Structure LinkId Text Cardinality Type Flags Description & Constraints QuestionnaireEtoc Questionnaire http://fhir.ch/ig/ch-etoc/Questionnaire/QuestionnaireEtoc#1.0.0 order Auftrag 1..1 group Definition: Bundle order.placerOrderIdentifier Auftragsnummer des Auftraggebers 1..1 string Definition: ServiceRequest.identifier:placerOrderIdentifier.value order.placerOrderIdentifierDomain Identifier Domain der Auftragsnummer des Auftraggebers 1..1 string Definition: ServiceRequest.identifier:placerOrderIdentifier.system order.fillerOrderIdentifier Auftragsnummer des Auftragsempfängers 0..1 string Definition: ServiceRequest.identifier:fillerOrderIdentifier.value order.fillerOrderIdentifierDomain Identifier Domain der Auftragsnummer des Auftragsempfängers 0..1 string Definition: ServiceRequest.identifier:fillerOrderIdentifier.system order.precedentDocumentIdentifier Identifier des Vorgängerdokuments 0..1 string Definition: Composition.extension:precedentDocument order.notificationContactDocument Dringender Benachrichtigungskontakt für dieses Dokument 0..1 group Definition: Composition.extension:urgentNoficationContactForThisDocument order.notificationContactDocument.practitioner Zu benachrichtigende Person 0..1 group Definition: PractitionerRole.practitioner order.notificationContactDocument.practitioner.title Titel 0..1 string Definition: Practitioner.name.prefix order.notificationContactDocument.practitioner.familyName Name 0..1 string Definition: Practitioner.name.family order.notificationContactDocument.practitioner.givenName Vorname 0..1 string Definition: Practitioner.name.given order.notificationContactDocument.practitioner.phone Telefon 0..1 string Definition: Practitioner.telecom.value order.notificationContactDocument.practitioner.email E-Mail 0..1 string Definition: Practitioner.telecom.value order.notificationContactDocumentResponse Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument 0..1 group Definition: Composition.extension:urgentNoficationContactForTheResponseToThisDocument order.notificationContactDocumentResponse.practitioner Zu benachrichtigende Person 0..1 group Definition: PractitionerRole.practitioner order.notificationContactDocumentResponse.practitioner.title Titel 0..1 string Definition: Practitioner.name.prefix order.notificationContactDocumentResponse.practitioner.familyName Name 0..1 string Definition: Practitioner.name.family order.notificationContactDocumentResponse.practitioner.givenName Vorname 0..1 string Definition: Practitioner.name.given order.notificationContactDocumentResponse.practitioner.phone Telefon 0..1 string Definition: Practitioner.telecom.value order.notificationContactDocumentResponse.practitioner.email E-Mail 0..1 string Definition: Practitioner.telecom.value order.priority Auftragspriorität 0..1 choice Definition: ServiceRequest.priority Options: 4 options patient Patient 0..1 group Definition: Composition.subject patient.familyName Name 0..1 string Definition: Patient.name.family patient.maidenName Ledigname 0..1 string Definition: Patient.name.family patient.givenName Vorname 0..1 string Definition: Patient.name.given patient.localPid Lokale Patienten-ID 0..1 string Definition: Patient.identifier:LocalPid.value patient.localPidDomain Lokale Patienten-ID Domain 0..1 string Definition: Patient.identifier:LocalPid.system patient.birthDate Geburtsdatum 0..1 date Definition: Patient.birthDate patient.gender Geschlecht 0..1 choice Definition: Patient.gender Options: 3 options patient.maritalStatus Zivilstand 0..1 choice Definition: Patient.maritalStatus Options: 8 options patient.phone Telefon 0..* string Definition: Patient.telecom.value patient.email E-Mail 0..1 string Definition: Patient.telecom.value patient.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: Patient.address.line patient.postalCode PLZ 0..1 string Definition: Patient.address.postalCode patient.city Ort 0..1 string Definition: Patient.address.city patient.country Land 0..1 string Definition: Patient.address.country patient.languageOfCorrespondance Korrespondenssprache 0..1 choice Definition: Patient.communication:languageOfCorrespondance Value Set: DocumentEntry.languageCode patient.contactperson Patient 0..1 group Definition: Composition.subject patient.contactperson.relationship Beziehung 0..1 string Definition: Patient.contact.relationship.text patient.contactperson.familyName Name 0..1 string Definition: Patient.contact.name.family patient.contactperson.givenName Vorname 0..1 string Definition: Patient.contact.name.given patient.contactperson.phone Telefon 0..