{ "description": null, "_filename": "example/Questionnaire-QuestionnaireRadiologyOrder.json", "package_name": "ch.fhir.ig.ch-rad-order", "subjectType": [ "Patient" ], "date": "2021-02-24", "meta": { "profile": [ "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire", "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire", "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extract" ] }, "publisher": "HL7 Switzerland", "jurisdiction": [ { "coding": [ { "code": "CH", "system": "urn:iso:std:iso:3166" } ] } ], "derivedFrom": [ "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire" ], "name": "QuestionnaireRadiologyOrder", "item": [ { "item": [ { "text": "Titel", "type": "string", "linkId": "order.title", "readOnly": true, "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.title" }, { "text": "Typ", "type": "choice", "linkId": "order.type", "readOnly": true, "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.type", "answerValueSet": "http://fhir.ch/ig/ch-epr-term/ValueSet/DocumentEntry.typeCode" }, { "text": "Kategorie", "type": "choice", "linkId": "order.category", "readOnly": true, "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.category", "answerValueSet": "http://fhir.ch/ig/ch-epr-term/ValueSet/DocumentEntry.classCode" }, { "text": "Auftragsnummer des Auftraggebers", "type": "string", "linkId": "order.placerOrderIdentifier", "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.identifier:placerOrderIdentifier.value" }, { "text": "Identifier Domain der Auftragsnummer des Auftraggebers", "type": "string", "linkId": "order.placerOrderIdentifierDomain", "required": true, "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true } ], "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.identifier:placerOrderIdentifier.system" }, { "text": "Auftragsnummer des Auftragsempfängers", "type": "string", "linkId": "order.fillerOrderIdentifier", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.identifier:fillerOrderIdentifier.value" }, { "text": "Identifier Domain der Auftragsnummer des Auftragsempfängers", "type": "string", "linkId": "order.fillerOrderIdentifierDomain", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true } ], "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.identifier:fillerOrderIdentifier.system" }, { "text": "Identifier des Vorgängerdokuments", "type": "string", "linkId": "order.precedentDocumentIdentifier", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true } ], "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.extension:precedentDocument" }, { "item": [ { "item": [ { "text": "Titel", "type": "string", "linkId": "order.notificationContactDocument.practitioner.title", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix" }, { "text": "Name", "type": "string", "linkId": "order.notificationContactDocument.practitioner.familyName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family" }, { "text": "Vorname", "type": "string", "linkId": "order.notificationContactDocument.practitioner.givenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given" }, { "text": "Telefon", "type": "string", "linkId": "order.notificationContactDocument.practitioner.phone", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" }, { "text": "E-Mail", "type": "string", "linkId": "order.notificationContactDocument.practitioner.email", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" } ], "text": "Zu benachrichtigende Person", "type": "group", "linkId": "order.notificationContactDocument.practitioner", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner" } ], "text": "Dringender Benachrichtigungskontakt für dieses Dokument", "type": "group", "linkId": "order.notificationContactDocument", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.extension:urgentNoficationContactForThisDocument" }, { "item": [ { "item": [ { "text": "Titel", "type": "string", "linkId": "order.notificationContactDocumentResponse.practitioner.title", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix" }, { "text": "Name", "type": "string", "linkId": "order.notificationContactDocumentResponse.practitioner.familyName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family" }, { "text": "Vorname", "type": "string", "linkId": "order.notificationContactDocumentResponse.practitioner.givenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given" }, { "text": "Telefon", "type": "string", "linkId": "order.notificationContactDocumentResponse.practitioner.phone", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" }, { "text": "E-Mail", "type": "string", "linkId": "order.notificationContactDocumentResponse.practitioner.email", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" } ], "text": "Zu benachrichtigende