Open Health Hub FHIR Implementation Guide
0.1.0 - v0.1.0

Open Health Hub FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: EncryptedQuestionnaireResponse - Detailed Descriptions

Active as of 2025-12-03

Definitions for the encrypted-questionnaire-response resource profile.

- Differential Elements Table
- Key Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. QuestionnaireResponse
2. QuestionnaireResponse.contained
Control | 1..1
Type | Patient(Ohh Patient Profile)
4. QuestionnaireResponse.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
6. QuestionnaireResponse.extension:encryptedAnswers
Slice Name | encryptedAnswers
Control | 1..1
Type | Extension(Encrypted Answers Extension) (Extension Type: string)
8. QuestionnaireResponse.identifier
Definition | Should be set to the identifier as set in the QuestionnaireResponse in the CarePlan.activity this response fulfills.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
10. QuestionnaireResponse.identifier.value
Control | 1..?
12. QuestionnaireResponse.basedOn
Control | 0..1
Type | Reference(CarePlan)
14. QuestionnaireResponse.questionnaire
Type | canonical(Ohh Questionnaire Profile)
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
16. QuestionnaireResponse.status
Fixed Value | `completed`
18. QuestionnaireResponse.subject
Control | 1..?
Type | Reference(Patient)
20. QuestionnaireResponse.subject.reference
Pattern Value | `#patient`
22. QuestionnaireResponse.source
Control | 1..?
Type | Reference(Patient, Practitioner)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Invariants | source-reference-pattern: Source reference must be either #patient or start with Practitioner/<respondentUuid> (`reference.matches('^(#patient|Practitioner/.+)$')`)
24. QuestionnaireResponse.item
26. QuestionnaireResponse.item.answer
28. QuestionnaireResponse.item.answer.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
30. QuestionnaireResponse.item.answer.value[x]:valueString
Slice Name | valueString
Control | 0..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
32. QuestionnaireResponse.item.answer.value[x]:valueString.extension
Invariants | answer-string-extension-slice: Must have either encrypted-stringType or encrypted-openChoiceType extension, but not both (`url.exists() and (url.matches('https://api.openhealthhub.com/OpenHealthhub/fhir/4/StructureDefinition/encrypted-stringType') or url.matches('https://api.openhealthhub.com/OpenHealthhub/fhir/4/StructureDefinition/encrypted-openChoiceType'))`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
34. QuestionnaireResponse.item.answer.value[x]:valueString.extension:encrypted-stringType
Slice Name | encrypted-stringType
Control | 0..1
Type | Extension(Encrypted String Extension) (Extension Type: string)
36. QuestionnaireResponse.item.answer.value[x]:valueString.extension:encrypted-openChoiceType
Slice Name | encrypted-openChoiceType
Control | 0..1
Type | Extension(Encrypted Open Choice Extension) (Extension Type: string)
38. QuestionnaireResponse.item.answer.value[x]:valueInteger
Slice Name | valueInteger
Control | 0..1
Type | integer
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
40. QuestionnaireResponse.item.answer.value[x]:valueInteger.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
42. QuestionnaireResponse.item.answer.value[x]:valueInteger.extension:encrypted-integerType
Slice Name | encrypted-integerType
Control | 1..1
Type | Extension(Encrypted Integer Extension) (Extension Type: string)
44. QuestionnaireResponse.item.answer.value[x]:valueDecimal
Slice Name | valueDecimal
Control | 0..1
Type | decimal
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
46. QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
48. QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension:encrypted-decimalType
Slice Name | encrypted-decimalType
Control | 1..1
Type | Extension(Encrypted Decimal Extension) (Extension Type: string)
50. QuestionnaireResponse.item.answer.value[x]:valueDate
Slice Name | valueDate
Control | 0..1
Type | date
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
52. QuestionnaireResponse.item.answer.value[x]:valueDate.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
54. QuestionnaireResponse.item.answer.value[x]:valueDate.extension:encrypted-dateType
Slice Name | encrypted-dateType
Control | 1..1
Type | Extension(Encrypted Date Extension) (Extension Type: string)
56. QuestionnaireResponse.item.answer.value[x]:valueDateTime
Slice Name | valueDateTime
Control | 0..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
58. QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
60. QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension:encrypted-dateTimeType
Slice Name | encrypted-dateTimeType
Control | 1..1
Type | Extension(Encrypted Date Time Extension) (Extension Type: string)
62. QuestionnaireResponse.item.answer.value[x]:valueTime
Slice Name | valueTime
Control | 0..1
Type | time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
64. QuestionnaireResponse.item.answer.value[x]:valueTime.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
66. QuestionnaireResponse.item.answer.value[x]:valueTime.extension:encrypted-timeType
Slice Name | encrypted-timeType
Control | 1..1
Type | Extension(Encrypted Time Extension) (Extension Type: string)
68. QuestionnaireResponse.item.answer.value[x]:valueAttachment
Slice Name | valueAttachment
Control | 0..1
Type | Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
70. QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
72. QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension:encrypted-attachment
Slice Name | encrypted-attachment
Control | 1..1
Type | Extension(Encrypted Attachment Extension) (Extension Type: string)
74. QuestionnaireResponse.item.answer.value[x]:valueBoolean
Slice Name | valueBoolean
Control | 0..1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
76. QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
78. QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension:encrypted-booleanType
Slice Name | encrypted-booleanType
Control | 1..1
Type | Extension(Encrypted Boolean Extension) (Extension Type: string)
80. QuestionnaireResponse.item.answer.value[x]:valueCoding
Slice Name | valueCoding
Control | 0..1
Type | Coding
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
82. QuestionnaireResponse.item.answer.value[x]:valueCoding.extension
Control | 1..?