* string Definition: Patient.contact.telecom.value patient.contactperson.email E-Mail 0..1 string Definition: Patient.contact.telecom.value requestedEncounter Patientenaufnahme 0..1 group Definition: ServiceRequest.extension:requestedencounterdetails requestedEncounter.class Voraussichtlich: Ambulant / Stationär / Notfall 1..1 choice Definition: Encounter.class Options: 3 options requestedEncounter.desiredAccommodation Zimmerkategorie 0..1 choice Definition: Encounter.extension:desiredaccommodation Options: 3 options coverage Kostenträger 0..1 group Definition: ServiceRequest.insurance coverage.beneficiary Begünstigter (Patient) 0..1 group Definition: Coverage.beneficiary coverage.beneficiary.ahvn13 AHV-Nr. des Patienten 0..1 string Definition: Patient.identifier:AHVN13 coverage.kvg Krankenkasse (nach KVG) 0..1 group Definition: Coverage.type coverage.kvg.name Name der Versicherung 0..1 string Definition: Coverage.payor coverage.kvg.insuranceCardNumber Kennnummer der Versichertenkarte 0..1 string Definition: Coverage.identifier coverage.uvg Unfallversicherung (nach UVG) 0..1 group Definition: Coverage.type coverage.uvg.name Name der Versicherung 0..1 string Definition: Coverage.payor coverage.uvg.claimNumber Schadennummer 0..1 string Definition: Coverage.identifier coverage.vvg Zusatzversicherung (nach VVG) 0..1 group Definition: Coverage.type coverage.vvg.name Name der Versicherung 0..1 string Definition: Coverage.payor coverage.vvg.insuranceCardNumber Kennnummer der Versichertenkarte 0..1 string Definition: Coverage.identifier coverage.iv Invalidenversicherung (IV) 0..1 group Definition: Coverage.type coverage.iv.verfuegungsnummer IV-Verfügungsnummer 0..1 string Definition: Coverage.identifier coverage.mv Militärversicherung (MV) 0..1 group Definition: Coverage.type coverage.mv.versichertennummer MV-Versichertennummer 0..1 string Definition: Coverage.identifier coverage.self Selbstzahler 0..1 group Definition: Coverage.type coverage.self.patient Patient selbst 0..1 boolean Definition: Coverage.payor coverage.self.patientRelatedPerson Andere Person 0..1 boolean Definition: Coverage.payor Enable When: coverage.self.patient = false coverage.self.relatedPerson Andere Person 0..1 group Definition: Coverage.payor Enable When: coverage.self.patientRelatedPerson = true coverage.self.relatedPerson.familyName Name 0..1 string Definition: RelatedPerson.name.family coverage.self.relatedPerson.givenName Vorname 0..1 string Definition: RelatedPerson.name.given coverage.self.relatedPerson.phone Telefon 0..* string Definition: RelatedPerson.telecom.value coverage.self.relatedPerson.email E-Mail 0..1 string Definition: RelatedPerson.telecom.value coverage.self.relatedPerson.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: RelatedPerson.address.line coverage.self.relatedPerson.postalCode PLZ 0..1 string Definition: RelatedPerson.address.postalCode coverage.self.relatedPerson.city Ort 0..1 string Definition: RelatedPerson.address.city coverage.self.relatedPerson.country Land 0..1 string Definition: RelatedPerson.address.country coverage.other Anderer Kostenträger 0..1 group Definition: Coverage.type coverage.other.name Name des Kostenträgers 0..1 string Definition: Coverage.payor coverage.other.id Beliebige ID 0..1 string Definition: Coverage.identifier coverage.other.id.note Bemerkung zur ID 0..1 string Definition: Coverage.identifier.type.text sender Absender 1..1 group sender.author Verantwortlicher 1..1 group Definition: Composition.author sender.author.practitioner Verantwortliche Person 1..1 group Definition: PractitionerRole.practitioner sender.author.practitioner.title Titel 0..1 string Definition: Practitioner.name.prefix sender.author.practitioner.familyName Name 1..1 string Definition: Practitioner.name.family sender.author.practitioner.givenName Vorname 1..1 string Definition: Practitioner.name.given sender.author.practitioner.gln GLN 0..1 string Definition: Practitioner.identifier:GLN.value sender.author.practitioner.zsr ZSR 0..1 string Definition: Practitioner.identifier:ZSR.value sender.author.practitioner.phone Telefon 0..1 string Definition: Practitioner.telecom.value sender.author.practitioner.email E-Mail 0..1 string Definition: Practitioner.telecom.value sender.author.organization Verantwortliche Organisation 1..1 group Definition: PractitionerRole.organization sender.author.organization.name Name der Organisation 1..1 string Definition: Organization.name sender.author.organization.