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Ontario eForms HL7® FHIR® SDC Implementation Guide - v1.1.0 TU-snapshot1
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    1. Index
    2. FHIR Artifacts
    3. Profiles
    4. QuestionnaireResponse Profile

For a full list of available versions, see the Directory of published versions

4.1.2. QuestionnaireResponse Profile

This profile defines common elements for Ontario eForms QuestionnaireResponses. It is functionally aligned with the HL7 SDC QuestionnaireResponse guidance/profile, but replaces SDC’s Must Support expectations with Ontario Health role-based implementation obligations. Because the SDC profile expresses conformance using Must Support, this IG defines an Ontario-specific QuestionnaireResponse profile rather than deriving directly from the SDC QuestionnaireResponse profile.

Simplifier project page: Ontario SDC QuestionnaireResponse Profile

Derived From: QuestionnaireResponse

Canonical_Url Profile_Status Profile_Version FHIR_Version


4.1.2.1. Usage

This profile is used when an Ontario Health eForm is completed and represented as a QuestionnaireResponse. It supports:

  • consistent capture of user responses by a form filler (Renderer),
  • native population workflows where a client pre-fills answers prior to user review,
  • extraction workflows that transform QuestionnaireResponse content into derived resources using extraction metadata declared in the associated Questionnaire, and
  • narrative generation workflows that create a human-readable summary in QuestionnaireResponse.text using Liquid templates declared in the Questionnaire.

Note: This profile uses role-based implementation obligations (Renderer, Population Engine, Extraction Engine, QR Narrative Generator). See the Conformance Rules section for how to interpret obligation codes such as SHALL:populate, SHALL:process, SHALL:display, and SHALL:user-input.


4.1.2.2. Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work

Differential View

OntarioSDCQuestionnaireResponse (QuestionnaireResponse)CQuestionnaireResponseElement id
QuestionnaireResponse
Short description

Generic Questionnaire Response

Alternate names

Form, QuestionnaireAnswers, Form Data

Definition

Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.

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

QuestionnaireResponse

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()
  • sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject.
    subject.exists()
  • sdcqr-2: When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers.
    (QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Observation[moodCode=EVN]
idΣ0..1id
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

id

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
metaΣ0..1Meta
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
implicitRulesΣ ?!0..1uri
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
languageO0..1codeBindingElement 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)

Binding extensions
maxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
text0..1Narrative
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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?
contained0..*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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
adheresToC0..*Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)Element id
QuestionnaireResponse.extension:adheresTo
Short description

Follows rules from

Alternate names

extensions, user content

Definition

The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

Comments

If changes are made to this event record, the determination must be made whether, with the change, the action still complies with the referenced Definition. Revisions may result in adheresTo assertions being removed, or - if the system has an algorithm for determining which targets are appropriate - being added. Adherence may be asserted after the fact. It is possible for a Request or Event to adhere to a Definition even if the author/performer of the action was not aware of the Definition at the time the action was taken/requested.

Also see the notes in the workflow extensions area for more guidance on this element.

Data type

Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)

Extension URL

AdheresTo

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
url1..1uriFixed Value
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.url
Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value
http://hl7.org/fhir/StructureDefinition/workflow-adheresTo
Mappings
  • rim: N/A
value[x]1..1
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.value[x]
Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
valueCanonicalcanonical(ActivityDefinition | PlanDefinition)Data type

canonical(ActivityDefinition | PlanDefinition)

valueReferenceReference(ActivityDefinition | PlanDefinition)Data type

Reference(ActivityDefinition | PlanDefinition)

valueUriuriData type

uri

triggeredByC0..1Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)Element id
QuestionnaireResponse.extension:triggeredBy
Short description

Created because of following

Alternate names

extensions, user content

Definition

This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a 'step' dictated within the protocol/order set/etc.

Comments

See the notes in the workflow extensions area for more guidance on this element.

