{
"description": null,
"_filename": "example/Questionnaire-questionnaire-sdc-profile-example-form-behavior.json",
"package_name": "hl7.fhir.uv.sdc",
"date": "2024-12-17T01:55:34+00:00",
"meta": {
"profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-behave" ]
},
"publisher": "HL7 International / FHIR Infrastructure",
"jurisdiction": [ {
"coding": [ {
"code": "001",
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"display": "World"
} ]
} ],
"name": "SDCAdvancedRenderingExample",
"item": [ {
"item": [ {
"text": "First Name",
"type": "string",
"linkId": "1.1",
"maxLength": 50
}, {
"text": "Last Name",
"type": "string",
"linkId": "1.2",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/minLength",
"valueInteger": 2
} ]
}, {
"text": "Postal Code (A1A 1A1)",
"type": "string",
"linkId": "1.3",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/targetConstraint",
"extension": [ {
"url": "key",
"valueId": "contraint-regex1"
}, {
"url": "severity",
"valueCode": "error"
}, {
"url": "expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%resource.repeat(item).where(linkId='1.3').answer.all(value.matches('[A-Z][0-9][A-Z] [0-9][A-Z][0-9]'))"
}
}, {
"url": "human",
"valueString": "Postal code must match syntax A1A 1A1."
} ]
} ]
}, {
"text": "Enter your weight in kg",
"type": "decimal",
"linkId": "1.4",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/minValue",
"valueDecimal": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueDecimal": 100
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxDecimalPlaces",
"valueInteger": 2
} ]
}, {
"text": "Body Weight",
"type": "quantity",
"linkId": "1.5",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/ucum-bodyweight"
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-minQuantity",
"valueQuantity": {
"code": "kg",
"value": 10,
"system": "http://unitsofmeasure.org"
}
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-maxQuantity",
"valueQuantity": {
"code": "kg",
"value": 100,
"system": "http://unitsofmeasure.org"
}
} ]
}, {
"text": "Attach Proof of Citizenship",
"type": "attachment",
"linkId": "1.6",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "image/jpeg"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/mimeType",
"valueCode": "application/pdf"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxSize",
"valueDecimal": 1048576
} ]
} ],
"text": "Value constraints",
"type": "group",
"linkId": "1"
}, {
"item": [ {
"text": "(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more.",
"type": "choice",
"linkId": "2.1",
"answerOption": [ {
"valueCoding": {
"code": "LA28397-0",
"system": "http://loinc.org",
"display": "Often true"
}
}, {
"valueCoding": {
"code": "LA6729-3",
"system": "http://loinc.org",
"display": "Sometimes true"
}
}, {
"valueCoding": {
"code": "LA28398-8",
"system": "http://loinc.org",
"display": "Never true"
}
}, {
"valueCoding": {
"code": "LA15775-2",
"system": "http://loinc.org",
"display": "Don't know/refused"
}
} ]
}, {
"text": "Activity Level",
"type": "choice",
"linkId": "2.3",
"answerValueSet": "http://loinc.org/vs/LL4882-8"
}, {
"text": "Applicable health conditions",
"type": "choice",
"linkId": "2.5",
"repeats": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression",
"extension": [ {
"url": "option",
"valueCoding": {
"code": "3",
"system": "http://example.org/CodeSystem/conditions"
}
}, {
"url": "expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.gender!='male'"
}
} ]
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression",
"extension": [ {
"url": "option",
"valueCoding": {
"code": "4",
"system": "http://example.org/CodeSystem/conditions"
}
}, {
"url": "expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.gender!='female'"
}
} ]
} ],
"answerValueSet": "#vsConditionsAll"
}, {
"text": "Email*",
"type": "string",
"linkId": "2.6",
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-keyboard",
"valueCoding": {
"code": "email",
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/keyboardType",
"display": "email"
}
} ]
}, {
"text": "Current Date:",
"type": "date",
"linkId": "2.7",
"readOnly": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "today()",
"description": "current date"
}
} ]
}, {
"type": "display",
"_text": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "'Please only enter data that has been validated as of ' + today()",
"description": "Substitute in current date"
}
} ]
},
"linkId": "2.7.1"
}, {
"text": "Heart History (check all that applies)",
"type": "open-choice",
"linkId": "2.8",
