Summary
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Complex
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ActivityDefinition
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ValueSet
default
A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.
Questionnaire
Path
Questionnaire
Id
Questionnaire
Cardinality
0 - *
Definition
A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection.
Comment
Constraint
cnl-0 [warning]
Name should be usable as an identifier for the module by machine processing applications such as code generation
que-2 [error]
The link ids for groups and questions must be unique within the questionnaire
url
Canonical identifier for this questionnaire, represented as an absolute URI (globally unique)
Path
Questionnaire.url
Id
Questionnaire.url
Type
Cardinality
0 - 1
Definition
An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.
Comment
Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.
The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](resource.html#versions).
In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](resource.html#meta) element to indicate where the current master source of the resource can be found.
The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.
Requirements
Allows the questionnaire to be referenced by a single globally unique identifier.
This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.
Constraint
cnl-1 [warning]
URL should not contain | or # - these characters make processing canonical references problematic
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier
Id
Questionnaire.identifier
Type
Cardinality
0 - *
Definition
A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance.
Comment
Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI.
Requirements
Allows externally provided and/or usable business identifiers to be easily associated with the questionnaire.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Binding
Strength
required
Description
Identifies the purpose for this identifier, if known .
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Binding
Strength
extensible
Description
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.type.CodeableConcept.coding
Id
CodeableConcept.coding
Type
Cardinality
0 - *
Definition
A reference to a code defined by a terminology system.
Comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.type.CodeableConcept.coding.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.type.CodeableConcept.coding.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.type.CodeableConcept.coding.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.identifier.Identifier.type.CodeableConcept.coding.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.identifier.Identifier.type.CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ident-1
Path
Questionnaire.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.period.Period.start
Id
Period.start
Type
Cardinality
0 - 1
Definition
The start of the period. The boundary is inclusive.
Comment
If the low element is missing, the meaning is that the low boundary is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Questionnaire.identifier.Identifier.period.Period.end
Id
Period.end
Type
Cardinality
0 - 1
Definition
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Comment
The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Questionnaire.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.assigner.Reference.reference
Id
Reference.reference
Type
Cardinality
0 - 1
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
ref-1
Path
Questionnaire.identifier.Identifier.assigner.Reference.type
Id
Reference.type
Type
Cardinality
0 - 1
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Comment
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.
Binding
Strength
extensible
Description
Aa resource (or, for logical models, the URI of the logical model).
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.assigner.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
This element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
Questionnaire.identifier.Identifier.assigner.Reference.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Binding
Strength
required
Description
Identifies the purpose for this identifier, if known .
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.assigner.Reference.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Binding
Strength
extensible
Description
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.assigner.Reference.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.assigner.Reference.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ident-1
Path
Questionnaire.identifier.Identifier.assigner.Reference.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.assigner.Reference.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.identifier.Identifier.assigner.Reference.display
Id
Reference.display
Type
Cardinality
0 - 1
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comment
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
Questionnaire.version
Id
Questionnaire.version
Type
Cardinality
0 - 1
Definition
The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
Comment
There may be different questionnaires that have the same url but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format. The version SHOULD NOT contain a '#' - see [Business Version](resource.html#bv-format).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.versionAlgorithm[x]
Id
Questionnaire.versionAlgorithm[x]
Type
Cardinality
0 - 1
Definition
Indicates the mechanism used to compare versions to determine which is more current.
Comment
If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.name
Id
Questionnaire.name
Type
Cardinality
0 - 1
Definition
A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.
Comment
The name is not expected to be globally unique. The name should be a simple alphanumeric type no-whitespace name to ensure that it is machine-processing friendly.
Requirements
Supports code generation.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cnl-0
Path
Questionnaire.title
Id
Questionnaire.title
Type
Cardinality
0 - 1
Definition
A short, descriptive, user-friendly title for the questionnaire.
Comment
This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.derivedFrom
Id
Questionnaire.derivedFrom
Type
Cardinality
0 - *
Definition
The URL of a Questionnaire that this Questionnaire is based on.
Comment
This element covers a broad range of relationships, from 'somewhat inspired by' to 'fully compliant with'. There is a standard extensionthat allows clearer differentiation between the specifics of the derivation relationship where this is needed - e.g. to determine substitutability and validation expectations - [http://hl7.org/fhir/StructureDefinition/questionnaire-derivationType](http://hl7.org/fhir/extensions/StructureDefinition-questionnaire-derivationType.html).
Requirements
Allows a Questionnaire to be created based on another Questionnaire.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.status
Id
Questionnaire.status
Type
Cardinality
1 - 1
Definition
The current state of this questionnaire.