Data type

Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)

Extension URL

TriggeredBy

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
url1..1uriFixed Value
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.url
Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value
http://hl7.org/fhir/StructureDefinition/workflow-triggeredBy
Mappings
  • rim: N/A
value[x]1..1
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.value[x]
Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
valueCanonicalcanonical(ActivityDefinition | PlanDefinition)Data type

canonical(ActivityDefinition | PlanDefinition)

valueReferenceReference(ActivityDefinition | PlanDefinition)Data type

Reference(ActivityDefinition | PlanDefinition)

valueUriuriData type

uri

signatureO C0..*Extension(Signature)Element id
QuestionnaireResponse.extension:signature
Short description

A signature attesting to the content

Alternate names

extensions, user content

Definition

Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

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(Signature)

Extension URL

signature

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererMAY:populate
completionModeC0..1Extension(CodeableConcept)Element id
QuestionnaireResponse.extension:completionMode
Short description

E.g. Verbal, written, electronic

Alternate names

extensions, user content

Definition

Indicates how the individual completing the QuestionnaireResponse provided their responses.

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(CodeableConcept)

Extension URL

completionMode

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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?! C0..*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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierO Σ0..1IdentifierElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
basedOnΣ C0..*Reference(CarePlan | ServiceRequest)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
partOfΣ C0..*Reference(Observation | Procedure)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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]
questionnaireO Σ1..1canonical(OntarioSDCQuestionnaire)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(OntarioSDCQuestionnaire)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
statusO Σ ?!1..1codeBindingElement 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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
subjectO Σ C0..1Reference(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. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
encounterΣ C0..1Reference(Encounter)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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]
authoredO Σ1..1dateTimeElement id
QuestionnaireResponse.authored
Short description

Date the answers were gathered

Alternate names

Date Created, Date published, Date Issued, Date updated

Definition

Identifies when this version of the answer set was created. Changes whenever the answers are 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.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
authorΣ C0..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
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 | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
sourceΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
referenceΣ C0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, ref-1

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
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Data type

uri

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .identifier
displayΣ0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.display
Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemO C0..*BackboneElementElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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()
  • qrs-2: Repeated answers are combined in the answers array of a single item
    repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
id0..1string
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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemMediaO C0..1Extension(Attachment)Element id
QuestionnaireResponse.item.extension:itemMedia
Short description

Media to display

Alternate names

extensions, user content

Definition

Media to render/make available as an accompaniment to the question being asked

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(Attachment)

Extension URL

ItemMedia

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:user-input
ItemSignatureO C0..*Extension(Signature)Element id
QuestionnaireResponse.item.extension:ItemSignature
Short description

A signature attesting to the content

Alternate names

extensions, user content

Definition

Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

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(Signature)

Extension URL

signature

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererMAY:populate
modifierExtensionΣ ?! C0..*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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
linkIdO1..1stringElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
definition0..1uri
There are no (further) constraints on this element
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
textO0..1stringElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .text
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
answerO0..*BackboneElementElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
id0..1string
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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemAnswerMediaO C0..1Extension(Attachment)Element id
QuestionnaireResponse.item.answer.extension:itemAnswerMedia
Short description

Answer Media to display

Alternate names

extensions, user content

Definition

Media to render/make available as an accompaniment to a specific answer option

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(Attachment)

Extension URL

ItemAnswerMedia

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
itemWeightO C0..1Extension(decimal)Element id
QuestionnaireResponse.item.answer.extension:itemWeight
Short description

Assigned Ordinal Value

Alternate names

extensions, user content

Definition

A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

Comments

Inclusion of weights in QRs can increase performance when calculating based on weights.

Data type

Extension(decimal)

Extension URL

ItemWeight

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
modifierExtensionΣ ?! C0..*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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]O0..1Element 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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .item
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:user-input
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
valueAttachmentAttachment
There are no (further) constraints on this element
Data type

Attachment

valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodingCoding
There are no (further) constraints on this element
Data type

Coding

valueDatedate
There are no (further) constraints on this element
Data type

date

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueDecimaldecimal
There are no (further) constraints on this element
Data type

decimal

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valueQuantityQuantity
There are no (further) constraints on this element
Data type

Quantity

valueReferenceReference(Resource)
There are no (further) constraints on this element
Data type

Reference(Resource)

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

valueUriuri
There are no (further) constraints on this element
Data type

uri

itemO0..*see (item)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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
itemO0..*see (item)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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
authorO
There are no (further) constraints on this element
Element id
QuestionnaireResponse.author
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process

Hybrid View

OntarioSDCQuestionnaireResponse (QuestionnaireResponse)CQuestionnaireResponseElement id
QuestionnaireResponse
Short description

Generic Questionnaire Response

Alternate names

Form, QuestionnaireAnswers, Form Data

Definition

Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.

