CH ORF (R4)
1.0.0 - STU 1

This page is part of the CH ORF (R4) (v1.0.0: STU 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Example Questionnaire: Questionnaire Order-Referral-Form

Active as of 2022-01-06
Structure
LinkIdTextCardinalityTypeFlagsDescription & Constraintsdoco
.. OrderReferralFormQuestionnaire
... orderAuftrag1..1groupDefinition: Bundle
.... order.placerOrderIdentifierAuftragsnummer des Auftraggebers0..1stringDefinition: ServiceRequest.identifier:placerOrderIdentifier.value
.... order.placerOrderIdentifierDomainIdentifier Domain der Auftragsnummer des Auftraggebers0..1stringDefinition: ServiceRequest.identifier:placerOrderIdentifier.system
.... order.fillerOrderIdentifierAuftragsnummer des Auftragsempfängers0..1stringDefinition: ServiceRequest.identifier:fillerOrderIdentifier.value
.... order.fillerOrderIdentifierDomainIdentifier Domain der Auftragsnummer des Auftragsempfängers0..1stringDefinition: ServiceRequest.identifier:fillerOrderIdentifier.system
.... order.precedentDocumentIdentifierIdentifier des Vorgängerdokuments0..1stringDefinition: Composition.extension:precedentDocument
.... order.notificationContactDocumentDringender Benachrichtigungskontakt für dieses Dokument0..1groupDefinition: Composition.extension:urgentNoficationContactForThisDocument
..... order.notificationContactDocument.practitionerZu benachrichtigende Person0..1groupDefinition: PractitionerRole.practitioner
...... order.notificationContactDocument.practitioner.titleTitel0..1stringDefinition: Practitioner.name.prefix
...... order.notificationContactDocument.practitioner.familyNameName0..1stringDefinition: Practitioner.name.family
...... order.notificationContactDocument.practitioner.givenNameVorname0..1stringDefinition: Practitioner.name.given
...... order.notificationContactDocument.practitioner.phoneTelefon0..1stringDefinition: Practitioner.telecom.value
...... order.notificationContactDocument.practitioner.emailE-Mail0..1stringDefinition: Practitioner.telecom.value
.... order.notificationContactDocumentResponseDringender Benachrichtigungskontakt für die Antwort auf dieses Dokument0..1groupDefinition: Composition.extension:urgentNoficationContactForTheResponseToThisDocument
..... order.notificationContactDocumentResponse.practitionerZu benachrichtigende Person0..1groupDefinition: PractitionerRole.practitioner
...... order.notificationContactDocumentResponse.practitioner.titleTitel0..1stringDefinition: Practitioner.name.prefix
...... order.notificationContactDocumentResponse.practitioner.familyNameName0..1stringDefinition: Practitioner.name.family
...... order.notificationContactDocumentResponse.practitioner.givenNameVorname0..1stringDefinition: Practitioner.name.given
...... order.notificationContactDocumentResponse.practitioner.phoneTelefon0..1stringDefinition: Practitioner.telecom.value
...... order.notificationContactDocumentResponse.practitioner.emailE-Mail0..1stringDefinition: Practitioner.telecom.value
.... order.priorityAuftragspriorität0..1choiceDefinition: ServiceRequest.priority
Options: 4 options
... receiverEmpfänger0..1groupDefinition: Composition.extension:receiver
.... receiver.practitionerEmpfangende Person0..1groupDefinition: PractitionerRole.practitioner
..... receiver.practitioner.titleTitel0..1stringDefinition: Practitioner.name.prefix
..... receiver.practitioner.familyNameName0..1stringDefinition: Practitioner.name.family
..... receiver.practitioner.givenNameVorname0..1stringDefinition: Practitioner.name.given
..... receiver.practitioner.glnGLN0..1stringDefinition: Practitioner.identifier:GLN.value
..... receiver.practitioner.zsrZSR0..1stringDefinition: Practitioner.identifier:ZSR.value
..... receiver.practitioner.phoneTelefon0..1stringDefinition: Practitioner.telecom.value
..... receiver.practitioner.emailE-Mail0..1stringDefinition: Practitioner.telecom.value
.... receiver.organizationEmpfangende Organisation0..1groupDefinition: PractitionerRole.organization
..... receiver.organization.nameName der Organisation0..1stringDefinition: Organization.name