"repeats": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-openLabel",
"valueString": "Other event (specify)"
} ],
"answerOption": [ {
"valueCoding": {
"code": "U1",
"system": "http://example.org/CodeSystem/procedures",
"display": "Heart attack"
}
}, {
"valueCoding": {
"code": "U2",
"system": "http://example.org/CodeSystem/procedures",
"display": "Heart surgery"
}
}, {
"valueCoding": {
"code": "U3",
"system": "http://example.org/CodeSystem/procedures",
"display": "Cardiac catheterization"
}
}, {
"valueCoding": {
"code": "U4",
"system": "http://example.org/CodeSystem/procedures",
"display": "Coronary angioplasty (PTCA)"
}
}, {
"valueCoding": {
"code": "U5",
"system": "http://example.org/CodeSystem/procedures",
"display": "Cardiac pacemaker"
}
} ]
}, {
"text": "Heart History (check at least 2):",
"type": "choice",
"linkId": "2.9",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 2
} ],
"answerOption": [ {
"valueCoding": {
"code": "U1",
"system": "http://example.org/CodeSystem/procedures",
"display": "Heart attack"
}
}, {
"valueCoding": {
"code": "U2",
"system": "http://example.org/CodeSystem/procedures",
"display": "Heart surgery"
}
}, {
"valueCoding": {
"code": "U3",
"system": "http://example.org/CodeSystem/procedures",
"display": "Cardiac catheterization"
}
}, {
"valueCoding": {
"code": "U4",
"system": "http://example.org/CodeSystem/procedures",
"display": "Coronary angioplasty (PTCA)"
}
}, {
"valueCoding": {
"code": "U5",
"system": "http://example.org/CodeSystem/procedures",
"display": "Cardiac pacemaker"
}
} ]
}, {
"text": "Heart History (check no more than 3):",
"type": "choice",
"linkId": "2.10",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 3
} ],
"answerOption": [ {
"valueCoding": {
"code": "U1",
"system": "http://example.org/CodeSystem/procedures",
"display": "Heart attack"
}
}, {
"valueCoding": {
"code": "U2",
"system": "http://example.org/CodeSystem/procedures",
"display": "Heart surgery"
}
}, {
"valueCoding": {
"code": "U3",
"system": "http://example.org/CodeSystem/procedures",
"display": "Cardiac catheterization"
}
}, {
"valueCoding": {
"code": "U4",
"system": "http://example.org/CodeSystem/procedures",
"display": "Coronary angioplasty (PTCA)"
}
}, {
"valueCoding": {
"code": "U5",
"system": "http://example.org/CodeSystem/procedures",
"display": "Cardiac pacemaker"
}
} ]
}, {
"text": "What treatments do you now have for heart disease? (select all that applies)",
"type": "choice",
"linkId": "2.11",
"repeats": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "check-box",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Check-box"
} ]
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "noTreatment",
"system": "http://example.org/CodeSystem/treatments",
"display": "NoTreatment"
}
}, {
"valueCoding": {
"code": "aspirin",
"system": "http://example.org/CodeSystem/treatments",
"display": "Aspirin"
}
}, {
"valueCoding": {
"code": "otherMeds",
"system": "http://example.org/CodeSystem/treatments",
"display": "Other medicines, tablets, or pills"
}
}, {
"valueCoding": {
"code": "diet",
"system": "http://example.org/CodeSystem/treatments",
"display": "Diet"
}
}, {
"valueCoding": {
"code": "exercise",
"system": "http://example.org/CodeSystem/treatments",
"display": "Exercise"
}
}, {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-optionExclusive",
"valueBoolean": true
} ],
"valueCoding": {
"code": "none",
"system": "http://example.org/CodeSystem/treatments",
"display": "None of the above"
}
} ]
}, {
"text": "Dosage",
"type": "quantity",
"linkId": "2.12",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding": {
"code": "mL",
"system": "http://unitsofmeasure.org",
"display": "mL"
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding": {
"code": "L",
"system": "http://unitsofmeasure.org",
"display": "L"
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding": {
"code": "g",
"system": "http://unitsofmeasure.org",
"display": "g"
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitOption",
"valueCoding": {
"code": "mg",
"system": "http://unitsofmeasure.org",
"display": "mg"
}
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitOpen",
"valueCode": "optionsOrType"
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-unitSupplementalSystem",
"valueCanonical": "http://example.org/SomeUnitCodeSystem"
} ]
}, {
"text": "Specify age:",
"type": "quantity",
"linkId": "2.13",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unitValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/age-units"
} ]
}, {
