{
  "description": "This represents an implementation of the \\\"US Surgeon General family health portrait\\\" form found at https://lforms-demo.nlm.nih.gov",
  "_filename": "example/Questionnaire-questionnaire-sdc-profile-example-ussg-fht.json",
  "package_name": "hl7.fhir.uv.sdc",
  "subjectType": [ "Patient" ],
  "date": "2015",
  "meta": {
    "profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-pop-obsn", "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-search" ]
  },
  "publisher": "HL7 International / FHIR Infrastructure",
  "approvalDate": "2015-10-31",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "purpose": "Captures basic family history information",
  "name": "USSurgeonGeneralFamilyHealthPortrait",
  "item": [ {
    "item": [ {
      "text": "Date Done",
      "type": "date",
      "linkId": "0.1"
    }, {
      "text": "Time Done",
      "type": "time",
      "linkId": "0.2"
    }, {
      "text": "Where Done",
      "type": "string",
      "linkId": "0.3"
    }, {
      "text": "Comment",
      "type": "string",
      "linkId": "0.4"
    } ],
    "type": "group",
    "linkId": "0"
  }, {
    "code": [ {
      "code": "54126-8",
      "system": "http://loinc.org"
    } ],
    "item": [ {
      "item": [ {
        "code": [ {
          "code": "54125-0",
          "system": "http://loinc.org"
        } ],
        "text": "Name",
        "type": "string",
        "linkId": "1.1.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "maxLength": 200,
        "definition": "http://loinc.org/fhir/DataElement/54125-0"
      }, {
        "definition": "http://loinc.org/fhir/DataElement/54131-8",
        "linkId": "1.1.2",
        "item": [ {
          "text": "Please specify",
          "type": "string",
          "linkId": "1.1.2.1.1",
          "required": true,
          "enableWhen": [ {
            "operator": "=",
            "question": "1.1.2",
            "answerCoding": {
              "code": "LA46-8",
              "system": "http://loinc.org"
            }
          } ]
        } ],
        "type": "choice",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "answerValueSet": "http://loinc.org/vs/LL1-9",
        "code": [ {
          "code": "54131-8",
          "system": "http://loinc.org"
        } ],
        "required": true,
        "text": "Gender"
      }, {
        "code": [ {
          "code": "21112-8",
          "system": "http://loinc.org"
        } ],
        "text": "Date of Birth",
        "type": "date",
        "linkId": "1.1.3",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/21112-8"
      }, {
        "code": [ {
          "code": "54132-6",
          "system": "http://loinc.org"
        } ],
        "text": "Were you born a twin?",
        "type": "choice",
        "linkId": "1.1.4",
        "initial": [ {
          "valueCoding": {
            "code": "LA32-8",
            "system": "http://loinc.org",
            "display": "No"
          }
        } ],
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54132-6",
        "answerValueSet": "http://loinc.org/vs/LL623-0"
      }, {
        "code": [ {
          "code": "54128-4",
          "system": "http://loinc.org"
        } ],
        "text": "Were you adopted?",
        "type": "choice",
        "linkId": "1.1.5",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54128-4",
        "answerValueSet": "http://loinc.org/vs/LL361-7"
      }, {
        "code": [ {
          "code": "54135-9",
          "system": "http://loinc.org"
        } ],
        "text": "Are your parents related to each other in any way other than marriage?",
        "type": "choice",
        "linkId": "1.1.6",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54135-9",
        "answerValueSet": "http://loinc.org/vs/LL361-7"
      }, {
        "code": [ {
          "code": "8302-2",
          "system": "http://loinc.org"
        } ],
        "item": [ {
          "text": "Units",
          "type": "choice",
          "linkId": "1.1.7.1.1",
          "answerValueSet": "#length"
        } ],
        "text": "Height",
        "type": "decimal",
        "linkId": "1.1.7",
        "required": true,
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/8302-2"
      }, {
        "code": [ {
          "code": "29463-7",
