Sets minimum expectations for questionnaire support for SDC-conformant systems, regardless of which SDC capabilities they're making use of.

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.

When the resource last changed - e.g. when the version changed.

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

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.

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.

Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

Allows capture of todos, rationale for design decisions, etc. It can also be used to capture comments about the completion of the form in general. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the "data" of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use Observation.

Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears). If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository.

This includes those referenced by answerValueSet as well as the unitValueSet extension.

Indicates the types of resources that can record answers to a Questionnaire. Open Issue: Should this extension be moved to core?

If present, indicates that this questionnaire has expectations with respect to assembly. Specifically, indicates whether this form requires assembly (i.e. it can't be used directly without invoking the $assemble operation operation on it) and/or whether it is intended for use only as a 'child' in an assembly process. The assembly processs might mean filling in item metadata based on information looked up from item.definitions and/or retrieving sub-questionnaires pointed to by sub-questionnaire extensions.

SDC-conformant Questionnaires SHALL declare this extension if they require an assembly process prior to use. If not declared, then the Questionnaire is not necessarily safe for use as a child form and does not require assembly prior to use.

Specifies a query or other expression that identifies the resource (or set of resources for a repeating item) to be extracted from this item once the QuestionnaireResponse is complete.

Variable specifying a logic to generate a variable for use in subsequent logic. The name of the variable will be added to FHIRPath's context when processing descendants of the element that contains this extension as well as extensions within the same element.

Ordering of variable extension declarations is significant as variables declared in one repetition of this extension might be used in subsequent extension repetitions

​For questionnaires, see additional guidance and examples in the SDC implementation guide.

If true, indicates that the observation-based approach should be used to extract either the particular item (if extension is defined on an individual question or group based on the code present) or all items in the questionnaire (if defined at the questionnaire root and if they have a code present).

This extension canot be specified on "display" items.

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).

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.

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.

An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.

The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.

… This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.

The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].

A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Support human navigation and code generation.

A short, descriptive, user-friendly title for the questionnaire.

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

The status of this questionnaire. Enables tracking the life-cycle of the content.

Allows filtering of questionnaires that are appropriate for use versus not.

The lifecycle status of an artifact.

A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Allows filtering of questionnaires that are appropriate for use versus not.

Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.

The types of subjects that can be the subject of responses created for the questionnaire.

If none are specified, then the subject is unlimited.

One of the resource types defined as part of this version of FHIR.

A Questionnaire SHOULD specify the subject. However, it is optional to support legacy questionnaires.

The date (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

The name of the organization or individual that published the questionnaire.

Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context.

Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.

A free text natural language description of the questionnaire from a consumer's perspective.

This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created).

A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire.

Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content.

An identifier for this question or group of questions in a particular terminology such as LOINC.

Codes for questionnaires, groups and individual questions.

Allows linking of the complete Questionnaire resources to formal terminologies. It's common for "panels" of questions to be identified by a code.

A particular question, question grouping or display text that is part of the questionnaire.

The content of the questionnaire is constructed from an ordered, hierarchical collection of items.

Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

Allows capture of todos, rationale for design decisions, etc. It can also be used to capture comments about specific groups or questions within it. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the "data" of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use Observation.

Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears). If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository.

This includes those referenced by answerValueSet as well as the unitValueSet extension.

The type of data entry control or structure that should be used to render the item.

​Different controls may be appropriate for different item types. It is up to the system rendering a questionnaire as to what controls it will support and for which data types. See additional guidance and examples in the SDC implementation guide.

The inclusive lower bound on the range of allowed values for the data element.

​Data type specified must be the same as the data type for the data element. For questionnaires, see additional guidance and examples in the SDC implementation guide.

The inclusive upper bound on the range of allowed values for the data element.

​Data type specified must be the same as the data type for the data element. For questionnaires, see additional guidance and examples in the SDC implementation guide.

Identifies the maximum number of decimal places that may be specified for the data element.

​For questionnaires, see additional guidance and examples in the SDC implementation guide. This specifies the maximum number of digits that can appear after the decimal point in a number. It counts all the digits to the right of the decimal point when the number is written out in full, standard decimal form (without 'e' or 'E'). For example, a number in scientific notation like 1.23e-4 equals 0.000123 when expanded; it would be consistent with a maximum number of decimal places of 6 or more.