Person", "type": "group", "linkId": "order.notificationContactDocumentResponse.practitioner", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner" } ], "text": "Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument", "type": "group", "linkId": "order.notificationContactDocumentResponse", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.extension:urgentNoficationContactForTheResponseToThisDocument" }, { "text": "Auftragspriorität", "type": "choice", "linkId": "order.priority", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.priority", "answerOption": [ { "valueCoding": { "code": "routine", "system": "http://hl7.org/fhir/request-priority", "display": "Die Anfrage hat normale Priorität." }, "initialSelected": true }, { "valueCoding": { "code": "urgent", "system": "http://hl7.org/fhir/request-priority", "display": "Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal." } }, { "valueCoding": { "code": "asap", "system": "http://hl7.org/fhir/request-priority", "display": "Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend." } }, { "valueCoding": { "code": "stat", "system": "http://hl7.org/fhir/request-priority", "display": "Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall." } } ] } ], "text": "Auftrag", "type": "group", "linkId": "order", "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-document#Bundle" }, { "item": [ { "text": "Name", "type": "string", "linkId": "patient.familyName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.family" }, { "text": "Ledigname", "type": "string", "linkId": "patient.maidenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.family" }, { "text": "Vorname", "type": "string", "linkId": "patient.givenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name.given" }, { "text": "Lokale Patienten-ID", "type": "string", "linkId": "patient.localPid", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:LocalPid.value" }, { "text": "Lokale Patienten-ID Domain", "type": "string", "linkId": "patient.localPidDomain", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean": true } ], "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:LocalPid.system" }, { "text": "Geburtsdatum", "type": "date", "linkId": "patient.birthDate", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.birthDate" }, { "text": "Geschlecht", "type": "choice", "linkId": "patient.gender", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.gender", "answerOption": [ { "valueCoding": { "code": "male", "system": "http://hl7.org/fhir/administrative-gender", "display": "Männlich" }, "initialSelected": true }, { "valueCoding": { "code": "female", "system": "http://hl7.org/fhir/administrative-gender", "display": "Weiblich" } }, { "valueCoding": { "code": "other", "system": "http://hl7.org/fhir/administrative-gender", "display": "Anderes" } } ] }, { "text": "Telefon", "type": "string", "linkId": "patient.phone", "repeats": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.telecom.value" }, { "text": "E-Mail", "type": "string", "linkId": "patient.email", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.telecom.value" }, { "text": "Strasse, Hausnummer, Postfach etc.", "type": "string", "linkId": "patient.streetAddressLine", "repeats": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.line" }, { "text": "PLZ", "type": "string", "linkId": "patient.postalCode", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.postalCode" }, { "text": "Ort", "type": "string", "linkId": "patient.city", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.city" }, { "text": "Land", "type": "string", "linkId": "patient.country", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.address.country" } ], "text": "Patient", "type": "group", "linkId": "patient", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.subject" }, { "item": [ { "text": "Voraussichtlich: Ambulant / Stationär / Notfall", "type": "choice", "linkId": "requestedEncounter.class", "required": true, "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-encounter#Encounter.class", "answerOption": [ { "valueCoding": { "code": "AMB", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "Ambulant" } }, { "valueCoding": { "code": "IMP", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "Stationär" } }, { "valueCoding": { "code": "EMER", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "Notfall" } } ] }, { "text": "Zimmerkategorie", "type": "choice", "linkId": "requestedEncounter.desiredAccommodation", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-encounter#Encounter.extension:desiredAccommodation", "answerOption": [ { "valueCoding": { "code": "P", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "Einerzimmer" } }, { "valueCoding": { "code": "SP", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "Zweierzimmer" } }, { "valueCoding": { "code": "W", "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", "display": "Mehrbettzimmer" } } ] } ], "text": "Patientenaufnahme", "type": "group", "linkId": "requestedEncounter", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.extension:requestedEncounterDetails" }, { "item": [ { "item": [ { "text": "AHV-Nr. des Patienten", "type": "string", "linkId": "coverage.beneficiary.ahvn13", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.identifier:AHVN13" } ], "text": "Begünstigter (Patient)", "type": "group", "linkId": "coverage.beneficiary", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.beneficiary" }, { "item": [ { "text": "Name der Versicherung", "type": "string", "linkId": "coverage.kvg.name", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor" }, { "text": "Kennnummer der Versichertenkarte", "type": "string", "linkId": "coverage.kvg.insuranceCardNumber", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier" } ], "text": "Krankenkasse (nach KVG)", "type": "group", "linkId": "coverage.kvg", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type" }, { "item": [ { "text": "Name der Versicherung", "type": "string", "linkId": "coverage.uvg.name", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor" }, { "text": "Schadennummer", "type": "string", "linkId": "coverage.uvg.claimNumber", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier" } ], "text": "Unfallversicherung (nach UVG)", "type": "group", "linkId": "coverage.uvg", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type" }, { "item": [ { "text": "Name der Versicherung", "type": "string", "linkId": "coverage.vvg.name", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor" }, { "text": "Kennnummer der Versichertenkarte", "type": "string", "linkId": "coverage.vvg.insuranceCardNumber", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier" } ], "text": "Zusatzversicherung (nach VVG)", "type": "group", "linkId": "coverage.vvg", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type" }, { "item": [ { "text": "IV-Verfügungsnummer", "type": "string", "linkId": "coverage.iv.verfuegungsnummer", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier" } ], "text": "Invalidenversicherung (IV)", "type": "group", "linkId": "coverage.iv", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type" }, { "item": [ { "text": "MV-Versichertennummer", "type": "string", "linkId": "coverage.mv.versichertennummer", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier" } ], "text": "Militärversicherung (MV)", "type": "group", "linkId": "coverage.mv", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type" }, { "item": [ { "text": "Name", "type": "string", "linkId": "coverage.self.familyName", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor" }, { "text": "Vorname", "type": "string", "linkId": "coverage.self.givenName", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor" } ], "text": "Selbstzahler", "type": "group", "linkId": "coverage.self", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type" }, { "item": [ { "text": "Name des Kostenträgers", "type": "string", "linkId": "coverage.other.name", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.payor" }, { "text": "Beliebige ID", "type": "string", "linkId": "coverage.other.id", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier" }, { "text": "Bemerkung zur ID", "type": "string", "linkId": "coverage.other.id.note", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.identifier.type.text" } ], "text": "Anderer Kostenträger", "type": "group", "linkId": "coverage.other", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage#Coverage.type" } ], "text": "Kostenträger", "type": "group", "linkId": "coverage", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.insurance" }, { "item": [ { "item": [ { "item": [ { "text": "Titel", "type": "string", "linkId": "sender.author.practitioner.title", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix" }, { "text": "Name", "type": "string", "linkId": "sender.author.practitioner.familyName", "required": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family" }, { "text": "Vorname", "type": "string", "linkId": "sender.author.practitioner.givenName", "required": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given" }, { "text": "GLN", "type": "string", "linkId": "sender.author.practitioner.gln", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:GLN.value" }, { "text": "Telefon", "type": "string", "linkId": "sender.author.practitioner.phone", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" }, { "text": "E-Mail", "type": "string", "linkId": "sender.author.practitioner.email", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" } ], "text": "Verantwortliche Person", "type": "group", "linkId": "sender.author.practitioner", "required": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner" }, { "item": [ { "text": "Name der Organisation", "type": "string", "linkId": "sender.author.organization.name", "required": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name" }, { "text": "Strasse, Hausnummer, Postfach