          "system": "http://loinc.org"
        } ],
        "item": [ {
          "text": "Units",
          "type": "choice",
          "linkId": "1.1.8.1.1",
          "answerValueSet": "#weight"
        } ],
        "text": "Weight",
        "type": "decimal",
        "linkId": "1.1.8",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/29463-7"
      }, {
        "code": [ {
          "code": "39156-5",
          "system": "http://loinc.org"
        } ],
        "text": "Body mass index (BMI) [Ratio]",
        "type": "decimal",
        "linkId": "1.1.9",
        "readOnly": true,
        "definition": "http://loinc.org/fhir/DataElement/39156-5"
      }, {
        "code": [ {
          "code": "54134-2",
          "system": "http://loinc.org"
        } ],
        "text": "Race",
        "type": "choice",
        "linkId": "1.1.10",
        "required": true,
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54134-2",
        "answerValueSet": "http://loinc.org/vs/LL629-7"
      }, {
        "code": [ {
          "code": "54133-4",
          "system": "http://loinc.org"
        } ],
        "text": "Ethnicity",
        "type": "choice",
        "linkId": "1.1.11",
        "repeats": true,
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54133-4",
        "answerValueSet": "http://loinc.org/vs/LL628-9"
      } ],
      "type": "group",
      "linkId": "1.1"
    }, {
      "code": [ {
        "code": "54137-5",
        "system": "http://loinc.org"
      } ],
      "item": [ {
        "code": [ {
          "code": "54140-9",
          "system": "http://loinc.org"
        } ],
        "text": "Disease or Condition",
        "type": "choice",
        "linkId": "1.2.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54140-9",
        "answerValueSet": "http://loinc.org/vs/LL626-3"
      }, {
        "code": [ {
          "code": "54130-0",
          "system": "http://loinc.org"
        } ],
        "text": "Age at Diagnosis",
        "type": "choice",
        "linkId": "1.2.2",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54130-0",
        "answerValueSet": "http://loinc.org/vs/LL619-8"
      } ],
      "text": "Your diseases history",
      "type": "group",
      "linkId": "1.2",
      "repeats": true,
      "definition": "http://loinc.org/fhir/DataElement/54137-5"
    } ],
    "text": "Your health information",
    "type": "group",
    "linkId": "1",
    "required": true,
    "definition": "http://loinc.org/fhir/DataElement/54126-8"
  }, {
    "code": [ {
      "code": "54114-4",
      "system": "http://loinc.org"
    } ],
    "item": [ {
      "item": [ {
        "code": [ {
          "code": "54136-7",
          "system": "http://loinc.org"
        } ],
        "text": "Relationship to you",
        "type": "choice",
        "linkId": "2.1.1.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54136-7",
        "answerValueSet": "http://loinc.org/vs/LL621-4"
      }, {
        "code": [ {
          "code": "54138-3",
          "system": "http://loinc.org"
        } ],
        "text": "Name",
        "type": "string",
        "linkId": "2.1.1.2",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54138-3"
      }, {
        "code": [ {
          "code": "54123-5",
          "system": "http://loinc.org"
        } ],
        "item": [ {
          "text": "Please specify",
          "type": "string",
          "linkId": "2.1.1.3.1.1",
          "required": true,
          "enableWhen": [ {
            "operator": "=",
            "question": "2.1.1.3",
            "answerCoding": {
              "code": "LA46-8",
              "system": "http://loinc.org"
            }
          } ]
        } ],
        "text": "Gender",
        "type": "choice",
        "linkId": "2.1.1.3",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54123-5",
        "answerValueSet": "http://loinc.org/vs/LL1-9"
      }, {
        "code": [ {
          "code": "54139-1",
          "system": "http://loinc.org"
        } ],
        "item": [ {
          "item": [ {
            "code": [ {
              "code": "54112-8",
              "system": "http://loinc.org"
            } ],
            "item": [ {
              "text": "Please specify",
              "type": "string",
              "linkId": "2.1.1.4.1.1.1",
              "enableWhen": [ {
