| Package | ch.fhir.ig.ch-lab-order |
| Resource Type | Questionnaire |
| Id | 5-biol-monit |
| FHIR Version | R4 |
| Source | http://fhir.ch/ig/ch-lab-order/https://build.fhir.org/ig/hl7ch/ch-lab-order/Questionnaire-5-biol-monit.html |
| URL | http://fhir.ch/ig/ch-lab-order/Questionnaire/5-biol-monit |
| Version | 3.0.0-ci-build |
| Status | active |
| Date | 2020-12-17 |
| Name | LabOrderFormExample |
| Title | Lab Order Form Example 5-biol-monit |
| Realm | ch |
| Authority | hl7 |
| Copyright | CC0-1.0 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire 5-biol-monit
version: 1; Last updated: 2019-04-01 20:17:53+0000
Profiles: CH ORF Questionnaire, SDCBaseQuestionnaire, Extractable Questionnaire - StructureMap
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  LabOrderFormExample | Questionnaire | http://fhir.ch/ig/ch-lab-order/Questionnaire/5-biol-monit#3.0.0-ci-build | |||
  order | Auftrag | 1..1 | group | ||
  order.placerOrderIdentifier | Auftragsnummer des Auftraggebers | 0..1 | string | ||
| order.placerOrderIdentifierDomain | Identifier Domain der Auftragsnummer des Auftraggebers | 0..1 | string |  | |
| order.fillerOrderIdentifier | Auftragsnummer des Auftragsempfängers | 0..1 | string | ||
| order.fillerOrderIdentifierDomain | Identifier Domain der Auftragsnummer des Auftragsempfängers | 0..1 | string | | |
| order.precedentDocumentIdentifier | Identifier des Vorgängerdokuments | 0..1 | string | | |
| order.notificationContactDocument | Dringender Benachrichtigungskontakt für dieses Dokument | 0..1 | group | ||
 order.notificationContactDocument.practitioner | Zu benachrichtigende Person | 0..1 | group | ||
 order.notificationContactDocument.practitioner.title | Titel | 0..1 | string | ||
| order.notificationContactDocument.practitioner.familyName | Name | 0..1 | string | ||
| order.notificationContactDocument.practitioner.givenName | Vorname | 0..1 | string | ||
| order.notificationContactDocument.practitioner.phone | Telefon | 0..1 | string | ||
| order.notificationContactDocument.practitioner.email | 0..1 | string | |||
| order.notificationContactDocumentResponse | Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument | 0..1 | group | ||
| order.notificationContactDocumentResponse.practitioner | Zu benachrichtigende Person | 0..1 | group | ||
| order.notificationContactDocumentResponse.practitioner.title | Titel | 0..1 | string | ||
| order.notificationContactDocumentResponse.practitioner.familyName | Name | 0..1 | string | ||
| order.notificationContactDocumentResponse.practitioner.givenName | Vorname | 0..1 | string | ||
| order.notificationContactDocumentResponse.practitioner.phone | Telefon | 0..1 | string | ||
| order.notificationContactDocumentResponse.practitioner.email | 0..1 | string | |||
 order.priority | Auftragspriorität | 0..1 | choice | Options: 4 options | |
| receiver | Empfänger | 0..1 | group | ||
| receiver.practitioner | Empfangende Person | 0..1 | group | ||
| receiver.practitioner.title | Titel | 0..1 | string | ||
| receiver.practitioner.familyName | Name | 0..1 | string | ||
| receiver.practitioner.givenName | Vorname | 0..1 | string | ||
| receiver.practitioner.gln | GLN | 0..1 | string | ||
| receiver.practitioner.zsr | ZSR | 0..1 | string | ||
| receiver.practitioner.phone | Telefon | 0..1 | string | ||
| receiver.practitioner.email | 0..1 | string | |||
| receiver.organization | Empfangende Organisation | 0..1 | group | ||
| receiver.organization.name | Name der Organisation | 0..1 | string | ||
| receiver.organization.gln | GLN | 0..1 | string | Definition: | |
| receiver.organization.streetAddressLine | Strasse, Hausnummer, Postfach etc. | 0..* | string | ||
| receiver.organization.postalCode | PLZ | 0..1 | string | ||
| receiver.organization.city | Ort | 0..1 | string | ||
