WARNING

Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from NHS England.

StructureDefinition

QuestionnaireResponse	I		DomainResource	Element id QuestionnaireResponse Short description A structured set of questions and their answers Alternate names Form, QuestionnaireAnswers Definition A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to. Comments The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse. Data type DomainResource Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim: Entity. Role, or Act workflow: Event rim: Observation[moodCode=EVN]
id	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id QuestionnaireResponse.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id QuestionnaireResponse.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id QuestionnaireResponse.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id QuestionnaireResponse.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments 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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id QuestionnaireResponse.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition 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. Comments 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	Element id QuestionnaireResponse.identifier Short description Unique id for this set of answers Definition A business identifier assigned to a particular completed (or partially completed) questionnaire. Requirements Used for tracking, registration and other business purposes. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier rim: .id
basedOn	Σ I	0..*	Reference(CarePlan \| ServiceRequest)	Element id QuestionnaireResponse.basedOn Short description Request fulfilled by this QuestionnaireResponse Alternate names order Definition The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression. Requirements Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CarePlan \| ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target
partOf	Σ I	0..*	Reference(Observation \| Procedure)	Element id QuestionnaireResponse.partOf Short description Part of this action Definition A procedure or observation that this questionnaire was performed as part of the execution of. For example, the surgery a checklist was executed as part of. Comments Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire. For relationships to referrals, and other types of requests, use basedOn. Data type Reference(Observation \| Procedure) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.partOf rim: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
questionnaire	Σ	0..1	canonical(Questionnaire)	Element id QuestionnaireResponse.questionnaire Short description Form being answered Alternate names Form Definition The Questionnaire that defines and organizes the questions for which answers are being provided. Requirements Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form. Comments If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.). Data type canonical(Questionnaire) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.instantiates rim: ./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]
status	Σ ?!	1..1	codeBinding	Element id QuestionnaireResponse.status Short description in-progress \| completed \| amended \| entered-in-error \| stopped Definition The position of the questionnaire response within its overall lifecycle. Requirements The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding Lifecycle status of the questionnaire response. QuestionnaireResponseStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.status w5: FiveWs.status rim: .statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish "in-progress" from "published)
subject	Σ I	0..1	Reference(Resource)	Element id QuestionnaireResponse.subject Short description The subject of the questions Alternate names Patient, Focus Definition The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information. Requirements Allows linking the answers to the individual the answers describe. May also affect access control. Comments If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role w5: FiveWs.subject
encounter	Σ I	0..1	Reference(Encounter)	Element id QuestionnaireResponse.encounter Short description Encounter created as part of Definition The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated. Requirements Provides context for the information that was captured. May also affect access control. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.encounter w5: FiveWs.context rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
authored	Σ	0..1	dateTime	Element id QuestionnaireResponse.authored Short description Date the answers were gathered Alternate names Date Created, Date published, Date Issued, Date updated Definition The date and/or time that this set of answers were last changed. Requirements Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers. Comments May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured. This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.occurrence[x] w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
author	Σ I	0..1	Reference(Device \| Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Organization)	Element id QuestionnaireResponse.author Short description Person who received and recorded the answers Alternate names Laboratory, Service, Practitioner, Department, Company, Performer Definition Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system. Requirements Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers. Comments Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated. Data type Reference(Device \| Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer w5: FiveWs.author rim: .participation[typeCode=AUT].role
source	Σ I	0..1	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson)	Element id QuestionnaireResponse.source Short description The person who answered the questions Definition The person who answered the questions about the subject. Requirements When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions. Comments If not specified, no inference can be made about who provided the data. Data type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.source rim: .participation[typeCode=INF].role
item	I	0..*	BackboneElement	Element id QuestionnaireResponse.item Short description Groups and questions Definition A group or question item from the original questionnaire for which answers are provided. Comments Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer). Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qrs-1: Nested item can't be beneath both item and answer `(answer.exists() and item.exists()).not()` Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
linkId		1..1	string	Element id QuestionnaireResponse.item.linkId Short description Pointer to specific item from Questionnaire Definition The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource. Requirements Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id
definition		0..1	uri	Element id QuestionnaireResponse.item.definition Short description ElementDefinition - details for the item Definition A reference to an ElementDefinition that provides the details for the item. Requirements A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition. Comments The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. There is no need for this element if the item pointed to by the linkId has a definition listed. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code
text		0..1	string	Element id QuestionnaireResponse.item.text Short description Name for group or question text Definition Text that is displayed above the contents of the group or as the text of the question being answered. Requirements Allows the questionnaire response to be read without access to the questionnaire. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .text
answer		0..*	BackboneElement	Element id QuestionnaireResponse.item.answer Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .value[type=LIST_ANY]
id		0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
value[x]		0..1		Element id QuestionnaireResponse.item.answer.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire. Binding Code indicating the response provided for a question. QuestionnaireAnswerCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .item
valueBoolean			boolean	Data type boolean
valueDecimal			decimal	Data type decimal
valueInteger			integer	Data type integer
valueDate			date	Data type date
valueDateTime			dateTime	Data type dateTime
valueTime			time	Data type time
valueString			string	Data type string
valueUri			uri	Data type uri
valueAttachment			Attachment	Data type Attachment
valueCoding			Coding	Data type Coding
valueQuantity			Quantity	Data type Quantity
valueReference			Reference(Resource)	Data type Reference(Resource)
item		0..*	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.item Short description Nested groups and questions Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
item		0..*	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.item Short description Nested questionnaire response items Definition Questions or sub-groups nested beneath a question or group. Requirements Reports can consist of complex nested groups. Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]

Detailed Descriptions

QuestionnaireResponse
Definition	A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.
Cardinality	0...*
Alias	Form, QuestionnaireAnswers
Comments	The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()`
Mappings	rim: Entity. Role, or Act workflow: Event rim: Observation[moodCode=EVN]
QuestionnaireResponse.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0...1
Type	string
Summary	True
Comments	The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
QuestionnaireResponse.meta
Definition	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.
Cardinality	0...1
Type	Meta
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A
QuestionnaireResponse.implicitRules
Definition	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.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
QuestionnaireResponse.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	A human language. CommonLanguages (preferred)
Comments	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).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
QuestionnaireResponse.text
Definition	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.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A rim: Act.text?
QuestionnaireResponse.contained
Definition	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.
Cardinality	0...*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	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.
