CH ORF (R4)
0.10.0 - STU 1 Ballot
This page is part of the CH ORF (R4) (v0.10.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 3.0.2. For a full list of available versions, see the Directory of published versions
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<id value="qr-radiology-order"/>
<meta>
<profile
value="http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-questionnaireresponse"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>questionnaire</b>: <a href="http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form">http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form</a></p><p><b>status</b>: completed</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order</p><p><b>text</b>: Auftrag</p><blockquote><p><b>item</b></p><p><b>linkId</b>: order.title</p><p><b>text</b>: Titel</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.type</p><p><b>text</b>: Typ</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.category</p><p><b>text</b>: Kategorie</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifier</p><p><b>text</b>: Auftragsnummer des Auftraggebers</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.placerOrderIdentifierDomain</p><p><b>text</b>: Identifier Domain der Auftragsnummer des Auftraggebers</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: order.priority</p><p><b>text</b>: Auftragspriorität</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver</p><p><b>text</b>: Empfänger</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.practitioner</p><p><b>text</b>: Empfangende Person</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiver.organization</p><p><b>text</b>: Empfangende Organisation</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient</p><p><b>text</b>: Patient</p><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.familyName</p><p><b>text</b>: Name</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.maidenName</p><p><b>text</b>: Ledigname</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.givenName</p><p><b>text</b>: Vorname</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.birthDate</p><p><b>text</b>: Geburtsdatum</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.gender</p><p><b>text</b>: Geschlecht</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.phone</p><p><b>text</b>: Telefon</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.email</p><p><b>text</b>: E-Mail</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.streetAddressLine</p><p><b>text</b>: Strasse, Hausnummer, Postfach etc.</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.postalCode</p><p><b>text</b>: PLZ</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.city</p><p><b>text</b>: Ort</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: patient.country</p><p><b>text</b>: Land</p><h3>Answers</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender</p><p><b>text</b>: Absender</p><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.author</p><p><b>text</b>: Verantwortlicher</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: sender.dataenterer</p><p><b>text</b>: Erfasser</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopies</p><p><b>text</b>: Kopieempfänger</p><blockquote><p><b>item</b></p><p><b>linkId</b>: receiverCopy</p><p><b>text</b>: Kopieempfangende Organisation oder Person</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></blockquote></div>
</text>
<questionnaire
value="http://fhir.ch/ig/ch-orf/Questionnaire/order-referral-form"/>
<status value="completed"/>
<item>
<linkId value="order"/>
<text value="Auftrag"/>
<item>
<linkId value="order.title"/>
<text value="Titel"/>
<answer>
<valueString value="Order-Referral-Form"/>
</answer>
</item>
<item>
<linkId value="order.type"/>
<text value="Typ"/>
<answer>
<valueCoding>
<system value="urn:oid:2.16.756.5.30.1.127.3.4"/>
<code value="2161000195103"/>
<display value="Imaging order (record artifact)"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="order.category"/>
<text value="Kategorie"/>
<answer>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="721963009"/>