| receiver.organization.country | Land | 0..1 | string | ||
| patient | Patient | 1..1 | group | ||
| patient.familyName | Name | 0..1 | string | ||
| patient.maidenName | Ledigname | 0..1 | string | ||
| patient.givenName | Vorname | 0..1 | string | ||
| patient.localPid | Lokale Patienten-ID | 0..1 | string | ||
 patient.birthDate | Geburtsdatum | 0..1 | date | ||
| patient.gender | Geschlecht | 0..1 | choice | Options: 3 options | |
| patient.maritalStatus | Zivilstand | 0..1 | choice | Definition: Patient.maritalStatus Options: 8 options | |
| patient.phone | Telefon | 0..1 | string | ||
| patient.email | 0..1 | string | |||
| patient.streetAddressLine | Strasse, Hausnummer, Postfach etc. | 0..* | string | ||
| patient.postalCode | PLZ | 0..1 | string | ||
| patient.city | Ort | 0..1 | string | ||
| patient.country | Land | 0..1 | string | ||
| patient.languageOfCorrespondance | Korrespondenssprache | 0..1 | choice | Definition: Patient.communication:languageOfCorrespondance Value Set: DocumentEntry.languageCode | |
| patient.contactperson | Kontaktperson | 0..1 | group | Definition: Patient.contact | |
| patient.contactperson.relationship | Beziehung | 0..1 | string | Definition: Patient.contact.relationship.text | |
| patient.contactperson.familyName | Name | 0..1 | string | Definition: Patient.contact.name.family | |
| patient.contactperson.givenName | Vorname | 0..1 | string | Definition: Patient.contact.name.given | |
| patient.contactperson.phone | Telefon | 0..* | string | Definition: Patient.contact.telecom.value | |
| patient.contactperson.email | 0..1 | string | Definition: Patient.contact.telecom.value | ||
| sender | Absender | 1..1 | group | ||
| sender.author | Verantwortlicher | 1..1 | group | ||
| sender.author.practitioner | Verantwortliche Person | 0..1 | group | ||
| sender.author.practitioner.title | Titel | 0..1 | string | ||
| sender.author.practitioner.familyName | Name | 0..1 | string | ||
| sender.author.practitioner.givenName | Vorname | 0..1 | string | ||
| sender.author.practitioner.gln | GLN | 0..1 | string | ||
| sender.author.practitioner.zsr | ZSR | 0..1 | string | ||
| sender.author.practitioner.phone | Telefon | 0..1 | string | ||
| sender.author.practitioner.email | 0..1 | string | |||
| sender.author.organization | Verantwortliche Organisation | 0..1 | group | ||
| sender.author.organization.name | Name der Organisation | 0..1 | string | ||
| sender.author.organization.streetAddressLine | Strasse, Hausnummer, Postfach etc. | 0..* | string | ||
| sender.author.organization.postalCode | PLZ | 0..1 | string | ||
| sender.author.organization.city | Ort | 0..1 | string | ||
| sender.author.organization.country | Land | 0..1 | string | ||
| sender.dataenterer | Erfasser | 0..1 | group | ||
| sender.dataenterer.practitioner | Erfassende Person | 0..1 | group | ||
| sender.dataenterer.practitioner.familyName | Name | 0..1 | string | ||
| sender.dataenterer.practitioner.givenName | Vorname | 0..1 | string | ||
| sender.dataenterer.practitioner.phone | Telefon | 0..1 | string | ||
| sender.dataenterer.practitioner.email | 0..1 | string | |||
| receiverCopies | Kopieempfänger | 0..1 | group | ||
| receiverCopy | Kopieempfangende Organisation oder Person | 0..* | group | Definition: PractitionerRole | |
| receiverCopy.organization.name | Name der Organisation | 0..1 | string | Definition: PractitionerRole.practitioner | |
| receiverCopy.practitionerRole.practitioner.title | Titel | 0..1 | string | Definition: HumanName.prefix | |
| receiverCopy.practitionerRole.practitioner.familyName | Name | 0..1 | string | Definition: HumanName.family | |
| receiverCopy.practitionerRole.practitioner.givenName | Vorname | 0..1 | string | Definition: HumanName.given | |
