CH LAB-Order (R4)
2.0.0-ballot - ballot Switzerland flag

This page is part of the CH LAB-Order (R4) (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Questionnaire: questionnaire 1-tvt

Official URL: http://fhir.ch/ig/ch-lab-order/Questionnaire/1-tvt Version: 2.0.0-ballot
Active as of 2020-12-17 Computable Name: LabOrderFormExample

Copyright/Legal: CC0-1.0

Structure
LinkIdTextCardinalityTypeFlagsDescription & Constraintsdoco
.. LabOrderFormExampleQuestionnairehttp://fhir.ch/ig/ch-lab-order/Questionnaire/1-tvt#2.0.0-ballot
... orderAuftrag1..1group
.... order.placerOrderIdentifierAuftragsnummer des Auftraggebers0..1string
.... order.placerOrderIdentifierDomainIdentifier Domain der Auftragsnummer des Auftraggebers0..1stringicon
.... order.fillerOrderIdentifierAuftragsnummer des Auftragsempfängers0..1string
.... order.fillerOrderIdentifierDomainIdentifier Domain der Auftragsnummer des Auftragsempfängers0..1stringicon
.... order.precedentDocumentIdentifierIdentifier des Vorgängerdokuments0..1stringicon
.... order.notificationContactDocumentDringender Benachrichtigungskontakt für dieses Dokument0..1group
..... order.notificationContactDocument.practitionerZu benachrichtigende Person0..1group
...... order.notificationContactDocument.practitioner.titleTitel0..1string
...... order.notificationContactDocument.practitioner.familyNameName0..1string
...... order.notificationContactDocument.practitioner.givenNameVorname0..1string
...... order.notificationContactDocument.practitioner.phoneTelefon0..1string
...... order.notificationContactDocument.practitioner.emailE-Mail0..1string
.... order.notificationContactDocumentResponseDringender Benachrichtigungskontakt für die Antwort auf dieses Dokument0..1group
..... order.notificationContactDocumentResponse.practitionerZu benachrichtigende Person0..1group
...... order.notificationContactDocumentResponse.practitioner.titleTitel0..1string
...... order.notificationContactDocumentResponse.practitioner.familyNameName0..1string
...... order.notificationContactDocumentResponse.practitioner.givenNameVorname0..1string
...... order.notificationContactDocumentResponse.practitioner.phoneTelefon0..1string
...... order.notificationContactDocumentResponse.practitioner.emailE-Mail0..1string
.... order.priorityAuftragspriorität0..1choiceOptions: 4 options
... receiverEmpfänger0..1group
.... receiver.practitionerEmpfangende Person0..1group
..... receiver.practitioner.titleTitel0..1string
..... receiver.practitioner.familyNameName0..1string
..... receiver.practitioner.givenNameVorname0..1string
..... receiver.practitioner.glnGLN0..1string
..... receiver.practitioner.zsrZSR0..1string
..... receiver.practitioner.phoneTelefon0..1string
..... receiver.practitioner.emailE-Mail0..1string
.... receiver.organizationEmpfangende Organisation0..1group
..... receiver.organization.nameName der Organisation0..1string
..... receiver.organization.glnGLN0..1string
..... receiver.organization.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*string
..... receiver.organization.postalCodePLZ0..1string
..... receiver.organization.cityOrt0..1string
..... receiver.organization.countryLand0..1string
... patientPatient1..1group
.... patient.familyNameName0..1string
.... patient.maidenNameLedigname0..1string
.... patient.givenNameVorname0..1string
.... patient.localPidLokale Patienten-ID0..1string
.... patient.birthDateGeburtsdatum0..1date
.... patient.genderGeschlecht0..1choiceOptions: 3 options
.... patient.maritalStatusZivilstand0..1choiceDefinition: Patient.maritalStatus
Options: 8 options
.... patient.phoneTelefon0..1string
.... patient.emailE-Mail0..1string
.... patient.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*string
.... patient.postalCodePLZ0..1string
.... patient.cityOrt0..1string
.... patient.countryLand0..1string
.... 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
... senderAbsender1..1group
.... sender.authorVerantwortlicher1..1group
..... sender.author.practitionerVerantwortliche Person0..1group
...... sender.author.practitioner.titleTitel0..1string
...... sender.author.practitioner.familyNameName0..1string
...... sender.author.practitioner.givenNameVorname0..1string
...... sender.author.practitioner.glnGLN0..1string
...... sender.author.practitioner.zsrZSR0..1string
...... sender.author.practitioner.phoneTelefon0..1string
...... sender.author.practitioner.emailE-Mail0..1string
..... sender.author.organizationVerantwortliche Organisation0..1group
...... sender.author.organization.nameName der Organisation0..1string
...... sender.author.organization.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*string
...... sender.author.organization.postalCodePLZ0..1string
...... sender.author.organization.cityOrt0..1string
...... sender.author.organization.countryLand0..1string
.... sender.dataentererErfasser0..1group
..... sender.dataenterer.practitionerErfassende Person0..1group
...... sender.dataenterer.practitioner.familyNameName0..1string
...... sender.dataenterer.practitioner.givenNameVorname0..1string
...... sender.dataenterer.practitioner.phoneTelefon0..1string
...... sender.dataenterer.practitioner.emailE-Mail0..1string
... receiverCopiesKopieempfänger0..1group
.... receiverCopyKopieempfangende Organisation oder Person0..*groupDefinition: PractitionerRole
..... receiverCopy.organization.nameName der Organisation0..1stringDefinition: 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.titleTitel0..1stringDefinition: 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.familyNameName0..1string
..... receiverCopy.givenNameVorname0..1string
..... receiverCopy.phoneTelefon0..1string
..... receiverCopy.emailE-Mail0..1string
..... receiverCopy.streetAddressLineStrasse, Hausnummer, Postfach etc.0..*string
..... receiverCopy.postalCodePLZ0..1string
..... receiverCopy.cityOrt0..1string
..... receiverCopy.countryLand0..1string
.... 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
... consentEinverständniserklärung0..1groupDefinition: http://fhir.ch/ig/ch-lab-order/StructureDefinition/ch-lab-order-servicerequest#ServiceRequest.supportingInfo
.... consent.treatmentEinverständnis des Patienten zur Behandlung0..1string
.... consent.patientPrivacyEinverständnis des Patienten zum Datenschutz0..1string
.... consent.researchEinverständnis des Patienten zur Forschung0..1string
.... consent.advancedCareDirectivePatientenverfügung0..1string
... coverageKostenträger0..1groupDefinition: http://fhir.ch/ig/ch-lab-order/StructureDefinition/ch-lab-order-servicerequest#ServiceRequest.insurance
.... coverage.uvgUnfallversicherung (nach UVG)0..1string
.... coverage.kvgGrundversicherung (nach KVG)0..1string
.... coverage.vvgZusatzversicherung (nach VVG)0..1string
.... coverage.vvgOtherAndere (nach VVG)0..1string
... previousResultVorheriges Untersuchungsresultat0..1groupDefinition: http://fhir.ch/ig/ch-lab-order/StructureDefinition/ch-lab-order-servicerequest#ServiceRequest.supportingInfo
.... previousResult.resultUntersuchungsresultat0..*string
... hematologyHematology0..1group
.... hemato-subsetHämatologie Subset0..*choiceOptions: 5 options
... coagulationCoagulation0..1group
.... d-dimerD-Dimer0..*choiceOptions: 1 option
... ccclinical chemistry0..1group
.... crpCRP0..*choiceOptions: 4 options

