CH_ORF (v0.9.1)
This page is part of the CH-ORF (R4) (v0.9.1: STU Draft) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
{
"resourceType" : "Questionnaire",
"id" : "lab-order-chemogram",
"meta" : {
"profile" : [
"http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n Lab Order Questionnarie Example for a Chemogram\n <pre>todo copy text out of rendering</pre>\n </div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap",
"valueCanonical" : "http://fhir.ch/ig/ch-orf/StructureMap/map-orf"
}
],
"url" : "http://fhir.ch/ig/ch-orf/Questionnaire/lab-order-chemogram",
"version" : "0.9.1",
"name" : "LabOrderExample",
"title" : "Lab Order Example",
"status" : "draft",
"experimental" : true,
"subjectType" : [
"Patient"
],
"date" : "2018-04-12T00:00:00+02:00",
"publisher" : "ahdis",
"item" : [
{
"linkId" : "info",
"text" : "Lab Order Questionnarie Example for a Chemogram",
"type" : "display"
},
{
"linkId" : "order",
"text" : "Auftrag",
"type" : "group",
"item" : [
{
"linkId" : "order.date",
"text" : "Auftrags-Datum",
"type" : "date"
}
]
},
{
"linkId" : "orderer",
"text" : "Auftraggeber",
"type" : "group",
"item" : [
{
"linkId" : "orderer.author",
"text" : "Author",
"type" : "group",
"item" : [
{
"linkId" : "orderer.author.visum",
"text" : "Visum",
"type" : "string"
},
{
"linkId" : "orderer.author.organization",
"text" : "Organisation",
"type" : "string"
},
{
"linkId" : "orderer.author.lastname",
"text" : "Name",
"type" : "string"
},
{
"linkId" : "orderer.author.firstname",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "orderer.author.tel",
"text" : "Telefon",
"type" : "string"
},
{
"linkId" : "orderer.author.e-mail",
"text" : "E-Mail",
"type" : "string"
},
{
"linkId" : "orderer.author.street",
"text" : "Strasse",
"type" : "string"
},
{
"linkId" : "orderer.author.postfach",
"text" : "Postfach",
"type" : "string"
},
{
"linkId" : "orderer.author.zip",
"text" : "PLZ",
"type" : "string"
},
{
"linkId" : "orderer.author.city",
"text" : "Ort",
"type" : "string"
}
]
},
{
"linkId" : "orderer.dataenterer",
"text" : "Erfasser",
"type" : "group",
"item" : [
{
"linkId" : "orderer.dataenterer.visum",
"text" : "Visum",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.organization",
"text" : "Organisation",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.lastname",
"code" : [
{
"system" : "http://tbd",
"code" : "datlname"
}
],
"text" : "Name",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.firstname",
"definition" : "http://ahdis.ch/fhir/StructureDefinition/QRFDataEntryPerson#Practitioner.name.first",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.tel",
"text" : "Telefon",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.e-mail",
"text" : "E-Mail",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.street",
"text" : "Strasse",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.postfach",
"text" : "Postfach",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.zip",
"text" : "PLZ",
"type" : "string"
},
{
"linkId" : "orderer.dataenterer.city",
"text" : "Ort",
"type" : "string"
}
]
},
{
"linkId" : "orderer.notcontactthisdoc",
"text" : "Urgent Notification Contact for this document:",
"type" : "group",
"item" : [
{
"linkId" : "orderer.notifcontactthisdoc.visum",
"text" : "Visum",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.organization",
"text" : "Organisation",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.lastname",
"text" : "Name",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.firstname",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.tel",
"text" : "Telefon",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.e-mail",
"text" : "E-Mail",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.street",
"text" : "Strasse",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.postfach",
"text" : "Postfach",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.zip",
"text" : "PLZ",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactthisdoc.city",
"text" : "Ort",
"type" : "string"
}
]
},
{
"linkId" : "orderer.notcontactresponsedoc",
"text" : "Urgent Notification Contact for the response of this document:",
"type" : "group",
"item" : [
{
"linkId" : "orderer.notifcontactresponsedoc.visum",
"text" : "Visum",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.organization",
"text" : "Organisation",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.lastname",
