FHIR IG Statistics: Questionnaire/cdex-questionnaire-example2

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Resources that this resource uses

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Questionnaire cdex-questionnaire-example2

Structure

LinkID	Text	Cardinality	Type	Description & Constraints
HomeOxygenTherapyQuestionnaire			Questionnaire	http://example.org/cdex-questionnaire-example2#2.1.0
1	Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)	1..1	text
2	Order Reason	1..1	choice	Options: 4 options
Documentation for this format

---

Options Sets

Answer options for 2

• http://example.org#1 ("Initial or original order for certification")
• http://example.org#2 ("Change in status")
• http://example.org#3 ("Revision or change in equipment")
• http://example.org#4 ("Replacement")

Source

{
  "resourceType": "Questionnaire",
  "id": "cdex-questionnaire-example2",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "urn:iso-astm:E1762-95:2013",
            "code": "1.2.840.10065.1.12.1.5",
            "display": "Verification Signature"
          }
        ]
      }
    }
  ],
  "url": "http://example.org/cdex-questionnaire-example2",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.21.35.2"
    }
  ],
  "version": "2.1.0",
  "name": "HomeOxygenTherapyQuestionnaire",
  "title": "Home Oxygen Therapy Questionnaire",
  "status": "active",
  "subjectType": [
    "Patient"
  ],
  "date": "2022-01-17",
  "publisher": "HL7 International / Payer/Provider Information Exchange Work Group",
  "contact": [
    {
      "name": "HL7 International / Payer/Provider Information Exchange Work Group",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/claims"
        },
        {
          "system": "email",
          "value": "pie@lists.hl7.org"
        }
      ]
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "copyright": "Used by permission of HL7 International all rights reserved Creative Commons License",
  "item": [
    {
      "linkId": "1",
      "text": "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
      "type": "text",
      "required": true
    },
    {
      "linkId": "2",
      "text": "Order Reason",
      "type": "choice",
      "required": true,
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://example.org",
            "code": "1",
            "display": "Initial or original order for certification"
          }
        },
        {
          "valueCoding": {
            "system": "http://example.org",
            "code": "2",
            "display": "Change in status"
          }
        },
        {
          "valueCoding": {
            "system": "http://example.org",
            "code": "3",
            "display": "Revision or change in equipment"
          }
        },
        {
          "valueCoding": {
            "system": "http://example.org",
            "code": "4",
            "display": "Replacement"
          }
        }
      ]
    }
  ]
}