Mappings	rim: Entity. Role, or Act rim: N/A
QuestionnaireResponse.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
QuestionnaireResponse.modifierExtension
Definition	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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
QuestionnaireResponse.identifier
Definition	A business identifier assigned to a particular completed (or partially completed) questionnaire.
Cardinality	0...1
Type	Identifier
Summary	True
Requirements	Used for tracking, registration and other business purposes.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier rim: .id
QuestionnaireResponse.basedOn
Definition	The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.
Cardinality	0...*
Type	Reference(CarePlan \| ServiceRequest)
Summary	True
Alias	order
Requirements	Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target
QuestionnaireResponse.partOf
Definition	A procedure or observation that this questionnaire was performed as part of the execution of. For example, the surgery a checklist was executed as part of.
Cardinality	0...*
Type	Reference(Observation \| Procedure)
Summary	True
Comments	Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire. For relationships to referrals, and other types of requests, use basedOn.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.partOf rim: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
QuestionnaireResponse.questionnaire
Definition	The Questionnaire that defines and organizes the questions for which answers are being provided.
Cardinality	0...1
Type	canonical(Questionnaire)
Summary	True
Alias	Form
Requirements	Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.
Comments	If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a workflow: Event.instantiates rim: ./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]
QuestionnaireResponse.status
Definition	The position of the questionnaire response within its overall lifecycle.
Cardinality	1...1
Type	code
Binding	Lifecycle status of the questionnaire response. QuestionnaireResponseStatus (required)
Modifier	True
Summary	True
Requirements	The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.
Comments	This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a workflow: Event.status w5: FiveWs.status rim: .statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish "in-progress" from "published)
QuestionnaireResponse.subject
Definition	The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information.
Cardinality	0...1
Type	Reference(Resource)
Summary	True
Alias	Patient, Focus
Requirements	Allows linking the answers to the individual the answers describe. May also affect access control.
Comments	If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role w5: FiveWs.subject
QuestionnaireResponse.encounter
Definition	The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.
Cardinality	0...1
Type	Reference(Encounter)
Summary	True
Requirements	Provides context for the information that was captured. May also affect access control.
Comments	This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.encounter w5: FiveWs.context rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
QuestionnaireResponse.authored
Definition	The date and/or time that this set of answers were last changed.
Cardinality	0...1
Type	dateTime
Summary	True
Alias	Date Created, Date published, Date Issued, Date updated
Requirements	Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.
Comments	May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured. This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a workflow: Event.occurrence[x] w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
QuestionnaireResponse.author
Definition	Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.
Cardinality	0...1
Type	Reference(Device \| Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Organization)
Summary	True
Alias	Laboratory, Service, Practitioner, Department, Company, Performer
Requirements	Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.
Comments	Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer w5: FiveWs.author rim: .participation[typeCode=AUT].role
QuestionnaireResponse.source
Definition	The person who answered the questions about the subject.
Cardinality	0...1
Type	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson)
Summary	True
Requirements	When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.
Comments	If not specified, no inference can be made about who provided the data.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.source rim: .participation[typeCode=INF].role
QuestionnaireResponse.item
Definition	A group or question item from the original questionnaire for which answers are provided.
Cardinality	0...*
Type	BackboneElement
Comments	Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qrs-1: Nested item can't be beneath both item and answer `(answer.exists() and item.exists()).not()`
Mappings	rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
QuestionnaireResponse.item.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
QuestionnaireResponse.item.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
QuestionnaireResponse.item.modifierExtension
Definition	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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
QuestionnaireResponse.item.linkId
Definition	The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.
Cardinality	1...1
Type	string
Requirements	Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id
QuestionnaireResponse.item.definition
Definition	A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.
Cardinality	0...1
Type	uri
Requirements	A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.
Comments	The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. There is no need for this element if the item pointed to by the linkId has a definition listed.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code
QuestionnaireResponse.item.text
Definition	Text that is displayed above the contents of the group or as the text of the question being answered.
Cardinality	0...1
Type	string
Requirements	Allows the questionnaire response to be read without access to the questionnaire.
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .text
QuestionnaireResponse.item.answer
Definition	The respondent's answer(s) to the question.
Cardinality	0...*
Type	BackboneElement
Comments	The value is nested because we cannot have a repeating structure that has variable type.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .value[type=LIST_ANY]
QuestionnaireResponse.item.answer.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
QuestionnaireResponse.item.answer.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
QuestionnaireResponse.item.answer.modifierExtension
Definition	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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
QuestionnaireResponse.item.answer.value[x]
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	boolean
Binding	Code indicating the response provided for a question. QuestionnaireAnswerCodes (example)
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .item
QuestionnaireResponse.item.answer.item
Definition	Nested groups and/or questions found within this particular answer.
Cardinality	0...*
Type	see (item)
Requirements	It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.
Mappings	rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
QuestionnaireResponse.item.item
Definition	Questions or sub-groups nested beneath a question or group.
Cardinality	0...*
Type	see (item)
Requirements	Reports can consist of complex nested groups.