Comment
A nominal state-transition diagram can be found in the] documentation
Unknown does not represent 'other' - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Requirements
Enables tracking the lifecycle of the content and filtering of questionnaires that are appropriate for use versus not.
Binding
Strength
required
Description
The lifecycle status of an artifact.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-1a
Path
Questionnaire.experimental
Id
Questionnaire.experimental
Type
Cardinality
0 - 1
Definition
A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended for genuine usage.
Comment
Allows filtering of questionnaires that are appropriate for use versus not.
Requirements
Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.subjectType
Id
Questionnaire.subjectType
Type
Cardinality
0 - *
Definition
The types of subjects that can be the subject of responses created for the questionnaire.
Comment
If none are specified, then the subject is unlimited.
Requirements
Allows enforcing that a QuestionnaireResponse only has a .subject element of the appropriate type.
Binding
Strength
required
Description
One of the resource types defined as part of this version of FHIR.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.date
Id
Questionnaire.date
Type
Cardinality
0 - 1
Definition
The date (and optionally time) when the questionnaire was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.
Comment
The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.publisher
Id
Questionnaire.publisher
Type
Cardinality
0 - 1
Definition
The name of the organization or individual responsible for the release and ongoing maintenance of the questionnaire.
Comment
Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context.
Requirements
Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.contact
Id
Questionnaire.contact
Type
Cardinality
0 - *
Definition
Contact details to assist a user in finding and communicating with the publisher.
Comment
May be a web site, an email address, a telephone number, etc.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.contact.ContactDetail.name
Id
ContactDetail.name
Type
Cardinality
0 - 1
Definition
The name of an individual to contact.
Comment
If there is no named individual, the telecom information is for the organization as a whole.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.contact.ContactDetail.telecom
Id
ContactDetail.telecom
Type
Cardinality
0 - *
Definition
The contact details for the individual (if a name was provided) or the organization.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.contact.ContactDetail.telecom.ContactPoint.system
Id
ContactPoint.system
Type
Cardinality
0 - 1
Definition
Telecommunications form for contact point - what communications system is required to make use of the contact.
Comment
Binding
Strength
required
Description
Telecommunications form for contact point.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cpt-2
Path
Questionnaire.contact.ContactDetail.telecom.ContactPoint.value
Id
ContactPoint.value
Type
Cardinality
0 - 1
Definition
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Comment
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Requirements
Need to support legacy numbers that are not in a tightly controlled format.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cpt-2
Path
Questionnaire.contact.ContactDetail.telecom.ContactPoint.use
Id
ContactPoint.use
Type
Cardinality
0 - 1
Definition
Identifies the purpose for the contact point.
Comment
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Requirements
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Binding
Strength
required
Description
Use of contact point.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.contact.ContactDetail.telecom.ContactPoint.rank
Id
ContactPoint.rank
Type
Cardinality
0 - 1
Definition
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Comment
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions.
Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.contact.ContactDetail.telecom.ContactPoint.period
Id
ContactPoint.period
Type
Cardinality
0 - 1
Definition
Time period when the contact point was/is in use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.contact.ContactDetail.telecom.ContactPoint.period.Period.start
Id
Period.start
Type
Cardinality
0 - 1
Definition
The start of the period. The boundary is inclusive.
Comment
If the low element is missing, the meaning is that the low boundary is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Questionnaire.contact.ContactDetail.telecom.ContactPoint.period.Period.end
Id
Period.end
Type
Cardinality
0 - 1
Definition
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Comment
The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Questionnaire.description
Id
Questionnaire.description
Type
Cardinality
0 - 1
Definition
A free text natural language description of the questionnaire from a consumer's perspective.
Comment
This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context. (E.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext
Id
Questionnaire.useContext
Type
Cardinality
0 - *
Definition
The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaires.
Comment
When multiple useContexts are specified, there is no expectation that all or even any of the contexts apply.
Requirements
Assist in searching for appropriate content.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.code
Id
UsageContext.code
Type
Cardinality
1 - 1
Definition
A code that identifies the type of context being specified by this usage context.
Comment
Binding
Strength
extensible
Description
A code that specifies a type of context being specified by a usage context.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.code.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.code.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.code.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.useContext.UsageContext.code.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.useContext.UsageContext.code.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.value[x]
Id
UsageContext.value[x]
Type
Cardinality
1 - 1
Definition
A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.
