Patient Finder Implementation Guide

QuestionnaireResponse

QuestionnaireResponse

Description

QuestionnaireResponse is represented in the Patient Finder as the categories form and form responses. The text in the answers will be pseudonymized. If a link to a Questionnaire is provided, the questions will be taken from there. This is not obligatory as the questions may also be provided in the QuestionnaireResponse. The preferred solution for Patient Finder is to have the questions in the QuestionnaireResponse. The linkId needs to be unique.

The QuestionnaireResponse mapping includes a reference to a department.

Instances

An example of a QuestionnaireResponse resource can be found here: QuestionnaireResponse Example 1

An example of the matching Questionnaire resource can be found here: Questionnaire Example 1

Profile

PatientFinderQuestionnaireResponse (QuestionnaireResponse)	I		QuestionnaireResponse	There are no (further) constraints on this element Element id QuestionnaireResponse Short description A structured set of questions and their answers Alternate names Form, QuestionnaireAnswers Definition A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to. Comments The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse. Data type QuestionnaireResponse Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event rim: Observation[moodCode=EVN]
id	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id QuestionnaireResponse.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id QuestionnaireResponse.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id QuestionnaireResponse.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id QuestionnaireResponse.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id QuestionnaireResponse.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	S I	0..1	Extension	Element id QuestionnaireResponse.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) 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
department	S I	0..1	Extension(Reference(Organization))	Element id QuestionnaireResponse.extension:department Short description departmentOrganization Alternate names extensions, user content Definition The organization representing the department. 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(Reference(Organization)) Extension URL https://fhir.iqvia.com/patientfinder/extension/department-organization 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 fhir-patient-finder-mapping: (Organization) department responsible for the registration of the form
specialism	S I	0..1	Extension(Reference(Organization))	Element id QuestionnaireResponse.extension:specialism Short description specialismOrganization Alternate names extensions, user content Definition The organization representing the specialism. 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(Reference(Organization)) Extension URL https://fhir.iqvia.com/patientfinder/extension/specialism-organization 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 fhir-patient-finder-mapping: (Organization) specialism responsible for the registration of the questionnaire
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension 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
identifier	S Σ	0..1	Identifier	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier Short description Unique id for this set of answers Definition A business identifier assigned to a particular completed (or partially completed) questionnaire. Requirements Used for tracking, registration and other business purposes. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id
id		0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
system	Σ	0..1	uri	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	0..1	string	Element id QuestionnaireResponse.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value fhir-patient-finder-mapping: form fact source id
period	Σ	0..1	Period	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id QuestionnaireResponse.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
basedOn	Σ	0..*	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. Data type Reference(CarePlan \| ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target
partOf	Σ	0..*	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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf rim: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
questionnaire	S Σ	0..1	canonical(Questionnaire)	There are no (further) constraints on this element Element id QuestionnaireResponse.questionnaire Short description Form being answered Alternate names Form Definition The Questionnaire that defines and organizes the questions for which answers are being provided. Requirements Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form. Comments If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.). Data type canonical(Questionnaire) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiates rim: ./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]
status	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id QuestionnaireResponse.status Short description in-progress \| completed \| amended \| entered-in-error \| stopped Definition The position of the questionnaire response within its overall lifecycle. Requirements The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding Lifecycle status of the questionnaire response. QuestionnaireResponseStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status rim: .statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish "in-progress" from "published)
subject	S Σ	0..1	Reference(Patient)	Element id QuestionnaireResponse.subject Short description The subject of the questions Alternate names Patient, Focus Definition The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information. Requirements Allows linking the answers to the individual the answers describe. May also affect access control. Comments If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role w5: FiveWs.subject
encounter	Σ	0..1	Reference(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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
authored	S Σ	0..1	dateTime	Element id QuestionnaireResponse.authored Short description Date the answers were gathered Alternate names Date Created, Date published, Date Issued, Date updated Definition The date and/or time that this set of answers were last changed. Requirements Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers. Comments May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured. This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.recorded rim: .participation[typeCode=AUT].time fhir-patient-finder-mapping: form response start date fhir-patient-finder-mapping: form start date