Specifies a query or other expression that identifies the resource (or set of resources for a repeating item) to be extracted from this item once the QuestionnaireResponse is complete.

A unit that the user may choose when providing a quantity value.

​Provide either unitOption(s) or unitValueSet. If either of the extensions are present, the units for a Quantity element are constrained to only the units listed by the extensions - i.e. it is treated as a "required", not an "extensible" binding. In the absence of either, any unit is valid. See additional guidance and examples in the SDC implementation guide. If this extension present and an answer is provided for the question item in the QuestionnaireResponse, then the valueQuantity SHALL have a Quantity.code and Quantity.system that match the Coding.code and system of one of the allowed values if the Coding has a code and/or system. If the Coding only has a display, then the Quantity.unit must match. (Note that Coding with only a display is strongly discouraged.) If there is a match on code and system, but no match on display/unit, systems MAY raise a warning. However, because of translation and bandwidth considerations, some systems MAY opt to drop the unit or express it in an alternate language.

If true, indicates that the extended item should not be displayed to the user.

​If an item is hidden, all descendant items are hidden as well. See additional guidance and examples in the SDC implementation guide.

Variable specifying a logic to generate a variable for use in subsequent logic. The name of the variable will be added to FHIRPath's context when processing descendants of the element that contains this extension as well as extensions within the same element.

Ordering of variable extension declarations is significant as variables declared in one repetition of this extension might be used in subsequent extension repetitions

​For questionnaires, see additional guidance and examples in the SDC implementation guide.

The label text to display beside free-text and/or unrestricted type values for an 'open' choice element. E.g. 'Other, please specify', or 'Additional condition', or 'More reason(s)', etc.

For slider-based controls, indicates the step size to use when toggling the control up or down.

​See additional guidance and examples in the SDC implementation guide.

The maximum number of times the group must appear, or the maximum number of answers for a question - when greater than 1 and not unlimited.

​Only relevant if the element has repeats=true and there's a need to constrain the number of allowed repetitions. See additional guidance and examples in the SDC implementation guide.

The minimum number of times the group must appear, or the minimum number of answers for a question - when greater than 1.

​Default assumption for "required" elements is minOccurs=1. See additional guidance and examples in the SDC implementation guide.

​A URL that resolves to additional supporting information or guidance related to the question. See additional guidance and examples in the SDC implementation guide. If there's more than one repetition of this extension, all a UI can do to help the user differentiate which to click on is displaying the URI (e.g. as a flyover). If displaying the URI might not be appropriate or helpful, it may be more useful to use a nested 'display' item of type 'helpText' which can then specify multiple hyperlinks with appropriate labels and/or surrounding guidance text.

If true, indicates that the observation-based approach should be used to extract either the particular item (if extension is defined on an individual question or group based on the code present) or all items in the questionnaire (if defined at the questionnaire root and if they have a code present).

This extension canot be specified on "display" items.

Indicates the Observation.category value(s) that should appear on extracted Observations for the entire Questionnaire or for the current item and descendant items. If this extension appears at multiple levels in the Questionnaire, those defined on lower-level items override those declared on higher-level items.

This extension canot be specified on "display" items.

Calculated value for a question answer as determined by an evaluated expression.

Calculated value is updated as other answers in the QuestionnaireResponse are filled in.

Provides a computable unit of measure associated with numeric questions to support subsequent computation on responses. This is for use on items of type integer and decimal, and it's purpose is to support converting the integer or decimal answer into a Quantity when extracting the data into a resource.

The human-readable unit is conveyed as a display element. This element is for computation purposes.

Captures the link from a Questionnaire.item to an ART-DECOR dataset element. Use this extension instead of item.definition, since item.definition is reserved for SDC mapping to a FHIR resource structure.

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).

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.

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.

An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource.

This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning. GUIDs or sequential numbers are appropriate here.

QuestionnaireResponse does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient.