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

QuestionnaireResponse

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()
  • sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject.
    subject.exists()
  • sdcqr-2: When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers.
    (QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Observation[moodCode=EVN]
idΣ0..1id
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

id

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
metaΣ0..1Meta
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
implicitRulesΣ ?!0..1uri
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
languageO0..1codeBindingElement 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)

Binding extensions
maxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
text0..1Narrative
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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?
contained0..*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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
adheresToC0..*Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)Element id
QuestionnaireResponse.extension:adheresTo
Short description

Follows rules from

Alternate names

extensions, user content

Definition

The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

Comments

If changes are made to this event record, the determination must be made whether, with the change, the action still complies with the referenced Definition. Revisions may result in adheresTo assertions being removed, or - if the system has an algorithm for determining which targets are appropriate - being added. Adherence may be asserted after the fact. It is possible for a Request or Event to adhere to a Definition even if the author/performer of the action was not aware of the Definition at the time the action was taken/requested.

Also see the notes in the workflow extensions area for more guidance on this element.

Data type

Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)

Extension URL

AdheresTo

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
url1..1uriFixed Value
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.url
Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value
http://hl7.org/fhir/StructureDefinition/workflow-adheresTo
Mappings
  • rim: N/A
value[x]1..1
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.value[x]
Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
valueCanonicalcanonical(ActivityDefinition | PlanDefinition)Data type

canonical(ActivityDefinition | PlanDefinition)

valueReferenceReference(ActivityDefinition | PlanDefinition)Data type

Reference(ActivityDefinition | PlanDefinition)

valueUriuriData type

uri

triggeredByC0..1Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)Element id
QuestionnaireResponse.extension:triggeredBy
Short description

Created because of following

Alternate names

extensions, user content

Definition

This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a 'step' dictated within the protocol/order set/etc.

Comments

See the notes in the workflow extensions area for more guidance on this element.

Data type

Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)

Extension URL

TriggeredBy

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
url1..1uriFixed Value
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.url
Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value
http://hl7.org/fhir/StructureDefinition/workflow-triggeredBy
Mappings
  • rim: N/A
value[x]1..1
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.value[x]
Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
valueCanonicalcanonical(ActivityDefinition | PlanDefinition)Data type

canonical(ActivityDefinition | PlanDefinition)

valueReferenceReference(ActivityDefinition | PlanDefinition)Data type

Reference(ActivityDefinition | PlanDefinition)

valueUriuriData type

uri

signatureO C0..*Extension(Signature)Element id
QuestionnaireResponse.extension:signature
Short description

A signature attesting to the content

Alternate names

extensions, user content

Definition

Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

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(Signature)

Extension URL

signature

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererMAY:populate
completionModeC0..1Extension(CodeableConcept)Element id
QuestionnaireResponse.extension:completionMode
Short description

E.g. Verbal, written, electronic

Alternate names

extensions, user content

Definition

Indicates how the individual completing the QuestionnaireResponse provided their responses.

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(CodeableConcept)

Extension URL

completionMode

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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?! C0..*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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierO Σ0..1IdentifierElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
basedOnΣ C0..*Reference(CarePlan | ServiceRequest)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
partOfΣ C0..*Reference(Observation | Procedure)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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]
questionnaireO Σ1..1canonical(OntarioSDCQuestionnaire)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(OntarioSDCQuestionnaire)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
statusO Σ ?!1..1codeBindingElement 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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
subjectO Σ C0..1Reference(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. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
encounterΣ C0..1Reference(Encounter)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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]
authoredO Σ1..1dateTimeElement id
QuestionnaireResponse.authored
Short description

Date the answers were gathered

Alternate names

Date Created, Date published, Date Issued, Date updated

Definition

Identifies when this version of the answer set was created. Changes whenever the answers are 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.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
authorΣ C0..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
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 | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
sourceΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
referenceΣ C0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, ref-1

