| Package | fhir.virtually.healthcare |
| Resource Type | Questionnaire |
| Id | BARS-Referral-Form |
| FHIR Version | R4 |
| Source | https://fhir.virtually.healthcare/https://build.fhir.org/ig/Virtually-Healthcare/R4/Questionnaire-BARS-Referral-Form.html |
| URL | https://fhir.virtually.healthcare/Questionnaire/BARS-Referral-Form |
| Version | 0.1.1-current |
| Status | draft |
| Date | 2025-08-12T10:08:23+00:00 |
| Title | BARS Referral Form |
| Realm | us |
| Authority | hl7 |
| Purpose | Mapping of BARS to FHIR Data Model |
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire BARS-Referral-Form
| LinkID | Text | Cardinality | Type | Flags | Description & Constraints |
|---|---|---|---|---|---|
  | Questionnaire | https://fhir.virtually.healthcare/Questionnaire/BARS-Referral-Form#0.1.1-current | |||
  1 | Patient Details | 0..1 | group | Definition: Patient | |
  1.1 | Patient last name | 0..1 | string | Definition: Patient.name.family | |
| 1.2 | Patient first name | 0..1 | string | Definition: Patient.name.given | |
 1.3 | Date of birth | 0..1 | date | Definition: Patient.birthDate | |
| 1.4 | Postcode | 0..1 | string | Definition: Patient.address.postalCode | |
 1.5 | Sex registered at birth | 0..1 | choice | Definition: Patient.gender Value Set: AdministrativeGender | |
| 1.6 | NHS Number | 0..1 | string | Definition: Patient.identifier:nhsNumber.value | |
| 1.7 | Hospital/Provider Number (Medical Record Number) | 0..1 | string | Definition: Patient.identifier:MedicalRecordNumber.value | |
| 1.8 | Phone Number | 0..1 | string | Definition: Patient.telecom | |
| 1.9 | 0..1 | string | Definition: Patient.telecom | ||
 1.10 | GP Surgery ODS Code | 0..1 | choice | Definition: Patient.generalPractitioner.identifier.value | |
| 2 | Episode Details | 0..1 | group | ||
| 2.1 | Episode Id (Patient Journey Id) | 0..1 | string | Definition: ServiceRequest.encounter.identifier.value | |
| 2.2 | Start Date | 0..1 | date | Definition: Encounter.period.start | |
| 3 | Referring Clinician | 0..1 | group | Definition: PractitionerRole | |
| 3.1 | Name | 0..1 | string | Definition: PractitionerRole.name | |
| 3.2 | Specialty | 0..1 | choice | Definition: PractitionerRole.specialty.coding.code Value Set: UK Core Practice Setting Code | |
| 3.3 | Professional/Consultant Code | 1..1 | string | Definition: PractitionerRole.practitioner.identifier.value | |
| 3.4 | Phone | 0..1 | string | Definition: PractitionerRole.telecom.value | |
| 3.5 | 0..1 | string | Definition: PractitionerRole.telecom.value | ||
| 3.6 | Referring Organisation ODS Code | 0..1 | string | Definition: PractitionerRole.organization.identifier.value | |
| 4 | Referral Details | 0..1 | group | Definition: ServiceRequest | |
| 4.1 | Order Number | 0..1 | string |  | Definition: ServiceRequest.identifier:OriginatingReferralIdentifier |
| 4.2 | Referral code | 1..* | choice | Definition: ServiceRequest.code:BARSReferralCode Value Set: BARS Referral Code | |
| 4.3 | Condition Code | 0..* | choice | Definition: ServiceRequest.reasonCode Value Set: http://snomed.info/sct/900000000000207008?fhir_vs=ecl%2F%3C404684003 | |
| 4.4 | Provider Directory of Service Id | 0..1 | choice | Definition: ServiceRequest.performer.identifier.value | |
| 4.5 | When the procedure should take place | 0..1 | group | ||
 4.5.1 | Start Date | 0..1 | date | Definition: ServiceRequest.occurrencePeriod.start | |
| 4.5.2 | End Date | 0..1 | date | Definition: ServiceRequest.occurrencePeriod.end | |
| 6 | Triage Assessment Details | 0..1 | group | ||
| 7 | Consent | 0..1 | group | Definition: Consent | |
 7.1 | Patient Consent for Referral and Sharing Data | 0..1 | boolean | ||
| Documentation for this format | |||||
FHIR{
"resourceType": "Questionnaire",
"id": "BARS-Referral-Form",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "https://fhir.virtually.healthcare/Questionnaire/BARS-Referral-Form",
"version": "0.1.1-current",
"title": "BARS Referral Form",
"status": "draft",
"date": "2025-08-12T10:08:23+00:00",
"publisher": "Virtually Healthcare",
"contact": [
{
"name": "Virtually Healthcare",
"telecom": [
{
"system": "url",
"value": "https://virtually.healthcare"
}
]
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "GB",
"display": "United Kingdom of Great Britain and Northern Ireland"
}
]
}
],
"purpose": "Mapping of BARS to FHIR Data Model",
"code": [
{
"system": "http://snomed.info/sct",
"code": "3457005",
"display": "Patient referral"
}
],
"item": [
{
"linkId": "1",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient",
"text": "Patient Details",
"type": "group",
"item": [
{
"linkId": "1.1",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.family",
"text": "Patient last name ",
"type": "string"
},
{
"linkId": "1.2",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.given",