author	S Σ	0..1	Reference(Practitioner)	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(Practitioner) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer w5: FiveWs.author rim: .participation[typeCode=AUT].role fhir-patient-finder-mapping: (Practitioner) practitioner used for care provdider name
source	Σ	0..1	Reference(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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source rim: .participation[typeCode=INF].role
item	S I	0..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item Short description Groups and questions Definition A group or question item from the original questionnaire for which answers are provided. Comments Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer). Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qrs-1: Nested item can't be beneath both item and answer `(answer.exists() and item.exists()).not()` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
linkId	S	1..1	string	Element id QuestionnaireResponse.item.linkId Short description Pointer to specific item from Questionnaire Definition The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource. Requirements Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id fhir-patient-finder-mapping: form response question ID
definition		0..1	uri	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code
text	S	0..1	string	Element id QuestionnaireResponse.item.text Short description Name for group or question text Definition Text that is displayed above the contents of the group or as the text of the question being answered. Requirements Allows the questionnaire response to be read without access to the questionnaire. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .text fhir-patient-finder-mapping: form response question
answer		0..*	BackboneElement	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer Short description The response(s) to the question Definition The respondent's answer(s) to the question. Comments The value is nested because we cannot have a repeating structure that has variable type. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .value[type=LIST_ANY]
id		0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
value[x]		0..1		Element id QuestionnaireResponse.item.answer.value[x] Short description Single-valued answer to the question Definition The answer (or one of the answers) provided by the respondent to the question. Requirements Ability to retain a single-valued answer to a question. Comments More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire. Sliced: Unordered, Open, by $this(Type) Binding Code indicating the response provided for a question. QuestionnaireAnswerCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
(All Slices)				There are no (further) constraints on this element
valueUri			uri	There are no (further) constraints on this element Data type uri
valueAttachment			Attachment	There are no (further) constraints on this element Data type Attachment
valueReference			Reference(Resource)	There are no (further) constraints on this element Data type Reference(Resource)
valueDecimal	S	0..1	decimal	Element id QuestionnaireResponse.item.answer.value[x]:valueDecimal 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. Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response numeric answer
valueInteger	S	0..1	integer	Element id QuestionnaireResponse.item.answer.value[x]:valueInteger 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. Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response numeric answer
valueQuantity	S	0..1	Quantity	Element id QuestionnaireResponse.item.answer.value[x]:valueQuantity 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. Data type Quantity Binding Code indicating the response provided for a question. QuestionnaireAnswerCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response numeric answer
valueDate	S	0..1	date	Element id QuestionnaireResponse.item.answer.value[x]:valueDate 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. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response date answer
valueDateTime	S	0..1	dateTime	Element id QuestionnaireResponse.item.answer.value[x]:valueDateTime 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response date answer
valueTime	S	0..1	time	Element id QuestionnaireResponse.item.answer.value[x]:valueTime 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. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response date answer
valueBoolean	S	0..1	boolean	Element id QuestionnaireResponse.item.answer.value[x]:valueBoolean 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response textual answer
valueString	S	0..1	string	Element id QuestionnaireResponse.item.answer.value[x]:valueString 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. Data type string Binding Code indicating the response provided for a question. QuestionnaireAnswerCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item fhir-patient-finder-mapping: form response textual answer
valueCoding		0..1	Coding	Element id QuestionnaireResponse.item.answer.value[x]:valueCoding 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. Data type Coding Binding Code indicating the response provided for a question. QuestionnaireAnswerCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .item
id		0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.value[x]:valueCoding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.value[x]:valueCoding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	0..1	uri	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.value[x]:valueCoding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.value[x]:valueCoding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	0..1	code	Element id QuestionnaireResponse.item.answer.value[x]:valueCoding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code fhir-patient-finder-mapping: form response textual answer
display	S Σ	0..1	string	Element id QuestionnaireResponse.item.answer.value[x]:valueCoding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName fhir-patient-finder-mapping: form response textual answer
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.value[x]:valueCoding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
item		0..*	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.answer.item Short description Nested groups and questions Definition Nested groups and/or questions found within this particular answer. Requirements It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
item		0..*	see (item)	There are no (further) constraints on this element Element id QuestionnaireResponse.item.item Short description Nested questionnaire response items Definition Questions or sub-groups nested beneath a question or group. Requirements Reports can consist of complex nested groups. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="pf-questionnaire-response" />