Mappings	rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]

Table View

QuestionnaireResponse		0..*
QuestionnaireResponse.id	string	0..1
QuestionnaireResponse.meta	Meta	0..1
QuestionnaireResponse.implicitRules	uri	0..1
QuestionnaireResponse.language	code	0..1
QuestionnaireResponse.text	Narrative	0..1
QuestionnaireResponse.contained	Resource	0..*
QuestionnaireResponse.extension	Extension	0..*
QuestionnaireResponse.modifierExtension	Extension	0..*
QuestionnaireResponse.identifier	Identifier	0..1
QuestionnaireResponse.basedOn	Reference(CarePlan \| ServiceRequest)	0..*
QuestionnaireResponse.partOf	Reference(Observation \| Procedure)	0..*
QuestionnaireResponse.questionnaire	canonical(Questionnaire)	0..1
QuestionnaireResponse.status	code	1..1
QuestionnaireResponse.subject	Reference(Resource)	0..1
QuestionnaireResponse.encounter	Reference(Encounter)	0..1
QuestionnaireResponse.authored	dateTime	0..1
QuestionnaireResponse.author	Reference(Device \| Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Organization)	0..1
QuestionnaireResponse.source	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson)	0..1
QuestionnaireResponse.item	BackboneElement	0..*
QuestionnaireResponse.item.id	string	0..1
QuestionnaireResponse.item.extension	Extension	0..*
QuestionnaireResponse.item.modifierExtension	Extension	0..*
QuestionnaireResponse.item.linkId	string	1..1
QuestionnaireResponse.item.definition	uri	0..1
QuestionnaireResponse.item.text	string	0..1
QuestionnaireResponse.item.answer	BackboneElement	0..*
QuestionnaireResponse.item.answer.id	string	0..1
QuestionnaireResponse.item.answer.extension	Extension	0..*
QuestionnaireResponse.item.answer.modifierExtension	Extension	0..*
QuestionnaireResponse.item.answer.value[x]	boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)	0..1
QuestionnaireResponse.item.answer.item		0..*
QuestionnaireResponse.item.item		0..*

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="QuestionnaireResponse" />
    <meta>
        <lastUpdated value="2019-11-01T09:29:23.356+11:00" />
    </meta>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
        <valueString value="Clinical.Diagnostics" />
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use" />
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="3" />
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
        <valueCode value="patient" />
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="fhir" />
    </extension>
    <url value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
    <version value="4.0.1" />
    <name value="QuestionnaireResponse" />
    <status value="draft" />
    <date value="2019-11-01T09:29:23+11:00" />
    <publisher value="Health Level Seven International (FHIR Infrastructure)" />
    <contact>
        <telecom>
            <system value="url" />
            <value value="http://hl7.org/fhir" />
        </telecom>
    </contact>
    <contact>
        <telecom>
            <system value="url" />
            <value value="http://www.hl7.org/Special/committees/fiwg/index.cfm" />
        </telecom>
    </contact>
    <description value="A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to." />
    <purpose value="To support structured, hierarchical reporting of data gathered using digital forms and other questionnaires." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <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/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="QuestionnaireResponse" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
    <derivation value="specialization" />
    <snapshot>
        <element id="QuestionnaireResponse">
            <path value="QuestionnaireResponse" />
            <short value="A structured set of questions and their answers" />
            <definition value="A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to." />
            <comment value="The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on.  I.e. You don&#39;t need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse." />
            <alias value="Form" />
            <alias value="QuestionnaireAnswers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="QuestionnaireResponse" />
                <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-3" />
                <severity value="error" />
                <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
                <expression value="contained.where(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()" />
                <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))" />
                <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-5" />
                <severity value="error" />
                <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
                <expression value="contained.meta.security.empty()" />
                <xpath value="not(exists(f:contained/*/f:meta/f:security))" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <constraint>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
                    <valueBoolean value="true" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
                    <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
                </extension>
                <key value="dom-6" />
                <severity value="warning" />
                <human value="A resource should have narrative for robust management" />
                <expression value="text.`div`.exists()" />
                <xpath value="exists(f:text/h:div)" />
                <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Observation[moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.id">
            <path value="QuestionnaireResponse.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>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="QuestionnaireResponse.meta">
            <path value="QuestionnaireResponse.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 might 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>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="QuestionnaireResponse.implicitRules">
            <path value="QuestionnaireResponse.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
            <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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it&#39;s narrative along with other profiles, value sets, etc." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.implicitRules" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation" />
            <isSummary value="true" />
        </element>
        <element id="QuestionnaireResponse.language">
            <path value="QuestionnaireResponse.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>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
                    <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Language" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="preferred" />
                <description value="A human language." />
                <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
            </binding>
        </element>
        <element id="QuestionnaireResponse.text">
            <path value="QuestionnaireResponse.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 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 &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 information 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>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="Act.text?" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.contained">
            <path value="QuestionnaireResponse.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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
            <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>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.extension">
            <path value="QuestionnaireResponse.extension" />
            <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. 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." />
            <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>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.modifierExtension">
            <path value="QuestionnaireResponse.modifierExtension" />
            <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 and/or the understanding of the containing element&#39;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)." />
            <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." />
            <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
            <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>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.identifier">
            <path value="QuestionnaireResponse.identifier" />
            <short value="Unique id for this set of answers" />
            <definition value="A business identifier assigned to a particular completed (or partially completed) questionnaire." />
            <requirements value="Used for tracking, registration and other business purposes." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.identifier" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.identifier" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.identifier" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".id" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.basedOn">
            <path value="QuestionnaireResponse.basedOn" />
            <short value="Request fulfilled by this QuestionnaireResponse" />
            <definition value="The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.  For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression." />
            <requirements value="Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon." />
            <alias value="order" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="QuestionnaireResponse.basedOn" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.basedOn" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=FLFS].target" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.partOf">
            <path value="QuestionnaireResponse.partOf" />
            <short value="Part of this action" />
            <definition value="A procedure or observation that this questionnaire was performed as part of the execution of.  For example, the surgery a checklist was executed as part of." />
            <comment value="Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire.  For relationships to referrals, and other types of requests, use basedOn." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="QuestionnaireResponse.partOf" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.partOf" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.questionnaire">
            <path value="QuestionnaireResponse.questionnaire" />
            <short value="Form being answered" />
            <definition value="The Questionnaire that defines and organizes the questions for which answers are being provided." />
            <comment value="If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.)." />
            <requirements value="Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form." />
            <alias value="Form" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.questionnaire" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="canonical" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.instantiates" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.status">
            <path value="QuestionnaireResponse.status" />
            <short value="in-progress | completed | amended | entered-in-error | stopped" />
            <definition value="The position of the questionnaire response within its overall lifecycle." />
            <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
            <requirements value="The information on Questionnaire resources  may possibly be gathered during multiple sessions and altered after considered being finished." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.status" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="QuestionnaireResponseStatus" />
                </extension>
                <strength value="required" />
                <description value="Lifecycle status of the questionnaire response." />
                <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1" />
            </binding>
            <mapping>
                <identity value="workflow" />
                <map value="Event.status" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.status" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".statusCode (also whether there&#39;s a revisionControlAct - and possibly mood to distinguish &quot;in-progress&quot; from &quot;published)" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.subject">
            <path value="QuestionnaireResponse.subject" />
            <short value="The subject of the questions" />
            <definition value="The subject of the questionnaire response.  This could be a patient, organization, practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily the source of information." />