..... receiver.organization.glnGLN0..1stringDefinition: Organization.identifier:GLN
..... receiver.organization.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*stringDefinition: Organization.address.line
..... receiver.organization.postalCodePLZ0..1stringDefinition: Organization.address.postalCode
..... receiver.organization.cityOrt0..1stringDefinition: Organization.address.city
..... receiver.organization.countryLand0..1stringDefinition: Organization.address.country
... patientPatient1..1groupDefinition: Composition.subject
.... patient.familyNameName0..1stringDefinition: Patient.name.family
.... patient.maidenNameLedigname0..1stringDefinition: Patient.name.family
.... patient.givenNameVorname0..1stringDefinition: Patient.name.given
.... patient.localPidLokale Patienten-ID0..1stringDefinition: Patient.identifier:LocalPid.value
.... patient.localPidDomainLokale Patienten-ID Domain0..1stringDefinition: Patient.identifier:LocalPid.system
.... patient.birthDateGeburtsdatum0..1dateDefinition: Patient.birthDate
.... patient.genderGeschlecht0..1choiceDefinition: Patient.gender
Options: 3 options
.... patient.maritalStatusZivilstand0..1choiceDefinition: Patient.maritalStatus
Options: 8 options
.... patient.phoneTelefon0..*stringDefinition: Patient.telecom.value
.... patient.emailE-Mail0..1stringDefinition: Patient.telecom.value
.... patient.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*stringDefinition: Patient.address.line
.... patient.postalCodePLZ0..1stringDefinition: Patient.address.postalCode
.... patient.cityOrt0..1stringDefinition: Patient.address.city
.... patient.countryLand0..1stringDefinition: Patient.address.country
.... patient.languageOfCorrespondanceKorrespondenssprache0..1choiceDefinition: Patient.communication:languageOfCorrespondance
Value Set: DocumentEntry.languageCode
.... patient.contactpersonKontaktperson0..1groupDefinition: Patient.contact
..... patient.contactperson.relationshipBeziehung0..1stringDefinition: Patient.contact.relationship.text
..... patient.contactperson.familyNameName0..1stringDefinition: Patient.contact.name.family
..... patient.contactperson.givenNameVorname0..1stringDefinition: Patient.contact.name.given
..... patient.contactperson.phoneTelefon0..*stringDefinition: Patient.contact.telecom.value
..... patient.contactperson.emailE-Mail0..1stringDefinition: Patient.contact.telecom.value
... requestedEncounterPatientenaufnahme0..1groupDefinition: ServiceRequest.extension:requestedEncounterDetails
.... requestedEncounter.classVoraussichtlich: Ambulant / Stationär / Notfall0..1choiceDefinition: Encounter.class
Options: 3 options
.... requestedEncounter.desiredAccommodationZimmerkategorie0..1choiceDefinition: Encounter.extension:desiredAccommodation
Options: 3 options
... coverageKostenträger0..1groupDefinition: ServiceRequest.insurance
.... coverage.beneficiaryBegünstigter (Patient)0..1groupDefinition: Coverage.beneficiary
..... coverage.beneficiary.ahvn13AHV-Nr. des Patienten0..1stringDefinition: Patient.identifier:AHVN13
.... coverage.kvgKrankenkasse (nach KVG)0..1groupDefinition: Coverage.type
..... coverage.kvg.nameName der Versicherung0..1stringDefinition: Coverage.payor
..... coverage.kvg.insuranceCardNumberKennnummer der Versichertenkarte0..1stringDefinition: Coverage.identifier
.... coverage.uvgUnfallversicherung (nach UVG)0..1groupDefinition: Coverage.type
..... coverage.uvg.nameName der Versicherung0..1stringDefinition: Coverage.payor
..... coverage.uvg.claimNumberSchadennummer0..1stringDefinition: Coverage.identifier
.... coverage.vvgZusatzversicherung (nach VVG)0..1groupDefinition: Coverage.type
..... coverage.vvg.nameName der Versicherung0..1stringDefinition: Coverage.payor
..... coverage.vvg.insuranceCardNumberKennnummer der Versichertenkarte0..1stringDefinition: Coverage.identifier
.... coverage.ivInvalidenversicherung (IV)0..1groupDefinition: Coverage.type
..... coverage.iv.verfuegungsnummerIV-Verfügungsnummer0..1stringDefinition: Coverage.identifier
.... coverage.mvMilitärversicherung (MV)0..1groupDefinition: Coverage.type