"text": "Select your preferred practitioner:",
"type": "reference",
"linkId": "2.14",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode": "Practitioner"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile",
"valueCanonical": "http://example.org/fhir/StructureDefinition/my-practitioner"
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-lookupQuestionnaire",
"valueCanonical": "http://example.org/Questionnaire/1234"
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Practitioner?active=true&_sort=family,given",
"description": "all active practitioners"
}
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn",
"extension": [ {
"url": "path",
"valueString": "name.where(use='official').family + ', ' + name.where(use='official').given.first()"
}, {
"url": "forDisplay",
"valueBoolean": true
} ]
} ]
} ],
"text": "Value constraints",
"type": "group",
"linkId": "2"
}, {
"item": [ {
"text": "Deadline for submission (7 days from now)",
"type": "date",
"linkId": "3.1",
"readOnly": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "today() + 7 days",
"description": "deadline for submission"
}
} ]
}, {
"item": [ {
"text": "Last Name:",
"type": "string",
"linkId": "3.2.1",
"readOnly": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.name.where(use='official').given.first()",
"description": "patient's last name"
}
} ]
}, {
"text": "First Name:",
"type": "string",
"linkId": "3.2.2",
"readOnly": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.name.where(use='official').family",
"description": "patient's first name"
}
} ]
}, {
"text": "Gender:",
"type": "string",
"linkId": "3.2.3",
"readOnly": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.gender",
"description": "patient's gender"
}
} ]
} ],
"type": "group",
"linkId": "3.2"
}, {
"item": [ {
"text": "Weight (kg)",
"type": "decimal",
"linkId": "3.3.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"code": "kg",
"system": "http://unitsofmeasure.org"
}
} ]
}, {
"text": "Body Height (inches)",
"type": "decimal",
"linkId": "3.3.2",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
"valueCoding": {
"code": "[in_i]",
"system": "http://unitsofmeasure.org"
}
} ]
}, {
"text": "Your Body Mass Index (BMI)",
"type": "decimal",
"linkId": "3.3.3",
"readOnly": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "(%weight/(%height.power(2))).round(1)",
"description": "BMI Calculation"
}
} ]
} ],
"text": "Calculated Expression",
"type": "group",
"linkId": "3.3"
}, {
"item": [ {
"text": "Enter weight in kg",
"type": "decimal",
"linkId": "3.4.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/minValue",
"valueDecimal": 1,
"_valueDecimal": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
"valueExpression": {
"language": "text/fhirpath",
"expression": "min_weight"
}
} ]
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/maxValue",
"valueDecimal": 100,
"_valueDecimal": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/cqf-calculatedValue",
"valueExpression": {
"language": "text/fhirpath",
"expression": "max_weight"
}
} ]
}
} ]
}, {
"text": "Enter email address",
"type": "string",
"linkId": "3.4.2",
"required": false,
"_required": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%patient.active",
"description": "current date"
}
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-keyboard",
"valueCoding": {
"code": "email",
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/keyboardType",
"display": "email"
}
} ]
} ],
"text": "CQF-related Example",
"type": "group",
"linkId": "3.4"
}, {
"type": "display",
"_text": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "'Your last immunization was on '+ %Immunization.occurrenceDateTime.substring(0,10) + '.'",
"description": "last immunization date"
}
} ]
},
"linkId": "3.5"
} ],
"text": "Calculation",
"type": "group",
"linkId": "3"
}, {
"item": [ {
"text": "Marital Status",
"type": "choice",
"linkId": "4.1",
"initial": [ {
"valueCoding": {
"code": "D",
"system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
"display": "Divorced"
}
} ],
"answerValueSet": "http://hl7.org/fhir/ValueSet/marital-status"
}, {
"item": [ {
"text": "Choose Gender",
"type": "choice",
"linkId": "4.2.1",
"answerValueSet": "http://hl7.org/fhir/ValueSet/administrative-gender"
}, {
"text": "Are you pregnant? (enableWhen = gender is Female, disableDisplay=protected)",
"type": "choice",
"linkId": "4.2.2",
"extension": [ {
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.disabledDisplay",
"valueCode": "protected"
} ],
"enableWhen": [ {
