Introduction

The ehealth-definedquestion profile of StructureDefinition represents the concept of a DefinedQuestion. A DefinedQuestion is a standalone representation of a question and possibly its answer options that can be used in one or more Questionnaire resources. Although a Questionnaire can be constructed without being based on any DefinedQuestion, it is expected that a catalogue of DefinedQuestion will emerge over time and the particular DefinedQuestion will be reused in multiple Questionnaire.

The DefinedQuestion concept is based on ideas described in https://www.hl7.org/fhir/stu3/questionnaire.html#2.38.5.4. Whether a DefinedQuestion is referenced in a Questionnaire or not, it is the Questionnaire’s own definition which takes precedence.

Scope and Usage

In the eHealth Infrastructure, a reference to a DefinedQuestion by url in a Questionnaire question is used to enable robust extraction in automated processing rule(s) of answer(s) to that question from corresponding QuestionnaireResponse. An answer in a QuestionnaireResponse is already unambiguously related to a question in a Questionnaire through the question’s linkId. If the same question is used in another Questionnaire it will likely end up with a different linkId in that Questionnaire. By referencing a DefinedQuestion by its url in Questionnaire.item.definition, the same question can be referenced unambiguously in multiple Questionnaire.

Multiple DefinedQuestion with identical url can coexist as long as they have differing business versions in version. This way, different versions of the same question can have different answer options.

When using a DefinedQuestion in a Questionnaire, the Questionnaire.item.definition element must contain the url followed by a pipe and the business version thereby referencing a versioned DefinedQuestion.

An automated processing rule captured in a Library resource can, when extracting answer(s) to the question in a QuestionnaireResponse, choose to search for either the versioned reference or the version-less reference to a DefinedQuestion. The latter can be obtained by disregarding the pipe and business version in the rule logic.

The actual details of the DefinedQuestion’s question and possible answers are described in the ElementDefinition found in either snapshot.element or differential.element.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from StructureDefinition

