Argonaut Questionnaire Implementation Guide (Release 1.0.0 )

This page is part of the Argonaut Questionnaire Implementation Guide (v1.0.0: Release) based on FHIR R3. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

XML Format: StructureDefinition-argo-adap-questionnaireresponse

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="argo-adap-questionnaireresponse"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-argo-adap-questionnaireresponse-definitions.html#QuestionnaireResponse">QuestionnaireResponse</a><a name="QuestionnaireResponse"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-argo-adap-questionnaireresponse-definitions.html#QuestionnaireResponse.contained">contained</a><a name="QuestionnaireResponse.contained"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-argo-questionnaire.html" title="Questionnaire">argo_questionnaire</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-adap-questionnaireresponse"/>
  <version value="1.0.0"/>
  <name value="argo_adap_questionnaireresponse"/>
  <title value="Argonaut Adaptive QuestionnaireResponse Profile"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2019-02-16T00:00:00+11:00"/>
  <description
               value="The Argonaut Adaptive QuestionnaireResponse Profile supports the [adaptive questionnaire use case](adaptive.html) and is derived from the [Argonaut QuestionnaireResponse profile](StructureDefinition-argo-questionnaireresponse.html). This profile defines the structure that is passed between the Client and Server using the [`$next-question`](OperationDefinition-next-question.html) operation and records the question-answer pairs and questionnaire questions from the adaptive questionnaire.

  **Mandatory Data Element:**
  - A [*contained*](http://hl7.org/fhir/STU3/references.html#contained) [Argonaut Questionnaire Profile](StructureDefinition-argo-questionnaire.html)"/>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="r4"/>
    <uri value="http://unknown.org/R4"/>
    <name value="R4"/>
  </mapping>
  <mapping>
    <identity value="r2"/>
    <uri value="http://unknown.org/R2"/>
    <name value="R2"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="QuestionnaireResponse"/>
  <baseDefinition
                  value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaireresponse"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="QuestionnaireResponse">
      <path value="QuestionnaireResponse"/>
      <short value="A structured set of questions and their answers"/>
      <definition
                  value="A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to."/>
      <comment
               value="The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on.  I.e. You don&#39;t need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse."/>
      <alias value="Form"/>
      <alias value="QuestionnaireAnswers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="QuestionnaireResponse"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="infrastructure.information"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.id">
      <path value="QuestionnaireResponse.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="QuestionnaireResponse.meta">
      <path value="QuestionnaireResponse.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="QuestionnaireResponse.implicitRules">
      <path value="QuestionnaireResponse.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="QuestionnaireResponse.language">
      <path value="QuestionnaireResponse.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="QuestionnaireResponse.text">
      <path value="QuestionnaireResponse.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.contained">
      <path value="QuestionnaireResponse.contained"/>
      <short value="A structured set of questions"/>
      <definition
                  value="A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection."/>
      <comment
               value="Since an adaptative questionnnaire is unique for each session,  the Server builds a unique questionnaire instance &quot;on the fly&quot; as each question is asked."/>
      <requirements
                    value="The responses to an adaptive questionnaire need the questionnaires context to be fully understood."/>
      <alias value="Form"/>
      <alias value="CRF"/>
      <alias value="Survey"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Questionnaire"/>
        <profile
                 value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaire"/>
      </type>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="que-2"/>
        <severity value="error"/>
        <human
               value="The link ids for groups and questions must be unique within the questionnaire"/>
        <expression value="descendants().linkId.isDistinct()"/>
        <xpath
               value="count(descendant::f:linkId/@value)=count(distinct-values(descendant::f:linkId/@value))"/>
        <source value="Questionnaire"/>
      </constraint>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[moodCode=DEF]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="infrastructure.information"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="Questionnaire"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="Questionnaire"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.extension">
      <path value="QuestionnaireResponse.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element id="QuestionnaireResponse.extension:q-response-period">
      <path value="QuestionnaireResponse.extension"/>
      <sliceName value="q-response-period"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-responsePeriod"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="QuestionnaireResponse.modifierExtension">
      <path value="QuestionnaireResponse.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.identifier">
      <path value="QuestionnaireResponse.identifier"/>
      <short value="Unique id for this set of answers"/>
      <definition
                  value="A business identifier assigned to a particular completed (or partially completed) questionnaire."/>
      <requirements
                    value="Used for tracking, registration and other business purposes."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.identifier"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.identifier"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.basedOn">
      <path value="QuestionnaireResponse.basedOn"/>
      <short value="Request fulfilled by this QuestionnaireResponse"/>
      <definition
                  value="The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse.  For example, a ProcedureRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression."/>
      <requirements
                    value="Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon."/>
      <alias value="order"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="QuestionnaireResponse.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ReferralRequest"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=FLFS].target"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.parent">
      <path value="QuestionnaireResponse.parent"/>
      <short value="Part of this action"/>
      <definition
                  value="A procedure or observation that this questionnaire was performed as part of the execution of.  For example, the surgery a checklist was executed as part of."/>
      <comment
               value="Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire.  For relationships to referrals, and other types of requests, use basedOn."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="QuestionnaireResponse.parent"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=COMP].source[moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.questionnaire">
      <path value="QuestionnaireResponse.questionnaire"/>
      <short value="Form being answered"/>
      <definition
                  value="The Questionnaire that defines and organizes the questions for which answers are being provided."/>
      <comment
               value="If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.)."/>
      <requirements
                    value="Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form."/>
      <alias value="Form"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.questionnaire"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaire"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="./outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.questionnaire"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.questionnaire"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.status">
      <path value="QuestionnaireResponse.status"/>
      <short
             value="in-progress | completed | amended | entered-in-error | stopped"/>
      <definition
                  value="The position of the questionnaire response within its overall lifecycle."/>
      <comment
               value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/>
      <requirements
                    value="The information on Questionnaire resources  may possibly be gathered during multiple sessions and altered after considered being finished."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireResponseStatus"/>
        </extension>
        <strength value="required"/>
        <description value="Lifecycle status of the questionnaire response."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/questionnaire-answers-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".statusCode (also whether there&#39;s a revisionControlAct - and possibly mood to distinguish &quot;in-progress&quot; from &quot;published)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.status"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.status"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.subject">
      <path value="QuestionnaireResponse.subject"/>
      <short value="The subject of the questions"/>
      <definition
                  value="The subject of the questionnaire response.  This could be a patient, organization, practitioner, device, etc.  This is who/what the answers apply to, but is not necessarily the source of information."/>
      <comment
               value="If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types."/>
      <requirements
                    value="Allows linking the answers to the individual the answers describe.  May also affect access control."/>
      <alias value="Patient"/>
      <alias value="Focus"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.subject"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.subject"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.context">
      <path value="QuestionnaireResponse.context"/>
      <short
             value="Encounter or Episode during which questionnaire was completed"/>
      <definition
                  value="The encounter or episode of care with primary association to the questionnaire response."/>
      <comment
               value="A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter."/>
      <requirements
                    value="Provides context for the information that was captured.  May also affect access control."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.context"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship(typeCode=COMP].source[classCode&lt;=PCPR, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.subject"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.subject"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.authored">
      <path value="QuestionnaireResponse.authored"/>
      <short value="Date the answers were gathered"/>
      <definition
                  value="The date and/or time that this set of answers were last changed."/>
      <comment
               value="May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured.