etc.", "type": "string", "linkId": "sender.author.organization.streetAddressLine", "repeats": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.line" }, { "text": "PLZ", "type": "string", "linkId": "sender.author.organization.postalCode", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.postalCode" }, { "text": "Ort", "type": "string", "linkId": "sender.author.organization.city", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.city" }, { "text": "Land", "type": "string", "linkId": "sender.author.organization.country", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.country" } ], "text": "Verantwortliche Organisation", "type": "group", "linkId": "sender.author.organization", "required": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization" } ], "text": "Verantwortlicher", "type": "group", "linkId": "sender.author", "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.author" }, { "item": [ { "item": [ { "text": "Name", "type": "string", "linkId": "sender.dataenterer.practitioner.familyName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family" }, { "text": "Vorname", "type": "string", "linkId": "sender.dataenterer.practitioner.givenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given" }, { "text": "Telefon", "type": "string", "linkId": "sender.dataenterer.practitioner.phone", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" }, { "text": "E-Mail", "type": "string", "linkId": "sender.dataenterer.practitioner.email", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" } ], "text": "Erfassende Person", "type": "group", "linkId": "sender.dataenterer.practitioner", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner" } ], "text": "Erfasser", "type": "group", "linkId": "sender.dataenterer", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.extension:dataEnterer" } ], "text": "Absender", "type": "group", "linkId": "sender", "required": true }, { "item": [ { "item": [ { "text": "Titel", "type": "string", "linkId": "receiver.practitioner.title", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.prefix" }, { "text": "Name", "type": "string", "linkId": "receiver.practitioner.familyName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family" }, { "text": "Vorname", "type": "string", "linkId": "receiver.practitioner.givenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given" }, { "text": "GLN", "type": "string", "linkId": "receiver.practitioner.gln", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.identifier:GLN.value" }, { "text": "Telefon", "type": "string", "linkId": "receiver.practitioner.phone", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" }, { "text": "E-Mail", "type": "string", "linkId": "receiver.practitioner.email", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.telecom.value" } ], "text": "Empfangende Person", "type": "group", "linkId": "receiver.practitioner", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.practitioner" }, { "item": [ { "text": "Name der Organisation", "type": "string", "linkId": "receiver.organization.name", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name" }, { "text": "Strasse, Hausnummer, Postfach etc.", "type": "string", "linkId": "receiver.organization.streetAddressLine", "repeats": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.line" }, { "text": "PLZ", "type": "string", "linkId": "receiver.organization.postalCode", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.postalCode" }, { "text": "Ort", "type": "string", "linkId": "receiver.organization.city", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.city" }, { "text": "Land", "type": "string", "linkId": "receiver.organization.country", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.address.country" } ], "text": "Empfangende Organisation", "type": "group", "linkId": "receiver.organization", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole#PractitionerRole.organization" } ], "text": "Empfänger", "type": "group", "linkId": "receiver", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.extension:receiver" }, { "item": [ { "item": [ { "text": "Name der Organisation", "type": "string", "linkId": "receiverCopy.organization.name", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization#Organization.name" }, { "text": "Titel", "type": "string", "linkId": "receiverCopy.title", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.prefix" }, { "text": "Name", "type": "string", "linkId": "receiverCopy.familyName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.family" }, { "text": "Vorname", "type": "string", "linkId": "receiverCopy.givenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-humanname#HumanName.given" }, { "text": "Telefon", "type": "string", "linkId": "receiverCopy.phone", "definition": "http://hl7.org/fhir/StructureDefinition/ContactPoint#ContactPoint.value" }, { "text": "E-Mail", "type": "string", "linkId": "receiverCopy.email", "definition": "http://hl7.org/fhir/StructureDefinition/ContactPoint#ContactPoint.value" }, { "text": "Strasse, Hausnummer, Postfach