Comment
Binding
Strength
example
Description
A code that defines the specific value for the context being specified.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.value[x].CodeableConcept.coding
Id
CodeableConcept.coding
Type
Cardinality
0 - *
Definition
A reference to a code defined by a terminology system.
Comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.jurisdiction
Id
Questionnaire.jurisdiction
Type
Cardinality
0 - *
Definition
A legal or geographic region in which the questionnaire is intended to be used.
Comment
It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended.
DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)
Binding
Strength
extensible
Description
Countries and regions within which this artifact is targeted for use.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.jurisdiction.CodeableConcept.coding
Id
CodeableConcept.coding
Type
Cardinality
0 - *
Definition
A reference to a code defined by a terminology system.
Comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.jurisdiction.CodeableConcept.coding.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.jurisdiction.CodeableConcept.coding.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.jurisdiction.CodeableConcept.coding.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.jurisdiction.CodeableConcept.coding.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.jurisdiction.CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.purpose
Id
Questionnaire.purpose
Type
Cardinality
0 - 1
Definition
Explanation of why this questionnaire is needed and why it has been designed as it has.
Comment
This element does not describe the usage of the questionnaire. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this questionnaire.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.copyright
Id
Questionnaire.copyright
Type
Cardinality
0 - 1
Definition
A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire.
Comment
Requirements
Consumers of the questionnaire must be able to determine any legal restrictions on the use of the artifact and/or its content.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.copyrightLabel
Id
Questionnaire.copyrightLabel
Type
Cardinality
0 - 1
Definition
A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
Comment
The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
Requirements
Defines the content expected to be rendered in all representations of the artifact.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.approvalDate
Id
Questionnaire.approvalDate
Type
Cardinality
0 - 1
Definition
The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.
Comment
The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.lastReviewDate
Id
Questionnaire.lastReviewDate
Type
Cardinality
0 - 1
Definition
The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.
Comment
If specified, this date follows the original approval date.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Requirements
Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.effectivePeriod
Id
Questionnaire.effectivePeriod
Type
Cardinality
0 - 1
Definition
The period during which the questionnaire content was or is planned to be in active use.
Comment
The effective period for a questionnaire determines when the content is applicable for usage and is independent of publication and review dates. For example, a questionnaire intended to be used for the year 2016 might be published in 2015.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Requirements
Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the questionnaire are or are expected to be used instead.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.effectivePeriod.Period.start
Id
Period.start
Type
Cardinality
0 - 1
Definition
The start of the period. The boundary is inclusive.
Comment
If the low element is missing, the meaning is that the low boundary is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Questionnaire.effectivePeriod.Period.end
Id
Period.end
Type
Cardinality
0 - 1
Definition
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Comment
The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
Questionnaire.code
Id
Questionnaire.code
Type
Cardinality
0 - *
Definition
An identifier for this collection of questions in a particular terminology such as LOINC.
Comment
Requirements
Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.
Binding
Strength
example
Description
Codes for questionnaires, groups and individual questions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.code.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.code.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.code.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.code.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.code.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item
Id
Questionnaire.item
Type
Cardinality
0 - *
Definition
A particular question, question grouping or display text that is part of the questionnaire.
Comment
The content of the questionnaire is constructed from an ordered, hierarchical collection of items.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
que-1a [error]
Group items must have nested items when Questionanire is complete
que-1b [warning]
Groups should have items
que-1c [error]
Display items cannot have child items
que-3 [error]
Display items cannot have a "code" asserted
que-4 [error]
A question cannot have both answerOption and answerValueSet
que-5 [error]
Only coding, decimal, integer, date, dateTime, time, string or quantity items can have answerOption or answerValueSet
que-6 [error]
Required and repeat aren't permitted for display items
que-8 [error]
Initial values can't be specified for groups or display items
que-9 [error]
Read-only can't be specified for "display" items
que-10 [error]
Maximum length can only be declared for simple question types
que-11 [error]
If one or more answerOption is present, initial cannot be present. Use answerOption.initialSelected instead
que-12 [error]
If there are more than one enableWhen, enableBehavior must be specified
que-13 [error]
Can only have multiple initial values for repeating items
que-14 [warning]
Can only have answerConstraint if answerOption or answerValueSet are present. (This is a warning because extensions may serve the same purpose)
Path
Questionnaire.item.linkId
Id
Questionnaire.item.linkId
Type
Cardinality
1 - 1
Definition
An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.
Comment
This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.
