{
  "description": "Constrained version of FHIR QuestionnaireResponse resource to facilitate Supported Hospital Discharges (SHD) to Social Care. The Supported Hospital Discharge API enables full digitisation of the process for safely discharging Patients where Social Care intervention may be required.",
  "_filename": "SHD-QuestionnaireResponse-AdditionalPatientInformation.StructureDefinition.json",
  "package_name": "supportedhospitaldischarge.stu3",
  "date": "2020-02-17T16:04:37.8379172+00:00",
  "derivation": "constraint",
  "meta": {
    "lastUpdated": "2021-04-22T06:31:46.230+00:00"
  },
  "publisher": null,
  "fhirVersion": "3.0.2",
  "purpose": "The SHD-QuestionnaireResponse-AdditionalPatientInformation resource can be used to share additional information about a patient that is pertinent to a supported hospital discharge",
  "name": "SHD-QuestionnaireResponse-AdditionalPatientInformation",
  "abstract": false,
  "copyright": "Copyright © Nottinghamshire County Council 2020",
  "type": "QuestionnaireResponse",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "0.1.3",
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-1",
        "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
        "xpath": "not(parent::f:contained and f:text)",
        "severity": "error",
        "expression": "contained.text.empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-3",
        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
        "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
        "severity": "error",
        "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()"
      } ],
      "path": "QuestionnaireResponse",
      "min": 0,
      "definition": "This QuestionnaireResponse contains additional patient information relating to a Supported Hospital Discharge. \r\nThe QuestionnaireResponse will always be contained/referenced in the initial ReferralRequest",
      "short": "Additional Patient Information",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Observation[moodCode=EVN]",
        "identity": "rim"
      }, {
        "map": "infrastructure.information",
        "identity": "w5"
      } ],
      "alias": [ "Form", "QuestionnaireAnswers" ],
      "max": "*",
      "id": "QuestionnaireResponse",
      "comment": "The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on.  I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Resource"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "short": "Logical id of this artifact",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.id",
      "condition": [ "ele-1" ],
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.meta",
      "min": 0,
      "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
      "short": "Metadata about the resource",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Meta"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.meta",
      "condition": [ "ele-1" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.implicitRules",
      "min": 0,
      "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.implicitRules",
      "condition": [ "ele-1" ],
      "comment": "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "short": "Language of the resource content",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueReference": {
            "reference": "http://hl7.org/fhir/ValueSet/all-languages"
          }
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/languages"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.language",
      "condition": [ "ele-1" ],
      "comment": "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).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.text",
      "min": 0,
      "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "QuestionnaireResponse.text",
      "condition": [ "ele-1", "dom-1" ],
      "comment": "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 in formation is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      }
    }, {
      "path": "QuestionnaireResponse.contained",
      "min": 0,
      "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "QuestionnaireResponse.contained",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.identifier",
      "requirements": "Used for tracking, registration and other business purposes.",
      "min": 0,
      "definition": "A business identifier assigned to a particular completed (or partially completed) questionnaire.",
      "short": "Unique id for this set of answers",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)",
        "identity": "v2"
      }, {
        "map": "II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]",
        "identity": "rim"
      }, {
        "map": "Identifier",
        "identity": "servd"
      }, {
        "map": ".id",
        "identity": "rim"
      }, {
        "map": "id",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.identifier",
      "condition": [ "ele-1" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.basedOn",
      "requirements": "Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon.",
      "min": 0,
      "definition": "The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.  For example, a ProcedureRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression.",
      "short": "Request fulfilled by this QuestionnaireResponse",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=FLFS].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
      } ],
      "alias": [ "order" ],
      "max": "*",
      "id": "QuestionnaireResponse.basedOn",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.basedOn"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.parent",
      "min": 0,
      "definition": "A procedure or observation that this questionnaire was performed as part of the execution of.  For example, the surgery a checklist was executed as part of.",
      "short": "Part of this action",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".inboundRelationship[typeCode=COMP].source[moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
      } ],
      "max": "*",
      "id": "QuestionnaireResponse.parent",
      "condition": [ "ele-1" ],
      "comment": "Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire.  For relationships to referrals, and other types of requests, use basedOn.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.parent"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.questionnaire",
      "requirements": "Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form.",
      "min": 1,
      "definition": "See https://simplifier.net/social-health-care-interoperability/shd-questionnaire-additionalpatientinformation for copy of template",
      "short": "Form being answered",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Questionnaire"
      } ],
      "mustSupport": true,
      "alias": [ "Form" ],
