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" : "referral-min",
"meta" : {
"profile" : [
"http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaire",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire",
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extract"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <pre>radio button für geschlecht horizontal, required Element, textbox für untersuchung, Checkboxen mit optional Textangaben, Angabe von mehreren Beilagen</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/referral-min",
"version" : "0.9.1",
"name" : "ORFReferralMinimial",
"title" : "ORF Referral Minimial",
"status" : "draft",
"experimental" : true,
"subjectType" : [
"Patient"
],
"date" : "2019-03-28T00:00:00+01:00",
"publisher" : "ahdis",
"item" : [
{
"linkId" : "order",
"text" : "Auftrag",
"type" : "group",
"item" : [
{
"linkId" : "order.number",
"text" : "Auftrags-Nummer",
"type" : "string",
"required" : true
}
]
},
{
"linkId" : "patient",
"definition" : "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient",
"text" : "Patient",
"type" : "group",
"item" : [
{
"linkId" : "patient.lastname",
"definition" : "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name",
"code" : [
{
"system" : "http://fhir.ch/ig/ch-orf/CodeSystem/minimaldataset",
"code" : "Patient.name.family"
}
],
"text" : "Name",
"type" : "string",
"required" : true
},
{
"linkId" : "patient.firstname",
"definition" : "http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient#Patient.name",
"code" : [
{
"system" : "http://fhir.ch/ig/ch-orf/CodeSystem/minimaldataset",
"code" : "Patient.name.given"
}
],
"text" : "Vorname",
"type" : "string",
"required" : true
},
{
"linkId" : "patient.pid",
"text" : "PID (sendendes System)",
"type" : "string"
},
{
"linkId" : "patient.birthdate",
"text" : "Geburtsdatum",
"type" : "date",
"required" : true
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode" : "horizontal"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "radio-button",
"display" : "Radio Button"
}
],
"text" : "A control where choices are listed with a button beside them. The button can be toggled to select or de-select a given choice. Selecting one item deselects all others."
}
}
],
"linkId" : "patient.sex",
"text" : "Geschlecht",
"type" : "choice",
"required" : true,
"answerOption" : [
{
"valueCoding" : {
"code" : "F",
"display" : "Weiblich"
},
"initialSelected" : true
},
{
"valueCoding" : {
"code" : "M",
"display" : "Männlich"
}
}
]
},
{
"linkId" : "patient.zip",
"text" : "PLZ",
"type" : "string",
"required" : true,
"maxLength" : 6
}
]
},
{
"linkId" : "examiniation",
"text" : "Untersuch",
"type" : "group",
"item" : [
{
"linkId" : "examiniation.reason",
"text" : "Grund Überweisung",
"type" : "text",
"required" : true
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-choiceOrientation",
"valueCode" : "horizontal"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/questionnaire-item-control",
"code" : "check-box"
}
]
}
}
],
"linkId" : "chemogramm",
"text" : "Chemogramm",
"type" : "open-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"
}
}
]
}
]
},
{
"linkId" : "examiniation.attachments",
"text" : "Beilage",
"type" : "attachment",
"repeats" : true
}
]
},
{
"linkId" : "receiver",
"text" : "Receiver",
"type" : "group",
"item" : [
{
"linkId" : "receiver.lastname",
"text" : "Name",
"type" : "string"
},
{
"linkId" : "receiver.firstname",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "receiver.organization",
"text" : "Organisation",
"type" : "string"
},
{
"linkId" : "receiver.street",
"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" : "orderer",
"text" : "Sender",
"type" : "group",
"item" : [
{
"linkId" : "orderer.sender",
"text" : "Sender",
"type" : "group",
"item" : [
{
"linkId" : "orderer.sender.visum",
"text" : "Visum",
"type" : "string"
},
{
"linkId" : "orderer.sender.bereich",
"text" : "Bereich",
"type" : "string"
},
{
"linkId" : "orderer.sender.abt",
"text" : "Bereich",
"type" : "string"
},
{
"linkId" : "orderer.sender.lastname",
"text" : "Name",
"type" : "string"
},
{
"linkId" : "orderer.sender.firstname",
"text" : "Vorname",
"type" : "string"
},
{
"linkId" : "orderer.sender.organization",
"text" : "Organisastion",
"type" : "string"
},
{
"linkId" : "orderer.sender.tel",
"text" : "Telefon",
"type" : "string"
},
{
"linkId" : "orderer.sender.e-mail",
"text" : "E-Mail",
"type" : "string"
},
{
"linkId" : "orderer.sender.street",
"text" : "Strasse",
"type" : "string"
},
{
"linkId" : "orderer.sender.postfach",
"text" : "Postfach",
"type" : "string"
},
{
"linkId" : "orderer.sender.zip",
"text" : "PLZ",
"type" : "string"
},
{
"linkId" : "orderer.sender.city",
"text" : "Ort",
"type" : "string"
}
]
}
]
}
]
}