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
84. QuestionnaireResponse.item.answer.value[x]:valueCoding.extension:encrypted-coding
Slice Name | encrypted-coding
Control | 1..1
Type | Extension(Encrypted Coding Extension) (Extension Type: string)

Guidance on how to interpret the contents of this table can be foundhere

0. QuestionnaireResponse
Definition | Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems. 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.
Short | SDC Questionnaire ResponseA structured set of questions and their answers
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.
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Form, QuestionnaireAnswers, Form Data
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject. (`subject.exists()`) sdcqr-2: 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. (`(QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()`)
2. QuestionnaireResponse.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. QuestionnaireResponse.contained
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services. These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Information about an individual or animal receiving health care servicesContained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 10..1*
Type | Patient Resource(Ohh Patient Profile)
Is Modifier | false
Summary | false
Alternate Names | SubjectOfCare Client Resident, inline resources, anonymous resources, contained resources
6. QuestionnaireResponse.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
8. QuestionnaireResponse.extension:signature
Slice Name | signature
Definition | Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.
Short | A signature attesting to the content
Control | 0..*
Type | Extension(QuestionnaireResponse Signature) (Extension Type: Signature)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. QuestionnaireResponse.extension:completionMode
Slice Name | completionMode
Definition | Indicates how the individual completing the QuestionnaireResponse provided their responses.
Short | E.g. Verbal, written, electronic
Control | 0..1
Type | Extension(QuestionnaireResponse Completion Mode) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. QuestionnaireResponse.extension:encryptedAnswers
Slice Name | encryptedAnswers
Definition | Extension containing encrypted answers in a pgp encrypted format
Short | Encrypted Answers Extension
Control | 1..1
Type | Extension(Encrypted Answers Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. QuestionnaireResponse.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. QuestionnaireResponse.identifier
Definition | Should be set to the identifier as set in the QuestionnaireResponse in the CarePlan.activity this response fulfills. A business identifier assigned to a particular completed (or partially completed) questionnaire.
Short | Unique id for this set of answers
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Used for tracking, registration and other business purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. QuestionnaireResponse.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. QuestionnaireResponse.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | 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 Rendered Value extension. 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. QuestionnaireResponse.basedOn
Definition | The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.
Short | Request fulfilled by this QuestionnaireResponse
Control | 0..1*
Type | Reference(CarePlan, CarePlan, ServiceRequest)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.
Alternate Names | order
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. QuestionnaireResponse.questionnaire
Definition | The Questionnaire that defines and organizes the questions for which answers are being provided.
Short | Form being answered
Comments | For SDC, this SHALL be the version-specific URL of the form as hosted on the Form Manager. 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.).
Control | 10..1
Type | canonical(Ohh Questionnaire Profile, Questionnaire)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.
Alternate Names | Form
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. QuestionnaireResponse.questionnaire.extension:questionnaireDisplay
Slice Name | questionnaireDisplay
Definition | The title or other name to display when referencing a resource by canonical URL.
Short | Display name for canonical reference
Comments | This SHALL be the title of the Questionnaire at the time the QuestionnaireResponse was originally authored.
Control | 0..1
Type | Extension(Display Name) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
28. QuestionnaireResponse.status
Definition | The position of the questionnaire response within its overall lifecycle.
Short | in-progress | completed | amended | entered-in-error | stopped
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from QuestionnaireResponseStatus http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1` ) Lifecycle status of the questionnaire response.
Type | code
Is Modifier | true because 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
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.
Fixed Value | `completed`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. 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.
Short | The subject of the questions
Comments | If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.