            <comment value="If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types." />
            <requirements value="Allows linking the answers to the individual the answers describe.  May also affect access control." />
            <alias value="Patient" />
            <alias value="Focus" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.subject" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.subject" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject[x]" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=SBJ].role" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.encounter">
            <path value="QuestionnaireResponse.encounter" />
            <short value="Encounter created as part of" />
            <definition value="The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated." />
            <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter." />
            <requirements value="Provides context for the information that was captured.  May also affect access control." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.encounter" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.encounter" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.context" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship(typeCode=COMP].source[classCode&lt;=PCPR, moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.authored">
            <path value="QuestionnaireResponse.authored" />
            <short value="Date the answers were gathered" />
            <definition value="The date and/or time that this set of answers were last changed." />
            <comment value="May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.\n\nThis element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible." />
            <requirements value="Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers." />
            <alias value="Date Created" />
            <alias value="Date published" />
            <alias value="Date Issued" />
            <alias value="Date updated" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.authored" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.occurrence[x]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.recorded" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].time" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.author">
            <path value="QuestionnaireResponse.author" />
            <short value="Person who received and recorded the answers" />
            <definition value="Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system." />
            <comment value="Mapping a subject&#39;s answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation.  Authoring by device would indicate that some portion of the questionnaire had been auto-populated." />
            <requirements value="Need to know who interpreted the subject&#39;s answers to the questions in the questionnaire, and selected the appropriate options for answers." />
            <alias value="Laboratory" />
            <alias value="Service" />
            <alias value="Practitioner" />
            <alias value="Department" />
            <alias value="Company" />
            <alias value="Performer" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.author" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.author" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].role" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.source">
            <path value="QuestionnaireResponse.source" />
            <short value="The person who answered the questions" />
            <definition value="The person who answered the questions about the subject." />
            <comment value="If not specified, no inference can be made about who provided the data." />
            <requirements value="When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.source" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.source" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=INF].role" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item">
            <path value="QuestionnaireResponse.item" />
            <short value="Groups and questions" />
            <definition value="A group or question item from the original questionnaire for which answers are provided." />
            <comment value="Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer)." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="QuestionnaireResponse.item" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="qrs-1" />
                <severity value="error" />
                <human value="Nested item can&#39;t be beneath both item and answer" />
                <expression value="(answer.exists() and item.exists()).not()" />
                <xpath value="not(exists(f:answer) and exists(f:item))" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.id">
            <path value="QuestionnaireResponse.item.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.extension">
            <path value="QuestionnaireResponse.item.extension" />
            <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 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." />
            <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="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.modifierExtension">
            <path value="QuestionnaireResponse.item.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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)." />
            <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." />
            <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.linkId">
            <path value="QuestionnaireResponse.item.linkId" />
            <short value="Pointer to specific item from Questionnaire" />
            <definition value="The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource." />
            <requirements value="Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.item.linkId" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.definition">
            <path value="QuestionnaireResponse.item.definition" />
            <short value="ElementDefinition - details for the item" />
            <definition value="A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item." />
            <comment value="The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed." />
            <requirements value="A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.item.definition" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.text">
            <path value="QuestionnaireResponse.item.text" />
            <short value="Name for group or question text" />
            <definition value="Text that is displayed above the contents of the group or as the text of the question being answered." />
            <requirements value="Allows the questionnaire response to be read without access to the questionnaire." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.item.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value=".text" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer">
            <path value="QuestionnaireResponse.item.answer" />
            <short value="The response(s) to the question" />
            <definition value="The respondent&#39;s answer(s) to the question." />
            <comment value="The value is nested because we cannot have a repeating structure that has variable type." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="QuestionnaireResponse.item.answer" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value=".value[type=LIST_ANY]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.id">
            <path value="QuestionnaireResponse.item.answer.id" />
            <representation value="xmlAttr" />
            <short value="Unique id for inter-element referencing" />
            <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
                    <valueUrl value="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.extension">
            <path value="QuestionnaireResponse.item.answer.extension" />
            <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 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." />
            <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="Element.extension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.modifierExtension">
            <path value="QuestionnaireResponse.item.answer.modifierExtension" />
            <short value="Extensions that cannot be ignored even if unrecognized" />
            <definition value="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&#39;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)." />
            <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." />
            <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
            <alias value="extensions" />
            <alias value="user content" />
            <alias value="modifiers" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="BackboneElement.modifierExtension" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Extension" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <constraint>
                <key value="ext-1" />
                <severity value="error" />
                <human value="Must have either extensions or value[x], not both" />
                <expression value="extension.exists() != value.exists()" />
                <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <isModifier value="true" />
            <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <short value="Single-valued answer to the question" />
            <definition value="The answer (or one of the answers) provided by the respondent to the question." />
            <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
            <requirements value="Ability to retain a single-valued answer to a question." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="QuestionnaireResponse.item.answer.value[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="decimal" />
            </type>
            <type>
                <code value="integer" />
            </type>
            <type>
                <code value="date" />
            </type>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="time" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="uri" />
            </type>
            <type>
                <code value="Attachment" />
            </type>
            <type>
                <code value="Coding" />
            </type>
            <type>
                <code value="Quantity" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
            </type>
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="QuestionnaireAnswer" />
                </extension>
                <strength value="example" />
                <description value="Code indicating the response provided for a question." />
                <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value=".item" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.item">
            <path value="QuestionnaireResponse.item.answer.item" />
            <short value="Nested groups and questions" />
            <definition value="Nested groups and/or questions found within this particular answer." />
            <requirements value="It is useful to have &quot;sub-questions&quot;, questions which normally appear when certain answers are given and which collect additional details." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="QuestionnaireResponse.item.answer.item" />
                <min value="0" />
                <max value="*" />
            </base>
            <contentReference value="#QuestionnaireResponse.item" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.item">
            <path value="QuestionnaireResponse.item.item" />
            <short value="Nested questionnaire response items" />
            <definition value="Questions or sub-groups nested beneath a question or group." />
            <requirements value="Reports can consist of complex nested groups." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="QuestionnaireResponse.item.item" />
                <min value="0" />
                <max value="*" />
            </base>
            <contentReference value="#QuestionnaireResponse.item" />
            <constraint>
                <key value="ele-1" />
                <severity value="error" />
                <human value="All FHIR elements must have a @value or children" />
                <expression value="hasValue() or (children().count() &gt; id.count())" />
                <xpath value="@value|f:*|h:div" />
                <source value="http://hl7.org/fhir/StructureDefinition/Element" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="false" />
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
            </mapping>
        </element>
    </snapshot>
    <differential>
        <element id="QuestionnaireResponse">
            <path value="QuestionnaireResponse" />
            <short value="A structured set of questions and their answers" />
            <definition value="A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to." />