<display value="Order (record artifact)"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="order.placerOrderIdentifier"/>
<text value="Auftragsnummer des Auftraggebers"/>
<answer>
<valueString value="2156286"/>
</answer>
</item>
<item>
<linkId value="order.placerOrderIdentifierDomain"/>
<text value="Identifier Domain der Auftragsnummer des Auftraggebers"/>
<answer>
<valueString value="urn:oid:2.999.1.3.4.5.6.7"/>
</answer>
</item>
<item>
<linkId value="order.priority"/>
<text value="Auftragspriorität"/>
<answer>
<valueCoding>
<system value="http://hl7.org/fhir/request-priority"/>
<code value="routine"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="receiver"/>
<text value="Empfänger"/>
<item>
<linkId value="receiver.practitioner"/>
<text value="Empfangende Person"/>
<item>
<linkId value="receiver.practitioner.title"/>
<text value="Titel"/>
<answer>
<valueString value="Dr. med."/>
</answer>
</item>
<item>
<linkId value="receiver.practitioner.familyName"/>
<text value="Name"/>
<answer>
<valueString value="Rderfiller"/>
</answer>
</item>
<item>
<linkId value="receiver.practitioner.givenName"/>
<text value="Vorname"/>
<answer>
<valueString value="Otto"/>
</answer>
</item>
<item>
<linkId value="receiver.practitioner.gln"/>
<text value="GLN"/>
<answer>
<valueString value="7601000066878"/>
</answer>
</item>
<item>
<linkId value="receiver.practitioner.phone"/>
<text value="Telefon"/>
<answer>
<valueString value="044 412 00 99"/>
</answer>
</item>
<item>
<linkId value="receiver.practitioner.email"/>
<text value="E-Mail"/>
<answer>
<valueString value="o.rderfiller@happyhospital.ch"/>
</answer>
</item>
</item>
<item>
<linkId value="receiver.organization"/>
<text value="Empfangende Organisation"/>
<item>
<linkId value="receiver.organization.name"/>
<text value="Name der Organisation"/>
<answer>
<valueString value="Klinik Happy Hospital"/>
</answer>
</item>
<item>
<linkId value="receiver.organization.streetAddressLine"/>
<text value="Strasse, Hausnummer, Postfach etc."/>
<answer>
<valueString value="Seestrasse 133"/>
</answer>
<answer>
<valueString value="Haus C"/>
</answer>
</item>
<item>
<linkId value="receiver.organization.postalCode"/>
<text value="PLZ"/>
<answer>
<valueString value="8000"/>
</answer>
</item>
<item>
<linkId value="receiver.organization.city"/>
<text value="Ort"/>
<answer>
<valueString value="Zürich"/>
</answer>
</item>
<item>
<linkId value="receiver.organization.country"/>
<text value="Land"/>
<answer>
<valueString value="Schweiz"/>
</answer>
</item>
</item>
</item>
<item>
<linkId value="patient"/>
<text value="Patient"/>
<item>
<linkId value="patient.familyName"/>
<text value="Name"/>
<answer>
<valueString value="Ufferer"/>
</answer>
</item>
<item>
<linkId value="patient.maidenName"/>
<text value="Ledigname"/>
<answer>
<valueString value="Leidend"/>
</answer>
</item>
<item>
<linkId value="patient.givenName"/>
<text value="Vorname"/>
<answer>
<valueString value="Susanna"/>
</answer>
</item>
<item>
<linkId value="patient.birthDate"/>
<text value="Geburtsdatum"/>
<answer>
<valueDate value="1970-03-14"/>
</answer>
</item>
<item>
<linkId value="patient.gender"/>
<text value="Geschlecht"/>
<answer>
<valueCoding>
<system value="http://hl7.org/fhir/administrative-gender"/>
<code value="female"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="patient.phone"/>
<text value="Telefon"/>
<answer>
<valueString value="079 979 79 79"/>
</answer>
</item>
<item>
<linkId value="patient.email"/>
<text value="E-Mail"/>
<answer>
<valueString value="susanna@ufferer.ch"/>
</answer>
</item>
<item>
<linkId value="patient.streetAddressLine"/>
<text value="Strasse, Hausnummer, Postfach etc."/>
<answer>
<valueString value="Musterweg"/>
</answer>
<answer>
<valueString value="6a"/>
</answer>
</item>
<item>
<linkId value="patient.postalCode"/>
<text value="PLZ"/>
<answer>
<valueString value="8000"/>
</answer>
</item>
<item>
<linkId value="patient.city"/>
<text value="Ort"/>
<answer>
<valueString value="Zürich"/>
</answer>
</item>
<item>
<linkId value="patient.country"/>
<text value="Land"/>
<answer>
<valueString value="Schweiz"/>
</answer>
</item>
</item>
<item>
<linkId value="sender"/>
