{
  "description": null,
  "_filename": "example/Questionnaire-lab-order-chemogram.json",
  "package_name": "ch.fhir.ig.ch-orf",
  "subjectType": [ "Patient" ],
  "date": "2018-04-12T00:00:00+02:00",
  "meta": {
    "profile": [ "http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire" ]
  },
  "publisher": "ahdis",
  "name": "LabOrderExample",
  "item": [ {
    "text": "Lab Order Questionnarie Example for a Chemogram",
    "type": "display",
    "linkId": "info"
  }, {
    "item": [ {
      "text": "Auftrags-Datum",
      "type": "date",
      "linkId": "order.date"
    } ],
    "text": "Auftrag",
    "type": "group",
    "linkId": "order"
  }, {
    "item": [ {
      "item": [ {
        "text": "Visum",
        "type": "string",
        "linkId": "orderer.author.visum"
      }, {
        "text": "Organisation",
        "type": "string",
        "linkId": "orderer.author.organization"
      }, {
        "text": "Name",
        "type": "string",
        "linkId": "orderer.author.lastname"
      }, {
        "text": "Vorname",
        "type": "string",
        "linkId": "orderer.author.firstname"
      }, {
        "text": "Telefon",
        "type": "string",
        "linkId": "orderer.author.tel"
      }, {
        "text": "E-Mail",
        "type": "string",
        "linkId": "orderer.author.e-mail"
      }, {
        "text": "Strasse",
        "type": "string",
        "linkId": "orderer.author.street"
      }, {
        "text": "Postfach",
        "type": "string",
        "linkId": "orderer.author.postfach"
      }, {
        "text": "PLZ",
        "type": "string",
        "linkId": "orderer.author.zip"
      }, {
        "text": "Ort",
        "type": "string",
        "linkId": "orderer.author.city"
      } ],
      "text": "Author",
      "type": "group",
      "linkId": "orderer.author"
    }, {
      "item": [ {
        "text": "Visum",
        "type": "string",
        "linkId": "orderer.dataenterer.visum"
      }, {
        "text": "Organisation",
        "type": "string",
        "linkId": "orderer.dataenterer.organization"
      }, {
        "code": [ {
          "code": "datlname",
          "system": "http://tbd"
        } ],
        "text": "Name",
        "type": "string",
        "linkId": "orderer.dataenterer.lastname"
      }, {
        "text": "Vorname",
        "type": "string",
        "linkId": "orderer.dataenterer.firstname",
        "definition": "http://ahdis.ch/fhir/StructureDefinition/QRFDataEntryPerson#Practitioner.name.first"
      }, {
        "text": "Telefon",
        "type": "string",
        "linkId": "orderer.dataenterer.tel"
      }, {
        "text": "E-Mail",
        "type": "string",
        "linkId": "orderer.dataenterer.e-mail"
      }, {
        "text": "Strasse",
        "type": "string",
        "linkId": "orderer.dataenterer.street"
      }, {
        "text": "Postfach",
        "type": "string",
        "linkId": "orderer.dataenterer.postfach"
      }, {
        "text": "PLZ",
        "type": "string",
        "linkId": "orderer.dataenterer.zip"
      }, {
        "text": "Ort",
        "type": "string",
        "linkId": "orderer.dataenterer.city"
      } ],
      "text": "Erfasser",
      "type": "group",
      "linkId": "orderer.dataenterer"
    }, {
      "item": [ {
        "text": "Visum",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.visum"
      }, {
        "text": "Organisation",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.organization"
      }, {
        "text": "Name",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.lastname"
      }, {
        "text": "Vorname",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.firstname"
      }, {
        "text": "Telefon",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.tel"
      }, {
        "text": "E-Mail",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.e-mail"
      }, {
        "text": "Strasse",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.street"
      }, {
        "text": "Postfach",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.postfach"
      }, {
        "text": "PLZ",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.zip"
      }, {
        "text": "Ort",
        "type": "string",
        "linkId": "orderer.notifcontactthisdoc.city"
      } ],
      "text": "Urgent Notification Contact for this document:",
      "type": "group",
      "linkId": "orderer.notcontactthisdoc"
    }, {
      "item": [ {
        "text": "Visum",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.visum"
      }, {
        "text": "Organisation",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.organization"
      }, {
        "text": "Name",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.lastname"
      }, {
        "text": "Vorname",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.firstname"
      }, {
        "text": "Telefon",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.tel"
      }, {
        "text": "E-Mail",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.e-mail"
      }, {
        "text": "Strasse",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.street"
      }, {
        "text": "Postfach",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.postfach"
      }, {
        "text": "PLZ",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.zip"
      }, {
        "text": "Ort",
        "type": "string",
        "linkId": "orderer.notifcontactresponsedoc.city"
      } ],
      "text": "Urgent Notification Contact for the response of this document:",
      "type": "group",
      "linkId": "orderer.notcontactresponsedoc"
    } ],
    "text": "Auftraggeber",
    "type": "group",
    "linkId": "orderer"
  }, {
    "item": [ {
      "text": "Visum",
      "type": "string",
      "linkId": "receiver.visum"
    }, {
      "text": "Bereich",
      "type": "string",
      "linkId": "receiver.bereich"
    }, {
      "text": "Bereich",