    <url value="https://fhir.iqvia.com/patientfinder/StructureDefinition/pf-questionnaire-response" />
    <name value="PatientFinderQuestionnaireResponse" />
    <title value="QuestionnaireResponse" />
    <status value="draft" />
    <description value="QuestionnaireResponse is represented in the Patient Finder as the categories form and form responses. The text in the answers will be pseudonymized. If a link to a Questionnaire is provided, the questions will be taken from there. This is not obligatory as the questions may also be provided in the QuestionnaireResponse. The preferred solution for Patient Finder is to have the questions in the QuestionnaireResponse. The linkId needs to be unique." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="fhir-patient-finder-mapping" />
        <name value="FHIR to Patient Finder Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="QuestionnaireResponse" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
    <derivation value="constraint" />
    <differential>
        <element id="QuestionnaireResponse.extension">
            <path value="QuestionnaireResponse.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="QuestionnaireResponse.extension:department">
            <path value="QuestionnaireResponse.extension" />
            <sliceName value="department" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.iqvia.com/patientfinder/extension/department-organization" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) department responsible for the registration of the form" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.extension:specialism">
            <path value="QuestionnaireResponse.extension" />
            <sliceName value="specialism" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.iqvia.com/patientfinder/extension/specialism-organization" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) specialism responsible for the registration of the questionnaire" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.identifier">
            <path value="QuestionnaireResponse.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="QuestionnaireResponse.identifier.value">
            <path value="QuestionnaireResponse.identifier.value" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form fact source id" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.questionnaire">
            <path value="QuestionnaireResponse.questionnaire" />
            <mustSupport value="true" />
        </element>
        <element id="QuestionnaireResponse.status">
            <path value="QuestionnaireResponse.status" />
            <mustSupport value="true" />
        </element>
        <element id="QuestionnaireResponse.subject">
            <path value="QuestionnaireResponse.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="QuestionnaireResponse.authored">
            <path value="QuestionnaireResponse.authored" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response start date" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form start date" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.author">
            <path value="QuestionnaireResponse.author" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Practitioner) practitioner used for care provdider name" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item">
            <path value="QuestionnaireResponse.item" />
            <mustSupport value="true" />
        </element>
        <element id="QuestionnaireResponse.item.linkId">
            <path value="QuestionnaireResponse.item.linkId" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response question ID" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.text">
            <path value="QuestionnaireResponse.item.text" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response question" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <slicing>
                <discriminator>
                    <type value="type" />
                    <path value="$this" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueDecimal">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueDecimal" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="decimal" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response numeric answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueInteger">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueInteger" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="integer" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response numeric answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueQuantity">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueQuantity" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Quantity" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response numeric answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueDate">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueDate" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="date" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response date answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueDateTime">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueDateTime" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="dateTime" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response date answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueTime">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueTime" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="time" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response date answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueBoolean">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueBoolean" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="boolean" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response textual answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueString">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueString" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="string" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response textual answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding">
            <path value="QuestionnaireResponse.item.answer.value[x]" />
            <sliceName value="valueCoding" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Coding" />
            </type>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.code">
            <path value="QuestionnaireResponse.item.answer.value[x].code" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response textual answer" />
            </mapping>
        </element>
        <element id="QuestionnaireResponse.item.answer.value[x]:valueCoding.display">
