CH_ORF


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