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
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Data type

uri

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .identifier
displayΣ0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.display
Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemO C0..*BackboneElementElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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()
  • qrs-2: Repeated answers are combined in the answers array of a single item
    repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
id0..1string
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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemMediaO C0..1Extension(Attachment)Element id
QuestionnaireResponse.item.extension:itemMedia
Short description

Media to display

Alternate names

extensions, user content

Definition

Media to render/make available as an accompaniment to the question being asked

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(Attachment)

Extension URL

ItemMedia

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:user-input
ItemSignatureO C0..*Extension(Signature)Element id
QuestionnaireResponse.item.extension:ItemSignature
Short description

A signature attesting to the content

Alternate names

extensions, user content

Definition

Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

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(Signature)

Extension URL

signature

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererMAY:populate
modifierExtensionΣ ?! C0..*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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
linkIdO1..1stringElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
definition0..1uri
There are no (further) constraints on this element
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
textO0..1stringElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .text
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
answerO0..*BackboneElementElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
id0..1string
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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemAnswerMediaO C0..1Extension(Attachment)Element id
QuestionnaireResponse.item.answer.extension:itemAnswerMedia
Short description

Answer Media to display

Alternate names

extensions, user content

Definition

Media to render/make available as an accompaniment to a specific answer option

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(Attachment)

Extension URL

ItemAnswerMedia

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
itemWeightO C0..1Extension(decimal)Element id
QuestionnaireResponse.item.answer.extension:itemWeight
Short description

Assigned Ordinal Value

Alternate names

extensions, user content

Definition

A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

Comments

Inclusion of weights in QRs can increase performance when calculating based on weights.

Data type

Extension(decimal)

Extension URL

ItemWeight

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
modifierExtensionΣ ?! C0..*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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]O0..1Element 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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .item
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:user-input
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
valueAttachmentAttachment
There are no (further) constraints on this element
Data type

Attachment

valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodingCoding
There are no (further) constraints on this element
Data type

Coding

valueDatedate
There are no (further) constraints on this element
Data type

date

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueDecimaldecimal
There are no (further) constraints on this element
Data type

decimal

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valueQuantityQuantity
There are no (further) constraints on this element
Data type

Quantity

valueReferenceReference(Resource)
There are no (further) constraints on this element
Data type

Reference(Resource)

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

valueUriuri
There are no (further) constraints on this element
Data type

uri

itemO0..*see (item)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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
itemO0..*see (item)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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
authorO
There are no (further) constraints on this element
Element id
QuestionnaireResponse.author
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process

Snapshot View

OntarioSDCQuestionnaireResponse (QuestionnaireResponse)CQuestionnaireResponseElement id
QuestionnaireResponse
Short description

Generic Questionnaire Response

Alternate names

Form, QuestionnaireAnswers, Form Data

Definition

Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.

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

QuestionnaireResponse

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()
  • sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject.
    subject.exists()
  • sdcqr-2: When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers.
    (QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Observation[moodCode=EVN]
idΣ0..1id
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

id

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
metaΣ0..1Meta
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
implicitRulesΣ ?!0..1uri
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
languageO0..1codeBindingElement 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)

Binding extensions
maxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
text0..1Narrative
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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?
contained0..*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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
adheresToC0..*Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)Element id
QuestionnaireResponse.extension:adheresTo
Short description

Follows rules from

Alternate names

extensions, user content

Definition

The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

Comments

If changes are made to this event record, the determination must be made whether, with the change, the action still complies with the referenced Definition. Revisions may result in adheresTo assertions being removed, or - if the system has an algorithm for determining which targets are appropriate - being added. Adherence may be asserted after the fact. It is possible for a Request or Event to adhere to a Definition even if the author/performer of the action was not aware of the Definition at the time the action was taken/requested.

Also see the notes in the workflow extensions area for more guidance on this element.