"text": "Patient first name",
"type": "string"
},
{
"linkId": "1.3",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.birthDate",
"text": "Date of birth",
"type": "date"
},
{
"linkId": "1.4",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.postalCode",
"text": "Postcode",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "1.5",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.gender",
"text": "Sex registered at birth",
"type": "choice",
"answerValueSet": "http://hl7.org/fhir/ValueSet/administrative-gender"
},
{
"linkId": "1.6",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.identifier:nhsNumber.value",
"text": "NHS Number",
"type": "string"
},
{
"linkId": "1.7",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.identifier:MedicalRecordNumber.value",
"text": "Hospital/Provider Number (Medical Record Number)",
"type": "string",
"required": false
},
{
"linkId": "1.8",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.telecom",
"text": "Phone Number",
"type": "string"
},
{
"linkId": "1.9",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.telecom",
"text": "Email",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "1.10",
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.generalPractitioner.identifier.value",
"text": "GP Surgery ODS Code",
"type": "choice"
}
]
},
{
"linkId": "2",
"text": "Episode Details",
"type": "group",
"item": [
{
"linkId": "2.1",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.encounter.identifier.value",
"text": "Episode Id (Patient Journey Id)",
"type": "string"
},
{
"linkId": "2.2",
"definition": "http://hl7.org/fhir/StructureDefinition/Encounter#Encounter.period.start",
"text": "Start Date",
"type": "date"
}
]
},
{
"linkId": "3",
"definition": "http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole",
"text": "Referring Clinician",
"type": "group",
"item": [
{
"linkId": "3.1",
"definition": "http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.name",
"text": "Name",
"type": "string"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "3.2",
"definition": "http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.specialty.coding.code",
"text": "Specialty",
"type": "choice",
"answerValueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode"
},
{
"linkId": "3.3",
"definition": "http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.practitioner.identifier.value",
"text": "Professional/Consultant Code",
"type": "string",
"required": true
},
{
"linkId": "3.4",
"definition": "http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.telecom.value",
"text": "Phone",
"type": "string"
},
{
"linkId": "3.5",
"definition": "http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.telecom.value",
"text": "Email",
"type": "string"
},
{
"linkId": "3.6",
"definition": "http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.organization.identifier.value",
"text": "Referring Organisation ODS Code ",
"type": "string"
}
]
},
{
"linkId": "4",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest",
"text": "Referral Details",
"type": "group",
"item": [
{
"linkId": "4.1",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.identifier:OriginatingReferralIdentifier",
"text": "Order Number",
"type": "string",
"required": false,
"readOnly": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "4.2",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.code:BARSReferralCode",
"text": "Referral code",
"type": "choice",
"required": true,
"repeats": true,
"answerValueSet": "https://fhir.virtually.healthcare/ValueSet/BARSReferralCode"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "4.3",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.reasonCode",
"text": "Condition Code",
"type": "choice",
"repeats": true,
"answerValueSet": "http://snomed.info/sct/900000000000207008?fhir_vs=ecl%2F%3C404684003"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "drop-down",
"display": "Drop down"
}
]
}
}
],
"linkId": "4.4",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.performer.identifier.value",
"text": "Provider Directory of Service Id",
"type": "choice"
},
{
"linkId": "4.5",
"text": "When the procedure should take place",
"type": "group",
"item": [
{
"linkId": "4.5.1",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.occurrencePeriod.start",
"text": "Start Date",
"type": "date"
},
{
"linkId": "4.5.2",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.occurrencePeriod.end",
"text": "End Date",
"type": "date"
}
]
}
]
},
{
"linkId": "6",
"text": "Triage Assessment Details",
"type": "group"
},
{
"linkId": "7",
"definition": "http://hl7.org/fhir/StructureDefinition/Consent#Consent",
"text": "Consent",
"type": "group",
"item": [
{
"linkId": "7.1",
"text": "Patient Consent for Referral and Sharing Data",
"type": "boolean"
}
]
}
]
}