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: Organization.address.line sender.author.organization.postalCode PLZ 0..1 string Definition: Organization.address.postalCode sender.author.organization.city Ort 0..1 string Definition: Organization.address.city sender.author.organization.country Land 0..1 string Definition: Organization.address.country sender.dataenterer Erfasser 0..1 group Definition: Composition.extension:dataEnterer sender.dataenterer.practitioner Erfassende Person 0..1 group Definition: PractitionerRole.practitioner sender.dataenterer.practitioner.familyName Name 0..1 string Definition: Practitioner.name.family sender.dataenterer.practitioner.givenName Vorname 0..1 string Definition: Practitioner.name.given sender.dataenterer.practitioner.phone Telefon 0..1 string Definition: Practitioner.telecom.value sender.dataenterer.practitioner.email E-Mail 0..1 string Definition: Practitioner.telecom.value receiver Empfänger 0..1 group Definition: Composition.extension:receiver receiver.practitioner Empfangende Person 0..1 group Definition: PractitionerRole.practitioner receiver.practitioner.title Titel 0..1 string Definition: Practitioner.name.prefix receiver.practitioner.familyName Name 0..1 string Definition: Practitioner.name.family receiver.practitioner.givenName Vorname 0..1 string Definition: Practitioner.name.given receiver.practitioner.gln GLN 0..1 string Definition: Practitioner.identifier:GLN.value receiver.practitioner.zsr ZSR 0..1 string Definition: Practitioner.identifier:ZSR.value receiver.practitioner.phone Telefon 0..1 string Definition: Practitioner.telecom.value receiver.practitioner.email E-Mail 0..1 string Definition: Practitioner.telecom.value receiver.organization Empfangende Organisation 0..1 group Definition: PractitionerRole.organization receiver.organization.name Name der Organisation 0..1 string Definition: Organization.name receiver.organization.gln GLN 0..1 string Definition: http://fhir.ch/ig/ch-core/StructureDefinition-ch-core-organization-definitions.html#Organization.identifier:GLN receiver.organization.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: Organization.address.line receiver.organization.postalCode PLZ 0..1 string Definition: Organization.address.postalCode receiver.organization.city Ort 0..1 string Definition: Organization.address.city receiver.organization.country Land 0..1 string Definition: Organization.address.country receiverCopy Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate) 0..1 group Definition: Composition.extension:copyReceiver receiverCopy.practitionerRole Gesundheitsfachperson oder -organisation 0..* group Definition: PractitionerRole receiverCopy.practitionerRole.practitioner Gesundheitsfachperson 0..1 group Definition: PractitionerRole.practitioner receiverCopy.practitionerRole.practitioner.title Titel 0..1 string Definition: HumanName.prefix receiverCopy.practitionerRole.practitioner.familyName Name 0..1 string Definition: HumanName.family receiverCopy.practitionerRole.practitioner.givenName Vorname 0..1 string Definition: HumanName.given receiverCopy.practitionerRole.practitioner.phone Telefon 0..1 string Definition: ContactPoint.value receiverCopy.practitionerRole.practitioner.email E-Mail 0..1 string Definition: ContactPoint.value receiverCopy.practitionerRole.organization Gesundheitsorganisatiton 0..1 group Definition: PractitionerRole.organization receiverCopy.practitionerRole.organization.name Name der Organisation 0..1 string Definition: Organization.name receiverCopy.practitionerRole.organization.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: Address.line receiverCopy.practitionerRole.organization.postalCode PLZ 0..1 string Definition: Address.postalCode receiverCopy.practitionerRole.organization.city Ort 0..1 string Definition: Address.city receiverCopy.practitionerRole.organization.country Land 0..1 string Definition: Address.country receiverCopy.patient Patient selbst 0..1 boolean Definition: Patient receiverCopy.relatedPerson Andere Person 0..* group Definition: RelatedPerson receiverCopy.relatedPerson.familyName Name 0..1 string Definition: RelatedPerson.name.family receiverCopy.relatedPerson.givenName Vorame 0..1 string Definition: RelatedPerson.name.given receiverCopy.relatedPerson.phone Telefon 0..* string Definition: RelatedPerson.telecom.value receiverCopy.relatedPerson.email E-Mail 0..1 string Definition: RelatedPerson.telecom.value receiverCopy.relatedPerson.