"operator": "=",
"question": "4.2.1",
"answerCoding": {
"code": "female",
"system": "http://hl7.org/fhir/administrative-gender"
}
} ],
"answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow"
}, {
"text": "Are you diabetic? (enableWhen = gender is Female, disableDisplay=hidden)",
"type": "choice",
"linkId": "4.2.3",
"extension": [ {
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.disabledDisplay",
"valueCode": "hidden"
} ],
"enableWhen": [ {
"operator": "=",
"question": "4.2.1",
"answerCoding": {
"code": "female",
"system": "http://hl7.org/fhir/administrative-gender"
}
} ],
"answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow"
}, {
"text": "Have you been diagnosed with Gestational Diabetes? (enableBehavior = only when pregnant and diabetic, disableDisplay=protected)",
"type": "choice",
"linkId": "4.2.4",
"extension": [ {
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.item.disabledDisplay",
"valueCode": "protected"
} ],
"enableWhen": [ {
"operator": "=",
"question": "4.2.2",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0136"
}
}, {
"operator": "=",
"question": "4.2.3",
"answerCoding": {
"code": "Y",
"system": "http://terminology.hl7.org/CodeSystem/v2-0136"
}
} ],
"answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow",
"enableBehavior": "all"
}, {
"text": "Enter your birthdate (MM/DD/YYYY)",
"type": "date",
"linkId": "4.2.5",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/entryFormat",
"valueString": "MM/DD/YYYY"
} ],
"answerValueSet": "http://hl7.org/fhir/ValueSet/administrative-gender"
}, {
"text": "Have you had mammogram before?(enableWhenExpression = only when gender is female and age > 40, disableDisplay=protected)",
"type": "choice",
"linkId": "4.2.6",
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%resource.repeat(item).where(linkId='4.2.b.1').answer.value.code ='female' and today().toString().substring(0, 4).toInteger() - %resource.repeat(item).where(linkId='4.2.b.5').answer.value.toString().substring(0, 4).toInteger() >= 40",
"description": "if last 2 questions were answered"
}
} ],
"answerValueSet": "http://hl7.org/fhir/ValueSet/yesnodontknow"
} ],
"type": "group",
"linkId": "4.2"
}, {
"text": "Signature of Patient",
"type": "attachment",
"linkId": "4.4",
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired",
"valueCodeableConcept": {
"text": "the signature of a witness to any other signature.",
"coding": [ {
"code": "1.2.840.10065.1.12.1.8",
"system": "urn:iso-astm:E1762-95:2013",
"display": "Signature Witness Signature"
} ]
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-usageMode",
"valueCode": "capture"
} ]
}, {
"text": "All the practitioners below can speak the patient's language. Choose all preferred practioners:",
"type": "reference",
"linkId": "4.5",
"repeats": true,
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-candidateExpression",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Practitioner?communication=&active=true",
"description": "active practitioners that speak at least one of the patient's language"
}
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn",
"extension": [ {
"url": "path",
"valueString": "name.first().family"
}, {
"url": "label",
"valueString": "LAST NAME"
}, {
"url": "width",
"valueQuantity": {
"code": "%",
"value": 40,
"system": "http://unitsofmeasure.org"
}
}, {
"url": "forDisplay",
"valueBoolean": true
} ]
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn",
"extension": [ {
"url": "path",
"valueString": "name.first().given.first()"
}, {
"url": "label",
"valueString": "FIRST NAME"
}, {
"url": "width",
"valueQuantity": {
"code": "%",
"value": 40,
"system": "http://unitsofmeasure.org"
}
}, {
"url": "forDisplay",
"valueBoolean": true
} ]
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-choiceColumn",
"extension": [ {
"url": "path",
"valueString": "gender"
}, {
"url": "label",
"valueString": "GENDER"
}, {
"url": "width",
"valueQuantity": {
"code": "%",
"value": 20,
"system": "http://unitsofmeasure.org"
}
}, {
"url": "forDisplay",
"valueBoolean": false
} ]
} ]
}, {
"item": [ {
"text": "Home Address",
"type": "display",
"linkId": "4.6.1"
}, {
"text": "Address",
"type": "string",
"linkId": "4.6.2",
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%homeAddress.line.first()",
"description": "Address Line 1"
}
} ],
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.line"
}, {
"text": "City",
"type": "string",
"linkId": "4.6.3",
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%homeAddress.city",
