See Questionnaire for introduction and use of the resources and its elements.

Creating and Maintaining Questionnaire

Questionnaire are created and updated through Questionnaire Create and Questionnaire Update, respectively.

Later finding appropriate Questionnaire resources depends on the quality and granularity with which the Questionnaire elements are populated when created/updated. Consequently, effort should be made to ensure these elements are populated.

Filtering applied on finding appropriate Questionnaire could involve the following elements of Questionnaire:

useContext
ehealth-intendedAudience
ehealth-recommendation
status
juristiction

Possibly, the following elements (and others) could be used as well:

title
description
version
publisher
identifier

Preparing a Questionnaire for Infrastructure Rule Use

The description here applies for Questionnaire resources where processing of corresponding QuestionnaireResponse involves extraction of answer(s) to certain questions in the Questionnaire.

In the eHealth Infrastructure, such processing is performed through rules captured in Library resources. In order to make the rules robust and allow for change of question order and additional questions and answer options, the Questionnaire shall utilize defined questions in the form of DefinedQuestion resources. See DefinedQuestion for further details.

When a question in Questionnaire.item is eligible for extraction in a rule, a DefinedQuestion shall be either found or created and subsequently referenced in Questionnaire.item.definition.

The Questionnaire.item.definition shall be a business versioned reference on the form url|(business) version.

An example:

Questionnaire.item.definition Example

A Questionnaire containing a question suitable for calculating a Medical Research Council (MRC) score is to processed by a MRC score rule. Therefore the particular question must be identifiable in order to extract the answer value from a QuestionnaireResponse in a robust way.

In the following it is given that the MRC score question has been defined (see #Managing-DefinedQuestion) as a DefinedQuestion with:

url set to http://ehealth.sundhed.dk/DefinedQuestion/d3db2ad6-b45e-4d21-81db-bcd0ce5d15a3
version set to, say, 1

Preparing for robust extraction, the Questionnaire is defined with:

Questionnaire.item.definition set to http://ehealth.sundhed.dk/DefinedQuestion/d3db2ad6-b45e-4d21-81db-bcd0ce5d15a3|1

As noted in DefinedQuestion, despite any reference through Questionnaire.item.definition and the values the DefinedQuestion may have, it is the answer list and other values of the Questionnaire.item that take precedence.

Preparing a Questionnaire with Embedded, Simple Calculations

A Questionnaire defined with the eHealth profile ehealth-questionnaire-advanced (see https://docs.ehealth.sundhed.dk/latest-released/ig/StructureDefinition-ehealth-questionnaire-advanced.html) can contain zero, one or more expressions performing a calculation based on answers to questions in the Questionnaire. The expression can make use of zero, one or more variables which identify the particular question/answers more concisely.

Defining a Variable

Defining an Expression

Releasing a Questionnaire

Once a Questionnaire has been finalized it is eligible for use in PlanDefinition/ActivityDefinition telemedicine packages. Finalizing is performed by setting the Questionnaire status to value active through a Questionnaire Update.

The Questionnaire cannot be changed once having status set to active, except for retiring it by changing status to retired.

Retiring a Questionnaire

Retire a Questionnaire by setting the Questionnaire status to value retired through a Questionnaire Update.

Retiring a Questionnaire does not impact current or past use in resources referencing it. It signals that further use in new PlanDefinition/ActivityDefinition telemedicine packages should not happen.

Managing Defined Questions/Answers

See DefinedQuestion for introduction and use of the resource and its elements.

A DefinedQuestion serves multiple purposes:

Allows for establishing a versioned set of reusable questions, possibly with answer lists, that can be copied when defining Questionnaire resources.
Enables robust identification of a question in a Questionnaire. By adding the DefinedQuestion elements url and version with a pipe as separator to a particular question through Questionnaire.item.definition as described above, a rule can process a QuestionnaireResponse to the Questionnaire and reliably identify the answer to that question. The QuestionnaireResponse already uses the linkId from the Questionnaire.item.linkId to identify the particular question, but by traversing this link and doing lookup on any Questionnaire.item.definition, a rule can work irrespective of linkId values.

Example DefinedQuestion for MRC question (question text in Danish)

{
    "resourceType": "StructureDefinition",
    "id": "80557",
    "meta": {
        "versionId": "1",
        "lastUpdated": "2020-12-16T09:25:25.068+00:00",
        "profile": [
            "http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-definedquestion"
        ]
    },
    "url": "http://ehealth.sundhed.dk/DefinedQuestion/d3db2ad6-b45e-4d21-81db-bcd0ce5d15a3",
    "version": "1",
    "name": "Hvilket af nedenstående udsagn beskriver din situation bedst? \n\nAngiv dit svar:",
    "title": "Hvilket af nedenstående udsagn beskriver din situation bedst? \n\nAngiv dit svar:",
    "status": "active",
    "publisher": "IT Telecare Nord",
    "purpose": "Genbrugeligt spørgsmål til spørgeskema",
    "kind": "logical",
    "abstract": true,
    "type": "StructureDefinition",
    "differential": {
        "element": [
            {
                "id": "StructureDefinition",
                "path": "StructureDefinition.type",
                "definition": "Hvilket af nedenstående udsagn beskriver din situation bedst? \n\nAngiv dit svar:"
            }
        ]
    }
}

Managing Questionnaires