This element is a URI that refers to an ElementDefinition that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. If this element is present then the following element values MAY be derived from the Element Definition if the corresponding elements of this Questionnaire resource instance have no value:

• code (ElementDefinition.code)
• type (ElementDefinition.type)
• required (ElementDefinition.min)
• repeats (ElementDefinition.max)
• maxLength (ElementDefinition.maxLength)
• answerValueSet (ElementDefinition.binding)
• options (ElementDefinition.binding).

The uri refers to an ElementDefinition in a StructureDefinition and always starts with the canonical URL for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id Element.id. E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition.

A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition.

A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers).

The value may come from the ElementDefinition referred to by .definition.

Codes for questionnaires, groups and individual questions.

Allows linking of groups of questions to formal terminologies.

A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire.

These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed. Typically, these won't be used for "display" items, though such use is not prohibited. Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire.

Separating the label from the question text allows improved rendering. Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used.

The name of a section, the text of a question or text content for a display item.

When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading. Group item instructions should be included as a display type item within the group.

An Extension

This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display.

​For questionnaires, see additional guidance and examples in the SDC implementation guide.

Indicates an HTML style that should be applied when rendering this element.

This extension would be equivalent to setting the HTML "style" attribute on the root element for the element containing the extension.

NOTE: HTML styles can include references to external content (images, fonts, etc.), which may constitute a security issue, as resolving the link can allow tracking. See here for more detail.

​For questionnaires, see additional guidance and examples in the SDC implementation guide. This style applies to the base string. If there is also a rendering-xhtml or rendering-markdown extension, they must declare any relevant styles within those extension values.

Setting styles on elements can be risky. It presumes knowledge of how elements are rendered "by default". For example, setting the color of an element to 'blue' to highlight it might be fine - unless the default background color for a particular renderer is already blue. As well, it's not a given that all elements will be represented by a single HTML element. One element might be referenced by a collection of table cells that span rows and columns. Setting a border style on all of those cells wouldn't give the desired results and auto-tweaking the border style on each cell (deciding whether the border is top,left, right, etc.) would require complex coding. Finally, systems might not be using HTML for their UI at all and will need to map the specified styles to their own UI mechanism. For this reason, this element is best used when: a) the default UI characteristics are already well understood (because the specification applies to a single system or to a set of systems that are already required to comply with specific UI expectations b) the set of allowed style values is tightly controlled to only those that are necessary and sensible in that context

Language translation from base language of resource to another language, used to provide translations for strings, including markdown. Generally, the type of the translation extension SHOULD match that of the element being extended.

The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.).

Time is handled using "string". File is handled using Attachment. (Content can be sent as a contained binary).

Distinguishes groups from questions and display text and indicates data type for questions.

Defines the format in which the user is to be prompted for the answer.

A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true.

If multiple repetitions of this extension are present, the item should be enabled when the condition for any of the repetitions is true. I.e. treat "enableWhen"s as being joined by an "or" clause. This element is a modifier because if enableWhen is present for an item, "required" is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to.

Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history. Also allows conditional display of instructions or groups of questions.

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).

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.

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.

The linkId for the question whose answer (or lack of answer) governs whether this item is enabled.

If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the "ancestor" axis and then the "preceding" axis and then the "following" axis.

Specifies the criteria by which the question is enabled.

The criteria by which a question is enabled.

A value that the referenced question is tested using the specified operator in order for the item to be enabled.

Allowed values to answer questions.

Controls how multiple enableWhen values are interpreted - whether all or any must be true.

This element must be specified if more than one enableWhen value is provided.

Controls how multiple enableWhen values are interpreted - whether all or any must be true.

An indication, if true, that the item must be present in a "completed" QuestionnaireResponse. If false, the item may be skipped when answering the questionnaire.

Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true. If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition.

An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items)

If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse. When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. "repeat the question") or to simply allow entry/selection of multiple answers for the question (repeat the answers). Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.

The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.

The value may come from the ElementDefinition referred to by .definition.

Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set.

An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire.

The value of readOnly elements can be established by asserting extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers.

Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it. May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc.

The maximum number of characters that are permitted in the answer to be considered a "valid" QuestionnaireResponse.

For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition.

A reference to a value set containing a list of codes representing permitted answers for a "choice" or "open-choice" question.

LOINC defines many useful value sets for questionnaire responses. See LOINC Answer Lists. The value may come from the ElementDefinition referred to by .definition.