| receiverCopy.practitionerRole.practitioner.phone | Telefon | 0..1 | string | Definition: ContactPoint.value | |
| receiverCopy.practitionerRole.practitioner.email | 0..1 | string | Definition: ContactPoint.value | ||
| receiverCopy.title | Titel | 0..1 | string | Definition: PractitionerRole.organization | |
| receiverCopy.practitionerRole.organization.name | Name der Organisation | 0..1 | string | Definition: Organization.name | |
| receiverCopy.practitionerRole.organization.streetAddressLine | Strasse, Hausnummer, Postfach etc. | 0..* | string | Definition: Address.line | |
| receiverCopy.practitionerRole.organization.postalCode | PLZ | 0..1 | string | Definition: Address.postalCode | |
| receiverCopy.practitionerRole.organization.city | Ort | 0..1 | string | Definition: Address.city | |
| receiverCopy.practitionerRole.organization.country | Land | 0..1 | string | Definition: Address.country | |
| receiverCopy.familyName | Name | 0..1 | string | ||
| receiverCopy.givenName | Vorname | 0..1 | string | ||
| receiverCopy.phone | Telefon | 0..1 | string | ||
| receiverCopy.email | 0..1 | string | |||
| receiverCopy.streetAddressLine | Strasse, Hausnummer, Postfach etc. | 0..* | string | ||
| receiverCopy.postalCode | PLZ | 0..1 | string | ||
| receiverCopy.city | Ort | 0..1 | string | ||
| receiverCopy.country | Land | 0..1 | string | ||
 receiverCopy.patient | Patient selbst | 0..1 | boolean | Definition: Patient | |
| receiverCopy.relatedPerson | Andere Person | 0..* | group | Definition: RelatedPerson | |
| receiverCopy.relatedPerson.familyName | Name | 0..1 | string | Definition: RelatedPerson.name.family | |
| receiverCopy.relatedPerson.givenName | Vorame | 0..1 | string | Definition: RelatedPerson.name.given | |
| receiverCopy.relatedPerson.phone | Telefon | 0..* | string | Definition: RelatedPerson.telecom.value | |
| receiverCopy.relatedPerson.email | 0..1 | string | Definition: RelatedPerson.telecom.value | ||
| receiverCopy.relatedPerson.streetAddressLine | Strasse, Hausnummer, Postfach etc. | 0..* | string | Definition: RelatedPerson.address.line | |
| receiverCopy.relatedPerson.postalCode | PLZ | 0..1 | string | Definition: RelatedPerson.address.postalCode | |
| receiverCopy.relatedPerson.city | Ort | 0..1 | string | Definition: RelatedPerson.address.city | |
| receiverCopy.relatedPerson.country | Land | 0..1 | string | Definition: RelatedPerson.address.country | |
| consent | Einverständniserklärung | 0..1 | group | Definition: ServiceRequest.supportingInfo | |
| consent.treatment | Einverständnis des Patienten zur Behandlung | 0..1 | string | ||
| consent.patientPrivacy | Einverständnis des Patienten zum Datenschutz | 0..1 | string | ||
| consent.research | Einverständnis des Patienten zur Forschung | 0..1 | string | ||
| consent.advancedCareDirective | Patientenverfügung | 0..1 | string | ||
| coverage | Kostenträger | 0..1 | group | Definition: insurance | |
| coverage.uvg | Unfallversicherung (nach UVG) | 0..1 | string | ||
| coverage.kvg | Grundversicherung (nach KVG) | 0..1 | string | ||
| coverage.vvg | Zusatzversicherung (nach VVG) | 0..1 | string | ||
| coverage.vvgOther | Andere (nach VVG) | 0..1 | string | ||
| previousResult | Vorheriges Untersuchungsresultat | 0..1 | group | Definition: ServiceRequest.supportingInfo | |
| previousResult.result | Untersuchungsresultat | 0..* | string | ||
| hematology | Hematology | 0..1 | group | ||
| lab | Laborwerte | 0..* | choice | Options: 5 options | |
| toxicology | Toxicology | 0..1 | group | ||
| tox | Toxic Content | 0..* | choice | Options: 3 options | |
| Documentation for this format | |||||
Options Sets
Answer options for order.priority
Answer options for patient.gender
Answer options for patient.maritalStatus
Answer options for lab
Answer options for tox
FHIR{