      "max": "1",
      "id": "QuestionnaireResponse.questionnaire",
      "condition": [ "ele-1" ],
      "comment": "If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.questionnaire"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.questionnaire.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.questionnaire.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.questionnaire.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.questionnaire.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.questionnaire.reference",
      "min": 1,
      "definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
      "short": "Literal reference, Relative, internal or absolute URL",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "https://fhir.nottinghamshire.gov.uk/STU3/Questionnaire/SHD-Questionnaire-AdditionalPatientInformation",
      "id": "QuestionnaireResponse.questionnaire.reference",
      "condition": [ "ele-1", "ref-1" ],
      "comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.reference"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.questionnaire.identifier",
      "min": 0,
      "definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
      "short": "Logical reference, when literal reference is not known",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)",
        "identity": "v2"
      }, {
        "map": "II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]",
        "identity": "rim"
      }, {
        "map": "Identifier",
        "identity": "servd"
      }, {
        "map": ".identifier",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.questionnaire.identifier",
      "condition": [ "ele-1" ],
      "comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.questionnaire.display",
      "min": 0,
      "definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
      "short": "Text alternative for the resource",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.questionnaire.display",
      "condition": [ "ele-1" ],
      "comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Reference.display"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.status",
      "fixedCode": "completed",
      "requirements": "The information on Questionnaire resources  may possibly be gathered during multiple sessions and altered after considered being finished.",
      "min": 1,
      "definition": "The position of the questionnaire response within its overall lifecycle.",
      "isModifier": true,
      "short": "in-progress | completed | amended | entered-in-error | stopped",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".statusCode (also whether there's a revisionControlAct - and possibly mood to distinguish \"in-progress\" from \"published)",
        "identity": "rim"
      }, {
        "map": "status",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireResponseStatus"
        } ],
        "description": "Lifecycle status of the questionnaire response.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers-status"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.status",
      "condition": [ "ele-1" ],
      "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.status"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.subject",
      "requirements": "Allows linking the answers to the individual the answers describe.  May also affect access control.",
      "min": 0,
      "definition": "The subject of the questionnaire response.  This could be a patient, organization, practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily the source of information.",
      "short": "The subject of the questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role",
        "identity": "rim"
      }, {
        "map": "who.focus",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "alias": [ "Patient", "Focus" ],
      "max": "1",
      "id": "QuestionnaireResponse.subject",
      "condition": [ "ele-1" ],
      "comment": "If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.subject"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.context",
      "requirements": "Provides context for the information that was captured.  May also affect access control.",
      "min": 0,
      "definition": "The encounter or episode of care with primary association to the questionnaire response.",
      "short": "Encounter or Episode during which questionnaire was completed",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]",
        "identity": "rim"
      }, {
        "map": "context",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.context",
      "condition": [ "ele-1" ],
      "comment": "A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.context"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.authored",
      "requirements": "Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers.",
      "min": 0,
      "definition": "The date and/or time that this set of answers were last changed.",
      "short": "Date the answers were gathered",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=AUT].time",
        "identity": "rim"
      }, {
        "map": "when.recorded",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "alias": [ "Date Created", "Date published", "Date Issued", "Date updated" ],
      "max": "1",
      "id": "QuestionnaireResponse.authored",
      "condition": [ "ele-1" ],
      "comment": "May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.\n\nThis element is optional to allow for systems that may not know the value, however it SHOULD be populated if possible.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.authored"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.author",
      "requirements": "Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers.",
      "min": 0,
      "definition": "Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system.",
      "short": "Person who received and recorded the answers",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=AUT].role",
        "identity": "rim"
      }, {
        "map": "who.author",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
      } ],
      "alias": [ "Laboratory", "Service", "Practitioner", "Department", "Company", "Performer" ],
      "max": "1",
      "id": "QuestionnaireResponse.author",
      "condition": [ "ele-1" ],
      "comment": "Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation.  Authoring by device would indicate that some portion of the questionnaire had been auto-populated.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.author"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.source",
      "requirements": "When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions.",
      "min": 0,
      "definition": "The person who answered the questions about the subject.",
      "short": "The person who answered the questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=INF].role",