"text" : "Name",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.firstname",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.tel",
"text" : "Telefon",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.e-mail",
"text" : "E-Mail",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.street",
"text" : "Strasse",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.postfach",
"text" : "Postfach",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.zip",
"text" : "PLZ",
"type" : "string"
},
{
"linkId" : "orderer.notifcontactresponsedoc.city",
"text" : "Ort",
"type" : "string"
}
]
}
]
},
{
"linkId" : "receiver",
"text" : "Receiver",
"type" : "group",
"item" : [
{
"linkId" : "receiver.visum",
"text" : "Visum",
"type" : "string"
},
{
"linkId" : "receiver.bereich",
"text" : "Bereich",
"type" : "string"
},
{
"linkId" : "receiver.abt",
"text" : "Bereich",
"type" : "string"
},
{
"linkId" : "receiver.lastname",
"text" : "Name",
"type" : "string"
},
{
"linkId" : "receiver.firstname",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "receiver.tel",
"text" : "Telefon",
"type" : "string"
},
{
"linkId" : "receiver.e-mail",
"text" : "E-Mail",
"type" : "string"
},
{
"linkId" : "receiver.cstreet",
"text" : "Strasse",
"type" : "string"
},
{
"linkId" : "receiver.postfach",
"text" : "Postfach",
"type" : "string"
},
{
"linkId" : "receiver.zip",
"text" : "PLZ",
"type" : "string"
},
{
"linkId" : "receiver.city",
"text" : "Ort",
"type" : "string"
}
]
},
{
"linkId" : "patient",
"text" : "Patient",
"type" : "group",
"item" : [
{
"linkId" : "patient.lastname",
"definition" : "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.given",
"text" : "Name",
"type" : "string"
},
{
"linkId" : "patient.firstname",
"definition" : "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.first",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "patient.pid",
"text" : "PID (sendendes System)",
"type" : "string"
},
{
"linkId" : "patient.birthdate",
"text" : "Geburtsdatum",
"type" : "date"
},
{
"linkId" : "patient.sex",
"text" : "Geschlecht",
"type" : "choice",
"answerOption" : [
{
"valueString" : "M"
},
{
"valueString" : "F"
}
]
},
{
"linkId" : "patient.amborstat",
"text" : "Amb/Stat",
"type" : "choice",
"answerOption" : [
{
"valueString" : "Amb"
},
{
"valueString" : "Stat"
}
]
}
]
},
{
"linkId" : "chemogramm",
"text" : "Chemogramm",
"type" : "choice",
"item" : [
{
"linkId" : "lab",
"text" : "Laborwerte",
"type" : "string",
"answerOption" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "27353-2",
"display" : "Glucose"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "33898-8",
"display" : "Bilirubin"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "3094-0",
"display" : "Harnstoff"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "57332-9",
"display" : "Harnsäure"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2160-0",
"display" : "Kreatinin"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "56776-8",
"display" : "Amylase"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2325-9",
"display" : "GGT"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "1916-6",
"display" : "GOT (ASAT)"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "76625-3",
"display" : "GPT (ALAT)"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "53524-5",
"display" : "AP"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "49129-0",
"display" : "CK gesamt"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2777-1",
"display" : "Phosphat"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2276-4",
"display" : "Ferritin"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "16615-7",
"display" : "Cholesterin"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "3043-7",
"display" : "Triglyceride"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2823-3",
"display" : "K"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2951-2",
"display" : "Na"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "17863-2",
"display" : "Ca"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2572-6",
"display" : "Lipase"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "2537-9",
"display" : "LDH"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "27340-9",
"display" : "HDL-Cholesterin"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "22748-8",
"display" : "LDL-Cholesterin"
}
},
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "1751-7",
"display" : "Albumin"
}
}
]
}
]
}
]
}