            <comment value="The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on.  I.e. You don&#39;t need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse." />
            <alias value="Form" />
            <alias value="QuestionnaireAnswers" />
            <min value="0" />
            <max value="*" />
            <mapping>
                <identity value="workflow" />
                <map value="Event" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Observation[moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.identifier">
            <path value="QuestionnaireResponse.identifier" />
            <short value="Unique id for this set of answers" />
            <definition value="A business identifier assigned to a particular completed (or partially completed) questionnaire." />
            <requirements value="Used for tracking, registration and other business purposes." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Identifier" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.identifier" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.identifier" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".id" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.basedOn">
            <path value="QuestionnaireResponse.basedOn" />
            <short value="Request fulfilled by this QuestionnaireResponse" />
            <definition value="The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.  For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression." />
            <requirements value="Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon." />
            <alias value="order" />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.basedOn" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=FLFS].target" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.partOf">
            <path value="QuestionnaireResponse.partOf" />
            <short value="Part of this action" />
            <definition value="A procedure or observation that this questionnaire was performed as part of the execution of.  For example, the surgery a checklist was executed as part of." />
            <comment value="Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire.  For relationships to referrals, and other types of requests, use basedOn." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.partOf" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.questionnaire">
            <path value="QuestionnaireResponse.questionnaire" />
            <short value="Form being answered" />
            <definition value="The Questionnaire that defines and organizes the questions for which answers are being provided." />
            <comment value="If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.)." />
            <requirements value="Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form." />
            <alias value="Form" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="canonical" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.instantiates" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.status">
            <path value="QuestionnaireResponse.status" />
            <short value="in-progress | completed | amended | entered-in-error | stopped" />
            <definition value="The position of the questionnaire response within its overall lifecycle." />
            <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
            <requirements value="The information on Questionnaire resources  may possibly be gathered during multiple sessions and altered after considered being finished." />
            <min value="1" />
            <max value="1" />
            <type>
                <code value="code" />
            </type>
            <isModifier value="true" />
            <isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="QuestionnaireResponseStatus" />
                </extension>
                <strength value="required" />
                <description value="Lifecycle status of the questionnaire response." />
                <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1" />
            </binding>
            <mapping>
                <identity value="workflow" />
                <map value="Event.status" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.status" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".statusCode (also whether there&#39;s a revisionControlAct - and possibly mood to distinguish &quot;in-progress&quot; from &quot;published)" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.subject">
            <path value="QuestionnaireResponse.subject" />
            <short value="The subject of the questions" />
            <definition value="The subject of the questionnaire response.  This could be a patient, organization, practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily the source of information." />
            <comment value="If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types." />
            <requirements value="Allows linking the answers to the individual the answers describe.  May also affect access control." />
            <alias value="Patient" />
            <alias value="Focus" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.subject" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject[x]" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=SBJ].role" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.subject" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.encounter">
            <path value="QuestionnaireResponse.encounter" />
            <short value="Encounter created as part of" />
            <definition value="The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated." />
            <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter." />
            <requirements value="Provides context for the information that was captured.  May also affect access control." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.encounter" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.context" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship(typeCode=COMP].source[classCode&lt;=PCPR, moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.authored">
            <path value="QuestionnaireResponse.authored" />
            <short value="Date the answers were gathered" />
            <definition value="The date and/or time that this set of answers were last changed." />
            <comment value="May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.\n\nThis element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible." />
            <requirements value="Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers." />
            <alias value="Date Created" />
            <alias value="Date published" />
            <alias value="Date Issued" />
            <alias value="Date updated" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="dateTime" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.occurrence[x]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.recorded" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].time" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.author">
            <path value="QuestionnaireResponse.author" />
            <short value="Person who received and recorded the answers" />
            <definition value="Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system." />
            <comment value="Mapping a subject&#39;s answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation.  Authoring by device would indicate that some portion of the questionnaire had been auto-populated." />
            <requirements value="Need to know who interpreted the subject&#39;s answers to the questions in the questionnaire, and selected the appropriate options for answers." />
            <alias value="Laboratory" />
            <alias value="Service" />
            <alias value="Practitioner" />
            <alias value="Department" />
            <alias value="Company" />
            <alias value="Performer" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="workflow" />
                <map value="Event.performer" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.author" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].role" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.source">
            <path value="QuestionnaireResponse.source" />
            <short value="The person who answered the questions" />
            <definition value="The person who answered the questions about the subject." />
            <comment value="If not specified, no inference can be made about who provided the data." />
            <requirements value="When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
            </type>
            <isSummary value="true" />
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.source" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=INF].role" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item">
            <path value="QuestionnaireResponse.item" />
            <short value="Groups and questions" />
            <definition value="A group or question item from the original questionnaire for which answers are provided." />
            <comment value="Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer)." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="BackboneElement" />
            </type>
            <constraint>
                <key value="qrs-1" />
                <severity value="error" />
                <human value="Nested item can&#39;t be beneath both item and answer" />
                <expression value="(answer.exists() and item.exists()).not()" />
                <xpath value="not(exists(f:answer) and exists(f:item))" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.linkId">
            <path value="QuestionnaireResponse.item.linkId" />
            <short value="Pointer to specific item from Questionnaire" />
            <definition value="The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource." />
            <requirements value="Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier." />
            <min value="1" />
            <max value="1" />
            <type>
                <code value="string" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.definition">
            <path value="QuestionnaireResponse.item.definition" />
            <short value="ElementDefinition - details for the item" />
            <definition value="A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item." />
            <comment value="The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed." />
            <requirements value="A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="uri" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.text">
            <path value="QuestionnaireResponse.item.text" />
            <short value="Name for group or question text" />
            <definition value="Text that is displayed above the contents of the group or as the text of the question being answered." />
            <requirements value="Allows the questionnaire response to be read without access to the questionnaire." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="string" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value=".text" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer">
            <path value="QuestionnaireResponse.item.answer" />
            <short value="The response(s) to the question" />
            <definition value="The respondent&#39;s answer(s) to the question." />
            <comment value="The value is nested because we cannot have a repeating structure that has variable type." />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="BackboneElement" />
            </type>
            <mapping>
                <identity value="rim" />
                <map value=".value[type=LIST_ANY]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <short value="Single-valued answer to the question" />
            <definition value="The answer (or one of the answers) provided by the respondent to the question." />
            <comment value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire." />
            <requirements value="Ability to retain a single-valued answer to a question." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="decimal" />
            </type>
            <type>
                <code value="integer" />
            </type>
            <type>
                <code value="date" />
            </type>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="time" />
            </type>
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="uri" />
            </type>
            <type>
                <code value="Attachment" />
            </type>
            <type>
                <code value="Coding" />
            </type>
            <type>
                <code value="Quantity" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
            </type>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="QuestionnaireAnswer" />
                </extension>
                <strength value="example" />