"resourceType": "Questionnaire",
"id": "5-biol-monit",
"meta": {
"versionId": "1",
"lastUpdated": "2019-04-01T20:17:53.340+00:00",
"profile": [
"http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap",
"valueCanonical": "http://fhir.ch/ig/ch-orf/StructureMap/OrfQrToBundle"
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-sourceStructureMap",
"valueCanonical": "http://fhir.ch/ig/ch-orf/StructureMap/OrfQrToBundle"
},
{
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "patient"
}
},
{
"url": "type",
"valueCode": "Patient"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
},
{
"extension": [
{
"url": "name",
"valueCoding": {
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"code": "user",
"display": "User"
}
},
{
"url": "type",
"valueCode": "Practitioner"
},
{
"url": "description",
"valueString": "The practitioner that is to be used to pre-populate the form"
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"
}
],
"url": "http://fhir.ch/ig/ch-lab-order/Questionnaire/5-biol-monit",
"version": "3.0.0-ci-build",
"name": "LabOrderFormExample",
"title": "Lab Order Form Example 5-biol-monit",
"status": "active",
"subjectType": [
"Patient"
],
"date": "2020-12-17",
"publisher": "HL7 Switzerland",
"contact": [
{
"name": "HL7 Switzerland",
"telecom": [
{
"system": "url",
"value": "https://www.hl7.ch"
}
]
},
{
"name": "Marcel Hanselmann",
"telecom": [
{
"system": "email",
"value": "laborprojektgruppe@gmail.com",
"use": "work"
}
]
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "CH"
}
]
}
],
"copyright": "CC0-1.0",
"item": [
{
"linkId": "order",
"text": "Auftrag",
"type": "group",
"required": true,
"item": [
{
"linkId": "order.placerOrderIdentifier",
"text": "Auftragsnummer des Auftraggebers",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "order.placerOrderIdentifierDomain",
"text": "Identifier Domain der Auftragsnummer des Auftraggebers",
"type": "string"
},
{
"linkId": "order.fillerOrderIdentifier",
"text": "Auftragsnummer des Auftragsempfängers",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "order.fillerOrderIdentifierDomain",
"text": "Identifier Domain der Auftragsnummer des Auftragsempfängers",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden",
"valueBoolean": true
}
],
"linkId": "order.precedentDocumentIdentifier",
"text": "Identifier des Vorgängerdokuments",
"type": "string"
},
{
"linkId": "order.notificationContactDocument",
"text": "Dringender Benachrichtigungskontakt für dieses Dokument",
"type": "group",
"item": [
{
"linkId": "order.notificationContactDocument.practitioner",
"text": "Zu benachrichtigende Person",
"type": "group",
"item": [
{
"linkId": "order.notificationContactDocument.practitioner.title",
"text": "Titel",
"type": "string"
},
{
"linkId": "order.notificationContactDocument.practitioner.familyName",
"text": "Name",
"type": "string"
},
{
"linkId": "order.notificationContactDocument.practitioner.givenName",
"text": "Vorname",
"type": "string"
},
{
"linkId": "order.notificationContactDocument.practitioner.phone",
"text": "Telefon",
"type": "string"
},
{
"linkId": "order.notificationContactDocument.practitioner.email",
"text": "E-Mail",
"type": "string"
}
]
}
]
},
{
"linkId": "order.notificationContactDocumentResponse",
"text": "Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument",
"type": "group",
"item": [
{
"linkId": "order.notificationContactDocumentResponse.practitioner",
"text": "Zu benachrichtigende Person",
"type": "group",
"item": [
{
"linkId": "order.notificationContactDocumentResponse.practitioner.title",
"text": "Titel",
"type": "string"
},
{
"linkId": "order.notificationContactDocumentResponse.practitioner.familyName",
"text": "Name",
"type": "string"
},
{
"linkId": "order.notificationContactDocumentResponse.practitioner.givenName",
"text": "Vorname",
