }
                    ],
                    "required": false,
                    "linkId": "removalReasonCode",
                    "text": "Removal Reason Code",
                    "answerOption":  [
                        {
                            "valueCoding": {
                                "code": "5",
                                "display": "Added in error"
                            }
                        },
                        {
                            "valueCoding": {
                                "code": "6",
                                "display": "No longer required"
                            }
                        }
                    ],
                    "item":  [
                        {
                            "text": "The code associated with the selected option will be provided.",
                            "type": "display",
                            "linkId": "removalReasonCode-help"
                        }
                    ]
                },
                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
                            "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole"
                        }
                    ],
                    "type": "reference",
                    "required": false,
                    "linkId": "removedByUser",
                    "text": "Removed by User",
                    "item":  [
                        {
                            "text": "The name of the user who removed the exemption outcome from SCRa.",
                            "type": "display",
                            "linkId": "RemovedByUser-help"
                        }
                    ]
                },
                {
                    "type": "string",
                    "required": false,
                    "linkId": "removedByUserRole",
                    "text": "Removed by user role",
                    "item":  [
                        {
                            "text": "The RBAC role associated with the user’s selected User Role Profile when the exemption outcome was removed from SCRa.",
                            "type": "display",
                            "linkId": "removedByUserRole-help"
                        }
                    ]
                },
                {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
                            "valueCanonical": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization"
                        }
                    ],
                    "type": "reference",
                    "required": false,
                    "linkId": "removedByOrganisation",
                    "text": "Removed by organisation",
                    "item":  [
                        {
                            "text": "The name and ods code of the organisation associated with the selected User Role Profile when the exemption outcome was removed from SCRa.",
                            "type": "display",
                            "linkId": "removedByOrganisationName-help"
                        }
                    ]
                },
                {
                    "text": "Only populated on historic (i.e. removed/deleted) exemption records. This is the reason for removal specified by the user.",
                    "type": "display",
                    "linkId": "undefined-help"
                }
            ]
        }
    ]
}

<Questionnaire xmlns="http://hl7.org/fhir">
    <id value="c624f57d-347a-4f82-b92f-d0bf420cb813" />
    <url value="https://fhir.nhs.uk/Questionnaire/COVIDVaccinationMedicalExemption" />
    <version value="0.0.2" />
    <name value="COVIDVaccinnationMedicalExemption" />
    <title value="COVID Vaccinnation Medical Exemption" />
    <status value="draft" />
    <subjectType value="Patient" />
    <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
                <coding>
                    <system value="http://hl7.org/fhir/questionnaire-item-control" />
                    <code value="drop-down" />
                    <display value="Drop down" />
                </coding>
                <text value="Drop down" />
            </valueCodeableConcept>
        </extension>
        <linkId value="exemptionStatus" />
        <text value="Exemption status" />
        <type value="choice" />
        <required value="true" />
        <answerOption>
            <valueCoding>
                <system value="https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption" />
                <code value="1" />
                <display value="Approved: Exemption from COVID vaccination" />
            </valueCoding>
        </answerOption>
        <answerOption>
            <valueCoding>
                <system value="https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption" />
                <code value="2" />
                <display value="Approved: Exemption from COVID vaccination and testing" />
            </valueCoding>
        </answerOption>
        <answerOption>
            <valueCoding>
                <system value="https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption" />
                <code value="3" />
                <display value="Rejected: Exemption from COVID vaccination" />
            </valueCoding>
        </answerOption>
        <answerOption>
            <valueCoding>
                <system value="https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption" />
                <code value="4" />
                <display value="Rejected: Exemption from COVID vaccination and testing" />
            </valueCoding>
        </answerOption>
        <item>
            <linkId value="exemption-Status-help" />