Data type

Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)

Extension URL

AdheresTo

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
url1..1uriFixed Value
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.url
Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value
http://hl7.org/fhir/StructureDefinition/workflow-adheresTo
Mappings
  • rim: N/A
value[x]1..1
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:adheresTo.value[x]
Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
valueCanonicalcanonical(ActivityDefinition | PlanDefinition)Data type

canonical(ActivityDefinition | PlanDefinition)

valueReferenceReference(ActivityDefinition | PlanDefinition)Data type

Reference(ActivityDefinition | PlanDefinition)

valueUriuriData type

uri

triggeredByC0..1Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)Element id
QuestionnaireResponse.extension:triggeredBy
Short description

Created because of following

Alternate names

extensions, user content

Definition

This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a 'step' dictated within the protocol/order set/etc.

Comments

See the notes in the workflow extensions area for more guidance on this element.

Data type

Extension(canonical(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)Reference(ActivityDefinition | Measure | ObservationDefinition | PlanDefinition | Questionnaire)uri)

Extension URL

TriggeredBy

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
url1..1uriFixed Value
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.url
Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value
http://hl7.org/fhir/StructureDefinition/workflow-triggeredBy
Mappings
  • rim: N/A
value[x]1..1
There are no (further) constraints on this element
Element id
QuestionnaireResponse.extension:triggeredBy.value[x]
Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
valueCanonicalcanonical(ActivityDefinition | PlanDefinition)Data type

canonical(ActivityDefinition | PlanDefinition)

valueReferenceReference(ActivityDefinition | PlanDefinition)Data type

Reference(ActivityDefinition | PlanDefinition)

valueUriuriData type

uri

signatureO C0..*Extension(Signature)Element id
QuestionnaireResponse.extension:signature
Short description

A signature attesting to the content

Alternate names

extensions, user content

Definition

Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

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(Signature)

Extension URL

signature

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererMAY:populate
completionModeC0..1Extension(CodeableConcept)Element id
QuestionnaireResponse.extension:completionMode
Short description

E.g. Verbal, written, electronic

Alternate names

extensions, user content

Definition

Indicates how the individual completing the QuestionnaireResponse provided their responses.

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(CodeableConcept)

Extension URL

completionMode

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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?! C0..*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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierO Σ0..1IdentifierElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
basedOnΣ C0..*Reference(CarePlan | ServiceRequest)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
partOfΣ C0..*Reference(Observation | Procedure)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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]
questionnaireO Σ1..1canonical(OntarioSDCQuestionnaire)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(OntarioSDCQuestionnaire)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
statusO Σ ?!1..1codeBindingElement 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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
subjectO Σ C0..1Reference(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. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
encounterΣ C0..1Reference(Encounter)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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]
authoredO Σ1..1dateTimeElement id
QuestionnaireResponse.authored
Short description

Date the answers were gathered

Alternate names

Date Created, Date published, Date Issued, Date updated

Definition

Identifies when this version of the answer set was created. Changes whenever the answers are 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.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
authorΣ C0..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
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 | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
sourceΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
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
id0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.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
extensionC0..0Extension
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
referenceΣ C0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, ref-1

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
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Data type

uri

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .identifier
displayΣ0..1string
There are no (further) constraints on this element
Element id
QuestionnaireResponse.source.display
Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemO C0..*BackboneElementElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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()
  • qrs-2: Repeated answers are combined in the answers array of a single item
    repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
id0..1string
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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemMediaO C0..1Extension(Attachment)Element id
QuestionnaireResponse.item.extension:itemMedia
Short description

Media to display

Alternate names

extensions, user content

Definition

Media to render/make available as an accompaniment to the question being asked

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(Attachment)

Extension URL

ItemMedia

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:user-input
ItemSignatureO C0..*Extension(Signature)Element id
QuestionnaireResponse.item.extension:ItemSignature
Short description

A signature attesting to the content

Alternate names

extensions, user content

Definition

Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.