            <path value="QuestionnaireResponse.item.answer.value[x].display" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="form response textual answer" />
            </mapping>
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "pf-questionnaire-response",
    "url": "https://fhir.iqvia.com/patientfinder/StructureDefinition/pf-questionnaire-response",
    "name": "PatientFinderQuestionnaireResponse",
    "title": "QuestionnaireResponse",
    "status": "draft",
    "description": "QuestionnaireResponse is represented in the Patient Finder as the categories form and form responses. The text in the answers will be pseudonymized. If a link to a Questionnaire is provided, the questions will be taken from there. This is not obligatory as the questions may also be provided in the QuestionnaireResponse. The preferred solution for Patient Finder is to have the questions in the QuestionnaireResponse. The linkId needs to be unique.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "fhir-patient-finder-mapping",
            "name": "FHIR to Patient Finder Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "QuestionnaireResponse",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "QuestionnaireResponse.extension",
                "path": "QuestionnaireResponse.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "QuestionnaireResponse.extension:department",
                "path": "QuestionnaireResponse.extension",
                "sliceName": "department",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.iqvia.com/patientfinder/extension/department-organization"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) department responsible for the registration of the form"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.extension:specialism",
                "path": "QuestionnaireResponse.extension",
                "sliceName": "specialism",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.iqvia.com/patientfinder/extension/specialism-organization"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) specialism responsible for the registration of the questionnaire"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.identifier",
                "path": "QuestionnaireResponse.identifier",
                "mustSupport": true
            },
            {
                "id": "QuestionnaireResponse.identifier.value",
                "path": "QuestionnaireResponse.identifier.value",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form fact source id"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.questionnaire",
                "path": "QuestionnaireResponse.questionnaire",
                "mustSupport": true
            },
            {
                "id": "QuestionnaireResponse.status",
                "path": "QuestionnaireResponse.status",
                "mustSupport": true
            },
            {
                "id": "QuestionnaireResponse.subject",
                "path": "QuestionnaireResponse.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "QuestionnaireResponse.authored",
                "path": "QuestionnaireResponse.authored",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response start date"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form start date"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.author",
                "path": "QuestionnaireResponse.author",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Practitioner"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Practitioner) practitioner used for care provdider name"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item",
                "path": "QuestionnaireResponse.item",
                "mustSupport": true
            },
            {
                "id": "QuestionnaireResponse.item.linkId",
                "path": "QuestionnaireResponse.item.linkId",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response question ID"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.text",
                "path": "QuestionnaireResponse.item.text",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response question"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueDecimal",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueDecimal",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "decimal"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response numeric answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueInteger",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueInteger",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "integer"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response numeric answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueQuantity",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueQuantity",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Quantity"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response numeric answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueDate",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueDate",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "date"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response date answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueDateTime",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueDateTime",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response date answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueTime",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueTime",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "time"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response date answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueBoolean",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueBoolean",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response textual answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueString",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueString",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response textual answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueCoding",
                "path": "QuestionnaireResponse.item.answer.value[x]",
                "sliceName": "valueCoding",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Coding"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueCoding.code",
                "path": "QuestionnaireResponse.item.answer.value[x].code",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response textual answer"
                    }
                ]
            },
            {
                "id": "QuestionnaireResponse.item.answer.value[x]:valueCoding.display",
                "path": "QuestionnaireResponse.item.answer.value[x].display",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "form response textual answer"
                    }
                ]
            }
        ]
    }
}