            <text value="This will be the code associated with the option selected by the user." />
            <type value="display" />
        </item>
    </item>
    <item>
        <linkId value="exemptionPeriodStart" />
        <text value="Exemption Period Start" />
        <type value="dateTime" />
        <required value="true" />
        <item>
            <linkId value="exemptionPeriodStart-help" />
            <text value="The date upon which the exemption outcome is recorded in SCRa. ." />
            <type value="display" />
        </item>
    </item>
    <item>
        <linkId value="exemptionPeriodEnd" />
        <text value="Exemption Period End" />
        <type value="dateTime" />
        <required value="false" />
        <item>
            <linkId value="exemptionPeriodEnd-help" />
            <text value="The date upon which the exemption outcome is moved to history (i.e. removed/deleted)." />
            <type value="display" />
        </item>
    </item>
    <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
            <valueCanonical value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole" />
        </extension>
        <linkId value="exemptionRecordedByUser" />
        <text value="Exemption by User" />
        <type value="reference" />
        <required value="false" />
    </item>
    <item>
        <linkId value="exemptionRecordedByUserRole" />
        <text value="Exemption Recorded by user role" />
        <type value="string" />
        <required value="false" />
        <item>
            <linkId value="exemptionRecordedByUserRole-help" />
            <text value="The RBAC role associated with the user’s selected User Role Profile when the exemption outcome was recorded." />
            <type value="display" />
        </item>
    </item>
    <item>
        <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
            <valueCanonical value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization" />
        </extension>
        <linkId value="exemptionRecordedByOrganisation" />
        <text value="Exemption by Organization" />
        <type value="reference" />
        <required value="false" />
    </item>
    <item>
        <linkId value="removalReason" />
        <text value="Removal Reason" />
        <type value="group" />
        <required value="false" />
        <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
                <valueCodeableConcept>
                    <coding>
                        <system value="http://hl7.org/fhir/questionnaire-item-control" />
                        <code value="drop-down" />
                        <display value="Drop down" />
                    </coding>
                    <text value="Drop down" />
                </valueCodeableConcept>
            </extension>
            <linkId value="removalReasonCode" />
            <text value="Removal Reason Code" />
            <type value="choice" />
            <required value="false" />
            <answerOption>
                <valueCoding>
                    <code value="5" />
                    <display value="Added in error" />
                </valueCoding>
            </answerOption>
            <answerOption>
                <valueCoding>
                    <code value="6" />
                    <display value="No longer required" />
                </valueCoding>
            </answerOption>
            <item>
                <linkId value="removalReasonCode-help" />
                <text value="The code associated with the selected option will be provided." />
                <type value="display" />
            </item>
        </item>
        <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
                <valueCanonical value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole" />
            </extension>
            <linkId value="removedByUser" />
            <text value="Removed by User" />
            <type value="reference" />
            <required value="false" />
            <item>
                <linkId value="RemovedByUser-help" />
                <text value="The name of the user who removed the exemption outcome from SCRa." />
                <type value="display" />
            </item>
        </item>
        <item>
            <linkId value="removedByUserRole" />
            <text value="Removed by user role" />
            <type value="string" />
            <required value="false" />
            <item>
                <linkId value="removedByUserRole-help" />
                <text value="The RBAC role associated with the user’s selected User Role Profile when the exemption outcome was removed from SCRa." />
                <type value="display" />
            </item>
        </item>
        <item>
            <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
                <valueCanonical value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization" />
            </extension>
            <linkId value="removedByOrganisation" />
            <text value="Removed by organisation" />
            <type value="reference" />
            <required value="false" />
            <item>
                <linkId value="removedByOrganisationName-help" />
                <text value="The name and ods code of the organisation associated with the selected User Role Profile when the exemption outcome was removed from SCRa." />
                <type value="display" />
            </item>
        </item>
        <item>
            <linkId value="undefined-help" />
            <text value="Only populated on historic (i.e. removed/deleted) exemption records. This is the reason for removal specified by the user." />
            <type value="display" />
        </item>
    </item>
</Questionnaire>