..... coverage.mv.versichertennummerMV-Versichertennummer0..1stringDefinition: Coverage.identifier
.... coverage.selfSelbstzahler0..1groupDefinition: Coverage.type
..... coverage.self.patientPatient selbst0..1booleanDefinition: Coverage.payor
..... coverage.self.patientRelatedPersonAndere Person0..1booleanDefinition: Coverage.payor
Enable When:
..... coverage.self.relatedPersonAndere Person0..1groupDefinition: Coverage.payor
Enable When:
...... coverage.self.relatedPerson.familyNameName0..1stringDefinition: RelatedPerson.name.family
...... coverage.self.relatedPerson.givenNameVorname0..1stringDefinition: RelatedPerson.name.given
...... coverage.self.relatedPerson.phoneTelefon0..*stringDefinition: RelatedPerson.telecom.value
...... coverage.self.relatedPerson.emailE-Mail0..1stringDefinition: RelatedPerson.telecom.value
...... coverage.self.relatedPerson.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*stringDefinition: RelatedPerson.address.line
...... coverage.self.relatedPerson.postalCodePLZ0..1stringDefinition: RelatedPerson.address.postalCode
...... coverage.self.relatedPerson.cityOrt0..1stringDefinition: RelatedPerson.address.city
...... coverage.self.relatedPerson.countryLand0..1stringDefinition: RelatedPerson.address.country
.... coverage.otherAnderer Kostenträger0..1groupDefinition: Coverage.type
..... coverage.other.nameName des Kostenträgers0..1stringDefinition: Coverage.payor
..... coverage.other.idBeliebige ID0..1stringDefinition: Coverage.identifier
..... coverage.other.id.noteBemerkung zur ID0..1stringDefinition: Coverage.identifier.type.text
... senderAbsender1..1group
.... sender.authorVerantwortlicher1..1groupDefinition: Composition.author
..... sender.author.practitionerVerantwortliche Person0..1groupDefinition: PractitionerRole.practitioner
...... sender.author.practitioner.titleTitel0..1stringDefinition: Practitioner.name.prefix
...... sender.author.practitioner.familyNameName0..1stringDefinition: Practitioner.name.family
...... sender.author.practitioner.givenNameVorname0..1stringDefinition: Practitioner.name.given
...... sender.author.practitioner.glnGLN0..1stringDefinition: Practitioner.identifier:GLN.value
...... sender.author.practitioner.zsrZSR0..1stringDefinition: Practitioner.identifier:ZSR.value
...... sender.author.practitioner.phoneTelefon0..1stringDefinition: Practitioner.telecom.value
...... sender.author.practitioner.emailE-Mail0..1stringDefinition: Practitioner.telecom.value
..... sender.author.organizationVerantwortliche Organisation0..1groupDefinition: PractitionerRole.organization
...... sender.author.organization.nameName der Organisation0..1stringDefinition: Organization.name
...... sender.author.organization.glnGLN0..1stringDefinition: Organization.identifier:GLN
...... sender.author.organization.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*stringDefinition: Organization.address.line
...... sender.author.organization.postalCodePLZ0..1stringDefinition: Organization.address.postalCode
...... sender.author.organization.cityOrt0..1stringDefinition: Organization.address.city
...... sender.author.organization.countryLand0..1stringDefinition: Organization.address.country
.... sender.dataentererErfasser0..1groupDefinition: Composition.extension:dataEnterer
..... sender.dataenterer.practitionerErfassende Person0..1groupDefinition: PractitionerRole.practitioner
...... sender.dataenterer.practitioner.familyNameName0..1stringDefinition: Practitioner.name.family
...... sender.dataenterer.practitioner.givenNameVorname0..1stringDefinition: Practitioner.name.given
...... sender.dataenterer.practitioner.phoneTelefon0..1stringDefinition: Practitioner.telecom.value
...... sender.dataenterer.practitioner.emailE-Mail0..1stringDefinition: Practitioner.telecom.value
... receiverCopyKopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)0..1groupDefinition: Composition.extension:copyReceiver
.... receiverCopy.practitionerRoleGesundheitsfachperson oder -organisation0..*groupDefinition: PractitionerRole
