Da Vinci - Documentation Templates and Rules
2.1.0 - STU 2.1

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## : $next-question Input Parameters Example - JSON Representation

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    {
      "resourceType" : "Parameters",
      "id" : "NextQuestionInputParamsExample",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-next-question-input-parameters"
        ]
      },
      "parameter" : [
        {
          "name" : "in",
          "resource" : {
            "resourceType" : "QuestionnaireResponse",
            "id" : "home-o2-questionnaireresponse",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse"
              ]
            },
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context",
                "valueReference" : {
                  🔗 "reference" : "Coverage/CoverageExample"
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context",
                "valueReference" : {
                  🔗 "reference" : "ServiceRequest/ServiceRequestExample"
                }
              },
              {
                "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/intendedUse",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
                      "code" : "withorder",
                      "display" : "Include with order"
                    }
                  ]
                }
              }
            ],
            "questionnaire" : "http://hl7.org/fhir/us/davinci-dtr/Questionnaire/referred-questionnaire",
            "status" : "completed",
            "subject" : {
              🔗 "reference" : "Patient/examplepatient",
              "display" : "Vlad"
            },
            "authored" : "2023-08-21",
            "item" : [
              {
                "linkId" : "1",
                "text" : "Patient Information",
                "item" : [
                  {
                    "linkId" : "1.1",
                    "text" : "Last Name but Different This Time",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "override"
                              },
                              {
                                "extension" : [
                                  {
                                    "url" : "role",
                                    "valueCodeableConcept" : {
                                      "coding" : [
                                        {
                                          "system" : "http://terminology.hl7.org/CodeSystem/practitioner-role",
                                          "code" : "doctor",
                                          "display" : "Doctor"
                                        }
                                      ]
                                    }
                                  },
                                  {
                                    "url" : "practitioner",
                                    "valueReference" : {
                                      🔗 "reference" : "Practitioner/PractitionerExample",
                                      "display" : "Dr. Jane Doe"
                                    }
                                  }
                                ],
                                "url" : "author"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "Quinton"
                      }
                    ]
                  },
                  {
                    "linkId" : "1.2",
                    "text" : "First Name",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "Vlad"
                      }
                    ]
                  },
                  {
                    "linkId" : "1.3",
                    "text" : "Middle Initial",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "A, N"
                      }
                    ]
                  },
                  {
                    "linkId" : "1.4",
                    "text" : "Date Of Birth",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueDate" : "1956-12-01"
                      }
                    ]
                  },
                  {
                    "linkId" : "1.5",
                    "text" : "Gender",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueCoding" : {
                          "system" : "http://hl7.org/fhir/administrative-gender",
                          "code" : "male",
                          "display" : "Male"
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "1.6",
                    "text" : "Medicare ID",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "10A3D58WH22"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "2",
                "text" : "Provider who is performing face-to-face evaluation",
                "item" : [
                  {
                    "linkId" : "2.1",
                    "text" : "Last Name",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "Doe"
                      }
                    ]
                  },
                  {
                    "linkId" : "2.2",
                    "text" : "First Name",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "Jane"
                      }
                    ]
                  },
                  {
                    "linkId" : "2.3",
                    "text" : "Middle Initial",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "B"
                      }
                    ]
                  },
                  {
                    "linkId" : "2.4",
                    "text" : "NPI",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "1122334455"
                      }
                    ]
                  },
                  {
                    "linkId" : "2.5",
                    "text" : "Date of Face-To-Face Evaluation",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "override"
                              },
                              {
                                "extension" : [
                                  {
                                    "url" : "role",
                                    "valueCodeableConcept" : {
                                      "coding" : [
                                        {
                                          "system" : "http://terminology.hl7.org/CodeSystem/practitioner-role",
                                          "code" : "doctor",
                                          "display" : "Doctor"
                                        }
                                      ]
                                    }
                                  },
                                  {
                                    "url" : "practitioner",
                                    "valueReference" : {
                                      🔗 "reference" : "Practitioner/PractitionerExample",
                                      "display" : "Dr. Jane Doe"
                                    }
                                  }
                                ],
                                "url" : "author"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueDate" : "2019-07-18"
                      }
                    ]
                  },
                  {
                    "linkId" : "2.6",
                    "text" : "Record",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/containedReference",
                            "valueBoolean" : false
                          }
                        ],
                        "valueReference" : {
                          🔗 "reference" : "Patient/examplepatient",
                          "display" : "Mr. Saul Moki"
                        }
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "3",
                "text" : "Coverage Requirements",
                "item" : [
                  {
                    "linkId" : "3.1",
                    "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueCoding" : {
                          "system" : "http://snomed.info/sct",
                          "code" : "313296004",
                          "display" : "Mild chronic obstructive pulmonary disease"
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "3.2",