"type": "string"
},
{
"linkId": "order.notificationContactDocumentResponse.practitioner.phone",
"text": "Telefon",
"type": "string"
},
{
"linkId": "order.notificationContactDocumentResponse.practitioner.email",
"text": "E-Mail",
"type": "string"
}
]
}
]
},
{
"linkId": "order.priority",
"text": "Auftragspriorität",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://hl7.org/fhir/request-priority",
"code": "routine",
"display": "Routine"
},
"initialSelected": true
},
{
"valueCoding": {
"system": "http://hl7.org/fhir/request-priority",
"code": "urgent",
"display": "Urgent"
}
},
{
"valueCoding": {
"system": "http://hl7.org/fhir/request-priority",
"code": "asap",
"display": "ASAP"
}
},
{
"valueCoding": {
"system": "http://hl7.org/fhir/request-priority",
"code": "stat",
"display": "STAT"
}
}
]
}
]
},
{
"linkId": "receiver",
"text": "Empfänger",
"type": "group",
"item": [
{
"linkId": "receiver.practitioner",
"text": "Empfangende Person",
"type": "group",
"item": [
{
"linkId": "receiver.practitioner.title",
"text": "Titel",
"type": "string"
},
{
"linkId": "receiver.practitioner.familyName",
"text": "Name",
"type": "string"
},
{
"linkId": "receiver.practitioner.givenName",
"text": "Vorname",
"type": "string"
},
{
"linkId": "receiver.practitioner.gln",
"text": "GLN",
"type": "string"
},
{
"linkId": "receiver.practitioner.zsr",
"text": "ZSR",
"type": "string"
},
{
"linkId": "receiver.practitioner.phone",
"text": "Telefon",
"type": "string"
},
{
"linkId": "receiver.practitioner.email",
"text": "E-Mail",
"type": "string"
}
]
},
{
"linkId": "receiver.organization",
"text": "Empfangende Organisation",
"type": "group",
"item": [
{
"linkId": "receiver.organization.name",
"text": "Name der Organisation",
"type": "string"
},
{
"linkId": "receiver.organization.gln",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-gln-identifier",
"text": "GLN",
"type": "string"
},
{
"linkId": "receiver.organization.streetAddressLine",
"text": "Strasse, Hausnummer, Postfach etc.",
"type": "string",
"repeats": true
},
{
"linkId": "receiver.organization.postalCode",
"text": "PLZ",
"type": "string"
},
{
"linkId": "receiver.organization.city",
"text": "Ort",
"type": "string"
},
{
"linkId": "receiver.organization.country",
"text": "Land",
"type": "string"
}
]
}
]
},
{
"linkId": "patient",
"text": "Patient",
"type": "group",
"required": true,
"item": [
{
"linkId": "patient.familyName",
"text": "Name",
"type": "string"
},
{
"linkId": "patient.maidenName",
"text": "Ledigname",
"type": "string"
},
{
"linkId": "patient.givenName",
"text": "Vorname",
"type": "string"
},
{
"linkId": "patient.localPid",
"text": "Lokale Patienten-ID",
"type": "string"
},
{
"linkId": "patient.birthDate",
"text": "Geburtsdatum",
"type": "date"
},
{
"linkId": "patient.gender",
"text": "Geschlecht",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://hl7.org/fhir/administrative-gender",
"code": "male",
"display": "Male"
},
"initialSelected": true
},
{
"valueCoding": {
"system": "http://hl7.org/fhir/administrative-gender",
"code": "female",
"display": "Female"
}
},
{
"valueCoding": {
"system": "http://hl7.org/fhir/administrative-gender",
"code": "other",
"display": "Other"
}
}
]
},
{
"linkId": "patient.maritalStatus",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.maritalStatus",
"text": "Zivilstand",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "1",
"display": "ledig"
}
},
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "2",
"display": "verheiratet"
}
},
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "3",
"display": "verwitwet"
}
},
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "4",
"display": "geschieden"
}
},
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "5",
"display": "unverheiratet"
}
},
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "6",