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: RelatedPerson.address.line receiverCopy.relatedPerson.postalCode PLZ 0..1 string Definition: RelatedPerson.address.postalCode receiverCopy.relatedPerson.city Ort 0..1 string Definition: RelatedPerson.address.city receiverCopy.relatedPerson.country Land 0..1 string Definition: RelatedPerson.address.country appointment Ort und Zeit der Durchführung der angeforderten Leistung 0..* group Definition: ServiceRequest.extension:locationAndTime appointment.location Ort der Durchführung 1..1 group Definition: Appointment.participant.actor appointment.location.name Name 1..1 string Definition: Location.name appointment.location.phone Telefon 0..1 string Definition: Location.telecom.value appointment.location.email E-Mail 0..1 string Definition: Location.telecom.value appointment.location.streetAddressLine Strasse, Hausnummer, Postfach etc. 0..* string Definition: Location.address.line appointment.location.postalCode PLZ 0..1 string Definition: Location.address.postalCode appointment.location.city Ort 0..1 string Definition: Location.address.city appointment.location.country Land 0..1 string Definition: Location.address.country appointment.requestedPeriod Datum und Zeit, wann der Termin bevorzugt geplant werden soll 0..1 group Definition: Appointment.requestedPeriod appointment.requestedPeriod.start Von 0..1 dateTime Definition: Appointment.requestedPeriod.start appointment.requestedPeriod.end Bis 0..1 dateTime Definition: Appointment.requestedPeriod.end appointment.status Status 1..1 choice Definition: Appointment.status Options: 3 options appointment.patientInstruction Patienteninformation für diesen Termin 0..1 string Definition: Appointment.patientInstruction purpose Wozu wird der Patient zugewiesen? 0..1 group purpose.aim Ziel 0..* string Definition: ServiceRequest.code.text reason.statement Begründung 0..* string Definition: ServiceRequest.reasonCode.text diagnosisList Diagnosen und Befunde 0..1 group diagnosisList.primarydiagnosis Hauptdiagnosen / Probleme 0..1 group diagnosisList.primaryDiagnosis.item Hauptdiagnose / Problem 0..* string Definition: ServiceRequest.reasonReference diagnosisList.secondarydiagnosis Nebendiagnosen / Probleme 0..1 group diagnosisList.secondaryDiagnosis.item Nebendiagnose / Problem 0..* string Definition: ServiceRequest.supportingInfo:diagnosis diagnosisList.bodyHeight Grösse (cm) 0..1 quantity Definition: ServiceRequest.supportingInfo:bodyHeight diagnosisList.bodyWeight Gewicht (kg) 0..1 quantity Definition: ServiceRequest.supportingInfo:bodyWeight diagnosisList.pregnancy Schwangerschaft 0..1 group diagnosisList.pregnancy.present Schwanger 0..1 boolean Definition: ServiceRequest.supportingInfo:pregnancy diagnosisList.pregnancy.expectedDeliveryDate Erwarteter Geburtstermin 0..1 dateTime Definition: ServiceRequest.supportingInfo:pregnancy anamnesis Anamnese 0..1 group anamnesis.historyofillnesses Bisherige Krankheiten und Unfälle 0..1 text Definition: ServiceRequest.supportingInfo:historyofIllnesses anamnesis.historyofprocedures Bisherige Abklärungen und Eingriffe 0..1 text Definition: ServiceRequest.supportingInfo:historyofProcedures anamnesis.devices Implantate, Schrittmacher, Neurostimulatoren etc. 0..1 text Definition: ServiceRequest.supportingInfo:devices anamnesis.socialhistory Sozialanamnese 0..1 text Definition: ServiceRequest.supportingInfo:socialHistory anamnesis.functionalStatus Funktion, Behinderungen 0..1 text Definition: ServiceRequest.supportingInfo:functionalStatus medication Aktuelle Medikation 0..1 group Definition: ServiceRequest.supportingInfo:medicationstatement medication.medicationstatement Medikation 0..* group Definition: MedicationStatement medication.medicationstatement.medication Medikament 0..1 string Definition: Medication.code.text medication.medicationstatement.dosage Dosierung 0..1 string Definition: MedicationStatement.dosage:nonstructured allergy Allergien und Intoleranzen 0..1 group allergy.allegiesIntolerances Allergien / Intoleranzen 0..1 text Definition: ServiceRequest.supportingInfo:allergiesIntolerances immunizationstatus Impfungen 0..1 group immunizationstatus.immunizations Bisherige Impfungen 0..1 text Definition: ServiceRequest.supportingInfo:immunizations lab Labor 0..1 group lab.labresults Laborresultat 0..