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(Signature)

Extension URL

signature

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererMAY:populate
modifierExtensionΣ ?! C0..*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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
linkIdO1..1stringElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
definition0..1uri
There are no (further) constraints on this element
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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
textO0..1stringElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .text
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
answerO0..*BackboneElementElement 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
id0..1string
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
extensionC0..*ExtensionElement 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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
itemAnswerMediaO C0..1Extension(Attachment)Element id
QuestionnaireResponse.item.answer.extension:itemAnswerMedia
Short description

Answer Media to display

Alternate names

extensions, user content

Definition

Media to render/make available as an accompaniment to a specific answer option

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(Attachment)

Extension URL

ItemAnswerMedia

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
itemWeightO C0..1Extension(decimal)Element id
QuestionnaireResponse.item.answer.extension:itemWeight
Short description

Assigned Ordinal Value

Alternate names

extensions, user content

Definition

A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

Comments

Inclusion of weights in QRs can increase performance when calculating based on weights.

Data type

Extension(decimal)

Extension URL

ItemWeight

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
modifierExtensionΣ ?! C0..*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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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]O0..1Element 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)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .item
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:user-input
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
valueAttachmentAttachment
There are no (further) constraints on this element
Data type

Attachment

valueBooleanboolean
There are no (further) constraints on this element
Data type

boolean

valueCodingCoding
There are no (further) constraints on this element
Data type

Coding

valueDatedate
There are no (further) constraints on this element
Data type

date

valueDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

valueDecimaldecimal
There are no (further) constraints on this element
Data type

decimal

valueIntegerinteger
There are no (further) constraints on this element
Data type

integer

valueQuantityQuantity
There are no (further) constraints on this element
Data type

Quantity

valueReferenceReference(Resource)
There are no (further) constraints on this element
Data type

Reference(Resource)

valueStringstring
There are no (further) constraints on this element
Data type

string

valueTimetime
There are no (further) constraints on this element
Data type

time

valueUriuri
There are no (further) constraints on this element
Data type

uri

itemO0..*see (item)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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
itemO0..*see (item)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]
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:display
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process
http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generatorSHALL:process
authorO
There are no (further) constraints on this element
Element id
QuestionnaireResponse.author
Obligations
ActorCode
http://ontariohealth.ca/fhir/eforms/ActorDefinition/rendererSHALL:populate
http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engineSHALL:process

Table View

QuestionnaireResponse..
QuestionnaireResponse.language..
QuestionnaireResponse.extension..
QuestionnaireResponse.extension:adheresToExtension0..*
QuestionnaireResponse.extension:adheresTo.value[x]canonical(ActivityDefinition | PlanDefinition) | Reference(ActivityDefinition | PlanDefinition) | uri..
QuestionnaireResponse.extension:triggeredByExtension0..1
QuestionnaireResponse.extension:triggeredBy.value[x]canonical(ActivityDefinition | PlanDefinition) | Reference(ActivityDefinition | PlanDefinition) | uri..
QuestionnaireResponse.extension:signatureExtension0..*
QuestionnaireResponse.extension:completionModeExtension0..1
QuestionnaireResponse.identifier..
QuestionnaireResponse.questionnairecanonical(OntarioSDCQuestionnaire)1..
QuestionnaireResponse.status..
QuestionnaireResponse.subject..
QuestionnaireResponse.authored1..
QuestionnaireResponse.source..
QuestionnaireResponse.source.extension:r5Source..0
QuestionnaireResponse.author..
QuestionnaireResponse.item..
QuestionnaireResponse.item.extension..
QuestionnaireResponse.item.extension:itemMediaExtension0..1
QuestionnaireResponse.item.extension:ItemSignatureExtension0..*
QuestionnaireResponse.item.linkId..
QuestionnaireResponse.item.text..
QuestionnaireResponse.item.answer..
QuestionnaireResponse.item.answer.extension..
QuestionnaireResponse.item.answer.extension:itemAnswerMediaExtension0..1
QuestionnaireResponse.item.answer.extension:itemWeightExtension0..1
QuestionnaireResponse.item.answer.value[x]..
QuestionnaireResponse.item.answer.item..
QuestionnaireResponse.item.item..