"display": "in eingetragener Partnerschaft"
}
},
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "7",
"display": "aufgelöste Partnerschaft"
}
},
{
"valueCoding": {
"system": "http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus",
"code": "9",
"display": "unbekannt"
}
}
]
},
{
"linkId": "patient.phone",
"text": "Telefon",
"type": "string"
},
{
"linkId": "patient.email",
"text": "E-Mail",
"type": "string"
},
{
"linkId": "patient.streetAddressLine",
"text": "Strasse, Hausnummer, Postfach etc.",
"type": "string",
"repeats": true
},
{
"linkId": "patient.postalCode",
"text": "PLZ",
"type": "string"
},
{
"linkId": "patient.city",
"text": "Ort",
"type": "string"
},
{
"linkId": "patient.country",
"text": "Land",
"type": "string"
},
{
"linkId": "patient.languageOfCorrespondance",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.communication:languageOfCorrespondance",
"text": "Korrespondenssprache",
"type": "choice",
"answerValueSet": "http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.languageCode"
},
{
"linkId": "patient.contactperson",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact",
"text": "Kontaktperson",
"type": "group",
"item": [
{
"linkId": "patient.contactperson.relationship",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.relationship.text",
"text": "Beziehung",
"type": "string"
},
{
"linkId": "patient.contactperson.familyName",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.name.family",
"text": "Name",
"type": "string"
},
{
"linkId": "patient.contactperson.givenName",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.name.given",
"text": "Vorname",
"type": "string"
},
{
"linkId": "patient.contactperson.phone",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.telecom.value",
"text": "Telefon",
"type": "string",
"repeats": true
},
{
"linkId": "patient.contactperson.email",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.contact.telecom.value",
"text": "E-Mail",
"type": "string"
}
]
}
]
},
{
"linkId": "sender",
"text": "Absender",
"type": "group",
"required": true,
"item": [
{
"linkId": "sender.author",
"text": "Verantwortlicher",
"type": "group",
"required": true,
"item": [
{
"linkId": "sender.author.practitioner",
"text": "Verantwortliche Person",
"type": "group",
"item": [
{
"linkId": "sender.author.practitioner.title",
"text": "Titel",
"type": "string"
},
{
"linkId": "sender.author.practitioner.familyName",
"text": "Name",
"type": "string"
},
{
"linkId": "sender.author.practitioner.givenName",
"text": "Vorname",
"type": "string"
},
{
"linkId": "sender.author.practitioner.gln",
"text": "GLN",
"type": "string"
},
{
"linkId": "sender.author.practitioner.zsr",
"text": "ZSR",
"type": "string"
},
{
"linkId": "sender.author.practitioner.phone",
"text": "Telefon",
"type": "string"
},
{
"linkId": "sender.author.practitioner.email",
"text": "E-Mail",
"type": "string"
}
]
},
{
"linkId": "sender.author.organization",
"text": "Verantwortliche Organisation",
"type": "group",
"item": [
{
"linkId": "sender.author.organization.name",
"text": "Name der Organisation",
"type": "string"
},
{
"linkId": "sender.author.organization.streetAddressLine",
"text": "Strasse, Hausnummer, Postfach etc.",
"type": "string",
"repeats": true
},
{
"linkId": "sender.author.organization.postalCode",
"text": "PLZ",
"type": "string"
},
{
"linkId": "sender.author.organization.city",
"text": "Ort",
"type": "string"
},
{
"linkId": "sender.author.organization.country",
"text": "Land",
"type": "string"
}
]
}
]
},
{
"linkId": "sender.dataenterer",
"text": "Erfasser",
"type": "group",
"item": [
{
"linkId": "sender.dataenterer.practitioner",
"text": "Erfassende Person",
"type": "group",
"item": [
{
"linkId": "sender.dataenterer.practitioner.familyName",
"text": "Name",
"type": "string"
},
{