QuestionnaireResponse
Definition	A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.
Cardinality	0...*
Alias	Form, QuestionnaireAnswers
Comments	The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists()
Mappings	rim: Entity. Role, or Act workflow: Event rim: Observation[moodCode=EVN]
QuestionnaireResponse.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0...1
Type	string
Summary	True
Comments	The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
QuestionnaireResponse.meta
Definition	The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality	0...1
Type	Meta
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
QuestionnaireResponse.implicitRules
Definition	A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
Comments	Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
QuestionnaireResponse.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	A human language. CommonLanguages (preferred)
Comments	Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
QuestionnaireResponse.text
Definition	A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: Act.text?
QuestionnaireResponse.contained
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality	0...*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Mappings	rim: N/A
QuestionnaireResponse.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...1
Type	Extension
Must Support	True
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
QuestionnaireResponse.extension:department
Definition	The organization representing the department.
Cardinality	0...1
Type	Extension(Reference(Organization))
Must Support	True
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A rim: n/a fhir-patient-finder-mapping: (Organization) department responsible for the registration of the form
QuestionnaireResponse.extension:specialism
Definition	The organization representing the specialism.
Cardinality	0...1
Type	Extension(Reference(Organization))
Must Support	True
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A rim: n/a fhir-patient-finder-mapping: (Organization) specialism responsible for the registration of the questionnaire
QuestionnaireResponse.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
QuestionnaireResponse.identifier
Definition	A business identifier assigned to a particular completed (or partially completed) questionnaire.
Cardinality	0...1
Type	Identifier
Must Support	True
Summary	True
Requirements	Used for tracking, registration and other business purposes.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.identifier w5: FiveWs.identifier rim: .id
QuestionnaireResponse.identifier.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
QuestionnaireResponse.identifier.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
QuestionnaireResponse.identifier.use
Definition	The purpose of this identifier.
Cardinality	0...1
Type	code
Binding	Identifies the purpose for this identifier, if known . IdentifierUse (required)
Modifier	True
Summary	True
Requirements	Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments	Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: N/A rim: Role.code or implied by context
QuestionnaireResponse.identifier.type
Definition	A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Cardinality	0...1
Type	CodeableConcept
Binding	A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)
Summary	True
Requirements	Allows users to make use of identifiers when the identifier system is not known.
Comments	This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.5 rim: Role.code or implied by context
QuestionnaireResponse.identifier.system
Definition	Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Cardinality	0...1
Type	uri
Summary	True
Requirements	There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments	Identifier.system is always case sensitive.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General http://www.acme.com/identifiers/patient
Mappings	v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
QuestionnaireResponse.identifier.value
Definition	The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality	0...1
Type	string
Must Support	True
Summary	True
Comments	If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Examples	General 123456
Mappings	v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value fhir-patient-finder-mapping: form fact source id
QuestionnaireResponse.identifier.period
Definition	Time period during which identifier is/was valid for use.
Cardinality	0...1
Type	Period
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
QuestionnaireResponse.identifier.assigner
Definition	Organization that issued/manages the identifier.
Cardinality	0...1
Type	Reference(Organization)
Summary	True
Comments	The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
QuestionnaireResponse.basedOn
Definition	The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.
Cardinality	0...*
Type	Reference(CarePlan \| ServiceRequest)
Summary	True
Alias	order
Requirements	Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target
QuestionnaireResponse.partOf
Definition	A procedure or observation that this questionnaire was performed as part of the execution of. For example, the surgery a checklist was executed as part of.
Cardinality	0...*
Type	Reference(Observation \| Procedure)
Summary	True
Comments	Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire. For relationships to referrals, and other types of requests, use basedOn.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.partOf rim: .inboundRelationship[typeCode=COMP].source[moodCode=EVN]
QuestionnaireResponse.questionnaire
Definition	The Questionnaire that defines and organizes the questions for which answers are being provided.
Cardinality	0...1
Type	canonical(Questionnaire)
Must Support	True
Summary	True
Alias	Form
Requirements	Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.
Comments	If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.instantiates rim: ./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]
QuestionnaireResponse.status
Definition	The position of the questionnaire response within its overall lifecycle.
Cardinality	1...1
Type	code
Binding	Lifecycle status of the questionnaire response. QuestionnaireResponseStatus (required)
Must Support	True
Modifier	True
Summary	True
Requirements	The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.
Comments	This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.status w5: FiveWs.status rim: .statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish "in-progress" from "published)
QuestionnaireResponse.subject
Definition	The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information.
Cardinality	0...1
Type	Reference(Patient)
Must Support	True
Summary	True
Alias	Patient, Focus
Requirements	Allows linking the answers to the individual the answers describe. May also affect access control.
Comments	If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role w5: FiveWs.subject
QuestionnaireResponse.encounter
Definition	The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.
Cardinality	0...1
Type	Reference(Encounter)
Summary	True
Requirements	Provides context for the information that was captured. May also affect access control.
Comments	This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.encounter w5: FiveWs.context rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
QuestionnaireResponse.authored
Definition	The date and/or time that this set of answers were last changed.
Cardinality	0...1
Type	dateTime
Must Support	True
Summary	True
Alias	Date Created, Date published, Date Issued, Date updated
Requirements	Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.
Comments	May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured. This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.occurrence[x] w5: FiveWs.recorded rim: .participation[typeCode=AUT].time fhir-patient-finder-mapping: form response start date fhir-patient-finder-mapping: form start date
QuestionnaireResponse.author
