CH_ORF


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