Control | 10..1
Type | Reference(Patient, Resource)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows linking the answers to the individual the answers describe. May also affect access control.
Alternate Names | Patient, Focus
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. QuestionnaireResponse.subject.reference
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.
Short | Literal reference, Relative, internal or absolute URL
Comments | 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.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Pattern Value | `#patient`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. QuestionnaireResponse.authored
Definition | Identifies when this version of the answer set was created. Changes whenever the answers are updated. The date and/or time that this set of answers were last changed.
Short | Date the answers were gathered
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 might not know the value, however it SHOULD be populated if possible.
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
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
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. QuestionnaireResponse.author
Definition | Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.
Short | Person who received and recorded the answers
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.
Control | 0..1
Type | Reference(Device, Practitioner, PractitionerRole, Patient, RelatedPerson, Organization)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
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
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. QuestionnaireResponse.source
Definition | The person who answered the questions about the subject.
Short | The person who answered the questions
Comments | If not specified, no inference can be made about who provided the data.
Control | 10..1
Type | Reference(Patient, Practitioner, Patient, Practitioner, PractitionerRole, RelatedPerson)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) source-reference-pattern: Source reference must be either #patient or start with Practitioner/<respondentUuid> (`reference.matches('^(#patient|Practitioner/.+)$')`)
40. QuestionnaireResponse.item
Definition | A group or question item from the original questionnaire for which answers are provided.
Short | Groups and questions
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).
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qrs-1: Nested item can't be beneath both item and answer (`(answer.exists() and item.exists()).not()`) qrs-1: Nested item can't be beneath both item and answer ((answer.exists() and item.exists()).not())
42. QuestionnaireResponse.item.extension:itemMedia
Slice Name | itemMedia
Definition | Media to render/make available as an accompaniment to the question being asked
Short | Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Media) (Extension Type: Attachment)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
44. QuestionnaireResponse.item.extension:ItemSignature
Slice Name | ItemSignature
Definition | Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.
Short | A signature attesting to the content
Control | 0..*
Type | Extension(QuestionnaireResponse Signature) (Extension Type: Signature)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
46. QuestionnaireResponse.item.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. QuestionnaireResponse.item.linkId
Definition | The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.
Short | Pointer to specific item from Questionnaire
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. QuestionnaireResponse.item.text
Definition | Text that is displayed above the contents of the group or as the text of the question being answered.
Short | Name for group or question text
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Allows the questionnaire response to be read without access to the questionnaire.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. QuestionnaireResponse.item.answer
Definition | The respondent's answer(s) to the question.
Short | The response(s) to the question
Comments | The value is nested because we cannot have a repeating structure that has variable type.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. QuestionnaireResponse.item.answer.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Definition | Media to render/make available as an accompaniment to a specific answer option
Short | Answer Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Answer Media) (Extension Type: Attachment)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
56. QuestionnaireResponse.item.answer.extension:ordinalValue
Slice Name | ordinalValue
Definition | A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores.
Short | Assigned Ordinal Value
Comments | Scores are commonly encountered in various clinical assessment scales. Assigning a value to a concept should generally be done in a formal code system that defines the value, or in an applicable value set for the concept, but some concepts do not have a formal definition (or are not even represented as a concept formally, especially in Questionnaires, so this extension is allowed to appear ouside those preferred contexts. Scores may even be assigned arbitrarily during use (hence, on Coding). The value may be constrained to an integer in some contexts of use. Todo: Scoring algorithms may also be defined directly, but how this is done is not yet defined.
Control | 0..1
Type | Extension(Ordinal Value) (Extension Type: decimal)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
58. QuestionnaireResponse.item.answer.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
60. QuestionnaireResponse.item.answer.value[x]
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Code indicating the response provided for a question.
Type | Choice of: boolean, date, dateTime, time, decimal, integer, string, Coding, uri, Quantity, Attachment, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
62. QuestionnaireResponse.item.answer.value[x]:valueString
Slice Name | valueString
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Code indicating the response provided for a question.