This element is optional to allow for systems that may not know the value, however it SHOULD be populated if possible."/>
      <requirements
                    value="Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers."/>
      <alias value="Date Created"/>
      <alias value="Date published"/>
      <alias value="Date Issued"/>
      <alias value="Date updated"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.authored"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.authored"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.authored"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.author">
      <path value="QuestionnaireResponse.author"/>
      <short value="Person who received and recorded the answers"/>
      <definition
                  value="Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system."/>
      <comment
               value="Mapping a subject&#39;s answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation.  Authoring by device would indicate that some portion of the questionnaire had been auto-populated."/>
      <requirements
                    value="Need to know who interpreted the subject&#39;s answers to the questions in the questionnaire, and selected the appropriate options for answers."/>
      <alias value="Laboratory"/>
      <alias value="Service"/>
      <alias value="Practitioner"/>
      <alias value="Department"/>
      <alias value="Company"/>
      <alias value="Performer"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.author"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.author"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.author"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.source">
      <path value="QuestionnaireResponse.source"/>
      <short value="The person who answered the questions"/>
      <definition
                  value="The person who answered the questions about the subject."/>
      <comment
               value="If not specified, no inference can be made about who provided the data."/>
      <requirements
                    value="When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.source"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=INF].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.source"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.source"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.source"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item">
      <path value="QuestionnaireResponse.item"/>
      <short value="Groups and questions"/>
      <definition
                  value="A group or question item from the original questionnaire for which answers are provided."/>
      <comment
               value="Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="QuestionnaireResponse.item"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="qrs-1"/>
        <severity value="error"/>
        <human value="Nested item can&#39;t be beneath both item and answer"/>
        <expression value="(answer.exists() and item.exists()).not()"/>
        <xpath value="not(exists(f:answer) and exists(f:item))"/>
        <source value="QuestionnaireResponse.item"/>
      </constraint>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.item"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.group"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.id">
      <path value="QuestionnaireResponse.item.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.extension">
      <path value="QuestionnaireResponse.item.extension"/>
      <slicing id="2">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element id="QuestionnaireResponse.item.extension:item-response-period">
      <path value="QuestionnaireResponse.item.extension"/>
      <sliceName value="item-response-period"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/extension-responsePeriod"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="QuestionnaireResponse.item.modifierExtension">
      <path value="QuestionnaireResponse.item.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.linkId">
      <path value="QuestionnaireResponse.item.linkId"/>
      <short value="Pointer to specific item from Questionnaire"/>
      <definition
                  value="The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource."/>
      <requirements
                    value="Items can repeat in the answers, so a direct 1..1 correspondence by position may not exist - requiring correspondence by identifier."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.item.linkId"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.item.linkId"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map
             value="QuestionnaireResponse.group.linkId, QuestionnaireResponse.group.question.linkId"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.definition">
      <path value="QuestionnaireResponse.item.definition"/>
      <short value="ElementDefinition - details for the item"/>
      <definition
                  value="A reference to an [ElementDefinition](http://hl7.org/fhir/STU3/elementdefinition.html) that provides the details for the item."/>
      <comment
               value="The ElementDefinition must be in a [StructureDefinition](http://hl7.org/fhir/STU3/structuredefinition.html) or a [DataElement](http://hl7.org/fhir/STU3/dataelement.html), and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x].