        "identity": "rim"
      }, {
        "map": "who.source",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.source",
      "condition": [ "ele-1" ],
      "comment": "If not specified, no inference can be made about who provided the data.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.source"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "See https://simplifier.net/social-health-care-interoperability/shd-questionnaire-additionalpatientinformation for copy of Questionnaire template",
        "discriminator": [ {
          "path": "linkId",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "QuestionnaireResponse.item",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 0,
      "definition": "Text that is displayed above the contents of the group or as the text of the question being answered.",
      "short": "Name for group or question text",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 0,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "QuestionnaireResponse.item.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.value[x]",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 0,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      }, {
        "code": "decimal"
      }, {
        "code": "integer"
      }, {
        "code": "date"
      }, {
        "code": "dateTime"
      }, {
        "code": "time"
      }, {
        "code": "string"
      }, {
        "code": "uri"
      }, {
        "code": "Attachment"
      }, {
        "code": "Coding"
      }, {
        "code": "Quantity"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item.answer.value[x]",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "*",
      "id": "QuestionnaireResponse.item.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "*",
      "id": "QuestionnaireResponse.item.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "livesAlone",
      "max": "1",
      "id": "QuestionnaireResponse.item:livesAlone",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:livesAlone.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:livesAlone.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:livesAlone.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "1.1",
      "id": "QuestionnaireResponse.item:livesAlone.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:livesAlone.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 1,
      "definition": "Text that is displayed above the contents of the group or as the text of the question being answered.",
      "short": "Name for group or question text",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "Does the patient live alone?",
      "id": "QuestionnaireResponse.item:livesAlone.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:livesAlone.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 1,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item:livesAlone.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:livesAlone.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:livesAlone.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:livesAlone.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 1,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "sliceName": "valueBoolean",
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item:livesAlone.answer.value[x]:valueBoolean",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:livesAlone.answer.value[x]:valueBoolean.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:livesAlone.answer.value[x]:valueBoolean.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.valueBoolean.value",
      "min": 0,
      "definition": "Primitive value for boolean",
      "short": "Primitive value for boolean",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "boolean"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:boolean"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:boolean"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item:livesAlone.answer.value[x]:valueBoolean.value",
      "base": {
        "max": "1",
        "min": 0,
        "path": "boolean.value"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:livesAlone.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:livesAlone.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "keySafe",
      "max": "1",
      "id": "QuestionnaireResponse.item:keySafe",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:keySafe.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:keySafe.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:keySafe.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "1.2",
      "id": "QuestionnaireResponse.item:keySafe.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:keySafe.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 1,
      "definition": "Text that is displayed above the contents of the group or as the text of the question being answered.",
      "short": "Name for group or question text",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "Does the patient have a Key Safe?",
      "id": "QuestionnaireResponse.item:keySafe.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:keySafe.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 1,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item:keySafe.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:keySafe.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:keySafe.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:keySafe.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 1,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "sliceName": "valueBoolean",
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item:keySafe.answer.value[x]:valueBoolean",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:keySafe.answer.value[x]:valueBoolean.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:keySafe.answer.value[x]:valueBoolean.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.valueBoolean.value",
      "min": 0,
      "definition": "Primitive value for boolean",
      "short": "Primitive value for boolean",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "boolean"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:boolean"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:boolean"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item:keySafe.answer.value[x]:valueBoolean.value",
      "base": {
        "max": "1",
        "min": 0,
        "path": "boolean.value"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:keySafe.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:keySafe.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "accommodationType",
      "max": "1",
      "id": "QuestionnaireResponse.item:accommodationType",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationType.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationType.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationType.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "1.3",
