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FHIR Infrastructure Work Group Maturity Level : 3   Trial Use Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Detailed Descriptions for the elements in the QuestionnaireResponse resource.

QuestionnaireResponse
Element Id QuestionnaireResponse
Definition

A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.

Control Cardinality 1..1 0..*
Type DomainResource
Requirements

To support structured, hierarchical reporting of data gathered using digital forms and other questionnaires.

Alternate Names Form; QuestionnaireAnswers
Comments

The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.

QuestionnaireResponse.identifier
Element Id QuestionnaireResponse.identifier
Definition

A business identifier assigned to a particular completed (or partially completed) questionnaire.

Note This is a business identifer, identifier, not a resource identifier (see discussion )
Control Cardinality 0..1
Type Identifier
Requirements

Used for tracking, registration and other business purposes.

Summary true
QuestionnaireResponse.basedOn
Element Id QuestionnaireResponse.basedOn
Definition

The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ProcedureRequest ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.

Control Cardinality 0..*
Type Reference ( ReferralRequest | CarePlan | ProcedureRequest ServiceRequest )
Patterns Reference(CarePlan,ServiceRequest): Common patterns = Request
Requirements

Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.

Alternate Names order
Summary true
QuestionnaireResponse.parent QuestionnaireResponse.partOf
Element Id QuestionnaireResponse.partOf
Definition

A procedure or observation that this questionnaire was performed as part of the execution of. For example, the surgery a checklist was executed as part of.

Control Cardinality 0..*
Type Reference ( Observation | Procedure )
Patterns Reference(Observation,Procedure): Common patterns = Event
Summary true
Comments

Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire. For relationships to referrals, and other types of requests, use basedOn.

QuestionnaireResponse.questionnaire
Element Id QuestionnaireResponse.questionnaire
Definition

The Questionnaire that defines and organizes the questions for which answers are being provided.

Control Cardinality 0..1
Type Reference canonical ( Questionnaire )
Requirements

Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.

Alternate Names Form
Summary true
Comments

If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).

QuestionnaireResponse.status
Element Id QuestionnaireResponse.status
Definition

The position of the questionnaire response within its overall lifecycle.

Control Cardinality 1..1
Terminology Binding QuestionnaireResponseStatus ( Required )
Type code
Is Modifier true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Requirements

The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.

Summary true
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

QuestionnaireResponse.subject
Element Id QuestionnaireResponse.subject
Definition

The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information.

Control Cardinality 0..1
Type Reference ( Any )
Requirements

Allows linking the answers to the individual the answers describe. May also affect access control.

Alternate Names Patient; Focus
Summary true
Comments

If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.

QuestionnaireResponse.context QuestionnaireResponse.encounter
Element Id QuestionnaireResponse.encounter
Definition

The encounter Encounter during which this questionnaire response was created or episode of care with primary association to which the questionnaire response. creation of this record is tightly associated.

Control Cardinality 0..1
Type Reference ( Encounter | EpisodeOfCare )
Requirements

Provides context for the information that was captured. May also affect access control.

Summary true
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.

QuestionnaireResponse.authored
Element Id QuestionnaireResponse.authored
Definition

The date and/or time that this set of answers were last changed.

Control Cardinality 0..1
Type dateTime
Requirements

Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.

Alternate Names Date Created; Date published; Date Issued; Date updated
Summary true
Comments

May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.

This element is optional to allow for systems that may might not know the value, however it SHOULD be populated if possible.

QuestionnaireResponse.author
Element Id QuestionnaireResponse.author
Definition

Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.

Control Cardinality 0..1
Type Reference ( Device | Practitioner | PractitionerRole | Patient | RelatedPerson | Organization )
Patterns Reference(Device,Practitioner,PractitionerRole,Patient,RelatedPerson,Organization): Common patterns = Participant
Requirements

Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.

Alternate Names Laboratory; Service; Practitioner; Department; Company; Performer
Summary true
Comments

Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated.

QuestionnaireResponse.source
Element Id QuestionnaireResponse.source
Definition

The person who answered the questions about the subject.

Control Cardinality 0..1
Type Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson )
Patterns Reference(Patient,Practitioner,PractitionerRole,RelatedPerson): Common patterns = Participant
Requirements

When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.

Summary true
Comments

If not specified, no inference can be made about who provided the data.

QuestionnaireResponse.item
Element Id QuestionnaireResponse.item
Definition

A group or question item from the original questionnaire for which answers are provided.

Control Cardinality 0..*
Comments

Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).

Invariants
Defined on this element
qrs-1 : Rule Nested item can't be beneath both item and answer ( expression : (answer.exists() and item.exists()).not(), xpath: not(exists(f:answer) and exists(f:item))) item.exists()).not()
QuestionnaireResponse.item.linkId
Element Id QuestionnaireResponse.item.linkId
Definition

The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.

Control Cardinality 1..1
Type string
Requirements

Items can repeat in the answers, so a direct 1..1 correspondence by position may might not exist - requiring correspondence by identifier.

QuestionnaireResponse.item.definition
Element Id QuestionnaireResponse.item.definition
Definition

A reference to an ElementDefinition that provides the details for the item.

Control Cardinality 0..1
Type uri
Requirements

A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.

Comments

The ElementDefinition must be in a StructureDefinition or a DataElement , and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

There is no need for this element if the item pointed to by the linkId has a definition listed.

QuestionnaireResponse.item.text
Element Id QuestionnaireResponse.item.text
Definition

Text that is displayed above the contents of the group or as the text of the question being answered.

Control Cardinality 0..1
Type string
Requirements

Allows the questionnaire response to be read without access to the questionnaire.

QuestionnaireResponse.item.subject QuestionnaireResponse.item.answer
Definition More specific subject this section's answers are about, details the subject given in QuestionnaireResponse. Control 0..1 Type Reference ( Any ) Requirements Element Id Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc. QuestionnaireResponse.item.answer
Definition

The respondent's answer(s) to the question.

Control Cardinality 0..*
Comments

The value is nested because we cannot have a repeating structure that has variable type.

QuestionnaireResponse.item.answer.value[x]
Element Id QuestionnaireResponse.item.answer.value[x]
Definition

The answer (or one of the answers) provided by the respondent to the question.

Control Cardinality 0..1
Terminology Binding Questionnaire Answer Codes ( Example )
Type boolean | decimal | integer | date | dateTime | time | string | uri | Attachment | Coding | Quantity | Reference ( Any )
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

Ability to retain a single-valued answer to a question.

Comments

More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire.

QuestionnaireResponse.item.answer.item
Element Id QuestionnaireResponse.item.answer.item
Definition

Nested groups and/or questions found within this particular answer.

Control Cardinality 0..*
Type See QuestionnaireResponse.item
Requirements

It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.

QuestionnaireResponse.item.item
Element Id QuestionnaireResponse.item.item
Definition

Questions or sub-groups nested beneath a question or group.

Control Cardinality 0..*
Type See QuestionnaireResponse.item
Requirements

Reports can consist of complex nested groups.