etc.", "type": "string", "linkId": "receiverCopy.streetAddressLine", "repeats": true, "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.line" }, { "text": "PLZ", "type": "string", "linkId": "receiverCopy.postalCode", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.postalCode" }, { "text": "Ort", "type": "string", "linkId": "receiverCopy.city", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.city" }, { "text": "Land", "type": "string", "linkId": "receiverCopy.country", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-address#Address.country" } ], "text": "Kopieempfangende Organisation oder Person", "type": "group", "linkId": "receiverCopy", "repeats": true } ], "text": "Kopieempfänger", "type": "group", "linkId": "receiverCopies", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-composition#Composition.extension:copyReceiver" }, { "item": [ { "item": [ { "text": "Name", "type": "string", "linkId": "appointment.location.name", "required": true, "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.name" }, { "text": "Telefon", "type": "string", "linkId": "appointment.location.phone", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.telecom.value" }, { "text": "E-Mail", "type": "string", "linkId": "appointment.location.email", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.telecom.value" }, { "text": "Strasse, Hausnummer, Postfach etc.", "type": "string", "linkId": "appointment.location.streetAddressLine", "repeats": true, "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.line" }, { "text": "PLZ", "type": "string", "linkId": "appointment.location.postalCode", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.postalCode" }, { "text": "Ort", "type": "string", "linkId": "appointment.location.city", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.city" }, { "text": "Land", "type": "string", "linkId": "appointment.location.country", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-location#Location.address.country" } ], "text": "Ort der Durchführung", "type": "group", "linkId": "appointment.location", "required": true, "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.participant.actor" }, { "item": [ { "text": "Von", "type": "dateTime", "linkId": "appointment.requestedPeriod.start", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod.start" }, { "text": "Bis", "type": "dateTime", "linkId": "appointment.requestedPeriod.end", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod.end" } ], "text": "Datum und Zeit, wann der Termin bevorzugt geplant werden soll", "type": "group", "linkId": "appointment.requestedPeriod", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.requestedPeriod" }, { "text": "Status", "type": "choice", "linkId": "appointment.status", "required": true, "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.status", "answerOption": [ { "valueCoding": { "code": "proposed", "system": "http://hl7.org/fhir/appointmentstatus", "display": "Wunsch des Patienten (vorgeschlagen)" }, "initialSelected": true }, { "valueCoding": { "code": "pending", "system": "http://hl7.org/fhir/appointmentstatus", "display": "Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)" } }, { "valueCoding": { "code": "booked", "system": "http://hl7.org/fhir/appointmentstatus", "display": "Vom Patienten und Leistungserbringer bestätigt (gebucht)" } } ] }, { "text": "Patienteninformation für diesen Termin", "type": "string", "linkId": "appointment.patientInstruction", "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-appointment#Appointment.patientInstruction" } ], "text": "Ort und Zeit der Durchführung der angeforderten Leistung", "type": "group", "linkId": "appointment", "repeats": true, "definition": "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-servicerequest#ServiceRequest.extension:locationAndTime" }, { "item": [ { "text": "Leistung", "type": "choice", "linkId": "requestedService.service", "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.category.coding", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-requested-service" } ], "text": "Angeforderte Leistung", "type": "group", "linkId": "requestedService", "required": true }, { "item": [ { "text": "Fragestellung", "type": "string", "linkId": "reason.question", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.reasonCode.text" } ], "text": "Klinische Fragestellung", "type": "group", "linkId": "reason" }, { "item": [ { "text": "Art", "type": "choice", "linkId": "imagingService.type", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.code.coding:RdlxModType", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-modality-type" } ], "text": "Bildgebendes Verfahren", "type": "group", "linkId": "imagingService" }, { "item": [ { "text": "Region", "type": "choice", "linkId": "orderDetail.imagingRegion", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.orderDetail:imagingRegion", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-imaging-region" }, { "text": "Fokus", "type": "choice", "linkId": "orderDetail.imagingFocus", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.bodySite", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-imaging-focus" }, { "text": "Seitenangabe", "type": "choice", "linkId": "orderDetail.laterality", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.orderDetail:laterality", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-laterality" }, { "text": "Ansicht", "type": "choice", "linkId": "orderDetail.viewType", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.orderDetail:viewType", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-view-type" }, { "text": "Manöver", "type": "choice", "linkId": "orderDetail.maneuverType", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.orderDetail:maneuverType", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-maneuver-type" }, { "text": "Handlungsanleitung", "type": "choice", "linkId": "orderDetail.guidanceForAction", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.orderDetail:guidanceForAction", "enableWhen": [ { "operator": "=", "question": "requestedService.service", "answerCoding": { "code": "RadIntervention", "system": "http://fhir.ch/ig/ch-rad-order/CodeSystem/ch-rad-order-requested-service" } }, { "operator": "=", "question": "requestedService.service", "answerCoding": { "code": "ImagingRequestWithIntervention", "system": "http://fhir.ch/ig/ch-rad-order/CodeSystem/ch-rad-order-requested-service" } } ], "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-guidance-for-action", "enableBehavior": "any" } ], "text": "Weitere Angaben zur Bildgebung", "type": "group", "linkId": "orderDetail" }, { "item": [ { "text": "Name", "type": "string", "linkId": "desiredRadiologist.familyName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.family" }, { "text": "Vorname", "type": "string", "linkId": "desiredRadiologist.givenName", "definition": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner#Practitioner.name.given" } ], "text": "Gewünschter Radiologe für die Befundung / für die Intervention", "type": "group", "linkId": "desiredRadiologist", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.performer" }, { "item": [ { "text": "Hauptdiagnose", "type": "string", "linkId": "diagnosisList.primaryDiagnosis", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.reasonReference" }, { "text": "Nebendiagnose", "type": "string", "linkId": "diagnosisList.secondaryDiagnosis", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.supportingInfo:diagnosis" }, { "text": "Grösse (cm)", "type": "quantity", "linkId": "diagnosisList.bodyHeight", "repeats": false, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.supportingInfo:bodyHeight" }, { "text": "Gewicht (kg)", "type": "quantity", "linkId": "diagnosisList.bodyWeight", "repeats": false, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.supportingInfo:bodyWeight" } ], "text": "Diagnosen und Befunde", "type": "group", "linkId": "diagnosisList" }, { "item": [ { "item": [ { "item": [ { "text": "Wert (INR)", "type": "quantity", "linkId": "caveat.bloodCoagulation.INR.quantity", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-INR-observation#Observation.valueQuantity" }, { "text": "Zeitpunkt der Bestimmung", "type": "dateTime", "linkId": "caveat.bloodCoagulation.INR.dateTime", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-INR-observation#Observation.effectiveDateTime" } ], "text": "INR", "type": "group", "linkId": "caveat.bloodCoagulation.INR", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.evidence.detail", "enableWhen": [ { "operator": "=", "question": "caveat.bloodCoagulation", "answerBoolean": true } ] }, { "item": [ { "text": "Wert (10^3/µl)", "type": "quantity", "linkId": "caveat.bloodCoagulation.platelets.quantity", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-platelets-observation#Observation.valueQuantity" }, { "text": "Zeitpunkt der Bestimmung", "type": "dateTime", "linkId": "caveat.bloodCoagulation.platelets.dateTime", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-platelets-observation#Observation.effectiveDateTime" } ], "text": "Thrombozyten", "type": "group", "linkId": "caveat.bloodCoagulation.platelets", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.evidence.detail", "enableWhen": [ { "operator": "=", "question": "caveat.bloodCoagulation", "answerBoolean": true } ] } ], "text": "Beinträchtigte Blutgerinnung", "type": "boolean", "linkId": "caveat.bloodCoagulation", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "item": [ { "item": [ { "text": "Wert (ml/min)", "type": "quantity", "linkId": "caveat.renalInsufficiency.creatinineClearance.quantity", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-creatinineclearance-observation#Observation.valueQuantity" }, { "text": "Zeitpunkt