      "id": "QuestionnaireResponse.item:accommodationType.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationType.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 1,
      "definition": "accommodation Type will provide social care teams with additional contextual infomation helping them identify the most appropriate interventions for the individual",
      "short": "e.g. House | Flat | Bungalow | Residential Home",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "What type of accommodation does the patient live in",
      "id": "QuestionnaireResponse.item:accommodationType.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationType.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 1,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item:accommodationType.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationType.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationType.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationType.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 1,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item:accommodationType.answer.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationType.answer.value[x]:valueString.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationType.answer.value[x]:valueString.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.valueString.value",
      "min": 0,
      "definition": "Primitive value for string",
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item:accommodationType.answer.value[x]:valueString.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationType.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationType.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "accommodationSubType",
      "max": "1",
      "id": "QuestionnaireResponse.item:accommodationSubType",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationSubType.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationSubType.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationSubType.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "1.4",
      "id": "QuestionnaireResponse.item:accommodationSubType.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationSubType.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 1,
      "definition": "Additional infomationtion about the patients accommodation, for example floor number if they live in a flat.",
      "short": "Additional accommodation details (e.g. floor number if a flat)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "Additional accommodation details (e.g. floor number if a flat)",
      "id": "QuestionnaireResponse.item:accommodationSubType.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationSubType.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 1,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item:accommodationSubType.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 1,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:accommodationSubType.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "tenureType",
      "max": "1",
      "id": "QuestionnaireResponse.item:tenureType",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:tenureType.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:tenureType.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:tenureType.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "1.5",
      "id": "QuestionnaireResponse.item:tenureType.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:tenureType.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 1,
      "definition": "TenureType will provide social care teams with additional contextual infomation helping them identify the most appropriate interventions for the individual",
      "short": "e.g. Owner Occupoed | Private Rented | Council Rented | Housing Association | etc",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "What type of tenure is the patient's accommodation",
      "id": "QuestionnaireResponse.item:tenureType.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:tenureType.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 1,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item:tenureType.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:tenureType.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:tenureType.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:tenureType.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 1,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item:tenureType.answer.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:tenureType.answer.value[x]:valueString.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:tenureType.answer.value[x]:valueString.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.valueString.value",
      "min": 0,
      "definition": "Primitive value for string",
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item:tenureType.answer.value[x]:valueString.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:tenureType.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:tenureType.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "safegaurdingIndicator",
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "2.1",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 1,
      "definition": "Text that is displayed above the contents of the group or as the text of the question being answered.",
      "short": "Name for group or question text",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "Are there any Safeguarding Concerns associated with the patient?",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 1,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 1,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "sliceName": "valueBoolean",
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.value[x]:valueBoolean",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.value[x]:valueBoolean.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueBoolean.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.value[x]:valueBoolean.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.valueBoolean.value",
      "min": 0,
      "definition": "Primitive value for boolean",
      "short": "Primitive value for boolean",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "boolean"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:boolean"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:boolean"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.value[x]:valueBoolean.value",
      "base": {
        "max": "1",
        "min": 0,
        "path": "boolean.value"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "qrs-1",
        "human": "Nested item can't be beneath both item and answer",
        "xpath": "not(exists(f:answer) and exists(f:item))",