..... receiverCopy.practitionerRole.practitionerGesundheitsfachperson0..1groupDefinition: PractitionerRole.practitioner
...... receiverCopy.practitionerRole.practitioner.titleTitel0..1stringDefinition: HumanName.prefix
...... receiverCopy.practitionerRole.practitioner.familyNameName0..1stringDefinition: HumanName.family
...... receiverCopy.practitionerRole.practitioner.givenNameVorname0..1stringDefinition: HumanName.given
...... receiverCopy.practitionerRole.practitioner.phoneTelefon0..1stringDefinition: ContactPoint.value
...... receiverCopy.practitionerRole.practitioner.emailE-Mail0..1stringDefinition: ContactPoint.value
..... receiverCopy.practitionerRole.organizationGesundheitsorganisatiton0..1groupDefinition: PractitionerRole.organization
...... receiverCopy.practitionerRole.organization.nameName der Organisation0..1stringDefinition: Organization.name
...... receiverCopy.practitionerRole.organization.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*stringDefinition: Address.line
...... receiverCopy.practitionerRole.organization.postalCodePLZ0..1stringDefinition: Address.postalCode
...... receiverCopy.practitionerRole.organization.cityOrt0..1stringDefinition: Address.city
...... receiverCopy.practitionerRole.organization.countryLand0..1stringDefinition: Address.country
.... receiverCopy.patientPatient selbst0..1booleanDefinition: Patient
.... receiverCopy.relatedPersonAndere Person0..*groupDefinition: RelatedPerson
..... receiverCopy.relatedPerson.familyNameName0..1stringDefinition: RelatedPerson.name.family
..... receiverCopy.relatedPerson.givenNameVorame0..1stringDefinition: RelatedPerson.name.given
..... receiverCopy.relatedPerson.phoneTelefon0..*stringDefinition: RelatedPerson.telecom.value
..... receiverCopy.relatedPerson.emailE-Mail0..1stringDefinition: RelatedPerson.telecom.value
..... receiverCopy.relatedPerson.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*stringDefinition: RelatedPerson.address.line
..... receiverCopy.relatedPerson.postalCodePLZ0..1stringDefinition: RelatedPerson.address.postalCode
..... receiverCopy.relatedPerson.cityOrt0..1stringDefinition: RelatedPerson.address.city
..... receiverCopy.relatedPerson.countryLand0..1stringDefinition: RelatedPerson.address.country
... appointmentOrt und Zeit der Durchführung der angeforderten Leistung0..*groupDefinition: ServiceRequest.extension:locationAndTime
.... appointment.locationOrt der Durchführung1..1groupDefinition: Appointment.participant.actor
..... appointment.location.nameName1..1stringDefinition: Location.name
..... appointment.location.phoneTelefon0..1stringDefinition: Location.telecom.value
..... appointment.location.emailE-Mail0..1stringDefinition: Location.telecom.value
..... appointment.location.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*stringDefinition: Location.address.line
..... appointment.location.postalCodePLZ0..1stringDefinition: Location.address.postalCode
..... appointment.location.cityOrt0..1stringDefinition: Location.address.city
..... appointment.location.countryLand0..1stringDefinition: Location.address.country
.... appointment.requestedPeriodDatum und Zeit, wann der Termin bevorzugt geplant werden soll0..1groupDefinition: Appointment.requestedPeriod
..... appointment.requestedPeriod.startVon0..1dateTimeDefinition: Appointment.requestedPeriod.start
..... appointment.requestedPeriod.endBis0..1dateTimeDefinition: Appointment.requestedPeriod.end
.... appointment.statusStatus1..1choiceDefinition: Appointment.status
Options: 3 options
.... appointment.patientInstructionPatienteninformation für diesen Termin0..1stringDefinition: Appointment.patientInstruction
... noteBemerkungen0..*group
.... note.textKommentar1..1stringDefinition: ServiceRequest.note.text

doco Documentation for this format

Option Sets

Answer options for order.priority

Answer options for patient.gender

Answer options for patient.maritalStatus

Answer options for requestedEncounter.class

Answer options for requestedEncounter.desiredAccommodation

Answer options for appointment.status