FHIR IG analytics| Package | ca.on.oh-eforms |
| Resource Type | QuestionnaireResponse |
| Id | translations-2.json |
| FHIR Version | R4 |
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Patient Safety Screening
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FHIR
FHIRsmith{
"resourceType": "QuestionnaireResponse",
"language": "fr",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"questionnaire": "http://ontariohealth.ca/fhir/eforms/Questionnaire/translations|1.1.0",
"status": "completed",
"subject": {
"reference": "http://example.org/Patient/pat-53234",
"display": "MOMO ABBAS"
},
"authored": "2026-08-30T21:33:21.444Z",
"author": {
"reference": "http://example.org/Practitioner/smart-Practitioner-71482713",
"type": "Practitioner",
"display": "Susan Clark"
},
"item": [
{
"linkId": "patient_header",
"text": "Renseignements sur le patient",
"item": [
{
"linkId": "patient_surname",
"text": "Nom de famille :",
"answer": [
{
"valueString": "Smith"
}
]
},
{
"linkId": "patient_firstname",
"text": "Prénom :",
"answer": [
{
"valueString": "Jane"
}
]
},
{
"linkId": "patient_date_of_birth",
"text": "Date de naissance :",
"answer": [
{
"valueDate": "1960-01-01"
}
]
},
{
"linkId": "patient_gender",
"text": "Genre :",
"answer": [
{
"valueCoding": {
"system": "http://hl7.org/fhir/administrative-gender",
"code": "female",
"display": "Féminin"
}
}
]
},
{
"linkId": "patient_address_line1",
"text": "Adresse (ligne 1) :",
"answer": [
{
"valueString": "123 Some Street"
}
]
},
{
"linkId": "patient_address_city",
"text": "Ville :",
"answer": [
{
"valueString": "Toronto"
}
]
},
{
"linkId": "patient_address_province",
"text": "Province :",
"answer": [
{
"valueString": "ON"
}
]
},
{
"linkId": "patient_address_postalcode",
"text": "Code postal :",
"answer": [
{
"valueString": "M1M 1M1"
}
]
}
]
},
{
"linkId": "847648250958",
"text": "Sélectionner la demande d'examen",
"item": [
{
"linkId": "medicalImaging_examRequest",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20390",
"display": "Demande de TDM"
}
},
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20391",
"display": "Demande d'IRM"
}
}
]
},
{
"linkId": "medicalImaging_weightHeightRequirement",
"text": "Exigence de poids/taille",
"answer": [
{
"valueString": "MRI_HEIGHT_WEIGHT_REQUIRED"
}
]
}
]
},
{
"linkId": "medicalImaging_referral_triageconsiderations",
"text": "Considérations de triage",
"item": [
{
"linkId": "medicalImaging_examRequest_triage",
"text": "Priorité de triage demandée",
"answer": [
{
"valueString": "Routine",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "De routine"
}
]
}
]
}
}
]
}
]
},
{
"linkId": "medicalImaging_referral_cds",
"text": "Aide à la décision clinique",
"item": [
{
"linkId": "medicalImaging_examRequest_cds",
"text": "Afficher l'aide à la décision clinique (ADC)",
"answer": [
{
"valueString": "Hide",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "Masquer"
}
]
}
]
}
}
]
}
]
},
{
"linkId": "medicalImaging_examRequest_CT_group",
"text": "Sélectionner l'examen/la ou les régions de TDM d'intérêt :",
"item": [
{
"linkId": "medicalImaging_examRequest_CT_neck",
"text": "Cou",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20396",
"display": "Cou"
}
}
]
},
{
"linkId": "medicalImaging_examRequest_CT_neck_group",
"item": [
{
"linkId": "medicalImaging_examRequest_CT_neck_specificarea",
"text": "Région d'intérêt précise (facultatif)",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20448",
"display": "Angiographie du cou"
}
},
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20414",
"display": "Tissus mous du cou"
}
}
]
}
]
},
{
"linkId": "medicalImaging_examRequest_CT_spine",
"text": "Colonne vertébrale",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20397",
"display": "Colonne vertébrale"
}
}
]
},
{
"linkId": "medicalImaging_examRequest_CT_spine_group",
"item": [
{
"linkId": "medicalImaging_examRequest_CT_spine_specificarea",
"text": "Région d'intérêt précise (facultatif)",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20415",
"display": "Colonne cervicale"
}
}
]
}
]
},
{
"linkId": "medicalImaging_CT_CDS_Osteoarthritis_enabled",
"text": "CT osteoarthritis CDS display condition",
"answer": [
{
"valueBoolean": false
}
]
}
]
},
{
"linkId": "medicalImaging_CT_clinicalindication_CTrefnote",
"text": "Demande de TDM : antécédents cliniques / indication",
"item": [
{
"linkId": "medicalImaging_CT_clinicalindication_text",
"text": "Motif de l'examen (veuillez aussi indiquer le ou les symptômes présents, le diagnostic sous-jacent pertinent et les traitements, le cas échéant)",
"answer": [
{
"valueString": "Motor vehicle accident"
}
]
}
]
},
{
"linkId": "medicalImaging_examRequest_MRI_group_MRIrefnote",
"text": "Sélectionner l'examen/la ou les régions d'IRM d'intérêt :",
"item": [
{
"linkId": "medicalImaging_examRequest_MRI_neck",
"text": "Cou",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20468",
"display": "Cou"
}
}
]
},
{
"linkId": "medicalImaging_examRequest_MRI_neck_group",
"item": [
{
"linkId": "medicalImaging_examRequest_MRI_neck_specificarea",
"text": "Région d'intérêt précise (facultatif)",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20541",
"display": "Angiographie du cou"
}
},