        "severity": "error",
        "expression": "(answer.exists() and item.exists()).not()"
      } ],
      "path": "QuestionnaireResponse.item",
      "min": 0,
      "definition": "A group or question item from the original questionnaire for which answers are provided.",
      "short": "Groups and questions",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "safegaurdingDetails",
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingDetails",
      "condition": [ "ele-1" ],
      "comment": "Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.linkId",
      "requirements": "Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier.",
      "min": 1,
      "definition": "The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource.",
      "short": "Pointer to specific item from Questionnaire",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "2.2",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.linkId",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "QuestionnaireResponse.item.linkId"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.definition",
      "requirements": "A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition.",
      "min": 0,
      "definition": "A reference to an [ElementDefinition](elementdefinition.html) that provides the details for the item.",
      "short": "ElementDefinition - details for the item",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.definition",
      "condition": [ "ele-1" ],
      "comment": "The ElementDefinition must be in a [StructureDefinition](structuredefinition.html) or a [DataElement](dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].\n\nThere is no need for this element if the item pointed to by the linkId has a definition listed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.definition"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.text",
      "requirements": "Allows the questionnaire response to be read without access to the questionnaire.",
      "min": 1,
      "definition": "Text that is displayed above the contents of the group or as the text of the question being answered.",
      "short": "Name for group or question text",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".text",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "fixedString": "If Safeguarding Concerns have been identified, please provide further relevant details of these",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.text",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.text"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "QuestionnaireResponse.item.subject",
      "requirements": "Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient's care or record, e.g. a specific Problem, RelatedPerson, Allergy etc.",
      "min": 0,
      "definition": "More specific subject this section's answers are about, details the subject given in QuestionnaireResponse.",
      "short": "The subject this group's answers are about",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
      } ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.subject"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer",
      "min": 1,
      "definition": "The respondent's answer(s) to the question.",
      "short": "The response(s) to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".value[type=LIST_ANY]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer",
      "condition": [ "ele-1" ],
      "comment": "The value is nested because we cannot have a repeating structure that has variable type.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString",
      "requirements": "Ability to retain a single-valued answer to a question.",
      "min": 1,
      "definition": "The answer (or one of the answers) provided by the respondent to the question.",
      "short": "Single-valued answer to the question",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".item",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "QuestionnaireAnswer"
        } ],
        "description": "Code indicating the response provided for a question.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/questionnaire-answers"
        }
      },
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.value[x]:valueString.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "QuestionnaireResponse.item.answer.valueString.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.value[x]:valueString.extension",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.valueString.value",
      "min": 0,
      "definition": "Primitive value for string",
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.value[x]:valueString.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      }
    }, {
      "path": "QuestionnaireResponse.item.answer.item",
      "requirements": "It is useful to have \"sub-questions\", questions which normally appear when certain answers are given and which collect additional details.",
      "min": 0,
      "definition": "Nested groups and/or questions found within this particular answer.",
      "short": "Nested groups and questions",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.answer.item"
      }
    }, {
      "path": "QuestionnaireResponse.item.item",
      "requirements": "Reports can consist of complex nested groups.",
      "min": 0,
      "definition": "Questions or sub-groups nested beneath a question or group.",
      "short": "Nested questionnaire response items",
      "mapping": [ {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#QuestionnaireResponse.item",
      "max": "0",
      "id": "QuestionnaireResponse.item:safegaurdingDetails.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "QuestionnaireResponse.item.item"
      }
    } ]
  },
  "status": "retired",
  "id": "8154b382-a8b8-4ca0-9470-ecd3de9c9dd9",
  "kind": "resource",
  "url": "https://fhir.nottinghamshire.gov.uk/STU3/StructureDefinition/SHD-QuestionnaireResponse-AdditionalPatientInformation",
  "version": "0.0.1",
  "differential": {
    "element": [ {
      "id": "QuestionnaireResponse",
      "path": "QuestionnaireResponse",
      "short": "Additional Patient Information",
      "definition": "This QuestionnaireResponse contains additional patient information relating to a Supported Hospital Discharge. \r\nThe QuestionnaireResponse will always be contained/referenced in the initial ReferralRequest"
    }, {
      "id": "QuestionnaireResponse.questionnaire",
      "min": 1,
      "path": "QuestionnaireResponse.questionnaire",
      "definition": "See https://simplifier.net/social-health-care-interoperability/shd-questionnaire-additionalpatientinformation for copy of template",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.questionnaire.id",
      "max": "0",
      "path": "QuestionnaireResponse.questionnaire.id"
    }, {
      "id": "QuestionnaireResponse.questionnaire.reference",