Type | string, date, dateTime, boolean, Coding, Reference(Resource), Quantity, Attachment, integer, time, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. QuestionnaireResponse.item.answer.value[x]:valueString.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) answer-string-extension-slice: Must have either encrypted-stringType or encrypted-openChoiceType extension, but not both (`url.exists() and (url.matches('https://api.openhealthhub.com/OpenHealthhub/fhir/4/StructureDefinition/encrypted-stringType') or url.matches('https://api.openhealthhub.com/OpenHealthhub/fhir/4/StructureDefinition/encrypted-openChoiceType'))`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
66. QuestionnaireResponse.item.answer.value[x]:valueString.extension:encrypted-stringType
Slice Name | encrypted-stringType
Definition | Extension containing encrypted string value
Short | Encrypted String Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted String Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
68. QuestionnaireResponse.item.answer.value[x]:valueString.extension:encrypted-openChoiceType
Slice Name | encrypted-openChoiceType
Definition | Extension containing encrypted open choice value
Short | Encrypted Open Choice Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Open Choice Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
70. QuestionnaireResponse.item.answer.value[x]:valueInteger
Slice Name | valueInteger
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | integer, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, time, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. QuestionnaireResponse.item.answer.value[x]:valueInteger.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
74. QuestionnaireResponse.item.answer.value[x]:valueInteger.extension:encrypted-integerType
Slice Name | encrypted-integerType
Definition | Extension containing encrypted integer value
Short | Encrypted Integer Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Integer Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. QuestionnaireResponse.item.answer.value[x]:valueDecimal
Slice Name | valueDecimal
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | decimal, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, integer, time, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
80. QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension:encrypted-decimalType
Slice Name | encrypted-decimalType
Definition | Extension containing encrypted decimal value
Short | Encrypted Decimal Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Decimal Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
82. QuestionnaireResponse.item.answer.value[x]:valueDate
Slice Name | valueDate
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, integer, time, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. QuestionnaireResponse.item.answer.value[x]:valueDate.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
86. QuestionnaireResponse.item.answer.value[x]:valueDate.extension:encrypted-dateType
Slice Name | encrypted-dateType
Definition | Extension containing encrypted date value
Short | Encrypted Date Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Date Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. QuestionnaireResponse.item.answer.value[x]:valueDateTime
Slice Name | valueDateTime
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | dateTime, date, boolean, string, Coding, Reference(Resource), Quantity, Attachment, integer, time, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
92. QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension:encrypted-dateTimeType
Slice Name | encrypted-dateTimeType
Definition | Extension containing encrypted dateTime value
Short | Encrypted Date Time Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Date Time Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
94. QuestionnaireResponse.item.answer.value[x]:valueTime
Slice Name | valueTime
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | time, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, Attachment, integer, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. QuestionnaireResponse.item.answer.value[x]:valueTime.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
98. QuestionnaireResponse.item.answer.value[x]:valueTime.extension:encrypted-timeType
Slice Name | encrypted-timeType
Definition | Extension containing encrypted time value
Short | Encrypted Time Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Time Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
100. QuestionnaireResponse.item.answer.value[x]:valueAttachment
Slice Name | valueAttachment
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | Attachment, date, dateTime, boolean, string, Coding, Reference(Resource), Quantity, integer, time, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
104. QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension:encrypted-attachment
Slice Name | encrypted-attachment
Definition | Extension containing encrypted attachment value
Short | Encrypted Attachment Extension
Control | 1..1
Type | Extension(Encrypted Attachment Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
106. QuestionnaireResponse.item.answer.value[x]:valueBoolean
Slice Name | valueBoolean
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | boolean, date, dateTime, string, Coding, Reference(Resource), Quantity, Attachment, integer, time, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
110. QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension:encrypted-booleanType
Slice Name | encrypted-booleanType
Definition | Extension containing encrypted boolean value
Short | Encrypted Boolean Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Boolean Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
112. QuestionnaireResponse.item.answer.value[x]:valueCoding
Slice Name | valueCoding
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Binding | For example codes, see QuestionnaireAnswerCodes http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Code indicating the response provided for a question.
Type | Coding, date, dateTime, boolean, string, Reference(Resource), Quantity, Attachment, integer, time, decimal, uri
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. QuestionnaireResponse.item.answer.value[x]:valueCoding.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators: value @ url
116. QuestionnaireResponse.item.answer.value[x]:valueCoding.extension:encrypted-coding
Slice Name | encrypted-coding
Definition | Extension containing encrypted coding value
Short | Encrypted Coding Extension
Control | 1..1
Type | Extension(Encrypted Coding Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
118. QuestionnaireResponse.item.answer.item
Definition | Nested groups and/or questions found within this particular answer.
Short | Nested groups and questions
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. QuestionnaireResponse.item.item
Definition | Questions or sub-groups nested beneath a question or group.
Short | Nested questionnaire response items
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | Reports can consist of complex nested groups.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. QuestionnaireResponse
Definition | Sets expectations for supported capabilities for questionnaire responses for SDC-conformant systems.
Short | SDC Questionnaire Response
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.