Name	Flags	Card.	Type	Description & Constraints
StructureDefinition		0..*	StructureDefinition	Structural Definition
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
StructureDefinition	C	0..*	StructureDefinition	Structural Definition sdf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation sdf-1: Element paths must be unique unless the structure is a constraint sdf-15a: If the first element in a differential has no "." in the path and it's not a logical model, it has no type sdf-4: If the structure is not abstract, then there SHALL be a baseDefinition sdf-5: If the structure defines an extension then the structure must have context information sdf-6: A structure must have either a differential, or a snapshot (or both) sdf-9: In any snapshot or differential, no label, code or requirements on an element without a "." in the path (e.g. the first element) sdf-11: If there's a type, its content must match the path name in the first element of a snapshot sdf-14: All element definitions must have an id sdf-15: The first element in a snapshot has no type unless model is a logical model. sdf-16: All element definitions must have unique ids (snapshot) sdf-17: All element definitions must have unique ids (diff) sdf-18: Context Invariants can only be used for extensions sdf-19: FHIR Specification models only use FHIR defined types sdf-21: Default values can only be specified on specializations sdf-22: FHIR Specification models never have default values sdf-23: No slice name on root
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this structure definition, represented as a URI (globally unique)
name	ΣC	1..1	string	Name for this structure definition (computer friendly)
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
kind	Σ	1..1	code	primitive-type | complex-type | resource | logical Binding: StructureDefinitionKind (required): Defines the type of structure that a definition is describing.
abstract	Σ	1..1	boolean	Whether the structure is abstract
type	ΣC	1..1	uri	Type defined or constrained by this structure Binding: FHIRDefinedType (extensible): Either a resource or a data type, including logical model types.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
StructureDefinition.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
StructureDefinition.kind	required	StructureDefinitionKind http://hl7.org/fhir/ValueSet/structure-definition-kind|4.0.1 from the FHIR Standard
StructureDefinition.type	extensible	FHIRDefinedType http://hl7.org/fhir/ValueSet/defined-types from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
StructureDefinition	C	0..*	StructureDefinition	Structural Definition sdf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation sdf-1: Element paths must be unique unless the structure is a constraint sdf-15a: If the first element in a differential has no "." in the path and it's not a logical model, it has no type sdf-4: If the structure is not abstract, then there SHALL be a baseDefinition sdf-5: If the structure defines an extension then the structure must have context information sdf-6: A structure must have either a differential, or a snapshot (or both) sdf-9: In any snapshot or differential, no label, code or requirements on an element without a "." in the path (e.g. the first element) sdf-11: If there's a type, its content must match the path name in the first element of a snapshot sdf-14: All element definitions must have an id sdf-15: The first element in a snapshot has no type unless model is a logical model. sdf-16: All element definitions must have unique ids (snapshot) sdf-17: All element definitions must have unique ids (diff) sdf-18: Context Invariants can only be used for extensions sdf-19: FHIR Specification models only use FHIR defined types sdf-21: Default values can only be specified on specializations sdf-22: FHIR Specification models never have default values sdf-23: No slice name on root
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this structure definition, represented as a URI (globally unique)
identifier	Σ	0..*	Identifier	Additional identifier for the structure definition
version	Σ	0..1	string	Business version of the structure definition
name	ΣC	1..1	string	Name for this structure definition (computer friendly)
title	Σ	0..1	string	Name for this structure definition (human friendly)
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	0..1	boolean	For testing purposes, not real usage
date	Σ	0..1	dateTime	Date last changed
publisher	Σ	0..1	string	Name of the publisher (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
description		0..1	markdown	Natural language description of the structure definition
useContext	Σ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	Σ	0..*	CodeableConcept	Intended jurisdiction for structure definition (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose		0..1	markdown	Why this structure definition is defined
copyright		0..1	markdown	Use and/or publishing restrictions
keyword	Σ	0..*	Coding	Assist with indexing and finding Binding: DefinitionUseCodes (extensible): Codes for the meaning of the defined structure (SNOMED CT and LOINC codes, as an example).
fhirVersion	Σ	0..1	code	FHIR Version this StructureDefinition targets Binding: FHIRVersion (required): All published FHIR Versions.
mapping	C	0..*	BackboneElement	External specification that the content is mapped to sdf-2: Must have at least a name or a uri (or both)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identity		1..1	id	Internal id when this mapping is used
uri	C	0..1	uri	Identifies what this mapping refers to
name	C	0..1	string	Names what this mapping refers to
comment		0..1	string	Versions, Issues, Scope limitations etc.
kind	Σ	1..1	code	primitive-type | complex-type | resource | logical Binding: StructureDefinitionKind (required): Defines the type of structure that a definition is describing.
abstract	Σ	1..1	boolean	Whether the structure is abstract
context	ΣC	0..*	BackboneElement	If an extension, where it can be used in instances
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	code	fhirpath | element | extension Binding: ExtensionContextType (required): How an extension context is interpreted.
expression	Σ	1..1	string	Where the extension can be used in instances
contextInvariant	ΣC	0..*	string	FHIRPath invariants - when the extension can be used
type	ΣC	1..1	uri	Type defined or constrained by this structure Binding: FHIRDefinedType (extensible): Either a resource or a data type, including logical model types.
baseDefinition	ΣC	0..1	canonical(StructureDefinition)	Definition that this type is constrained/specialized from
derivation	Σ	0..1	code	specialization | constraint - How relates to base definition Binding: TypeDerivationRule (required): How a type relates to its baseDefinition.
snapshot	C	0..1	BackboneElement	Snapshot view of the structure sdf-3: Each element definition in a snapshot must have a formal definition and cardinalities sdf-8: All snapshot elements must start with the StructureDefinition's specified type for non-logical models, or with the same type name for logical models sdf-8b: All snapshot elements must have a base definition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
element	C	1..*	ElementDefinition	Definition of elements in the resource (if no StructureDefinition) sdf-10: provide either a binding reference or a description (or both)
differential	C	0..1	BackboneElement	Differential view of the structure sdf-20: No slicing on the root element sdf-8a: In any differential, all the elements must start with the StructureDefinition's specified type for non-logical models, or with the same type name for logical models
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
element		1..*	ElementDefinition	Definition of elements in the resource (if no StructureDefinition)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
StructureDefinition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
StructureDefinition.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
StructureDefinition.jurisdiction	extensible	Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction from the FHIR Standard
StructureDefinition.keyword	extensible	DefinitionUseCodes http://hl7.org/fhir/ValueSet/definition-use from the FHIR Standard
StructureDefinition.fhirVersion	required	FHIRVersion http://hl7.org/fhir/ValueSet/FHIR-version|4.0.1 from the FHIR Standard
StructureDefinition.kind	required	StructureDefinitionKind http://hl7.org/fhir/ValueSet/structure-definition-kind|4.0.1 from the FHIR Standard
StructureDefinition.context.type	required	ExtensionContextType http://hl7.org/fhir/ValueSet/extension-context-type|4.0.1 from the FHIR Standard
StructureDefinition.type	extensible	FHIRDefinedType http://hl7.org/fhir/ValueSet/defined-types from the FHIR Standard
StructureDefinition.derivation	required	TypeDerivationRule http://hl7.org/fhir/ValueSet/type-derivation-rule|4.0.1 from the FHIR Standard