      "min": 1,
      "path": "QuestionnaireResponse.questionnaire.reference",
      "fixedString": "https://fhir.nottinghamshire.gov.uk/STU3/Questionnaire/SHD-Questionnaire-AdditionalPatientInformation"
    }, {
      "id": "QuestionnaireResponse.questionnaire.identifier",
      "max": "0",
      "path": "QuestionnaireResponse.questionnaire.identifier"
    }, {
      "id": "QuestionnaireResponse.questionnaire.display",
      "max": "0",
      "path": "QuestionnaireResponse.questionnaire.display"
    }, {
      "id": "QuestionnaireResponse.status",
      "path": "QuestionnaireResponse.status",
      "fixedCode": "completed",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item",
      "path": "QuestionnaireResponse.item",
      "slicing": {
        "rules": "open",
        "description": "See https://simplifier.net/social-health-care-interoperability/shd-questionnaire-additionalpatientinformation for copy of Questionnaire template",
        "discriminator": [ {
          "path": "linkId",
          "type": "value"
        } ]
      }
    }, {
      "id": "QuestionnaireResponse.item:livesAlone",
      "max": "1",
      "path": "QuestionnaireResponse.item",
      "sliceName": "livesAlone",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.id"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.linkId",
      "path": "QuestionnaireResponse.item.linkId",
      "fixedString": "1.1"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.definition",
      "max": "0",
      "path": "QuestionnaireResponse.item.definition"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.text",
      "min": 1,
      "path": "QuestionnaireResponse.item.text",
      "fixedString": "Does the patient live alone?"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.subject",
      "max": "0",
      "path": "QuestionnaireResponse.item.subject"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.answer",
      "max": "1",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.answer.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.id"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.answer.value[x]:valueBoolean",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer.valueBoolean",
      "type": [ {
        "code": "boolean"
      } ],
      "sliceName": "valueBoolean"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.answer.value[x]:valueBoolean.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.valueBoolean.id"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.answer.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.item"
    }, {
      "id": "QuestionnaireResponse.item:livesAlone.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.item"
    }, {
      "id": "QuestionnaireResponse.item:keySafe",
      "max": "1",
      "path": "QuestionnaireResponse.item",
      "sliceName": "keySafe",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item:keySafe.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.id"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.linkId",
      "path": "QuestionnaireResponse.item.linkId",
      "fixedString": "1.2"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.definition",
      "max": "0",
      "path": "QuestionnaireResponse.item.definition"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.text",
      "min": 1,
      "path": "QuestionnaireResponse.item.text",
      "fixedString": "Does the patient have a Key Safe?"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.subject",
      "max": "0",
      "path": "QuestionnaireResponse.item.subject"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.answer",
      "max": "1",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.answer.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.id"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.answer.value[x]:valueBoolean",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer.valueBoolean",
      "type": [ {
        "code": "boolean"
      } ],
      "sliceName": "valueBoolean"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.answer.value[x]:valueBoolean.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.valueBoolean.id"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.answer.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.item"
    }, {
      "id": "QuestionnaireResponse.item:keySafe.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.item"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType",
      "max": "1",
      "path": "QuestionnaireResponse.item",
      "sliceName": "accommodationType",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.id"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.linkId",
      "path": "QuestionnaireResponse.item.linkId",
      "fixedString": "1.3"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.definition",
      "max": "0",
      "path": "QuestionnaireResponse.item.definition"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.text",
      "min": 1,
      "path": "QuestionnaireResponse.item.text",
      "short": "e.g. House | Flat | Bungalow | Residential Home",
      "definition": "accommodation Type will provide social care teams with additional contextual infomation helping them identify the most appropriate interventions for the individual",
      "fixedString": "What type of accommodation does the patient live in"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.subject",
      "max": "0",
      "path": "QuestionnaireResponse.item.subject"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.answer",
      "max": "1",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.answer.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.id"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.answer.value[x]:valueString",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer.valueString",
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.answer.value[x]:valueString.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.valueString.id"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.answer.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.item"
    }, {
      "id": "QuestionnaireResponse.item:accommodationType.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.item"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType",
      "max": "1",
      "path": "QuestionnaireResponse.item",
      "sliceName": "accommodationSubType",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.id"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.linkId",
      "path": "QuestionnaireResponse.item.linkId",
      "fixedString": "1.4"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.definition",
      "max": "0",
      "path": "QuestionnaireResponse.item.definition"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.text",
      "min": 1,
      "path": "QuestionnaireResponse.item.text",
