| Package | ch.fhir.ig.ch-orf |
| Resource Type | Questionnaire |
| Id | order-referral-form-modular |
| FHIR Version | R4 |
| Source | http://fhir.ch/ig/ch-orf/https://build.fhir.org/ig/hl7ch/ch-orf/Questionnaire-order-referral-form-modular.html |
| URL | http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form-modular |
| Version | 3.0.2-ci-build |
| Status | active |
| Date | 2022-07-07 |
| Name | OrderReferralForm |
| Title | Order Referral Form |
| 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 order-referral-form-modular
Language: de-CH
Profiles: CH ORF Questionnaire, SDCBaseQuestionnaire, Extractable Questionnaire - StructureMap, Populatable Questionnaire - Expression
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  OrderReferralForm | Questionnaire | http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form-modular#3.0.2-ci-build | ||
  order | Auftrag | 1..1 | group | |
   order.1 | Unable to resolve 'order' sub-questionnaire | 0..1 | display | |
| receiver | Empfänger | 0..1 | group | Definition: Composition.extension |
| receiver.1 | Unable to resolve 'receiver' sub-questionnaire | 0..1 | display | |
| initiator | Initiant dieser Anmeldung | 0..1 | group | Definition: Composition.extension |
| initiator.1 | Unable to resolve 'intitiator' sub-questionnaire | 0..1 | display | |
| patient | Patient | 1..1 | group | Definition: Composition.subject |
| patient.1 | Unable to resolve 'patient' sub-questionnaire | 0..1 | display | |
| requestedEncounter | Patientenaufnahme | 0..1 | group | Definition: ServiceRequest.extension |
| requestedEncounter.1 | Unable to resolve 'requestedEncounter' sub-questionnaire | 0..1 | display | |
| coverage | Kostenträger | 0..1 | group | Definition: ServiceRequest.insurance |
| coverage.1 | Unable to resolve 'coverage' sub-questionnaire | 0..1 | display | |
| sender | Absender | 1..1 | group | |
| sender.1 | Unable to resolve 'sender' sub-questionnaire | 1..1 | display | Definition: Composition.author |
| receiverCopy | Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate) | 0..1 | group | Definition: Composition.extension |
| receiverCopy.1 | Unable to resolve 'receiverCopy' sub-questionnaire | 0..1 | display | |
| antecedentEpisodeOfCare | Vorgängiger Aufenthalt in Spital / Heim | 0..1 | group | Definition: Composition.extension |
 antecedentEpisodeOfCare.start | Von | 0..1 | dateTime | Definition: EpisodeOfCare.period |
| antecedentEpisodeOfCare.end | Bis | 0..1 | dateTime | Definition: EpisodeOfCare.period |
| antecedentEpisodeOfCare.managingOrganization | Spital /Heim | 0..1 | group | Definition: EpisodeOfCare.managingOrganization |
  antecedentEpisodeOfCare.managingOrganization.name | Name der Organisation | 0..1 | string | Definition: Organization.name |
| antecedentEpisodeOfCare.managingOrganization.1 | Unable to resolve 'address' sub-questionnaire | 0..1 | display | |
| appointment | Ort und Zeit der Durchführung der angeforderten Leistung | 0..* | group | Definition: ServiceRequest.extension |
| appointment.1 | Unable to resolve 'appointment' sub-questionnaire | 0..1 | display | |
| consent | Einverständniserklärung | 0..1 | group | Definition: Composition.extension |
| consent.1 | Unable to resolve 'consent' sub-questionnaire | 0..1 | display | |
| note | Bemerkungen | 0..* | group | |
| note.text | Kommentar | 0..1 | string | Definition: ServiceRequest.note.text |
| Documentation for this format | ||||
FHIR{
"resourceType": "Questionnaire",
"id": "order-referral-form-modular",
"meta": {
"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",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-exp"
]
},
"language": "de-CH",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assemble-expectation",
"valueCode": "assemble-root"
},
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap",
"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-orf/Questionnaire/order-referral-form-modular",
"version": "3.0.2-ci-build",
"name": "OrderReferralForm",
"title": "Order Referral Form",
"status": "active",
"subjectType": [
"Patient"
],
"date": "2022-07-07",
"publisher": "HL7 Switzerland",
"contact": [
{
"name": "HL7 Switzerland",
"telecom": [
{
"system": "url",
"value": "https://www.hl7.ch/"
}
]
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "CH"
}
]
}
],
"copyright": "CC0-1.0",
"item": [
{
"linkId": "order",
"text": "Auftrag",
"type": "group",
"required": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-order|3.0.1"
}
],
"linkId": "order.1",
"text": "Unable to resolve 'order' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "receiver",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