There is no need for this element if the item pointed to by the linkId has a definition listed."/>
      <requirements
                    value="A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.item.definition"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].code"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.text">
      <path value="QuestionnaireResponse.item.text"/>
      <short value="Name for group or question text"/>
      <definition
                  value="Text that is displayed above the contents of the group or as the text of the question being answered."/>
      <requirements
                    value="Allows the questionnaire response to be read without access to the questionnaire."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.item.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.item.text"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map
             value="QuestionnaireResponse.group.text. QuestionnaireResponse.group.question.text (QuestionnaireResponse.group.title (removed element in R3))"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.subject">
      <path value="QuestionnaireResponse.item.subject"/>
      <short value="The subject this group&#39;s answers are about"/>
      <definition
                  value="More specific subject this section&#39;s answers are about, details the subject given in QuestionnaireResponse."/>
      <requirements
                    value="Sometimes a group of answers is about a specific participant, artifact or piece of information in the patient&#39;s care or record, e.g. a specific Problem, RelatedPerson, Allergy etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.item.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=SBJ].role or .outboundRelationship[typeCode=SUBJ].target"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer">
      <path value="QuestionnaireResponse.item.answer"/>
      <short value="The response(s) to the question"/>
      <definition value="The respondent&#39;s answer(s) to the question."/>
      <comment
               value="The value is nested because we cannot have a repeating structure that has variable type."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="QuestionnaireResponse.item.answer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".value[type=LIST_ANY]"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.item.answer"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.group.question.answer"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.id">
      <path value="QuestionnaireResponse.item.answer.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.extension">
      <path value="QuestionnaireResponse.item.answer.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.modifierExtension">
      <path value="QuestionnaireResponse.item.answer.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.value[x]">
      <path value="QuestionnaireResponse.item.answer.value[x]"/>
      <short value="Single-valued answer to the question"/>
      <definition
                  value="The answer (or one of the answers) provided by the respondent to the question."/>
      <comment
               value="More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type.  Additional complex types can be introduced through extensions."/>
      <requirements
                    value="Ability to retain a single-valued answer to a question."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="QuestionnaireResponse.item.answer.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="date"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="decimal"/>
      </type>
      <type>
        <code value="integer"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="uri"/>
      </type>
      <type>
        <code value="Coding"/>
      </type>
      <type>
        <code value="Quantity"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="QuestionnaireAnswer"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Code indicating the response provided for a question."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".item"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.item.answer.value[x]"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.group.question.answer.value[x]"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.answer.item">
      <path value="QuestionnaireResponse.item.answer.item"/>
      <short value="Nested groups and questions"/>
      <definition
                  value="Nested groups and/or questions found within this particular answer."/>
      <requirements
                    value="It is useful to have &quot;sub-questions&quot;, questions which normally appear when certain answers are given and which collect additional details."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="QuestionnaireResponse.item.answer.item"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <contentReference value="#QuestionnaireResponse.item"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.item.answer.item"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse.group.question.answer.group"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.item.item">
      <path value="QuestionnaireResponse.item.item"/>
      <short value="Nested questionnaire response items"/>
      <definition
                  value="Questions or sub-groups nested beneath a question or group."/>
      <requirements value="Reports can consist of complex nested groups."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="QuestionnaireResponse.item.item"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <contentReference value="#QuestionnaireResponse.item"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse.item.item"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map
             value="QuestionnaireResponse.group.question, QuestionnaireResponse.group.group"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="QuestionnaireResponse">
      <path value="QuestionnaireResponse"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="r4"/>
        <map value="QuestionnaireResponse"/>
      </mapping>
      <mapping>
        <identity value="r2"/>
        <map value="QuestionnaireResponse"/>
      </mapping>
    </element>
    <element id="QuestionnaireResponse.contained">
      <path value="QuestionnaireResponse.contained"/>
      <comment
               value="Since an adaptative questionnnaire is unique for each session,  the Server builds a unique questionnaire instance &quot;on the fly&quot; as each question is asked."/>
      <requirements
                    value="The responses to an adaptive questionnaire need the questionnaires context to be fully understood."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Questionnaire"/>
        <profile
                 value="http://fhir.org/guides/argonaut/questionnaire/StructureDefinition/argo-questionnaire"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
  </differential>
</StructureDefinition>