Definition	Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.
Cardinality	0...1
Type	Reference(Practitioner)
Must Support	True
Summary	True
Alias	Laboratory, Service, Practitioner, Department, Company, Performer
Requirements	Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.
Comments	Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer w5: FiveWs.author rim: .participation[typeCode=AUT].role fhir-patient-finder-mapping: (Practitioner) practitioner used for care provdider name
QuestionnaireResponse.source
Definition	The person who answered the questions about the subject.
Cardinality	0...1
Type	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson)
Summary	True
Requirements	When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.
Comments	If not specified, no inference can be made about who provided the data.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.source rim: .participation[typeCode=INF].role
QuestionnaireResponse.item
Definition	A group or question item from the original questionnaire for which answers are provided.
Cardinality	0...*
Type	BackboneElement
Must Support	True
Comments	Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qrs-1: Nested item can't be beneath both item and answer `(answer.exists() and item.exists()).not()`
Mappings	rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
QuestionnaireResponse.item.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
QuestionnaireResponse.item.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
QuestionnaireResponse.item.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
QuestionnaireResponse.item.linkId
Definition	The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.
Cardinality	1...1
Type	string
Must Support	True
Requirements	Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id fhir-patient-finder-mapping: form response question ID
QuestionnaireResponse.item.definition
Definition	A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.
Cardinality	0...1
Type	uri
Requirements	A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.
Comments	The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. There is no need for this element if the item pointed to by the linkId has a definition listed.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code
QuestionnaireResponse.item.text
Definition	Text that is displayed above the contents of the group or as the text of the question being answered.
Cardinality	0...1
Type	string
Must Support	True
Requirements	Allows the questionnaire response to be read without access to the questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .text fhir-patient-finder-mapping: form response question
QuestionnaireResponse.item.answer
Definition	The respondent's answer(s) to the question.
Cardinality	0...*
Type	BackboneElement
Comments	The value is nested because we cannot have a repeating structure that has variable type.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .value[type=LIST_ANY]
QuestionnaireResponse.item.answer.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
QuestionnaireResponse.item.answer.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
QuestionnaireResponse.item.answer.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
QuestionnaireResponse.item.answer.value[x]
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	boolean
Binding	Code indicating the response provided for a question. QuestionnaireAnswerCodes (example)
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Slicing	Unordered, Open, by $this(Type)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item
QuestionnaireResponse.item.answer.value[x]:valueDecimal
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	decimal
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response numeric answer
QuestionnaireResponse.item.answer.value[x]:valueInteger
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	integer
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response numeric answer
QuestionnaireResponse.item.answer.value[x]:valueQuantity
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	Quantity
Binding	Code indicating the response provided for a question. QuestionnaireAnswerCodes (example)
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response numeric answer
QuestionnaireResponse.item.answer.value[x]:valueDate
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	date
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response date answer
QuestionnaireResponse.item.answer.value[x]:valueDateTime
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	dateTime
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response date answer
QuestionnaireResponse.item.answer.value[x]:valueTime
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	time
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response date answer
QuestionnaireResponse.item.answer.value[x]:valueBoolean
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	boolean
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response textual answer
QuestionnaireResponse.item.answer.value[x]:valueString
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	string
Binding	Code indicating the response provided for a question. QuestionnaireAnswerCodes (example)
Must Support	True
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item fhir-patient-finder-mapping: form response textual answer
QuestionnaireResponse.item.answer.value[x]:valueCoding
Definition	The answer (or one of the answers) provided by the respondent to the question.
Cardinality	0...1
Type	Coding
Binding	Code indicating the response provided for a question. QuestionnaireAnswerCodes (example)
Requirements	Ability to retain a single-valued answer to a question.
Comments	More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .item
QuestionnaireResponse.item.answer.value[x]:valueCoding.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
QuestionnaireResponse.item.answer.value[x]:valueCoding.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
QuestionnaireResponse.item.answer.value[x]:valueCoding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Cardinality	0...1
Type	uri
Summary	True
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Comments	The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
QuestionnaireResponse.item.answer.value[x]:valueCoding.version
Definition	The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality	0...1
Type	string
Summary	True
Comments	Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
QuestionnaireResponse.item.answer.value[x]:valueCoding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality	0...1
Type	code
Must Support	True
Summary	True
Requirements	Need to refer to a particular code in the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code fhir-patient-finder-mapping: form response textual answer
QuestionnaireResponse.item.answer.value[x]:valueCoding.display
Definition	A representation of the meaning of the code in the system, following the rules of the system.
Cardinality	0...1
Type	string
Must Support	True
Summary	True
Requirements	Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName fhir-patient-finder-mapping: form response textual answer
QuestionnaireResponse.item.answer.value[x]:valueCoding.userSelected
Definition	Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality	0...1
Type	boolean
Summary	True
Requirements	This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments	Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
QuestionnaireResponse.item.answer.item
Definition	Nested groups and/or questions found within this particular answer.
Cardinality	0...*
Type	see (item)
Requirements	It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]
QuestionnaireResponse.item.item
Definition	Questions or sub-groups nested beneath a question or group.
Cardinality	0...*
Type	see (item)
Requirements	Reports can consist of complex nested groups.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]