      "short": "Additional accommodation details (e.g. floor number if a flat)",
      "definition": "Additional infomationtion about the patients accommodation, for example floor number if they live in a flat.",
      "fixedString": "Additional accommodation details (e.g. floor number if a flat)"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.subject",
      "max": "0",
      "path": "QuestionnaireResponse.item.subject"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.answer",
      "max": "1",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.id"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.value[x]:valueString",
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      "path": "QuestionnaireResponse.item.answer.valueString",
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        "code": "string"
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      "sliceName": "valueString"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.answer.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.item"
    }, {
      "id": "QuestionnaireResponse.item:accommodationSubType.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.item"
    }, {
      "id": "QuestionnaireResponse.item:tenureType",
      "max": "1",
      "path": "QuestionnaireResponse.item",
      "sliceName": "tenureType",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item:tenureType.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.id"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.linkId",
      "path": "QuestionnaireResponse.item.linkId",
      "fixedString": "1.5"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.definition",
      "max": "0",
      "path": "QuestionnaireResponse.item.definition"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.text",
      "min": 1,
      "path": "QuestionnaireResponse.item.text",
      "short": "e.g. Owner Occupoed | Private Rented | Council Rented | Housing Association | etc",
      "definition": "TenureType will provide social care teams with additional contextual infomation helping them identify the most appropriate interventions for the individual",
      "fixedString": "What type of tenure is the patient's accommodation"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.subject",
      "max": "0",
      "path": "QuestionnaireResponse.item.subject"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.answer",
      "max": "1",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.answer.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.id"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.answer.value[x]:valueString",
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      "path": "QuestionnaireResponse.item.answer.valueString",
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        "code": "string"
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      "sliceName": "valueString"
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      "id": "QuestionnaireResponse.item:tenureType.answer.value[x]:valueString.id",
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      "path": "QuestionnaireResponse.item.answer.valueString.id"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.answer.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.item"
    }, {
      "id": "QuestionnaireResponse.item:tenureType.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.item"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator",
      "max": "1",
      "path": "QuestionnaireResponse.item",
      "sliceName": "safegaurdingIndicator",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.id"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.linkId",
      "path": "QuestionnaireResponse.item.linkId",
      "fixedString": "2.1"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.definition",
      "max": "0",
      "path": "QuestionnaireResponse.item.definition"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.text",
      "min": 1,
      "path": "QuestionnaireResponse.item.text",
      "fixedString": "Are there any Safeguarding Concerns associated with the patient?"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.subject",
      "max": "0",
      "path": "QuestionnaireResponse.item.subject"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer",
      "max": "1",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.id"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.value[x]:valueBoolean",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer.valueBoolean",
      "type": [ {
        "code": "boolean"
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      "sliceName": "valueBoolean"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.value[x]:valueBoolean.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.valueBoolean.id"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.answer.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.item"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingIndicator.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.item"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails",
      "max": "1",
      "path": "QuestionnaireResponse.item",
      "sliceName": "safegaurdingDetails",
      "mustSupport": true
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.id"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.linkId",
      "path": "QuestionnaireResponse.item.linkId",
      "fixedString": "2.2"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.definition",
      "max": "0",
      "path": "QuestionnaireResponse.item.definition"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.text",
      "min": 1,
      "path": "QuestionnaireResponse.item.text",
      "fixedString": "If Safeguarding Concerns have been identified, please provide further relevant details of these"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.subject",
      "max": "0",
      "path": "QuestionnaireResponse.item.subject"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer",
      "max": "1",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.id"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.value[x]:valueString",
      "min": 1,
      "path": "QuestionnaireResponse.item.answer.valueString",
      "type": [ {
        "code": "string"
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      "sliceName": "valueString"
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      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.value[x]:valueString.id",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.valueString.id"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.answer.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.answer.item"
    }, {
      "id": "QuestionnaireResponse.item:safegaurdingDetails.item",
      "max": "0",
      "path": "QuestionnaireResponse.item.item"
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"
}