Differential View

This structure is derived from StructureDefinition

Name	Flags	Card.	Type	Description & Constraints
StructureDefinition		0..*	StructureDefinition	Structural Definition
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
StructureDefinition	C	0..*	StructureDefinition	Structural Definition sdf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation sdf-1: Element paths must be unique unless the structure is a constraint sdf-15a: If the first element in a differential has no "." in the path and it's not a logical model, it has no type sdf-4: If the structure is not abstract, then there SHALL be a baseDefinition sdf-5: If the structure defines an extension then the structure must have context information sdf-6: A structure must have either a differential, or a snapshot (or both) sdf-9: In any snapshot or differential, no label, code or requirements on an element without a "." in the path (e.g. the first element) sdf-11: If there's a type, its content must match the path name in the first element of a snapshot sdf-14: All element definitions must have an id sdf-15: The first element in a snapshot has no type unless model is a logical model. sdf-16: All element definitions must have unique ids (snapshot) sdf-17: All element definitions must have unique ids (diff) sdf-18: Context Invariants can only be used for extensions sdf-19: FHIR Specification models only use FHIR defined types sdf-21: Default values can only be specified on specializations sdf-22: FHIR Specification models never have default values sdf-23: No slice name on root
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this structure definition, represented as a URI (globally unique)
name	ΣC	1..1	string	Name for this structure definition (computer friendly)
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
kind	Σ	1..1	code	primitive-type | complex-type | resource | logical Binding: StructureDefinitionKind (required): Defines the type of structure that a definition is describing.
abstract	Σ	1..1	boolean	Whether the structure is abstract
type	ΣC	1..1	uri	Type defined or constrained by this structure Binding: FHIRDefinedType (extensible): Either a resource or a data type, including logical model types.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
StructureDefinition.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
StructureDefinition.kind	required	StructureDefinitionKind http://hl7.org/fhir/ValueSet/structure-definition-kind|4.0.1 from the FHIR Standard
StructureDefinition.type	extensible	FHIRDefinedType http://hl7.org/fhir/ValueSet/defined-types from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
StructureDefinition	C	0..*	StructureDefinition	Structural Definition sdf-0: Name should be usable as an identifier for the module by machine processing applications such as code generation sdf-1: Element paths must be unique unless the structure is a constraint sdf-15a: If the first element in a differential has no "." in the path and it's not a logical model, it has no type sdf-4: If the structure is not abstract, then there SHALL be a baseDefinition sdf-5: If the structure defines an extension then the structure must have context information sdf-6: A structure must have either a differential, or a snapshot (or both) sdf-9: In any snapshot or differential, no label, code or requirements on an element without a "." in the path (e.g. the first element) sdf-11: If there's a type, its content must match the path name in the first element of a snapshot sdf-14: All element definitions must have an id sdf-15: The first element in a snapshot has no type unless model is a logical model. sdf-16: All element definitions must have unique ids (snapshot) sdf-17: All element definitions must have unique ids (diff) sdf-18: Context Invariants can only be used for extensions sdf-19: FHIR Specification models only use FHIR defined types sdf-21: Default values can only be specified on specializations sdf-22: FHIR Specification models never have default values sdf-23: No slice name on root
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	1..1	uri	Canonical identifier for this structure definition, represented as a URI (globally unique)
identifier	Σ	0..*	Identifier	Additional identifier for the structure definition
version	Σ	0..1	string	Business version of the structure definition
name	ΣC	1..1	string	Name for this structure definition (computer friendly)
title	Σ	0..1	string	Name for this structure definition (human friendly)
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	0..1	boolean	For testing purposes, not real usage