LinkIds can have whitespaces and slashes by design. Tooling should not rely on linkIds being valid XHTML element IDs, and should not directly embed them as such
Requirements
[QuestionnaireResponse](questionnaireresponse.html#) does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
que-15 [warning]
Link ids should be 255 characters or less
Condition
que-2
Path
Questionnaire.item.definition
Id
Questionnaire.item.definition
Type
Cardinality
0 - 1
Definition
This element is a URI that refers to an [ElementDefinition](elementdefinition.html) or to an [ObservationDefinition](observationdefinition.html) that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in [Comments](questionnaire.html#definition), below.
Comment
The uri refers to an ElementDefinition in a [StructureDefinition](structuredefinition.html#) or to an [ObservationDefinition](observationdefinition.html) and always starts with the [canonical URL](references.html#canonical) for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id [Element.id](types-definitions.html#Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition.
Requirements
A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.code
Id
Questionnaire.item.code
Type
Cardinality
0 - *
Definition
A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers).
Comment
The value may come from the ElementDefinition referred to by .definition.
Requirements
Allows linking of groups of questions to formal terminologies.
Binding
Strength
example
Description
Codes for questionnaires, groups and individual questions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-3
Path
Questionnaire.item.code.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.code.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.code.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.item.code.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
Questionnaire.item.code.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.prefix
Id
Questionnaire.item.prefix
Type
Cardinality
0 - 1
Definition
A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.
Comment
These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.
Requirements
Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.type
Id
Questionnaire.item.type
Type
Cardinality
1 - 1
Definition
The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, Coding, etc.).
Comment
Additional constraints on the type of answer can be conveyed by extensions. The value may come from the ElementDefinition referred to by .definition.
Requirements
Defines the format in which the user is to be prompted for the answer.
Binding
Strength
required
Description
Distinguishes groups from questions and display text and indicates data type for questions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-9
que-8
que-6
que-5
que-3
que-10
que-1a
que-1b
que-1c
Path
Questionnaire.item.enableWhen
Id
Questionnaire.item.enableWhen
Type
Cardinality
0 - *
Definition
A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.
Comment
If multiple repetitions of this extension are present, the interpretation is driven by enableBehavior (either all repetitions must evaluate to true for this item to be enabled, or only one must evaluate to true for the item to be enabled). If the enableWhen.question has multiple answers, the condition evaluates to true if *any* of the answers for the referenced item match the enableWhen condition. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to. If enableWhen logic depends on an item that is disabled, the logic should proceed as though the item is not valued - even if a default value or other value might be retained in memory in the event of the item being re-enabled. In some cases, the comparison between the indicated answer and the specified value may differ only by precision. For example, the enableWhen might be Q1 > 1970, but the answer to Q1 is 1970-10-15. There is not a clear answer as to whether 1970-10-15 should be considered 'greater' than 1970, given that it is an imprecise value. In these indeterminate situations, the form filler has the option of refusing to render the form. If the form **is** displayed, items where enableWhen is indeterminate SHOULD be treated as enabled with a warning indicating that the questionnaire logic was faulty and it is possible that the item should not be enabled. Questionnaires SHOULD be designed to take into account challenges around varying precision to minimize non-deterministic situations by setting constraints around expected precision, etc.
Requirements
Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
que-7 [error]
If the operator is 'exists', the value must be a boolean
Condition
que-12
Path
Questionnaire.item.enableWhen.question
Id
Questionnaire.item.enableWhen.question
Type
Cardinality
1 - 1
Definition
The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.
Comment
If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis. If there are multiple items with the same linkId and all are equadistant (e.g. a question references a question that appears in a separate repeating group), that is an error. (Consider using the enableWhenExpression extension to define logic to handle such a situation.)
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.enableWhen.operator
Id
Questionnaire.item.enableWhen.operator
Type
Cardinality
1 - 1
Definition
Specifies the criteria by which the question is enabled.
Comment
Binding
Strength
required
Description
The criteria by which a question is enabled.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-7
Path
Questionnaire.item.enableWhen.answer[x]
Id
Questionnaire.item.enableWhen.answer[x]
Type
Cardinality
1 - 1
Definition
A value that the referenced question is tested using the specified operator in order for the item to be enabled. If there are multiple answers, a match on any of the answers suffices. If different behavior is desired (all must match, at least 2 must match, etc.), consider using the enableWhenExpression extension.
Comment
Binding
Strength
example
Description
Allowed values to answer questions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-7
Path
Questionnaire.item.enableBehavior
Id
Questionnaire.item.enableBehavior
Type
Cardinality
0 - 1
Definition
Controls how multiple enableWhen values are interpreted - whether all or any must be true.
Comment
This element must be specified if more than one enableWhen value is provided.