"linkId": "sender.dataenterer.practitioner.givenName",
"text": "Vorname",
"type": "string"
},
{
"linkId": "sender.dataenterer.practitioner.phone",
"text": "Telefon",
"type": "string"
},
{
"linkId": "sender.dataenterer.practitioner.email",
"text": "E-Mail",
"type": "string"
}
]
}
]
}
]
},
{
"linkId": "receiverCopies",
"text": "Kopieempfänger",
"type": "group",
"item": [
{
"linkId": "receiverCopy",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole",
"text": "Kopieempfangende Organisation oder Person",
"type": "group",
"repeats": true,
"item": [
{
"linkId": "receiverCopy.organization.name",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner",
"text": "Name der Organisation",
"type": "string",
"item": [
{
"linkId": "receiverCopy.practitionerRole.practitioner.title",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.prefix",
"text": "Titel",
"type": "string"
},
{
"linkId": "receiverCopy.practitionerRole.practitioner.familyName",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.family",
"text": "Name",
"type": "string"
},
{
"linkId": "receiverCopy.practitionerRole.practitioner.givenName",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.given",
"text": "Vorname",
"type": "string"
},
{
"linkId": "receiverCopy.practitionerRole.practitioner.phone",
"definition": "http://hl7.org/fhir/StructureDefinition/ContactPoint#ContactPoint.value",
"text": "Telefon",
"type": "string"
},
{
"linkId": "receiverCopy.practitionerRole.practitioner.email",
"definition": "http://hl7.org/fhir/StructureDefinition/ContactPoint#ContactPoint.value",
"text": "E-Mail",
"type": "string"
}
]
},
{
"linkId": "receiverCopy.title",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization",
"text": "Titel",
"type": "string",
"item": [
{
"linkId": "receiverCopy.practitionerRole.organization.name",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
"text": "Name der Organisation",
"type": "string"
},
{
"linkId": "receiverCopy.practitionerRole.organization.streetAddressLine",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.line",
"text": "Strasse, Hausnummer, Postfach etc.",
"type": "string",
"repeats": true
},
{
"linkId": "receiverCopy.practitionerRole.organization.postalCode",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.postalCode",
"text": "PLZ",
"type": "string"
},
{
"linkId": "receiverCopy.practitionerRole.organization.city",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.city",
"text": "Ort",
"type": "string"
},
{
"linkId": "receiverCopy.practitionerRole.organization.country",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.country",
"text": "Land",
"type": "string"
}
]
},
{
"linkId": "receiverCopy.familyName",
"text": "Name",
"type": "string"
},
{
"linkId": "receiverCopy.givenName",
"text": "Vorname",
"type": "string"
},
{
"linkId": "receiverCopy.phone",
"text": "Telefon",
"type": "string"
},
{
"linkId": "receiverCopy.email",
"text": "E-Mail",
"type": "string"
},
{
"linkId": "receiverCopy.streetAddressLine",
"text": "Strasse, Hausnummer, Postfach etc.",
"type": "string",
"repeats": true
},
{
"linkId": "receiverCopy.postalCode",
"text": "PLZ",
"type": "string"
},
{
"linkId": "receiverCopy.city",
"text": "Ort",
"type": "string"
},
{
"linkId": "receiverCopy.country",
"text": "Land",
"type": "string"
}
]
},
{
"linkId": "receiverCopy.patient",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient",
"text": "Patient selbst",
"type": "boolean"
},
{
"linkId": "receiverCopy.relatedPerson",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson",
"text": "Andere Person",
"type": "group",
"repeats": true,
"item": [
{
"linkId": "receiverCopy.relatedPerson.familyName",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.family",
"text": "Name",
"type": "string"
},
{
"linkId": "receiverCopy.relatedPerson.givenName",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.name.given",