"description": "City"
}
} ],
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.city"
}, {
"text": "Province",
"type": "choice",
"linkId": "4.6.4",
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%homeAddress.state",
"description": "State"
}
} ],
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.state",
"answerOption": [ {
"valueCoding": {
"code": "Alberta",
"system": "http://example.org/CodeSystem/provinces",
"display": "Alberta"
}
}, {
"valueCoding": {
"code": "BritishColumbia",
"system": "http://example.org/CodeSystem/provinces",
"display": "British Columbia"
}
}, {
"valueCoding": {
"code": "Manitoba",
"system": "http://example.org/CodeSystem/provinces",
"display": "Manitoba"
}
}, {
"valueCoding": {
"code": "NewBrunswick",
"system": "http://example.org/CodeSystem/provinces",
"display": "New Brunswick"
}
}, {
"valueCoding": {
"code": "NewfoundlandAndLabrador",
"system": "http://example.org/CodeSystem/provinces",
"display": "Newfoundland and Labrador"
}
}, {
"valueCoding": {
"code": "NovaScotia",
"system": "http://example.org/CodeSystem/provinces",
"display": "Nova Scotia"
}
}, {
"valueCoding": {
"code": "Ontario",
"system": "http://example.org/CodeSystem/provinces",
"display": "Ontario"
}
}, {
"valueCoding": {
"code": "PrinceEdwardIsland",
"system": "http://example.org/CodeSystem/provinces",
"display": "Prince Edward Island"
}
}, {
"valueCoding": {
"code": "Quebec",
"system": "http://example.org/CodeSystem/provinces",
"display": "Quebec"
}
}, {
"valueCoding": {
"code": "Saskatchewan",
"system": "http://example.org/CodeSystem/provinces",
"display": "Saskatchewan"
}
} ]
}, {
"text": "Postal Code",
"type": "string",
"linkId": "4.6.5",
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "%homeAddress.postalCode",
"description": "Postal Code"
}
} ],
"definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.postalCode"
} ],
"type": "group",
"linkId": "4.6",
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemPopulationContext",
"valueExpression": {
"name": "homeAddress",
"language": "text/fhirpath",
"expression": "%patient.address.where(use='home').first()",
"description": "Home address of the patient"
}
} ]
} ],
"text": "Other Controls",
"type": "group",
"linkId": "4"
} ],
"type": null,
"experimental": null,
"resourceType": "Questionnaire",
"title": null,
"package_version": "4.0.0-ballot",
"extension": [ {
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]",
"valueCoding": {
"code": "semver",
"system": "http://hl7.org/fhir/version-algorithm"
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "weight",
"language": "text/fhirpath",
"expression": "%resource.repeat(item).where(linkId='3.3.1').item.answer.value"
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/variable",
"valueExpression": {
"name": "height",
"language": "text/fhirpath",
"expression": "%resource.repeat(item).where(linkId='3.3.2').item.answer.value*0.0254"
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/cqf-library",
"valueCanonical": "http://example.org/Library/MeasurementLimits"
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext",
"extension": [ {
"url": "name",
"valueCoding": {
"code": "patient",
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext",
"display": "Patient"
}
}, {
"url": "type",
"valueCode": "Patient"
}, {
"url": "description",
"valueString": "The patient that is to be used to pre-populate the form"
} ]
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-endpoint",
"valueUri": "http://example.org/QuestionnaireResponse/create"
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode",
"valueCode": "sequential"
} ],
"status": "active",
"id": "7e195d35-742d-43fc-9ee1-5d66ae0ab90a",
"kind": null,
"url": "http://build.fhir.org/ig/HL7/sdc/questionnaire-sdc-profile-example-form-behavior",
"identifier": [ {
"value": "urn:oid:2.16.840.1.113883.4.642.40.17.35.9",
"system": "urn:ietf:rfc:3986"
} ],
"version": "4.0.0-ballot",
"contact": [ {
"name": "HL7 International / FHIR Infrastructure",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/fiwg",
"system": "url"
} ]
}, {
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/fiwg",
"system": "url"
} ]
} ],
"modifierExtension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-rendering-criticalExtension",
"valueCanonical": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-entryMode"
}, {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-rendering-criticalExtension",
"valueCanonical": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerOptionsToggleExpression"
} ]
}