<text value="Absender"/>
<item>
<linkId value="sender.author"/>
<text value="Verantwortlicher"/>
<item>
<linkId value="sender.author.practitioner"/>
<text value="Verantwortliche Person"/>
<item>
<linkId value="sender.author.practitioner.title"/>
<text value="Titel"/>
<answer>
<valueString value="Dr. med."/>
</answer>
</item>
<item>
<linkId value="sender.author.practitioner.familyName"/>
<text value="Name"/>
<answer>
<valueString value="Rderplacer"/>
</answer>
</item>
<item>
<linkId value="sender.author.practitioner.givenName"/>
<text value="Vorname"/>
<answer>
<valueString value="Ottilie"/>
</answer>
</item>
<item>
<linkId value="sender.author.practitioner.gln"/>
<text value="GLN"/>
<answer>
<valueString value="7601000034321"/>
</answer>
</item>
<item>
<linkId value="sender.author.practitioner.phone"/>
<text value="Telefon"/>
<answer>
<valueString value="044 333 22 11"/>
</answer>
</item>
<item>
<linkId value="sender.author.practitioner.email"/>
<text value="E-Mail"/>
<answer>
<valueString value="o.rderplacer@happydoctors.ch"/>
</answer>
</item>
</item>
<item>
<linkId value="sender.author.organization"/>
<text value="Verantwortliche Organisation"/>
<item>
<linkId value="sender.author.organization.name"/>
<text value="Name der Organisation"/>
<answer>
<valueString value="Praxis Happy Doctors"/>
</answer>
</item>
<item>
<linkId value="sender.author.organization.streetAddressLine"/>
<text value="Strasse, Hausnummer, Postfach etc."/>
<answer>
<valueString value="Kantonsstrasse 14"/>
</answer>
<answer>
<valueString value="Postfach 14"/>
</answer>
</item>
<item>
<linkId value="sender.author.organization.postalCode"/>
<text value="PLZ"/>
<answer>
<valueString value="8000"/>
</answer>
</item>
<item>
<linkId value="sender.author.organization.city"/>
<text value="Ort"/>
<answer>
<valueString value="Zürich"/>
</answer>
</item>
<item>
<linkId value="sender.author.organization.country"/>
<text value="Land"/>
<answer>
<valueString value="Schweiz"/>
</answer>
</item>
</item>
</item>
<item>
<linkId value="sender.dataenterer"/>
<text value="Erfasser"/>
<item>
<linkId value="sender.dataenterer.practitioner"/>
<text value="Erfassende Person"/>
<item>
<linkId value="sender.dataenterer.practitioner.familyName"/>
<text value="Name"/>
<answer>
<valueString value="Ataenterer"/>
</answer>
</item>
<item>
<linkId value="sender.dataenterer.practitioner.givenName"/>
<text value="Vorname"/>
<answer>
<valueString value="Doris"/>
</answer>
</item>
<item>
<linkId value="sender.dataenterer.practitioner.phone"/>
<text value="Telefon"/>
<answer>
<valueString value="044 333 22 11"/>
</answer>
</item>
<item>
<linkId value="sender.dataenterer.practitioner.email"/>
<text value="E-Mail"/>
<answer>
<valueString value="d.ataenterer@happydoctors.ch"/>
</answer>
</item>
</item>
</item>
</item>
<item>
<linkId value="receiverCopies"/>
<text value="Kopieempfänger"/>
<item>
<linkId value="receiverCopy"/>
<text value="Kopieempfangende Organisation oder Person"/>
<item>
<linkId value="receiverCopy.familyName"/>
<text value="Name"/>
<answer>
<valueString value="Ufferer"/>
</answer>
</item>
<item>
<linkId value="receiverCopy.givenName"/>
<text value="Vorname"/>
<answer>
<valueString value="Susanna"/>
</answer>
</item>
<item>
<linkId value="receiverCopy.phone"/>
<text value="Telefon"/>
<answer>
<valueString value="079 979 79 79"/>
</answer>
</item>
<item>
<linkId value="receiverCopy.email"/>
<text value="E-Mail"/>
<answer>
<valueString value="susanna@ufferer.ch"/>
</answer>
</item>
<item>
<linkId value="receiverCopy.streetAddressLine"/>
<text value="Strasse, Hausnummer, Postfach etc."/>
<answer>
<valueString value="Musterweg"/>
</answer>
<answer>
<valueString value="6a"/>
</answer>
</item>
<item>
<linkId value="receiverCopy.postalCode"/>
<text value="PLZ"/>
<answer>
<valueString value="8000"/>
</answer>
</item>
<item>
<linkId value="receiverCopy.city"/>
<text value="Ort"/>
<answer>
<valueString value="Zürich"/>
</answer>
</item>
<item>
<linkId value="receiverCopy.country"/>
<text value="Land"/>
<answer>
<valueString value="Schweiz"/>
</answer>
</item>
</item>
</item>
</QuestionnaireResponse>