                <description value="Code indicating the response provided for a question." />
                <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value=".item" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.item">
            <path value="QuestionnaireResponse.item.answer.item" />
            <short value="Nested groups and questions" />
            <definition value="Nested groups and/or questions found within this particular answer." />
            <requirements value="It is useful to have &quot;sub-questions&quot;, questions which normally appear when certain answers are given and which collect additional details." />
            <min value="0" />
            <max value="*" />
            <contentReference value="#QuestionnaireResponse.item" />
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.item">
            <path value="QuestionnaireResponse.item.item" />
            <short value="Nested questionnaire response items" />
            <definition value="Questions or sub-groups nested beneath a question or group." />
            <requirements value="Reports can consist of complex nested groups." />
            <min value="0" />
            <max value="*" />
            <contentReference value="#QuestionnaireResponse.item" />
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]" />
            </mapping>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "QuestionnaireResponse",
    "meta": {
        "lastUpdated": "2019-11-01T09:29:23.356+11:00"
    },
    "extension":  [
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-category",
            "valueString": "Clinical.Diagnostics"
        },
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
            "valueCode": "trial-use"
        },
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
            "valueInteger": 3
        },
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category",
            "valueCode": "patient"
        },
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
            "valueCode": "fhir"
        }
    ],
    "url": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse",
    "version": "4.0.1",
    "name": "QuestionnaireResponse",
    "status": "draft",
    "date": "2019-11-01T09:29:23+11:00",
    "publisher": "Health Level Seven International (FHIR Infrastructure)",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "http://hl7.org/fhir"
                }
            ]
        },
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "http://www.hl7.org/Special/committees/fiwg/index.cfm"
                }
            ]
        }
    ],
    "description": "A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.",
    "purpose": "To support structured, hierarchical reporting of data gathered using digital forms and other questionnaires.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "QuestionnaireResponse",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource",
    "derivation": "specialization",
    "snapshot": {
        "element":  [
            {
                "id": "QuestionnaireResponse",
                "path": "QuestionnaireResponse",
                "short": "A structured set of questions and their answers",
                "definition": "A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.",
                "comment": "The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on.  I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.",
                "alias":  [
                    "Form",
                    "QuestionnaireAnswers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "QuestionnaireResponse",
                    "min": 0,
                    "max": "*"
                },
                "constraint":  [
                    {
                        "key": "dom-2",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
                        "expression": "contained.contained.empty()",
                        "xpath": "not(parent::f:contained and f:contained)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-3",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
                        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-4",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-5",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
                        "expression": "contained.meta.security.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                                "valueBoolean": true
                            },
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
                            }
                        ],
                        "key": "dom-6",
                        "severity": "warning",
                        "human": "A resource should have narrative for robust management",
                        "expression": "text.`div`.exists()",
                        "xpath": "exists(f:text/h:div)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event"
                    },
                    {
                        "identity": "rim",
                        "map": "Observation[moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.id",
                "path": "QuestionnaireResponse.id",
                "short": "Logical id of this artifact",
                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
                "comment": "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": 0,
                "max": "1",
                "base": {
                    "path": "Resource.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "QuestionnaireResponse.meta",
                "path": "QuestionnaireResponse.meta",
                "short": "Metadata about the resource",
                "definition": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.meta",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Meta"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "QuestionnaireResponse.implicitRules",
                "path": "QuestionnaireResponse.implicitRules",
                "short": "A set of rules under which this content was created",
                "definition": "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.",
                "comment": "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.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.implicitRules",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
                "isSummary": true
            },
            {
                "id": "QuestionnaireResponse.language",
                "path": "QuestionnaireResponse.language",
                "short": "Language of the resource content",
                "definition": "The base language in which the resource is written.",
                "comment": "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": 0,
                "max": "1",
                "base": {
                    "path": "Resource.language",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Language"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "preferred",
                    "description": "A human language.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
                }
            },
            {
                "id": "QuestionnaireResponse.text",
                "path": "QuestionnaireResponse.text",
                "short": "Text summary of the resource, for human interpretation",
                "definition": "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.",
                "comment": "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 \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
                "alias":  [
                    "narrative",
                    "html",
                    "xhtml",
                    "display"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Narrative"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Act.text?"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.contained",
                "path": "QuestionnaireResponse.contained",
                "short": "Contained, inline Resources",
                "definition": "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": "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.",
                "alias":  [
                    "inline resources",
                    "anonymous resources",
                    "contained resources"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.contained",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Resource"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.extension",
                "path": "QuestionnaireResponse.extension",
                "short": "Additional content defined by implementations",
                "definition": "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.",
                "comment": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.modifierExtension",
                "path": "QuestionnaireResponse.modifierExtension",
                "short": "Extensions that cannot be ignored",
                "definition": "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).",
                "comment": "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.",
                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.identifier",
                "path": "QuestionnaireResponse.identifier",
                "short": "Unique id for this set of answers",
                "definition": "A business identifier assigned to a particular completed (or partially completed) questionnaire.",
                "requirements": "Used for tracking, registration and other business purposes.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.identifier",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.identifier"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "rim",
                        "map": ".id"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.basedOn",
                "path": "QuestionnaireResponse.basedOn",
                "short": "Request fulfilled by this QuestionnaireResponse",
                "definition": "The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.  For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.",
                "requirements": "Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.",
                "alias":  [
                    "order"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "QuestionnaireResponse.basedOn",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/CarePlan",
                            "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.basedOn"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=FLFS].target"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.partOf",
                "path": "QuestionnaireResponse.partOf",
                "short": "Part of this action",
                "definition": "A procedure or observation that this questionnaire was performed as part of the execution of.  For example, the surgery a checklist was executed as part of.",
                "comment": "Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire.  For relationships to referrals, and other types of requests, use basedOn.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "QuestionnaireResponse.partOf",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Observation",
                            "http://hl7.org/fhir/StructureDefinition/Procedure"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.partOf"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.questionnaire",
                "path": "QuestionnaireResponse.questionnaire",
                "short": "Form being answered",
                "definition": "The Questionnaire that defines and organizes the questions for which answers are being provided.",
                "comment": "If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).",
                "requirements": "Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.",
                "alias":  [
                    "Form"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.questionnaire",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "canonical",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Questionnaire"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.instantiates"
                    },
                    {
                        "identity": "rim",
                        "map": "./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.status",
                "path": "QuestionnaireResponse.status",
                "short": "in-progress | completed | amended | entered-in-error | stopped",
                "definition": "The position of the questionnaire response within its overall lifecycle.",
                "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
                "requirements": "The information on Questionnaire resources  may possibly be gathered during multiple sessions and altered after considered being finished.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.status",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "QuestionnaireResponseStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "Lifecycle status of the questionnaire response.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.status"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.status"