"text": "Vorame",
"type": "string"
},
{
"linkId": "receiverCopy.relatedPerson.phone",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
"text": "Telefon",
"type": "string",
"repeats": true
},
{
"linkId": "receiverCopy.relatedPerson.email",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.telecom.value",
"text": "E-Mail",
"type": "string"
},
{
"linkId": "receiverCopy.relatedPerson.streetAddressLine",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.line",
"text": "Strasse, Hausnummer, Postfach etc.",
"type": "string",
"repeats": true
},
{
"linkId": "receiverCopy.relatedPerson.postalCode",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.postalCode",
"text": "PLZ",
"type": "string"
},
{
"linkId": "receiverCopy.relatedPerson.city",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.city",
"text": "Ort",
"type": "string"
},
{
"linkId": "receiverCopy.relatedPerson.country",
"definition": "http://hl7.org/fhir/StructureDefinition/RelatedPerson#RelatedPerson.address.country",
"text": "Land",
"type": "string"
}
]
}
]
},
{
"linkId": "consent",
"definition": "http://fhir.ch/ig/ch-lab-order/StructureDefinition/ch-lab-order-SR#ServiceRequest.supportingInfo",
"text": "Einverständniserklärung",
"type": "group",
"item": [
{
"linkId": "consent.treatment",
"text": "Einverständnis des Patienten zur Behandlung",
"type": "string"
},
{
"linkId": "consent.patientPrivacy",
"text": "Einverständnis des Patienten zum Datenschutz",
"type": "string"
},
{
"linkId": "consent.research",
"text": "Einverständnis des Patienten zur Forschung",
"type": "string"
},
{
"linkId": "consent.advancedCareDirective",
"text": "Patientenverfügung",
"type": "string"
}
]
},
{
"linkId": "coverage",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#insurance",
"text": "Kostenträger",
"type": "group",
"item": [
{
"linkId": "coverage.uvg",
"text": "Unfallversicherung (nach UVG)",
"type": "string"
},
{
"linkId": "coverage.kvg",
"text": "Grundversicherung (nach KVG)",
"type": "string"
},
{
"linkId": "coverage.vvg",
"text": "Zusatzversicherung (nach VVG)",
"type": "string"
},
{
"linkId": "coverage.vvgOther",
"text": "Andere (nach VVG)",
"type": "string"
}
]
},
{
"linkId": "previousResult",
"definition": "http://fhir.ch/ig/ch-lab-order/StructureDefinition/ch-lab-order-SR#ServiceRequest.supportingInfo",
"text": "Vorheriges Untersuchungsresultat",
"type": "group",
"item": [
{
"linkId": "previousResult.result",
"text": "Untersuchungsresultat",
"type": "string",
"repeats": true
}
]
},
{
"linkId": "hematology",
"text": "Hematology",
"type": "group",
"item": [
{
"linkId": "lab",
"text": "Laborwerte",
"type": "choice",
"repeats": true,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "24360-0",
"display": "Hemoglobin and Hematocrit panel - Blood"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "43113-0",
"display": "Hemoglobin electrophoresis panel in Blood"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "57021-8",
"display": "CBC W Auto Differential panel - Blood"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "58410-2",
"display": "CBC panel - Blood by Automated count"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "57021-8",
"display": "CBC W Auto Differential panel - Blood"
}
}
]
}
]
},
{
"linkId": "toxicology",
"text": "Toxicology",
"type": "group",
"item": [
{
"linkId": "tox",
"text": "Toxic Content",
"type": "choice",
"repeats": true,
"answerOption": [
{
"valueCoding": {
"system": "http://loinc.org",
"code": "29587-3",
"display": "Toxicology panel - Blood"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "54454-4",
"display": "Arsenic fractions panel - Urine"
}
},
{
"valueCoding": {
"system": "http://loinc.org",
"code": "29589-9",
"display": "Heavy metals panel - Urine"
}
}
]
}
]
}
]
}