      "type": "string",
      "linkId": "receiver.abt"
    }, {
      "text": "Name",
      "type": "string",
      "linkId": "receiver.lastname"
    }, {
      "text": "Vorname",
      "type": "string",
      "linkId": "receiver.firstname"
    }, {
      "text": "Telefon",
      "type": "string",
      "linkId": "receiver.tel"
    }, {
      "text": "E-Mail",
      "type": "string",
      "linkId": "receiver.e-mail"
    }, {
      "text": "Strasse",
      "type": "string",
      "linkId": "receiver.cstreet"
    }, {
      "text": "Postfach",
      "type": "string",
      "linkId": "receiver.postfach"
    }, {
      "text": "PLZ",
      "type": "string",
      "linkId": "receiver.zip"
    }, {
      "text": "Ort",
      "type": "string",
      "linkId": "receiver.city"
    } ],
    "text": "Receiver",
    "type": "group",
    "linkId": "receiver"
  }, {
    "item": [ {
      "text": "Name",
      "type": "string",
      "linkId": "patient.lastname",
      "definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.given"
    }, {
      "text": "Vorname",
      "type": "string",
      "linkId": "patient.firstname",
      "definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.first"
    }, {
      "text": "PID (sendendes System)",
      "type": "string",
      "linkId": "patient.pid"
    }, {
      "text": "Geburtsdatum",
      "type": "date",
      "linkId": "patient.birthdate"
    }, {
      "text": "Geschlecht",
      "type": "choice",
      "linkId": "patient.sex",
      "answerOption": [ {
        "valueString": "M"
      }, {
        "valueString": "F"
      } ]
    }, {
      "text": "Amb/Stat",
      "type": "choice",
      "linkId": "patient.amborstat",
      "answerOption": [ {
        "valueString": "Amb"
      }, {
        "valueString": "Stat"
      } ]
    } ],
    "text": "Patient",
    "type": "group",
    "linkId": "patient"
  }, {
    "item": [ {
      "text": "Laborwerte",
      "type": "string",
      "linkId": "lab",
      "answerOption": [ {
        "valueCoding": {
          "code": "27353-2",
          "system": "http://loinc.org",
          "display": "Glucose"
        }
      }, {
        "valueCoding": {
          "code": "33898-8",
          "system": "http://loinc.org",
          "display": "Bilirubin"
        }
      }, {
        "valueCoding": {
          "code": "3094-0",
          "system": "http://loinc.org",
          "display": "Harnstoff"
        }
      }, {
        "valueCoding": {
          "code": "57332-9",
          "system": "http://loinc.org",
          "display": "Harnsäure"
        }
      }, {
        "valueCoding": {
          "code": "2160-0",
          "system": "http://loinc.org",
          "display": "Kreatinin"
        }
      }, {
        "valueCoding": {
          "code": "56776-8",
          "system": "http://loinc.org",
          "display": "Amylase"
        }
      }, {
        "valueCoding": {
          "code": "2325-9",
          "system": "http://loinc.org",
          "display": "GGT"
        }
      }, {
        "valueCoding": {
          "code": "1916-6",
          "system": "http://loinc.org",
          "display": "GOT (ASAT)"
        }
      }, {
        "valueCoding": {
          "code": "76625-3",
          "system": "http://loinc.org",
          "display": "GPT (ALAT)"
        }
      }, {
        "valueCoding": {
          "code": "53524-5",
          "system": "http://loinc.org",
          "display": "AP"
        }
      }, {
        "valueCoding": {
          "code": "49129-0",
          "system": "http://loinc.org",
          "display": "CK gesamt"
        }
      }, {
        "valueCoding": {
          "code": "2777-1",
          "system": "http://loinc.org",
          "display": "Phosphat"
        }
      }, {
        "valueCoding": {
          "code": "2276-4",
          "system": "http://loinc.org",
          "display": "Ferritin"
        }
      }, {
        "valueCoding": {
          "code": "16615-7",
          "system": "http://loinc.org",
          "display": "Cholesterin"
        }
      }, {
        "valueCoding": {
          "code": "3043-7",
          "system": "http://loinc.org",
          "display": "Triglyceride"
        }
      }, {
        "valueCoding": {
          "code": "2823-3",
          "system": "http://loinc.org",
          "display": "K"
        }
      }, {
        "valueCoding": {
          "code": "2951-2",
          "system": "http://loinc.org",
          "display": "Na"
        }
      }, {
        "valueCoding": {
          "code": "17863-2",
          "system": "http://loinc.org",
          "display": "Ca"
        }
      }, {
        "valueCoding": {
          "code": "2572-6",
          "system": "http://loinc.org",
          "display": "Lipase"
        }
      }, {
        "valueCoding": {
          "code": "2537-9",
          "system": "http://loinc.org",
          "display": "LDH"
        }
      }, {
        "valueCoding": {
          "code": "27340-9",
          "system": "http://loinc.org",
          "display": "HDL-Cholesterin"
        }
      }, {
        "valueCoding": {
          "code": "22748-8",
          "system": "http://loinc.org",
          "display": "LDL-Cholesterin"
        }
      }, {
        "valueCoding": {
          "code": "1751-7",
          "system": "http://loinc.org",
          "display": "Albumin"
        }
      } ]
    } ],
    "text": "Chemogramm",
    "type": "choice",
    "linkId": "chemogramm"
  } ],
  "type": null,
  "experimental": "true",
  "resourceType": "Questionnaire",
  "title": "Lab Order Example",
  "package_version": "0.9.1",
  "extension": [ {
    "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap",
    "valueCanonical": "http://fhir.ch/ig/ch-orf/StructureMap/map-orf"
  } ],
  "status": "draft",
  "id": "a1652d04-7503-4ae7-8de1-216d4d870bcb",
  "kind": null,
  "url": "http://fhir.ch/ig/ch-orf/Questionnaire/lab-order-chemogram",
  "version": "0.9.1"
}