JSON View

{
"resourceType": "StructureDefinition",
"id": "sdc-questionnaireresponsecommon",
"url": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/sdc-questionnaireresponse",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.4.642.40.17.42.90"
}
],
"version": "1.1.0",
"name": "OntarioSDCQuestionnaireResponse",
"title": "Ontario SDC QuestionnaireResponse Profile",
"status": "active",
"date": "2026-02-10",
"publisher": "Ontario Health",
"description": "Defines common elements for Ontario eForms SDC QuestionnaireResponses. Based on SDC content, with Must Support replaced by role-based Obligations.",
"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/QuestionnaireResponse",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "QuestionnaireResponse",
"path": "QuestionnaireResponse",
"short": "Generic Questionnaire Response",
"definition": "Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.",
"alias": [
"Form Data",
"QuestionnaireAnswers"
],
"constraint": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}
],
"key": "sdcqr-1",
"severity": "warning",
"human": "Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject.",
"expression": "subject.exists()",
"xpath": "exists(f:subject)",
"source": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/sdc-questionnaireresponsecommon"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}
],
"key": "sdcqr-2",
"severity": "error",
"human": "When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers.",
"expression": "(QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()",
"xpath": "not(exists(for $item in descendant::f:item[f:answer] return $item/preceding-sibling::f:item[f:linkId/@value=$item/f:linkId/@value]))",
"source": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/sdc-questionnaireresponsecommon"
}
]
},
{
"id": "QuestionnaireResponse.language",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generator"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.language"
},
{
"id": "QuestionnaireResponse.extension",
"path": "QuestionnaireResponse.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "QuestionnaireResponse.extension:adheresTo",
"path": "QuestionnaireResponse.extension",
"sliceName": "adheresTo",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/workflow-adheresTo"
]
}
]
},
{
"id": "QuestionnaireResponse.extension:adheresTo.value[x]",
"path": "QuestionnaireResponse.extension.value[x]",
"type": [
{
"code": "canonical",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
"http://hl7.org/fhir/StructureDefinition/PlanDefinition"
]
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
"http://hl7.org/fhir/StructureDefinition/PlanDefinition"
]
},
{
"code": "uri"
}
]
},
{
"id": "QuestionnaireResponse.extension:triggeredBy",
"path": "QuestionnaireResponse.extension",
"sliceName": "triggeredBy",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/workflow-triggeredBy"
]
}
]
},
{
"id": "QuestionnaireResponse.extension:triggeredBy.value[x]",
"path": "QuestionnaireResponse.extension.value[x]",
"type": [
{
"code": "canonical",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
"http://hl7.org/fhir/StructureDefinition/PlanDefinition"
]
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
"http://hl7.org/fhir/StructureDefinition/PlanDefinition"
]
},
{
"code": "uri"
}
]
},
{
"id": "QuestionnaireResponse.extension:signature",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "MAY:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.extension",
"sliceName": "signature",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature"
]
}
]
},
{
"id": "QuestionnaireResponse.extension:completionMode",
"path": "QuestionnaireResponse.extension",
"sliceName": "completionMode",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/questionnaireresponse-completionMode"
]
}
]
},
{
"id": "QuestionnaireResponse.identifier",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.identifier"
},
{
"id": "QuestionnaireResponse.questionnaire",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.questionnaire",
"min": 1,
"type": [
{
"code": "canonical",
"targetProfile": [
"http://ontariohealth.ca/fhir/eforms/StructureDefinition/sdc-questionnaire"
]
}
]
},
{
"id": "QuestionnaireResponse.status",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.status"
},
{
"id": "QuestionnaireResponse.subject",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.subject",
"comment": "... If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse"
},
{
"id": "QuestionnaireResponse.authored",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.authored",
"definition": "Identifies when this version of the answer set was created. Changes whenever the answers are updated.",
"min": 1
},
{
"id": "QuestionnaireResponse.source.extension:r5Source",
"path": "QuestionnaireResponse.source.extension",
"max": "0"
},
{
"id": "QuestionnaireResponse.author",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.author"
},
{
"id": "QuestionnaireResponse.item",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generator"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item",
"constraint": [
{
"key": "qrs-2",
"severity": "error",
"human": "Repeated answers are combined in the answers array of a single item",
"expression": "repeat(answer|item).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()",
"xpath": "true()",
"source": "http://ontariohealth.ca/fhir/eforms/StructureDefinition/sdc-questionnaireresponsecommon"
}
]
},
{
"id": "QuestionnaireResponse.item.extension",
"path": "QuestionnaireResponse.item.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "QuestionnaireResponse.item.extension:itemMedia",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:display"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:user-input"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.extension",
"sliceName": "itemMedia",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemMedia"
]
}
]
},
{
"id": "QuestionnaireResponse.item.extension:ItemSignature",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "MAY:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.extension",
"sliceName": "ItemSignature",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature"
]
}
]
},
{
"id": "QuestionnaireResponse.item.linkId",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generator"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.linkId"
},
{
"id": "QuestionnaireResponse.item.text",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:display"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.text"
},
{
"id": "QuestionnaireResponse.item.answer",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generator"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.answer"
},
{
"id": "QuestionnaireResponse.item.answer.extension",
"path": "QuestionnaireResponse.item.answer.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "QuestionnaireResponse.item.answer.extension:itemAnswerMedia",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:display"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.answer.extension",
"sliceName": "itemAnswerMedia",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia"
]
}
]
},
{
"id": "QuestionnaireResponse.item.answer.extension:itemWeight",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.answer.extension",
"sliceName": "itemWeight",
"comment": "Inclusion of weights in QRs can increase performance when calculating based on weights.",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/itemWeight"
]
}
]
},
{
"id": "QuestionnaireResponse.item.answer.value[x]",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:display"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:user-input"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generator"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.answer.value[x]"
},
{
"id": "QuestionnaireResponse.item.answer.item",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:display"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generator"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.answer.item",
"contentReference": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item"
},
{
"id": "QuestionnaireResponse.item.item",
"extension": [
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:populate"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:display"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/renderer"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/population-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/extraction-engine"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "actor",
"valueCanonical": "http://ontariohealth.ca/fhir/eforms/ActorDefinition/qr-narrative-generator"
},
{
"url": "code",
"valueCode": "SHALL:process"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "QuestionnaireResponse.item.item",
"contentReference": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item"
}
]
}
}