                "operator": "=",
                "question": "2.1.1.4.1.1",
                "answerCoding": {
                  "code": "LA10589-2",
                  "system": "http://loinc.org"
                }
              } ]
            } ],
            "text": "Cause of Death",
            "type": "choice",
            "linkId": "2.1.1.4.1.1",
            "extension": [ {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
              "valueDuration": {
                "code": "a",
                "value": 200,
                "system": "http://unitsofmeasure.org"
              }
            } ],
            "definition": "http://loinc.org/fhir/DataElement/54112-8",
            "answerValueSet": "http://loinc.org/vs/LL627-1"
          }, {
            "code": [ {
              "code": "54113-6",
              "system": "http://loinc.org"
            } ],
            "text": "Age at Death",
            "type": "choice",
            "linkId": "2.1.1.4.1.2",
            "extension": [ {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
              "valueDuration": {
                "code": "a",
                "value": 200,
                "system": "http://unitsofmeasure.org"
              }
            } ],
            "definition": "http://loinc.org/fhir/DataElement/54113-6",
            "answerValueSet": "http://loinc.org/vs/LL619-8"
          } ],
          "type": "group",
          "linkId": "2.1.1.4.1"
        }, {
          "item": [ {
            "code": [ {
              "code": "54124-3",
              "system": "http://loinc.org"
            } ],
            "text": "Date of Birth",
            "type": "date",
            "linkId": "2.1.1.4.2.1",
            "extension": [ {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
              "valueDuration": {
                "code": "a",
                "value": 200,
                "system": "http://unitsofmeasure.org"
              }
            } ],
            "definition": "http://loinc.org/fhir/DataElement/54124-3"
          }, {
            "code": [ {
              "code": "54141-7",
              "system": "http://loinc.org"
            } ],
            "text": "Age",
            "type": "decimal",
            "linkId": "2.1.1.4.2.2",
            "extension": [ {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
              "valueDuration": {
                "code": "a",
                "value": 200,
                "system": "http://unitsofmeasure.org"
              }
            } ],
            "definition": "http://loinc.org/fhir/DataElement/54141-7"
          } ],
          "type": "group",
          "linkId": "2.1.1.4.2"
        } ],
        "text": "Living?",
        "type": "choice",
        "linkId": "2.1.1.4",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54139-1",
        "answerValueSet": "http://loinc.org/vs/LL361-7"
      }, {
        "code": [ {
          "code": "54121-9",
          "system": "http://loinc.org"
        } ],
        "text": "Was this person born a twin?",
        "type": "choice",
        "linkId": "2.1.1.5",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54121-9",
        "answerValueSet": "http://loinc.org/vs/LL623-0"
      }, {
        "code": [ {
          "code": "54122-7",
          "system": "http://loinc.org"
        } ],
        "text": "Was this person adopted?",
        "type": "choice",
        "linkId": "2.1.1.6",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54122-7",
        "answerValueSet": "http://loinc.org/vs/LL623-0"
      }, {
        "code": [ {
          "code": "54119-3",
          "system": "http://loinc.org"
        } ],
        "text": "Race",
        "type": "choice",
        "linkId": "2.1.1.7",
        "repeats": true,
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54119-3",
        "answerValueSet": "http://loinc.org/vs/LL629-7"
      }, {
        "code": [ {
          "code": "54120-1",
          "system": "http://loinc.org"
        } ],
        "text": "Ethnicity",
        "type": "choice",
        "linkId": "2.1.1.8",
        "repeats": true,
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54120-1",
        "answerValueSet": "http://loinc.org/vs/LL628-9"
      } ],
      "type": "group",
      "linkId": "2.1.1"
    }, {