* string Definition: ServiceRequest.supportingInfo:labresults pathology Pathologie 0..1 group pathology.pathologyresults Pathologiebefunde 0..1 text Definition: ServiceRequest.supportingInfo:pathologyresults imaging Bildgebung 0..1 group imaging.imagingresults Befunde aus der Bildgebung 0..1 text Definition: ServiceRequest.supportingInfo:imagingresults cardiology Kardiologie 0..1 group cardiology.cardiologyresults EKG / Kardiologische Befunde 0..1 text Definition: ServiceRequest.supportingInfo:cardiologyresults carePlans Verlauf 0..1 group carePlans.medical Ärztlicher Bericht 0..* text Definition: ServiceRequest.supportingInfo:medicalCarePlan carePlans.nursing Pflegebericht 0..* text Definition: ServiceRequest.supportingInfo:nursingCarePlan attachments Anhang 0..* group attachtment.title Dateiname und -endung der angehängten Datei (z.B. "shoulder_re_F_Muster_12021988.pdf") 0..1 string Definition: Media.content.title attachment.note Anmerkung 0..1 text Definition: Media.content.annotation attachment.data Daten 0..1 string Definition: Media.content.data note Bemerkungen 0..1 group note.text Text 0..1 text Definition: ServiceRequest.note.text Documentation for this format Option Sets Answer options for order.priority http://hl7.org/fhir/request-priority: routine ("Die Anfrage hat normale Priorität.") http://hl7.org/fhir/request-priority: urgent ("Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal.") http://hl7.org/fhir/request-priority: asap ("Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend.") http://hl7.org/fhir/request-priority: stat ("Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall.") Answer options for patient.gender http://hl7.org/fhir/administrative-gender: male ("Männlich") http://hl7.org/fhir/administrative-gender: female ("Weiblich") http://hl7.org/fhir/administrative-gender: other ("Anderes") Answer options for patient.maritalStatus http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 1 ("ledig") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 2 ("verheiratet") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 3 ("verwitwet") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 4 ("geschieden") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 5 ("unverheiratet") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 6 ("in eingetragener Partnerschaft") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 7 ("aufgelöste Partnerschaft") http://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus: 9 ("unbekannt") Answer options for requestedEncounter.class http://terminology.hl7.org/CodeSystem/v3-ActCode: AMB ("Ambulant") http://terminology.hl7.org/CodeSystem/v3-ActCode: IMP ("Stationär") http://terminology.hl7.org/CodeSystem/v3-ActCode: EMER ("Notfall") Answer options for requestedEncounter.desiredAccommodation http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype: 1 ("allgemein") http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype: 2 ("halbprivat") http://fhir.ch/ig/ch-core/CodeSystem/bfs-medstats-21-encountertype: 3 ("privat") Answer options for appointment.status http://hl7.org/fhir/appointmentstatus: proposed ("Wunsch des Patienten (vorgeschlagen)") http://hl7.org/fhir/appointmentstatus: pending ("Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)") http://hl7.org/fhir/appointmentstatus: booked ("Vom Patienten und Leistungserbringer bestätigt (gebucht)")
The Bundle that is to be used to pre-populate the form
Questionnaire Electronic Transition of Carer
Identifier Domain der Auftragsnummer des Auftraggebers
Identifier Domain der Auftragsnummer des Auftragsempfängers
Dringender Benachrichtigungskontakt für dieses Dokument
Dringender Benachrichtigungskontakt für die Antwort auf dieses Dokument
Die Anfrage sollte dringend bearbeitet werden - höhere Priorität als normal.
Die Anfrage sollte so schnell wie möglich bearbeitet werden - höhere Priorität als dringend.
Die Anfrage sollte sofort bearbeitet werden - höchstmögliche Priorität. Z.B. bei einem Notfall.
Voraussichtlich: Ambulant / Stationär / Notfall
Kopieempfänger (Kopie dieses Auftrags und aller daraus resultierenden Resultate)
Gesundheitsfachperson oder -organisation
Ort und Zeit der Durchführung der angeforderten Leistung
Datum und Zeit, wann der Termin bevorzugt geplant werden soll
Vom Patienten bestätigt, aber vom Leistungserbringer noch nicht (ausstehend)
Vom Patienten und Leistungserbringer bestätigt (gebucht)
Implantate, Schrittmacher, Neurostimulatoren etc.
Dateiname und -endung der angehängten Datei (z.B. "shoulder_re_F_Muster_12021988.pdf")