4.1.2.3. Notes

4.1.2.3.1. Relationship to HL7 SDC QuestionnaireResponse

  • This profile is intended to be semantically consistent with SDC QuestionnaireResponse expectations for representing completed forms.
  • This IG expresses conformance using role-based obligations rather than SDC’s Must Support approach; therefore, this profile is defined as an Ontario Health artifact rather than being derived directly from the SDC QuestionnaireResponse profile.

4.1.2.3.2. Required response metadata and linkage to the Questionnaire

  • QuestionnaireResponse.questionnaire is required and constrained to reference the Ontario eForms Questionnaire profile (sdc-questionnaire).
  • Implementations are expected to populate response-level metadata that supports tracking, audit, and downstream processing, including:
    • identifier, status, subject, authored, and author (as applicable to the workflow and obligations).

4.1.2.3.3. Response structure and repeated content conventions

  • This profile enforces response structure conventions that support consistent rendering and processing:
    • When repeats=true for a group in the Questionnaire, it is represented as multiple QuestionnaireResponse.item instances with the same linkId.
    • When repeats=true for a question in the Questionnaire, it is represented as a single QuestionnaireResponse.item instance with multiple answer repetitions.
  • Response processing components rely on item.linkId alignment with the Questionnaire item linkId to locate answers and apply population/extraction/narrative logic.

4.1.2.3.4. Population, extraction, and narrative processing expectations

  • Population, extraction, and narrative generation are driven by the response item framework:
    • item, item.linkId, item.text, item.answer, item.answer.value[x], and nested item.item / answer.item structures.
  • Where weighted answers are present (item.answer.extension:itemWeight), downstream components that process weights (e.g., extraction or scoring logic) are expected to read and use them as required by the use case.

4.1.2.3.5. Media capture support

  • This profile supports capturing and rendering media:
    • item.extension:itemMedia supports question-level media capture/display.
    • item.answer.extension:itemAnswerMedia supports answer-level media capture/display.

4.1.2.3.6. Signature support

  • Signatures may be captured:
    • at the QuestionnaireResponse level (extension:signature), and/or
    • at the item level (item.extension:ItemSignature), as permitted by the associated obligations.

Version: v1.1.0TUsnapshot1 FHIR Version: R4.0.1

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