                    },
                    {
                        "identity": "rim",
                        "map": ".statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish \"in-progress\" from \"published)"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.subject",
                "path": "QuestionnaireResponse.subject",
                "short": "The subject of the questions",
                "definition": "The subject of the questionnaire response.  This could be a patient, organization, practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily the source of information.",
                "comment": "If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.",
                "requirements": "Allows linking the answers to the individual the answers describe.  May also affect access control.",
                "alias":  [
                    "Patient",
                    "Focus"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.subject",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Resource"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.subject"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject[x]"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=SBJ].role"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.encounter",
                "path": "QuestionnaireResponse.encounter",
                "short": "Encounter created as part of",
                "definition": "The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.",
                "comment": "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.",
                "requirements": "Provides context for the information that was captured.  May also affect access control.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.encounter",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Encounter"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.encounter"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.context"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.authored",
                "path": "QuestionnaireResponse.authored",
                "short": "Date the answers were gathered",
                "definition": "The date and/or time that this set of answers were last changed.",
                "comment": "May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.\n\nThis element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.",
                "requirements": "Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.",
                "alias":  [
                    "Date Created",
                    "Date published",
                    "Date Issued",
                    "Date updated"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.authored",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.occurrence[x]"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.recorded"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].time"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.author",
                "path": "QuestionnaireResponse.author",
                "short": "Person who received and recorded the answers",
                "definition": "Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.",
                "comment": "Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation.  Authoring by device would indicate that some portion of the questionnaire had been auto-populated.",
                "requirements": "Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.",
                "alias":  [
                    "Laboratory",
                    "Service",
                    "Practitioner",
                    "Department",
                    "Company",
                    "Performer"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.author",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Device",
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
                            "http://hl7.org/fhir/StructureDefinition/Patient",
                            "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.performer"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.author"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].role"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.source",
                "path": "QuestionnaireResponse.source",
                "short": "The person who answered the questions",
                "definition": "The person who answered the questions about the subject.",
                "comment": "If not specified, no inference can be made about who provided the data.",
                "requirements": "When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.source",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient",
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
                            "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.source"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=INF].role"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item",
                "path": "QuestionnaireResponse.item",
                "short": "Groups and questions",
                "definition": "A group or question item from the original questionnaire for which answers are provided.",
                "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "QuestionnaireResponse.item",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "qrs-1",
                        "severity": "error",
                        "human": "Nested item can't be beneath both item and answer",
                        "expression": "(answer.exists() and item.exists()).not()",
                        "xpath": "not(exists(f:answer) and exists(f:item))"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.id",
                "path": "QuestionnaireResponse.item.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.extension",
                "path": "QuestionnaireResponse.item.extension",
                "short": "Additional content defined by implementations",
                "definition": "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.",
                "comment": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.modifierExtension",
                "path": "QuestionnaireResponse.item.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "definition": "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).",
                "comment": "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.",
                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.linkId",
                "path": "QuestionnaireResponse.item.linkId",
                "short": "Pointer to specific item from Questionnaire",
                "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
                "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.item.linkId",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.definition",
                "path": "QuestionnaireResponse.item.definition",
                "short": "ElementDefinition - details for the item",
                "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
                "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
                "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.item.definition",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.text",
                "path": "QuestionnaireResponse.item.text",
                "short": "Name for group or question text",
                "definition": "Text that is displayed above the contents of the group or as the text of the question being answered.",
                "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.item.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".text"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer",
                "path": "QuestionnaireResponse.item.answer",
                "short": "The response(s) to the question",
                "definition": "The respondent's answer(s) to the question.",
                "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "QuestionnaireResponse.item.answer",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".value[type=LIST_ANY]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.id",
                "path": "QuestionnaireResponse.item.answer.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.extension",
                "path": "QuestionnaireResponse.item.answer.extension",
                "short": "Additional content defined by implementations",
                "definition": "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.",
                "comment": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.modifierExtension",
                "path": "QuestionnaireResponse.item.answer.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "definition": "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).",
                "comment": "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.",
                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "short": "Single-valued answer to the question",
                "definition": "The answer (or one of the answers) provided by the respondent to the question.",
                "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.",
                "requirements": "Ability to retain a single-valued answer to a question.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "QuestionnaireResponse.item.answer.value[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "decimal"
                    },
                    {
                        "code": "integer"
                    },
                    {
                        "code": "date"
                    },
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "time"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "uri"
                    },
                    {
                        "code": "Attachment"
                    },
                    {
                        "code": "Coding"
                    },
                    {
                        "code": "Quantity"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Resource"
                        ]
                    }
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "QuestionnaireAnswer"
                        }
                    ],
                    "strength": "example",
                    "description": "Code indicating the response provided for a question.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".item"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.item",
                "path": "QuestionnaireResponse.item.answer.item",
                "short": "Nested groups and questions",
                "definition": "Nested groups and/or questions found within this particular answer.",
                "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "QuestionnaireResponse.item.answer.item",
                    "min": 0,
                    "max": "*"
                },
                "contentReference": "#QuestionnaireResponse.item",
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.item",
                "path": "QuestionnaireResponse.item.item",
                "short": "Nested questionnaire response items",
                "definition": "Questions or sub-groups nested beneath a question or group.",
                "requirements": "Reports can consist of complex nested groups.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "QuestionnaireResponse.item.item",
                    "min": 0,
                    "max": "*"
                },
                "contentReference": "#QuestionnaireResponse.item",
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": false,
                "isSummary": false,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"
                    }
                ]
            }
        ]
    },
    "differential": {
        "element":  [
            {
                "id": "QuestionnaireResponse",
                "path": "QuestionnaireResponse",
                "short": "A structured set of questions and their answers",
                "definition": "A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.",
                "comment": "The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on.  I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.",
                "alias":  [
                    "Form",
                    "QuestionnaireAnswers"
                ],
                "min": 0,
                "max": "*",
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event"
                    },
                    {
                        "identity": "rim",
                        "map": "Observation[moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.identifier",
                "path": "QuestionnaireResponse.identifier",
                "short": "Unique id for this set of answers",
                "definition": "A business identifier assigned to a particular completed (or partially completed) questionnaire.",
                "requirements": "Used for tracking, registration and other business purposes.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.identifier"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "rim",