der Bestimmung", "type": "dateTime", "linkId": "caveat.renalInsufficiency.creatinineClearance.dateTime", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-creatinineclearance-observation#Observation.effectiveDateTime" } ], "text": "Creatinin-Clearance", "type": "group", "linkId": "caveat.renalInsufficiency.creatinineClearance", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.evidence.detail", "enableWhen": [ { "operator": "=", "question": "caveat.renalInsufficiency", "answerBoolean": true } ] }, { "item": [ { "text": "Wert (µmol/l)", "type": "quantity", "linkId": "caveat.renalInsufficiency.creatinine.quantity", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-creatinine-observation#Observation.valueQuantity" }, { "text": "Zeitpunkt der Bestimmung", "type": "dateTime", "linkId": "caveat.renalInsufficiency.creatinine.dateTime", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-creatinine-observation#Observation.effectiveDateTime" } ], "text": "Creatinin", "type": "group", "linkId": "caveat.renalInsufficiency.creatinine", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.evidence.detail", "enableWhen": [ { "operator": "=", "question": "caveat.renalInsufficiency", "answerBoolean": true } ] } ], "text": "Niereninsuffizienz", "type": "boolean", "linkId": "caveat.renalInsufficiency", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "text": "Klaustrophobie", "type": "boolean", "linkId": "caveat.claustrophobia", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "text": "Körperpiercing", "type": "boolean", "linkId": "caveat.bodyPiercing", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "text": "Device (Herzschrittmacher, Herzklappenersatz, Insulinpumpe etc.)", "type": "choice", "linkId": "caveat.device", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-caveat-device" }, { "text": "Hyperthyreose", "type": "boolean", "linkId": "caveat.hyperthyroidism", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "text": "Diabetes mellitus", "type": "boolean", "linkId": "caveat.diabetes", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "text": "Schwangerschaft", "type": "boolean", "linkId": "caveat.gravida", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "text": "Kontrastmittelallergie", "type": "boolean", "linkId": "caveat.contrastMediaAllergy", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code" }, { "text": "Relevante Medikamente, z.B. Metformin", "type": "choice", "linkId": "caveat.drugPrescription", "repeats": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-caveat-condition#Condition.code", "answerValueSet": "http://fhir.ch/ig/ch-rad-order/ValueSet/ch-rad-order-caveat-substance" } ], "text": "Caveats", "type": "group", "linkId": "caveat", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.supportingInfo:caveats" }, { "item": [ { "item": [ { "text": "Dateiname und -endung der angehängten Datei (z.B. \"shoulder_re_F_Muster_12021988.pdf\")", "type": "string", "linkId": "previousResults.attachtment.title", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-media#Media.content.title" }, { "text": "Daten", "type": "string", "linkId": "previousResults.attachment.data", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-media#Media.content.data" } ], "text": "Anhang", "type": "group", "linkId": "previousResults.attachment", "repeats": true } ], "text": "Vorherige Untersuchungsresultate", "type": "group", "linkId": "previousResults", "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.supportingInfo:previousImagingResults" }, { "item": [ { "text": "Kommentar", "type": "string", "linkId": "note.text", "required": true, "definition": "http://fhir.ch/ig/ch-rad-order/StructureDefinition/ch-rad-order-servicerequest#ServiceRequest.note.text" } ], "text": "Bemerkungen", "type": "group", "linkId": "note", "repeats": true } ], "copyright": "CC-BY-SA-4.0", "type": null, "experimental": null, "resourceType": "Questionnaire", "title": "Questionnaire Radiology Order", "package_version": "0.1.0", "extension": [ { "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap", "valueCanonical": "http://fhir.ch/ig/ch-rad-order/StructureMap/RadOrderQrToBundle" }, { "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-sourceStructureMap", "valueCanonical": "http://fhir.ch/ig/ch-orf/StructureMap/OrfPrepopBundleToQr" }, { "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext", "extension": [ { "url": "name", "valueId": "Bundle" }, { "url": "type", "valueCode": "Bundle" }, { "url": "description", "valueString": "The Bundle that is to be used to pre-populate the form" } ] } ], "status": "active", "id": "67d5152a-5b99-424c-b4c3-b0a096b95a5b", "kind": null, "url": "http://fhir.ch/ig/ch-rad-order/Questionnaire/QuestionnaireRadiologyOrder", "version": "0.1.0", "contact": [ { "name": "Juerg P. Bleuer", "telecom": [ { "value": "https://www.hl7.ch", "system": "url" } ] } ] }