Attribute list

Attribute	Description	Example
identifier.value	The identifier of the questionnaire	'12345a'
questionnaire	A reference to the questionnaire	'94518'
status	The status of the response to the questionnaire	'completed'
extension:department	A reference to the department that was responsible for the registration of the questionnaire	'Nuclear medicine'
extension:specialism	A reference to the specialism that was responsible for the registration of the questionnaire	'Radiology'
subject	A reference to the patient who answered the questions in the questionnaire
authored	The startdate on which the question and answer are registered	Format: YYYY-MM-DDThh:mm:ss+zz:zz
author	(Practitioner) A reference to the person who recieved and recorder the answers to the questionnaire
item.linkId	The unique identifier for the question	'1.1'
item.text	The question	'Do you have allergies?'
item.answer.value:valueDecimal	The answer to the question if it is a decimal number	'1.1'
item.answer.value:valueInteger	The answer to the question if it is a number	'1'
item.answer.value:valueQuantity	The answer to the question if it is a quantity	'1'
item.answer.value:valueDate	The answer to the question if it is a date	Format: YYYY-MM-DD
item.answer.value:valueDateTime	The answer to the question if it is a datetime	Format: YYYY-MM-DDThh:mm:ss+zz:zz
item.answer.value:valueTime	The answer to the question if it is a time	Format: hh:mm:ss+zz:zz
item.answer.value:valueBoolean	The answer to the question if it is a boolean	True
item.answer.value:valueString	The answer to the question if it is a string	'Sometimes'
item.answer.value:valueCoding.code	The answer to the question if it is the code for a codable concept	'LA6560-2'
item.answer.value:valueCoding.display	The answer to the question if it is the display for a codable concept	'Confused'