                    "text" : "Arterial oxygen saturation (Patient on room air while at rest and awake when tested)",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueQuantity" : {
                          "value" : 95,
                          "system" : "http://unitsofmeasure.org",
                          "code" : "mm[Hg]"
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "3.3",
                    "text" : "Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueQuantity" : {
                          "value" : 83,
                          "system" : "http://unitsofmeasure.org",
                          "code" : "mm[Hg]"
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "3.4",
                    "text" : "Arterial oxygen saturation (Patient tested during exercise)",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueQuantity" : {
                          "value" : 95,
                          "system" : "http://unitsofmeasure.org",
                          "code" : "mm[Hg]"
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "3.5",
                    "text" : "Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueQuantity" : {
                          "value" : 78,
                          "system" : "http://unitsofmeasure.org",
                          "code" : "mm[Hg]"
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "3.6",
                    "text" : "Is there a documented improvement of hypoxemia during exercise with oxygen?",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueBoolean" : true
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "4",
                "text" : "Prescribed Use",
                "item" : [
                  {
                    "linkId" : "4.1",
                    "text" : "Start date",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueDate" : "2019-07-18"
                      }
                    ]
                  },
                  {
                    "linkId" : "4.2",
                    "text" : "Length of need: (months) (99 = lifetime)",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueQuantity" : {
                          "value" : 99
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "4.3",
                    "text" : "Peak Flow Rate",
                    "item" : [
                      {
                        "linkId" : "4.3.1",
                        "text" : "LPM",
                        "answer" : [
                          {
                            "extension" : [
                              {
                                "extension" : [
                                  {
                                    "url" : "source",
                                    "valueCode" : "auto"
                                  }
                                ],
                                "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                              }
                            ],
                            "valueQuantity" : {
                              "value" : 2
                            }
                          }
                        ]
                      },
                      {
                        "linkId" : "4.3.2",
                        "text" : "oxygen %",
                        "answer" : [
                          {
                            "extension" : [
                              {
                                "extension" : [
                                  {
                                    "url" : "source",
                                    "valueCode" : "auto"
                                  }
                                ],
                                "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                              }
                            ],
                            "valueQuantity" : {
                              "value" : 98
                            }
                          }
                        ]
                      }
                    ]
                  },
                  {
                    "linkId" : "4.4",
                    "text" : "Average Flow Rate",
                    "item" : [
                      {
                        "linkId" : "4.4.1",
                        "text" : "LPM",
                        "answer" : [
                          {
                            "extension" : [
                              {
                                "extension" : [
                                  {
                                    "url" : "source",
                                    "valueCode" : "auto"
                                  }
                                ],
                                "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                              }
                            ],
                            "valueQuantity" : {
                              "value" : 2
                            }
                          }
                        ]
                      },
                      {
                        "linkId" : "4.4.2",
                        "text" : "oxygen %",
                        "answer" : [
                          {
                            "extension" : [
                              {
                                "extension" : [
                                  {
                                    "url" : "source",
                                    "valueCode" : "auto"
                                  }
                                ],
                                "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                              }
                            ],
                            "valueQuantity" : {
                              "value" : 97
                            }
                          }
                        ]
                      }
                    ]
                  },
                  {
                    "linkId" : "4.5",
                    "text" : "Frequency of use (choose all that apply)",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "At rest and awake"
                      }
                    ]
                  }
                ]
              },
              {
                "linkId" : "5",
                "text" : "Oxygen Supply Order Details",
                "item" : [
                  {
                    "linkId" : "5.1",
                    "text" : "Current Order Description",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueString" : "HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental"
                      }
                    ]
                  },
                  {
                    "linkId" : "5.1b",
                    "text" : "Current Order Is For A Portable Device"
                  },
                  {
                    "linkId" : "5.2",
                    "text" : "Type",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueCoding" : {
                          "system" : "http://example.org",
                          "code" : "122",
                          "display" : "Compressed Gas"
                        }
                      }
                    ]
                  },
                  {
                    "linkId" : "5.3",
                    "text" : "Means of oxygen delivery and accessories",
                    "answer" : [
                      {
                        "extension" : [
                          {
                            "extension" : [
                              {
                                "url" : "source",
                                "valueCode" : "auto"
                              }
                            ],
                            "url" : "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/information-origin"
                          }
                        ],
                        "valueCoding" : {
                          "system" : "http://example.org",
                          "code" : "134",
                          "display" : "Mask"
                        }
                      }
                    ]
                  }
                ]
              }
            ]
          }
        }
      ]
    }