Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1

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## : CDex QuestionnaireResponse Example3 - XML Representation

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    <QuestionnaireResponse xmlns="http://hl7.org/fhir">
      <id value="cdex-questionnaireresponse-example3"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse cdex-questionnaireresponse-example3</b></p><a name="cdex-questionnaireresponse-example3"> </a><a name="hccdex-questionnaireresponse-example3"> </a><a name="cdex-questionnaireresponse-example3-en-US"> </a><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Definition</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Answer</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #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_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireResponseRoot" class="hierarchy"/> cdex-questionnaireresponse-example3</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire:<a href="Questionnaire-cdex-questionnaire-example2.html">Home Oxygen Therapy Questionnaire</a></td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> 1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Examplitis</td></tr>
    <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #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-q-string.png" alt="." style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> 2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Order Reason</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span><span>example.org 4: Replacement</span></span></td></tr>
    <tr><td colspan="4" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature">
        <valueSignature>
          <type>
            <system value="urn:iso-astm:E1762-95:2013"/>
            <code value="1.2.840.10065.1.12.1.5"/>
            <display value="Verification Signature"/>
          </type>
          <when value="2022-06-17T22:42:19-07:00"/>
          <who>
            <identifier>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="NPI"/>
                  <display value="National Provider Identifier"/>
                </coding>
              </type>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="9941339108"/>
            </identifier>
            <display value="CDex Example Provider"/>
          </who>
          <onBehalfOf>
            <identifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1184932014"/>
            </identifier>
          </onBehalfOf>
          <sigFormat value="image/jpg"/>
          <data
                value=" "/>
        </valueSignature>
      </extension>
      <questionnaire value="http://example.org/cdex-questionnaire-example2"/>
      <status value="completed"/>
      <subject>
        <identifier>
          <use value="usual"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="MB"/>
              <display value="Member Number"/>
            </coding>
            <text value="Member Number"/>
          </type>
          <system value="http://example.org/cdex/payer/member-ids"/>
          <value value="Member123"/>
        </identifier>
        <display value="Amy Shaw"/>
      </subject>
      <authored value="2022-06-17"/>
      <author>
        <identifier>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="9941339100"/>
        </identifier>
      </author>
      <item>
        <linkId value="1"/>
        <text
              value="Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)"/>
        <answer>
          <valueString value="Examplitis"/>
        </answer>
      </item>
      <item>
        <linkId value="2"/>
        <text value="Order Reason"/>
        <answer>
          <valueCoding>
            <system value="http://example.org"/>
            <code value="4"/>
            <display value="Replacement"/>
          </valueCoding>
        </answer>
      </item>
    </QuestionnaireResponse>