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Form, QuestionnaireAnswers, Form Data
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) sdcqr-1: Subject SHOULD be present (searching is difficult without subject). Almost all QuestionnaireResponses should be with respect to some sort of subject. (`subject.exists()`) sdcqr-2: 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. (`(QuestionnaireResponse|repeat(answer|item)).select(item.where(answer.value.exists()).linkId.isDistinct()).allTrue()`)
2. QuestionnaireResponse.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. QuestionnaireResponse.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. QuestionnaireResponse.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. QuestionnaireResponse.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. QuestionnaireResponse.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. QuestionnaireResponse.contained
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Short | Information about an individual or animal receiving health care services
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 1..1
Type | Patient(Ohh Patient Profile)
Is Modifier | false
Summary | false
Alternate Names | SubjectOfCare Client Resident
14. QuestionnaireResponse.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
16. QuestionnaireResponse.extension:signature
Slice Name | signature
Definition | Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.
Short | A signature attesting to the content
Control | 0..*
Type | Extension(QuestionnaireResponse Signature) (Extension Type: Signature)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. QuestionnaireResponse.extension:completionMode
Slice Name | completionMode
Definition | Indicates how the individual completing the QuestionnaireResponse provided their responses.
Short | E.g. Verbal, written, electronic
Control | 0..1
Type | Extension(QuestionnaireResponse Completion Mode) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. QuestionnaireResponse.extension:encryptedAnswers
Slice Name | encryptedAnswers
Definition | Extension containing encrypted answers in a pgp encrypted format
Short | Encrypted Answers Extension
Control | 1..1
Type | Extension(Encrypted Answers Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
22. QuestionnaireResponse.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
24. QuestionnaireResponse.identifier
Definition | Should be set to the identifier as set in the QuestionnaireResponse in the CarePlan.activity this response fulfills.
Short | Unique id for this set of answers
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Used for tracking, registration and other business purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. QuestionnaireResponse.identifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
28. QuestionnaireResponse.identifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
30. QuestionnaireResponse.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. QuestionnaireResponse.identifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | 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.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. QuestionnaireResponse.identifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. QuestionnaireResponse.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | 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 Rendered Value extension. 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. QuestionnaireResponse.identifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. QuestionnaireResponse.identifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | 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.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. QuestionnaireResponse.basedOn
Definition | The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.
Short | Request fulfilled by this QuestionnaireResponse
Control | 0..1
Type | Reference(CarePlan)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.
Alternate Names | order
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. 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.
Short | Part of this action
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.
Control | 0..*
Type | Reference(Observation, Procedure)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. QuestionnaireResponse.questionnaire
Definition | The Questionnaire that defines and organizes the questions for which answers are being provided.
Short | Form being answered
Comments | For SDC, this SHALL be the version-specific URL of the form as hosted on the Form Manager.
Control | 1..1
Type | canonical(Ohh Questionnaire Profile)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.
Alternate Names | Form
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. QuestionnaireResponse.questionnaire.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
50. QuestionnaireResponse.questionnaire.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.questionnaire.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
52. QuestionnaireResponse.questionnaire.extension:questionnaireDisplay
Slice Name | questionnaireDisplay
Definition | The title or other name to display when referencing a resource by canonical URL.
Short | Display name for canonical reference
Comments | This SHALL be the title of the Questionnaire at the time the QuestionnaireResponse was originally authored.
Control | 0..1
Type | Extension(Display Name) (Extension Type: string)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
54. QuestionnaireResponse.questionnaire.value
Definition | Primitive value for canonical
Short | Primitive value for canonical
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
56. QuestionnaireResponse.status
Definition | The position of the questionnaire response within its overall lifecycle.
Short | in-progress | completed | amended | entered-in-error | stopped
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from QuestionnaireResponseStatus (required to `http://hl7.org/fhir/ValueSet/questionnaire-answers-status|4.0.1` ) Lifecycle status of the questionnaire response.
Type | code
Is Modifier | true because 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
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished.
Fixed Value | `completed`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. 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.
Short | The subject of the questions
Comments | If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. If subject is omitted - because the QuestionnaireResponse is not associated with a specific subject, ensure that QuestionnaireRsponse.identifier is present or the QuestionnaireResponse is referenced somewhere (e.g. Task.output, Composition.section.entry, etc.) to allow tracking and retrieval of the QuestionnaireResponse
Control | 1..1
Type | Reference(Patient)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows linking the answers to the individual the answers describe. May also affect access control.
Alternate Names | Patient, Focus
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. QuestionnaireResponse.subject.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
62. QuestionnaireResponse.subject.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.subject.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
64. QuestionnaireResponse.subject.reference
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.
Short | Literal reference, Relative, internal or absolute URL
Comments | 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.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Pattern Value | `#patient`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. QuestionnaireResponse.subject.type
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).
Short | Type the reference refers to (e.g. "Patient")
Comments | 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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. QuestionnaireResponse.subject.identifier
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.