date	Σ	0..1	dateTime	Date last changed
publisher	Σ	0..1	string	Name of the publisher (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
description		0..1	markdown	Natural language description of the structure definition
useContext	Σ	0..*	UsageContext	The context that the content is intended to support
jurisdiction	Σ	0..*	CodeableConcept	Intended jurisdiction for structure definition (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose		0..1	markdown	Why this structure definition is defined
copyright		0..1	markdown	Use and/or publishing restrictions
keyword	Σ	0..*	Coding	Assist with indexing and finding Binding: DefinitionUseCodes (extensible): Codes for the meaning of the defined structure (SNOMED CT and LOINC codes, as an example).
fhirVersion	Σ	0..1	code	FHIR Version this StructureDefinition targets Binding: FHIRVersion (required): All published FHIR Versions.
mapping	C	0..*	BackboneElement	External specification that the content is mapped to sdf-2: Must have at least a name or a uri (or both)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identity		1..1	id	Internal id when this mapping is used
uri	C	0..1	uri	Identifies what this mapping refers to
name	C	0..1	string	Names what this mapping refers to
comment		0..1	string	Versions, Issues, Scope limitations etc.
kind	Σ	1..1	code	primitive-type | complex-type | resource | logical Binding: StructureDefinitionKind (required): Defines the type of structure that a definition is describing.
abstract	Σ	1..1	boolean	Whether the structure is abstract
context	ΣC	0..*	BackboneElement	If an extension, where it can be used in instances
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	code	fhirpath | element | extension Binding: ExtensionContextType (required): How an extension context is interpreted.
expression	Σ	1..1	string	Where the extension can be used in instances
contextInvariant	ΣC	0..*	string	FHIRPath invariants - when the extension can be used
type	ΣC	1..1	uri	Type defined or constrained by this structure Binding: FHIRDefinedType (extensible): Either a resource or a data type, including logical model types.
baseDefinition	ΣC	0..1	canonical(StructureDefinition)	Definition that this type is constrained/specialized from
derivation	Σ	0..1	code	specialization | constraint - How relates to base definition Binding: TypeDerivationRule (required): How a type relates to its baseDefinition.
snapshot	C	0..1	BackboneElement	Snapshot view of the structure sdf-3: Each element definition in a snapshot must have a formal definition and cardinalities sdf-8: All snapshot elements must start with the StructureDefinition's specified type for non-logical models, or with the same type name for logical models sdf-8b: All snapshot elements must have a base definition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
element	C	1..*	ElementDefinition	Definition of elements in the resource (if no StructureDefinition) sdf-10: provide either a binding reference or a description (or both)
differential	C	0..1	BackboneElement	Differential view of the structure sdf-20: No slicing on the root element sdf-8a: In any differential, all the elements must start with the StructureDefinition's specified type for non-logical models, or with the same type name for logical models
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
element		1..*	ElementDefinition	Definition of elements in the resource (if no StructureDefinition)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
StructureDefinition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
StructureDefinition.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
StructureDefinition.jurisdiction	extensible	Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction from the FHIR Standard
StructureDefinition.keyword	extensible	DefinitionUseCodes http://hl7.org/fhir/ValueSet/definition-use from the FHIR Standard
StructureDefinition.fhirVersion	required	FHIRVersion http://hl7.org/fhir/ValueSet/FHIR-version|4.0.1 from the FHIR Standard
StructureDefinition.kind	required	StructureDefinitionKind http://hl7.org/fhir/ValueSet/structure-definition-kind|4.0.1 from the FHIR Standard
StructureDefinition.context.type	required	ExtensionContextType http://hl7.org/fhir/ValueSet/extension-context-type|4.0.1 from the FHIR Standard
StructureDefinition.type	extensible	FHIRDefinedType http://hl7.org/fhir/ValueSet/defined-types from the FHIR Standard
StructureDefinition.derivation	required	TypeDerivationRule http://hl7.org/fhir/ValueSet/type-derivation-rule|4.0.1 from the FHIR Standard

This structure is derived from StructureDefinition

Summary