{
"description": "A sample questionnaire using itemMedia and itemAnswerMedia extensions",
"_filename": "example/Questionnaire-anc-quick-check.json",
"package_name": "hl7.fhir.uv.sdc",
"subjectType": [ "Patient" ],
"date": "2024-12-17T01:55:34+00:00",
"meta": {
"profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-render" ]
},
"publisher": "HL7 International / FHIR Infrastructure",
"jurisdiction": [ {
"coding": [ {
"code": "001",
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"display": "World"
} ]
} ],
"name": "ANC_Quick_Check",
"item": [ {
"text": "Why did you come?",
"type": "choice",
"linkId": "reason-for-visit",
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemMedia",
"valueAttachment": {
"url": "http://example.org/images/reason-for-visit.png"
}
} ],
"answerOption": [ {
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia",
"valueAttachment": {
"url": "http://example.org/images/reason-for-visit-routine.png"
}
} ],
"valueString": "For a scheduled (routine) visit"
}, {
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia",
"valueAttachment": {
"url": "http://example.org/images/reason-for-visit-specific-complaint.png"
}
} ],
"valueString": "For specific complaints about you or your baby"
}, {
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia",
"valueAttachment": {
"url": "http://example.org/images/reason-for-visit-first.png"
}
} ],
"valueString": "First visit"
}, {
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia",
"valueAttachment": {
"url": "http://example.org/images/reason-for-visit-follow-up.png"
}
} ],
"valueString": "Follow-up visit"
}, {
"extension": [ {
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia",
"valueAttachment": {
"url": "http://example.org/images/reason-for-visit-include-family-member.png"
}
} ],
"valueString": "Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion?"
} ]
} ],
"type": null,
"experimental": "true",
"resourceType": "Questionnaire",
"title": "Questionnaire - ANC Quick Check",
"package_version": "4.0.0-ballot",
"extension": [ {
"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Questionnaire.versionAlgorithm[x]",
"valueCoding": {
"code": "semver",
"system": "http://hl7.org/fhir/version-algorithm"
}
} ],
"status": "active",
"id": "f20825e0-b28e-4040-8409-a79541d6ef83",
"kind": null,
"url": "http://hl7.org/fhir/uv/sdc/Questionnaire/anc-quick-check",
"identifier": [ {
"value": "urn:oid:2.16.840.1.113883.4.642.40.17.35.2",
"system": "urn:ietf:rfc:3986"
} ],
"version": "4.0.0-ballot",
"contact": [ {
"name": "HL7 International / FHIR Infrastructure",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/fiwg",
"system": "url"
} ]
}, {
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/fiwg",
"system": "url"
} ]
} ]
}