                        "map": ".id"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.basedOn",
                "path": "QuestionnaireResponse.basedOn",
                "short": "Request fulfilled by this QuestionnaireResponse",
                "definition": "The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.  For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.",
                "requirements": "Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.",
                "alias":  [
                    "order"
                ],
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/CarePlan",
                            "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
                        ]
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.basedOn"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=FLFS].target"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.partOf",
                "path": "QuestionnaireResponse.partOf",
                "short": "Part of this action",
                "definition": "A procedure or observation that this questionnaire was performed as part of the execution of.  For example, the surgery a checklist was executed as part of.",
                "comment": "Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire.  For relationships to referrals, and other types of requests, use basedOn.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Observation",
                            "http://hl7.org/fhir/StructureDefinition/Procedure"
                        ]
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.partOf"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.questionnaire",
                "path": "QuestionnaireResponse.questionnaire",
                "short": "Form being answered",
                "definition": "The Questionnaire that defines and organizes the questions for which answers are being provided.",
                "comment": "If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).",
                "requirements": "Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.",
                "alias":  [
                    "Form"
                ],
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "canonical",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Questionnaire"
                        ]
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.instantiates"
                    },
                    {
                        "identity": "rim",
                        "map": "./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.status",
                "path": "QuestionnaireResponse.status",
                "short": "in-progress | completed | amended | entered-in-error | stopped",
                "definition": "The position of the questionnaire response within its overall lifecycle.",
                "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
                "requirements": "The information on Questionnaire resources  may possibly be gathered during multiple sessions and altered after considered being finished.",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "QuestionnaireResponseStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "Lifecycle status of the questionnaire response.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.status"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.status"
                    },
                    {
                        "identity": "rim",
                        "map": ".statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish \"in-progress\" from \"published)"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.subject",
                "path": "QuestionnaireResponse.subject",
                "short": "The subject of the questions",
                "definition": "The subject of the questionnaire response.  This could be a patient, organization, practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily the source of information.",
                "comment": "If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.",
                "requirements": "Allows linking the answers to the individual the answers describe.  May also affect access control.",
                "alias":  [
                    "Patient",
                    "Focus"
                ],
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Resource"
                        ]
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.subject"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject[x]"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=SBJ].role"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.encounter",
                "path": "QuestionnaireResponse.encounter",
                "short": "Encounter created as part of",
                "definition": "The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.",
                "comment": "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.",
                "requirements": "Provides context for the information that was captured.  May also affect access control.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Encounter"
                        ]
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.encounter"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.context"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.authored",
                "path": "QuestionnaireResponse.authored",
                "short": "Date the answers were gathered",
                "definition": "The date and/or time that this set of answers were last changed.",
                "comment": "May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.\n\nThis element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.",
                "requirements": "Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.",
                "alias":  [
                    "Date Created",
                    "Date published",
                    "Date Issued",
                    "Date updated"
                ],
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.occurrence[x]"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.recorded"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].time"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.author",
                "path": "QuestionnaireResponse.author",
                "short": "Person who received and recorded the answers",
                "definition": "Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.",
                "comment": "Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation.  Authoring by device would indicate that some portion of the questionnaire had been auto-populated.",
                "requirements": "Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.",
                "alias":  [
                    "Laboratory",
                    "Service",
                    "Practitioner",
                    "Department",
                    "Company",
                    "Performer"
                ],
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Device",
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
                            "http://hl7.org/fhir/StructureDefinition/Patient",
                            "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "workflow",
                        "map": "Event.performer"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.author"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].role"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.source",
                "path": "QuestionnaireResponse.source",
                "short": "The person who answered the questions",
                "definition": "The person who answered the questions about the subject.",
                "comment": "If not specified, no inference can be made about who provided the data.",
                "requirements": "When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient",
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
                            "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
                        ]
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "w5",
                        "map": "FiveWs.source"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=INF].role"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item",
                "path": "QuestionnaireResponse.item",
                "short": "Groups and questions",
                "definition": "A group or question item from the original questionnaire for which answers are provided.",
                "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "constraint":  [
                    {
                        "key": "qrs-1",
                        "severity": "error",
                        "human": "Nested item can't be beneath both item and answer",
                        "expression": "(answer.exists() and item.exists()).not()",
                        "xpath": "not(exists(f:answer) and exists(f:item))"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.linkId",
                "path": "QuestionnaireResponse.item.linkId",
                "short": "Pointer to specific item from Questionnaire",
                "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
                "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.definition",
                "path": "QuestionnaireResponse.item.definition",
                "short": "ElementDefinition - details for the item",
                "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
                "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html#), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
                "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.text",
                "path": "QuestionnaireResponse.item.text",
                "short": "Name for group or question text",
                "definition": "Text that is displayed above the contents of the group or as the text of the question being answered.",
                "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".text"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer",
                "path": "QuestionnaireResponse.item.answer",
                "short": "The response(s) to the question",
                "definition": "The respondent's answer(s) to the question.",
                "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".value[type=LIST_ANY]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "short": "Single-valued answer to the question",
                "definition": "The answer (or one of the answers) provided by the respondent to the question.",
                "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.",
                "requirements": "Ability to retain a single-valued answer to a question.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "decimal"
                    },
                    {
                        "code": "integer"
                    },
                    {
                        "code": "date"
                    },
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "time"
                    },
                    {
                        "code": "string"
                    },
                    {
                        "code": "uri"
                    },
                    {
                        "code": "Attachment"
                    },
                    {
                        "code": "Coding"
                    },
                    {
                        "code": "Quantity"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Resource"
                        ]
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "QuestionnaireAnswer"
                        }
                    ],
                    "strength": "example",
                    "description": "Code indicating the response provided for a question.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".item"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.item",
                "path": "QuestionnaireResponse.item.answer.item",
                "short": "Nested groups and questions",
                "definition": "Nested groups and/or questions found within this particular answer.",
                "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
                "min": 0,
                "max": "*",
                "contentReference": "#QuestionnaireResponse.item",
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.item",
                "path": "QuestionnaireResponse.item.item",
                "short": "Nested questionnaire response items",
                "definition": "Questions or sub-groups nested beneath a question or group.",
                "requirements": "Reports can consist of complex nested groups.",
                "min": 0,
                "max": "*",
                "contentReference": "#QuestionnaireResponse.item",
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"
                    }
                ]
            }
        ]
    }
}

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