Short | Logical reference, when literal reference is not known
Comments | 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).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. QuestionnaireResponse.subject.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | 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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. QuestionnaireResponse.encounter
Definition | The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated.
Short | Encounter created as part of
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.
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Provides context for the information that was captured. May also affect access control.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. QuestionnaireResponse.authored
Definition | Identifies when this version of the answer set was created. Changes whenever the answers are updated.
Short | Date the answers were gathered
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 might not know the value, however it SHOULD be populated if possible.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
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
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. QuestionnaireResponse.author
Definition | Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.
Short | Person who received and recorded the answers
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.
Control | 0..1
Type | Reference(Device, Practitioner, PractitionerRole, Patient, RelatedPerson, Organization)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
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
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. QuestionnaireResponse.source
Definition | The person who answered the questions about the subject.
Short | The person who answered the questions
Comments | If not specified, no inference can be made about who provided the data.
Control | 1..1
Type | Reference(Patient, Practitioner)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) source-reference-pattern: Source reference must be either #patient or start with Practitioner/<respondentUuid> (`reference.matches('^(#patient|Practitioner/.+)$')`)
80. QuestionnaireResponse.item
Definition | A group or question item from the original questionnaire for which answers are provided.
Short | Groups and questions
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).
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) qrs-1: Nested item can't be beneath both item and answer (`(answer.exists() and item.exists()).not()`)
82. QuestionnaireResponse.item.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
84. QuestionnaireResponse.item.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
86. QuestionnaireResponse.item.extension:itemMedia
Slice Name | itemMedia
Definition | Media to render/make available as an accompaniment to the question being asked
Short | Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Media) (Extension Type: Attachment)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
88. QuestionnaireResponse.item.extension:ItemSignature
Slice Name | ItemSignature
Definition | Represents a wet or electronic signature for either the form overall or for the question or item it's associated with.
Short | A signature attesting to the content
Control | 0..*
Type | Extension(QuestionnaireResponse Signature) (Extension Type: Signature)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
90. QuestionnaireResponse.item.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
92. QuestionnaireResponse.item.linkId
Definition | The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.
Short | Pointer to specific item from Questionnaire
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. QuestionnaireResponse.item.definition
Definition | A reference to an ElementDefinition that provides the details for the item.
Short | ElementDefinition - details for the item
Comments | The ElementDefinition must be in a StructureDefinition, 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.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. QuestionnaireResponse.item.text
Definition | Text that is displayed above the contents of the group or as the text of the question being answered.
Short | Name for group or question text
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Allows the questionnaire response to be read without access to the questionnaire.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. QuestionnaireResponse.item.answer
Definition | The respondent's answer(s) to the question.
Short | The response(s) to the question
Comments | The value is nested because we cannot have a repeating structure that has variable type.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. QuestionnaireResponse.item.answer.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
102. QuestionnaireResponse.item.answer.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
104. QuestionnaireResponse.item.answer.extension:itemAnswerMedia
Slice Name | itemAnswerMedia
Definition | Media to render/make available as an accompaniment to a specific answer option
Short | Answer Media to display
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Item Answer Media) (Extension Type: Attachment)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
106. QuestionnaireResponse.item.answer.extension:ordinalValue
Slice Name | ordinalValue
Definition | A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores.
Short | Assigned Ordinal Value
Comments | Scores are commonly encountered in various clinical assessment scales. Assigning a value to a concept should generally be done in a formal code system that defines the value, or in an applicable value set for the concept, but some concepts do not have a formal definition (or are not even represented as a concept formally, especially in Questionnaires, so this extension is allowed to appear ouside those preferred contexts. Scores may even be assigned arbitrarily during use (hence, on Coding). The value may be constrained to an integer in some contexts of use. Todo: Scoring algorithms may also be defined directly, but how this is done is not yet defined.
Control | 0..1
Type | Extension(Ordinal Value) (Extension Type: decimal)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
108. QuestionnaireResponse.item.answer.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
110. QuestionnaireResponse.item.answer.value[x]
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Code indicating the response provided for a question.
Type | Choice of: boolean, date, dateTime, time, decimal, integer, string, Coding, uri, Quantity, Attachment, Reference
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
112. QuestionnaireResponse.item.answer.value[x]:valueString
Slice Name | valueString
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Code indicating the response provided for a question.