      "code": [ {
        "code": "54117-7",
        "system": "http://loinc.org"
      } ],
      "item": [ {
        "code": [ {
          "code": "54116-9",
          "system": "http://loinc.org"
        } ],
        "text": "Disease or Condition",
        "type": "choice",
        "linkId": "2.1.2.1",
        "required": true,
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54116-9",
        "answerValueSet": "http://loinc.org/vs/LL626-3"
      }, {
        "code": [ {
          "code": "54115-1",
          "system": "http://loinc.org"
        } ],
        "text": "Age at Diagnosis",
        "type": "choice",
        "linkId": "2.1.2.2",
        "extension": [ {
          "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-observationLinkPeriod",
          "valueDuration": {
            "code": "a",
            "value": 200,
            "system": "http://unitsofmeasure.org"
          }
        } ],
        "definition": "http://loinc.org/fhir/DataElement/54115-1",
        "answerValueSet": "http://loinc.org/vs/LL619-8"
      }, {
        "text": "Mock-up item: Height",
        "type": "decimal",
        "linkId": "2.1.2.3"
      }, {
        "text": "Mock-up item: Weight",
        "type": "decimal",
        "linkId": "2.1.2.4"
      }, {
        "text": "Mock-up item: BMI",
        "type": "decimal",
        "linkId": "2.1.2.5"
      } ],
      "text": "This family member's history of disease",
      "type": "group",
      "linkId": "2.1.2",
      "repeats": true,
      "definition": "http://loinc.org/fhir/DataElement/54117-7"
    } ],
    "text": "Family member health information",
    "type": "group",
    "linkId": "2",
    "repeats": true,
    "definition": "http://loinc.org/fhir/DataElement/54114-4"
  } ],
  "useContext": [ {
    "code": {
      "code": "species",
      "system": "http://terminology.hl7.org/CodeSystem/usage-context-type"
    },
    "valueCodeableConcept": {
      "coding": [ {
        "code": "337915000",
        "system": "http://snomed.info/sct",
        "display": "Homo sapiens"
      } ]
    }
  } ],
  "copyright": "(c) 2015 Regenstrief Institute",
  "type": null,
  "experimental": "true",
  "resourceType": "Questionnaire",
  "title": "US Surgeon General - Family Health Portrait",
  "package_version": "4.0.0-ballot",
  "extension": [ {
    "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]",
    "valueCoding": {
      "code": "date",
      "system": "http://hl7.org/fhir/version-algorithm"
    }
  } ],
  "contained": [ {
    "id": "length",
    "name": "LengthUnits",
    "title": "Length Units",
    "status": "active",
    "compose": {
      "include": [ {
        "system": "http://unitsofmeasure.org",
        "concept": [ {
          "code": "[in_i]",
          "display": "inch (international)"
        }, {
          "code": "cm",
          "display": "centimeters"
        } ]
      } ]
    },
    "immutable": true,
    "description": "Length units",
    "resourceType": "ValueSet"
  }, {
    "id": "weight",
    "name": "WeightUnits",
    "title": "Weight Units",
    "status": "active",
    "compose": {
      "include": [ {
        "system": "http://unitsofmeasure.org",
        "concept": [ {
          "code": "[lb_av]",
          "display": "pound (US and British)"
        }, {
          "code": "kg",
          "display": "kilograms"
        } ]
      } ]
    },
    "immutable": true,
    "description": "Weight units",
    "resourceType": "ValueSet"
  } ],
  "status": "active",
  "id": "a409fe5c-36b0-48d8-b9d8-99f1bc3ab25f",
  "kind": null,
  "url": "http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-ussg-fht",
  "code": [ {
    "code": "54127-6",
    "system": "http://loinc.org",
    "display": "US Surgeon General family health portrait [USSG-FHT]"
  } ],
  "identifier": [ {
    "value": "54127-6",
    "system": "http://example.org/panel-id"
  }, {
    "value": "urn:oid:2.16.840.1.113883.4.642.40.17.35.17",
    "system": "urn:ietf:rfc:3986"
  } ],
  "lastReviewDate": "2017-03-15",
  "version": "4.0.0-ballot",
  "contact": [ {
    "name": "HL7 International / FHIR Infrastructure",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fiwg",
      "system": "url"
    } ]
  }, {
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fiwg",
      "system": "url"
    } ]
  } ]
}