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "20488",
"display": "Plexus brachial"
}
}
]
},
{
"linkId": "medicalImaging_examRequest_MRI_neck_specificarea_brachial",
"text": "Plexus brachial :",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "21323",
"display": "Bilatéral"
}
}
]
}
]
},
{
"linkId": "medicalImaging_MRI_CDS_Osteoarthritis_enabled",
"text": "MRI osteoarthritis CDS display condition",
"answer": [
{
"valueBoolean": false
}
]
}
]
},
{
"linkId": "medicalImaging_MRI_clinicalindication_MRIrefnote",
"text": "Demande d'IRM : antécédents cliniques / indication",
"item": [
{
"linkId": "medicalImaging_MRI_clinicalindication_text",
"text": "Motif de l'examen (veuillez aussi indiquer le ou les symptômes présents, le diagnostic sous-jacent pertinent et les traitements, le cas échéant)",
"answer": [
{
"valueString": "Motor vehicle accident"
}
]
}
]
},
{
"linkId": "medicalImaging_MRIsafety_group_MRIrefnote",
"text": "Dépistage de sécurité pour l'IRM",
"item": [
{
"linkId": "MRI_safety_none",
"text": "Aucune de ces réponses",
"answer": [
{
"valueString": "None of the above",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "Aucune de ces réponses"
}
]
}
]
}
}
]
}
]
},
{
"linkId": "medicalImaging_patientsafety_group",
"text": "Dépistage relatif à la sécurité du patient\n Sélectionner s'il y a lieu",
"item": [
{
"linkId": "medicalImaging_patientsafety_renal",
"text": "Questions d'évaluation rénale :",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "21283",
"display": "Aucun problème rénal connu"
}
}
]
},
{
"linkId": "medicalImaging_patientsafety_knownhypersensitivity",
"text": "Hypersensibilité connue aux produits de contraste :",
"answer": [
{
"valueString": "Unknown",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "Inconnu"
}
]
}
]
}
}
]
},
{
"linkId": "medicalImaging_patientsafety_breastfeeding",
"text": "Allaite actuellement",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "21293",
"display": "Allaite actuellement"
}
}
]
},
{
"linkId": "medicalImaging_weight_height",
"text": "Poids et taille du patient",
"item": [
{
"linkId": "medicalImaging_weight_height_units",
"text": "Unités :",
"answer": [
{
"valueString": "Metric (cm/kgs)",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "Système métrique (cm/kg)"
}
]
}
]
}
}
]
},
{
"linkId": "medicalImaging_weight_height_required_metric",
"text": "Taille et poids requis en unités métriques",
"item": [
{
"linkId": "medicalImaging_weight_height_required_metric_kg",
"text": "Poids (kg) :",
"answer": [
{
"valueDecimal": 73
}
]
},
{
"linkId": "medicalImaging_weight_height_required_metric_cm",
"text": "Taille (cm) :",
"answer": [
{
"valueDecimal": 164
}
]
}
]
},
{
"linkId": "medicalImaging_weight_height_date",
"text": "Date de la mesure du poids/de la taille :",
"answer": [
{
"valueDate": "2026-08-30"
}
]
}
]
}
]
},
{
"linkId": "medicalImaging_scheduling_",
"text": "Planification",
"item": [
{
"linkId": "medicalImaging_scheduling",
"text": "Demander une date de rendez-vous précise ou un intervalle de temps en fonction de :",
"answer": [
{
"valueString": "Clinical Reasons",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "Raisons cliniques"
}
]
}
]
}
}
]
},
{
"linkId": "medicalImaging_scheduling_clinicalreasons_other",
"text": "Préciser le délai :",
"answer": [
{
"valueString": "2 weeks"
}
]
},
{
"linkId": "medicalImaging_scheduling_clinicalreasons",
"text": "Raisons cliniques :",
"answer": [
{
"valueString": "Patient navigation (eg., Before a specialist appointment) ",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "Accompagnement du patient (p. ex. avant un rendez-vous avec un spécialiste)"
}
]
}
]
}
}
]
}
]
},
{
"linkId": "pref_consultant_group",
"item": [
{
"linkId": "preferredconsultlocation_header",
"text": "Consultant ou lieu préféré",
"item": [
{
"linkId": "preferredconsultlocation_willingtotravel",
"text": "Le patient est prêt à se déplacer pour obtenir un délai d'attente plus court",
"answer": [
{
"valueString": "Patient willing to travel for shorter wait time",
"_valueString": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/translation",
"extension": [
{
"url": "lang",
"valueCode": "fr"
},
{
"url": "content",
"valueString": "Le patient est prêt à se déplacer pour obtenir un délai d'attente plus court"
}
]
}
]
}
}
]
}
]
}
]
},
{
"linkId": "602618746069",
"text": "Renseignements sur le demandeur",
"item": [
{
"linkId": "referrer_address_line1",
"text": "Adresse (ligne 1) :",
"answer": [
{
"valueString": "456 Another Street"
}
]
},
{
"linkId": "referrer_address_city",
"text": "Ville :",
"answer": [
{
"valueString": "Toronto"
}
]
},
{
"linkId": "referrer_address_province",
"text": "Province :",
"answer": [
{
"valueString": "ON"
}
]
},
{
"linkId": "referrer_address_postalcode",
"text": "Code postal :",
"answer": [
{
"valueString": "M2M 2M2"
}
]
},
{
"linkId": "referrer_signature",
"text": "Signé :",
"answer": [
{
"valueString": "Dr. Bones"
}
]
},
{
"linkId": "referrer_role",
"text": "Rôle :",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/eforms/CodeSystem/example-referral-form-codes",
"code": "21276",
"display": "Médecin de famille"
}
}
]
}
]
},
{
"linkId": "referralService",
"text": "referralService",
"answer": [
{
"valueString": "CT | MRI"
}
]
}
]
}