Binding
Strength
required
Description
Controls how multiple enableWhen values are interpreted - whether all or any must be true.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-12
Path
Questionnaire.item.disabledDisplay
Id
Questionnaire.item.disabledDisplay
Type
Cardinality
0 - 1
Definition
Indicates if and how items that are disabled (because enableWhen evaluates to 'false') should be displayed.
Comment
If not specified, rendering behavior is up to the client. This element is only meaningful if enableWhen or an equivalent extension is present
Binding
Strength
required
Description
Defines how disabled elements should be rendered
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.required
Id
Questionnaire.item.required
Type
Cardinality
0 - 1
Definition
An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.
Comment
If the required item is a question, it must have a direct answer (i.e. an answer to the question itself, not merely answers to child questions) in order for the QuestionnaireResponse to be complete. If the required item is a group, it must have at least one descendant question which has an answer Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. It also only has meaning if the parent element is present. If a non-required 'group' item contains a 'required' question item, it's completely fine to omit the group (because it's not required) despite it having a required child. Similarly, if an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one descendant item with a populated answer). The value for 'required' may come from the ElementDefinition referred to by .definition.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-6
Path
Questionnaire.item.repeats
Id
Questionnaire.item.repeats
Type
Cardinality
0 - 1
Definition
An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items).
Comment
If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.
The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.
The value may come from the ElementDefinition referred to by .definition. When repeats=true for a group, it'll be represented with multiple items with the same linkId in the QuestionnaireResponse. For a question, it'll be represented by a single item with that linkId with multiple answers.
Requirements
Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-6
que-13
Path
Questionnaire.item.readOnly
Id
Questionnaire.item.readOnly
Type
Cardinality
0 - 1
Definition
An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.
Comment
If specified on a 'group', then all items beneath the specified group are read only. For questions, this only marks the answer associated with the specific item read only. Descendant questions are not impacted. The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.
Requirements
Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-9
Path
Questionnaire.item.maxLength
Id
Questionnaire.item.maxLength
Type
Cardinality
0 - 1
Definition
The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.
Comment
For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-10
Path
Questionnaire.item.answerConstraint
Id
Questionnaire.item.answerConstraint
Type
Cardinality
0 - 1
Definition
For items that have a defined set of allowed answers (via answerOption or answerValueSet), indicates whether values *other* than those specified can be selected.
Comment
Requirements
Introduces the ability for questions to have 'other' answers
Binding
Strength
required
Description
Indicates differnt modes for restricting values when options or valueset are specified
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-10
que-14
Path
Questionnaire.item.answerValueSet
Id
Questionnaire.item.answerValueSet
Type
Cardinality
0 - 1
Definition
A reference to a value set containing a list of values representing permitted answers for a question.
Comment
LOINC defines many useful value sets for questionnaire responses. See [LOINC Answer Lists](https://terminology.hl7.org/LOINC.html). The value may come from the ElementDefinition referred to by .definition.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-5
que-4
que-14
Path
Questionnaire.item.answerOption
Id
Questionnaire.item.answerOption
Type
Cardinality
0 - *
Definition
One of the permitted answers for the question.
Comment
This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-5
que-4
que-11
que-14
Path
Questionnaire.item.answerOption.value[x]
Id
Questionnaire.item.answerOption.value[x]
Type
Cardinality
1 - 1
Definition
A potential answer that's allowed as the answer to this question.
Comment
The data type of the value must agree with the item.type.
Binding
Strength
example
Description
Allowed values to answer questions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.answerOption.initialSelected
Id
Questionnaire.item.answerOption.initialSelected
Type
Cardinality
0 - 1
Definition
Indicates whether the answer value is selected when the list of possible answers is initially shown.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.initial
Id
Questionnaire.item.initial
Type
Cardinality
0 - *
Definition
One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.
Comment
The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial.answer[x] must agree with the item.type, and only repeating items can have more then one initial value.
Requirements
In some workflows, having defaults saves time.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
que-8
que-13
que-11
Path
Questionnaire.item.initial.value[x]
Id
Questionnaire.item.initial.value[x]
Type
Cardinality
1 - 1
Definition
The actual value to for an initial answer.
Comment
The type of the initial value must be consistent with the type of the item.
Binding
Strength
example
Description
Allowed values to answer questions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
Questionnaire.item.item
Id
Questionnaire.item.item
Type
Cardinality
0 - *
Definition
Text, questions and other groups to be nested beneath a question or group.
Comment
There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.
Requirements
Reports can consist of complex nested groups.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children