One of the permitted answers for a "choice" or "open-choice" question.

This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes.

An Extension

The label to list in front of a code when presenting a list of possible values in a questionnaire-like fashion.

​See additional guidance and examples in the SDC implementation guide.

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. In the CodeSystem and ValueSet resources, the item weight is represented using the itemWeight property. In questionnaires, this extension goes on answerOption where possible.

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

​For questionnaires, see additional guidance and examples in the SDC implementation guide.

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).

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.

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.

A potential answer that's allowed as the answer to this question.

The data type of the value must agree with the item.type.

Allowed values to answer questions.

Indicates whether the answer value is selected when the list of possible answers is initially shown.

Use this instead of initial[v] if answerValueSet is present.

One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input.

The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created. Note that initial values can influence results. The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value.

In some workflows, having defaults saves time.

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).

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.

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.

The actual value to for an initial answer.

The type of the initial value must be consistent with the type of the item.

Allowed values to answer questions.

Text, questions and other groups to be nested beneath a question or group.

There is no specified limit to the depth of nesting. However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting.

Reports can consist of complex nested groups.

Sets minimum expectations for questionnaire support for SDC-conformant systems, regardless of which SDC capabilities they're making use of.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

When the resource last changed - e.g. when the version changed.

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Security Labels from the Healthcare Privacy and Security Classification System.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

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.

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.

The base language in which the resource is written.

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).

A human language.

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.

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.

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.

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.

An Extension

Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

Allows capture of todos, rationale for design decisions, etc. It can also be used to capture comments about the completion of the form in general. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the "data" of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use Observation.

Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears). If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository.

This includes those referenced by answerValueSet as well as the unitValueSet extension.

Indicates the types of resources that can record answers to a Questionnaire. Open Issue: Should this extension be moved to core?

If present, indicates that this questionnaire has expectations with respect to assembly. Specifically, indicates whether this form requires assembly (i.e. it can't be used directly without invoking the $assemble operation operation on it) and/or whether it is intended for use only as a 'child' in an assembly process. The assembly processs might mean filling in item metadata based on information looked up from item.definitions and/or retrieving sub-questionnaires pointed to by sub-questionnaire extensions.

SDC-conformant Questionnaires SHALL declare this extension if they require an assembly process prior to use. If not declared, then the Questionnaire is not necessarily safe for use as a child form and does not require assembly prior to use.

Specifies a query or other expression that identifies the resource (or set of resources for a repeating item) to be extracted from this item once the QuestionnaireResponse is complete.

Variable specifying a logic to generate a variable for use in subsequent logic. The name of the variable will be added to FHIRPath's context when processing descendants of the element that contains this extension as well as extensions within the same element.

Ordering of variable extension declarations is significant as variables declared in one repetition of this extension might be used in subsequent extension repetitions

​For questionnaires, see additional guidance and examples in the SDC implementation guide.

If true, indicates that the observation-based approach should be used to extract either the particular item (if extension is defined on an individual question or group based on the code present) or all items in the questionnaire (if defined at the questionnaire root and if they have a code present).

This extension canot be specified on "display" items.

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).

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.

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.

An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers.

The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension.

… This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for.

A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance.

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI.

Allows externally provided and/or usable business identifiers to be easily associated with the module.

The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

There may be different questionnaire instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version].

A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation.

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Support human navigation and code generation.

A short, descriptive, user-friendly title for the questionnaire.

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

The URL of a Questionnaire that this Questionnaire is based on.

Allows a Questionnaire to be created based on another Questionnaire.

The status of this questionnaire. Enables tracking the life-cycle of the content.

Allows filtering of questionnaires that are appropriate for use versus not.

The lifecycle status of an artifact.

A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Allows filtering of questionnaires that are appropriate for use versus not.

Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire.

The types of subjects that can be the subject of responses created for the questionnaire.

If none are specified, then the subject is unlimited.

One of the resource types defined as part of this version of FHIR.

A Questionnaire SHOULD specify the subject. However, it is optional to support legacy questionnaires.

The date (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes.

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

The name of the organization or individual that published the questionnaire.

Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context.

Helps establish the "authority/credibility" of the questionnaire. May also allow for contact.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.