"text": "Empfänger",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receiver|3.0.1"
}
],
"linkId": "receiver.1",
"text": "Unable to resolve 'receiver' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "initiator",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
"text": "Initiant dieser Anmeldung",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-initiator|3.0.1"
}
],
"linkId": "initiator.1",
"text": "Unable to resolve 'intitiator' sub-questionnaire",
"type": "display"
}
]
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "linkIdPrefix",
"language": "text/fhirpath",
"expression": "'patient.'"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "address",
"language": "text/fhirpath",
"expression": "%patient.address"
}
}
],
"linkId": "patient",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.subject",
"text": "Patient",
"type": "group",
"required": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-patient|3.0.1"
}
],
"linkId": "patient.1",
"text": "Unable to resolve 'patient' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "requestedEncounter",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.extension",
"text": "Patientenaufnahme",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-requestedencounter|3.0.1"
}
],
"linkId": "requestedEncounter.1",
"text": "Unable to resolve 'requestedEncounter' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "coverage",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.insurance",
"text": "Kostenträger",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-coverage|3.0.1"
}
],
"linkId": "coverage.1",
"text": "Unable to resolve 'coverage' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "sender",
"text": "Absender",
"type": "group",
"required": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-sender|3.0.1"
}
],
"linkId": "sender.1",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.author",
"text": "Unable to resolve 'sender' sub-questionnaire",
"type": "display",
"required": true
}
]
},
{
"linkId": "receiverCopy",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
"text": "Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-receivercopy|3.0.1"
}
],
"linkId": "receiverCopy.1",
"text": "Unable to resolve 'receiverCopy' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "antecedentEpisodeOfCare",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
"text": "Vorgängiger Aufenthalt in Spital / Heim",
"type": "group",
"item": [
{
"linkId": "antecedentEpisodeOfCare.start",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-episodeofcare#EpisodeOfCare.period",
"text": "Von",
"type": "dateTime"
},
{
"linkId": "antecedentEpisodeOfCare.end",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-episodeofcare#EpisodeOfCare.period",
"text": "Bis",
"type": "dateTime"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "linkIdPrefix",
"language": "text/fhirpath",
"expression": "'antecedentEpisodeOfCare.managingOrganization.'"
}
}
],
"linkId": "antecedentEpisodeOfCare.managingOrganization",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-episodeofcare#EpisodeOfCare.managingOrganization",
"text": "Spital /Heim",
"type": "group",
"item": [
{
"linkId": "antecedentEpisodeOfCare.managingOrganization.name",
"definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name",
"text": "Name der Organisation",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-address|3.0.1"
}
],
"linkId": "antecedentEpisodeOfCare.managingOrganization.1",
"text": "Unable to resolve 'address' sub-questionnaire",
"type": "display"
}
]
}
]
},
{
"linkId": "appointment",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.extension",
"text": "Ort und Zeit der Durchführung der angeforderten Leistung",
"type": "group",
"repeats": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-appointment|3.0.1"
}
],
"linkId": "appointment.1",
"text": "Unable to resolve 'appointment' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "consent",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-composition#Composition.extension",
"text": "Einverständniserklärung",
"type": "group",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-subQuestionnaire",
"valueCanonical": "http://fhir.ch/ig/ch-orf/Questionnaire/ch-orf-module-consent|3.0.1"
}
],
"linkId": "consent.1",
"text": "Unable to resolve 'consent' sub-questionnaire",
"type": "display"
}
]
},
{
"linkId": "note",
"text": "Bemerkungen",
"type": "group",
"repeats": true,
"item": [
{
"linkId": "note.text",
"definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.note.text",
"text": "Kommentar",
"type": "string"
}
]
}
]
}