doco Documentation for this format

Option Sets

Answer options for order.priority

  • iconhttp://hl7.org/fhir/request-priority#routine ("Routine")
  • iconhttp://hl7.org/fhir/request-priority#urgent ("Urgent")
  • iconhttp://hl7.org/fhir/request-priority#asap ("ASAP")
  • iconhttp://hl7.org/fhir/request-priority#stat ("STAT")

Answer options for patient.gender

  • iconhttp://hl7.org/fhir/administrative-gender#male ("Male")
  • iconhttp://hl7.org/fhir/administrative-gender#female ("Female")
  • iconhttp://hl7.org/fhir/administrative-gender#other ("Other")

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 hemato-subset

  • http://loinc.org#24360-0 ("Hemoglobin and Hematocrit panel - Blood")
  • http://loinc.org#43113-0 ("Hemoglobin electrophoresis panel in Blood")
  • http://loinc.org#57021-8 ("CBC W Auto Differential panel - Blood")
  • http://loinc.org#58410-2 ("CBC panel - Blood by Automated count")
  • http://loinc.org#57023-4 ("Auto Differential panel - Blood")

Answer options for d-dimer

  • http://loinc.org#55398-2 ("Short Fibrin D-dimer FEU and DDU panel - Platelet poor plasma")

Answer options for crp

  • iconhttp://loinc.org#1988-5 ("C reactive protein [Mass/Volume] in Serum or Plasma")
  • iconhttp://loinc.org#76485-2 ("C reactive protein [Moles/volume] in Serum or Plasma")
  • iconhttp://loinc.org#30522-7 ("C reactive protein [Mass/volume] in Serum or Plasma by High sensitivity method")
  • iconhttp://loinc.org#76486-0 ("C reactive protein [Moles/volume] in Serum or Plasma by High sensitivity method")