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. QuestionnaireResponse.item.answer.value[x]:valueString.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
116. QuestionnaireResponse.item.answer.value[x]:valueString.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) answer-string-extension-slice: Must have either encrypted-stringType or encrypted-openChoiceType extension, but not both (`url.exists() and (url.matches('https://api.openhealthhub.com/OpenHealthhub/fhir/4/StructureDefinition/encrypted-stringType') or url.matches('https://api.openhealthhub.com/OpenHealthhub/fhir/4/StructureDefinition/encrypted-openChoiceType'))`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
118. QuestionnaireResponse.item.answer.value[x]:valueString.extension:encrypted-stringType
Slice Name | encrypted-stringType
Definition | Extension containing encrypted string value
Short | Encrypted String Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted String Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
120. QuestionnaireResponse.item.answer.value[x]:valueString.extension:encrypted-openChoiceType
Slice Name | encrypted-openChoiceType
Definition | Extension containing encrypted open choice value
Short | Encrypted Open Choice Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Open Choice Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
122. QuestionnaireResponse.item.answer.value[x]:valueString.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
124. QuestionnaireResponse.item.answer.value[x]:valueInteger
Slice Name | valueInteger
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | integer
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. QuestionnaireResponse.item.answer.value[x]:valueInteger.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
128. QuestionnaireResponse.item.answer.value[x]:valueInteger.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
130. QuestionnaireResponse.item.answer.value[x]:valueInteger.extension:encrypted-integerType
Slice Name | encrypted-integerType
Definition | Extension containing encrypted integer value
Short | Encrypted Integer Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Integer Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
132. QuestionnaireResponse.item.answer.value[x]:valueInteger.value
Definition | The actual value
Short | Primitive value for integer
Control | 0..1
Type | integer
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Min Value | -2147483648
Max Value | 2147483647
134. QuestionnaireResponse.item.answer.value[x]:valueDecimal
Slice Name | valueDecimal
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | decimal
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. QuestionnaireResponse.item.answer.value[x]:valueDecimal.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
138. QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
140. QuestionnaireResponse.item.answer.value[x]:valueDecimal.extension:encrypted-decimalType
Slice Name | encrypted-decimalType
Definition | Extension containing encrypted decimal value
Short | Encrypted Decimal Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Decimal Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
142. QuestionnaireResponse.item.answer.value[x]:valueDecimal.value
Definition | The actual value
Short | Primitive value for decimal
Control | 0..1
Type | decimal
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
144. QuestionnaireResponse.item.answer.value[x]:valueDate
Slice Name | valueDate
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | date
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. QuestionnaireResponse.item.answer.value[x]:valueDate.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
148. QuestionnaireResponse.item.answer.value[x]:valueDate.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
150. QuestionnaireResponse.item.answer.value[x]:valueDate.extension:encrypted-dateType
Slice Name | encrypted-dateType
Definition | Extension containing encrypted date value
Short | Encrypted Date Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Date Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
152. QuestionnaireResponse.item.answer.value[x]:valueDate.value
Definition | The actual value
Short | Primitive value for date
Control | 0..1
Type | date
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
154. QuestionnaireResponse.item.answer.value[x]:valueDateTime
Slice Name | valueDateTime
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. QuestionnaireResponse.item.answer.value[x]:valueDateTime.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
158. QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
160. QuestionnaireResponse.item.answer.value[x]:valueDateTime.extension:encrypted-dateTimeType
Slice Name | encrypted-dateTimeType
Definition | Extension containing encrypted dateTime value
Short | Encrypted Date Time Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Date Time Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
162. QuestionnaireResponse.item.answer.value[x]:valueDateTime.value
Definition | The actual value
Short | Primitive value for dateTime
Control | 0..1
Type | dateTime
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
164. QuestionnaireResponse.item.answer.value[x]:valueTime
Slice Name | valueTime
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. QuestionnaireResponse.item.answer.value[x]:valueTime.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
168. QuestionnaireResponse.item.answer.value[x]:valueTime.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
170. QuestionnaireResponse.item.answer.value[x]:valueTime.extension:encrypted-timeType
Slice Name | encrypted-timeType
Definition | Extension containing encrypted time value
Short | Encrypted Time Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Time Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
172. QuestionnaireResponse.item.answer.value[x]:valueTime.value
Definition | The actual value
Short | Primitive value for time
Control | 0..1
Type | time
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
174. QuestionnaireResponse.item.answer.value[x]:valueAttachment
Slice Name | valueAttachment
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
176. QuestionnaireResponse.item.answer.value[x]:valueAttachment.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
178. QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
180. QuestionnaireResponse.item.answer.value[x]:valueAttachment.extension:encrypted-attachment
Slice Name | encrypted-attachment
Definition | Extension containing encrypted attachment value
Short | Encrypted Attachment Extension
Control | 1..1
Type | Extension(Encrypted Attachment Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
182. QuestionnaireResponse.item.answer.value[x]:valueAttachment.contentType
Definition | Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.
Short | Mime type of the content, with charset etc.
Control | 0..1
Binding | The codes SHALL be taken from Mime Types (required to `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` ) The mime type of an attachment. Any valid mime type is allowed.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Processors of the data need to be able to know how to interpret the data.
Example | General: text/plain; charset=UTF-8, image/png
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. QuestionnaireResponse.item.answer.value[x]:valueAttachment.language
Definition | The human language of the content. The value can be any valid value according to BCP 47.
Short | Human language of the content (BCP-47)
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Users need to be able to choose between the languages in a set of attachments.
Example | General: en-AU
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. QuestionnaireResponse.item.answer.value[x]:valueAttachment.data
Definition | The actual data of the attachment - a sequence of bytes, base64 encoded.
Short | Data inline, base64ed
Comments | The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.
Control | 0..1
Type | base64Binary
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | The data needs to able to be transmitted inline.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. QuestionnaireResponse.item.answer.value[x]:valueAttachment.url
Definition | A location where the data can be accessed.
Short | Uri where the data can be found
Comments | If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.
Control | 0..1
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The data needs to be transmitted by reference.
Example | General: http://www.acme.com/logo-small.png
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. QuestionnaireResponse.item.answer.value[x]:valueAttachment.size
Definition | The number of bytes of data that make up this attachment (before base64 encoding, if that is done).
Short | Number of bytes of content (if url provided)
Comments | The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. QuestionnaireResponse.item.answer.value[x]:valueAttachment.hash
Definition | The calculated hash of the data using SHA-1. Represented using base64.
Short | Hash of the data (sha-1, base64ed)
Comments | The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.
Control | 0..1
Type | base64Binary
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. QuestionnaireResponse.item.answer.value[x]:valueAttachment.title
Definition | A label or set of text to display in place of the data.
Short | Label to display in place of the data
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.
Example | General: Official Corporate Logo
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. QuestionnaireResponse.item.answer.value[x]:valueAttachment.creation
Definition | The date that the attachment was first created.
Short | Date attachment was first created
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This is often tracked as an integrity issue for use of the attachment.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. QuestionnaireResponse.item.answer.value[x]:valueBoolean
Slice Name | valueBoolean
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. QuestionnaireResponse.item.answer.value[x]:valueBoolean.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
202. QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
204. QuestionnaireResponse.item.answer.value[x]:valueBoolean.extension:encrypted-booleanType
Slice Name | encrypted-booleanType
Definition | Extension containing encrypted boolean value
Short | Encrypted Boolean Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Encrypted Boolean Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
206. QuestionnaireResponse.item.answer.value[x]:valueBoolean.value
Definition | The actual value
Short | Primitive value for boolean
Control | 0..1
Type | boolean
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
208. QuestionnaireResponse.item.answer.value[x]:valueCoding
Slice Name | valueCoding
Definition | The answer (or one of the answers) provided by the respondent to the question.
Short | Single-valued answer to the 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.
Control | 0..1
Binding | For example codes, see QuestionnaireAnswerCodes (example to `http://hl7.org/fhir/ValueSet/questionnaire-answers|4.0.1` ) Code indicating the response provided for a question.
Type | Coding
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | Ability to retain a single-valued answer to a question.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
210. QuestionnaireResponse.item.answer.value[x]:valueCoding.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
212. QuestionnaireResponse.item.answer.value[x]:valueCoding.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `QuestionnaireResponse.item.answer.value[x].extension`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ url
214. QuestionnaireResponse.item.answer.value[x]:valueCoding.extension:encrypted-coding
Slice Name | encrypted-coding
Definition | Extension containing encrypted coding value
Short | Encrypted Coding Extension
Control | 1..1
Type | Extension(Encrypted Coding Extension) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
216. QuestionnaireResponse.item.answer.value[x]:valueCoding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | 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 reference to some definition that establishes the system clearly and unambiguously.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. QuestionnaireResponse.item.answer.value[x]:valueCoding.version
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.
Short | Version of the system - if relevant
Comments | 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.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. QuestionnaireResponse.item.answer.value[x]:valueCoding.code
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).
Short | Symbol in syntax defined by the system
Control | 0..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. QuestionnaireResponse.item.answer.value[x]:valueCoding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. QuestionnaireResponse.item.answer.value[x]:valueCoding.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | 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.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
226. QuestionnaireResponse.item.answer.item
Definition | Nested groups and/or questions found within this particular answer.
Short | Nested groups and questions
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. QuestionnaireResponse.item.item
Definition | Questions or sub-groups nested beneath a question or group.
Short | Nested questionnaire response items
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/QuestionnaireResponse#QuestionnaireResponse.item
Is Modifier | false
Must Support | true
Summary | false
Requirements | Reports can consist of complex nested groups.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)