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  1. FHIR Specification Feedback
  2. FHIR-39722

The use of Observations where QuestionnaireReponse is more applicable

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US Core (FHIR)
    • 6.0.0-ballot [deprecated]
    • Cross-Group Projects
    • STU
    • Screening and Assessments
    • 3.6.2.3
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      1) Regarding the comment:

      The current text leans towards disallowing the use of Questionnaire and QuestionnaireResponse in US core compatible systems. I think this is one step to far. 

      US  Core will not disallow using Questionnaire and QuestionnaireResponse. See FHIR-39495 further details.

      In addition, unchanged from version 5.0.1, the Observation profile will:

      a) maintain a must support Observation.derivedFrom US CoreQuestionnaire Response

       

      b)  add an item to Observation Survey's Profile specific implementation guidance that

      • Although both `Reference(US Core Observation Survey Profile)` or `Reference(US Core QuestionnaireResponse Profile)` are marked as MustSupport for Observation.derivedFrom, the server system are not required to support both, but SHALL support at least one.

      c)  Add a US Core v5.0.1 Patch

       

      2) Regarding the comment:

      I propose that US core states that it specifies/defines the way that the results (answers) to the questionnaires who's support is required by US core are stored. This would be the Observation resources.

      US Core will provide the following guidance on storing responses:

      US Core Profile 5.0.1 6.0.0
      The US Core Observation Screening Assessment Profile SHALL(US Core Observation SDOH Assessment Profile) SHALL
      SDC Base Questionnaire undefined SHOULD
      US Core QuestionnaireResponse Profile MAY SHOULD

      and fully documented in the Screening and Assessments page

      3) Regarding the comment:

      US core should leave open whether the source questions and answers are stored using Questionnaire and QuestionnaireResponse resources for systems that choose to do so.

      We agree see 2) as well as FHIR-39495 for further details.

       

       

       

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      1) Regarding the comment: The current text leans towards disallowing the use of Questionnaire and QuestionnaireResponse in US core compatible systems. I think this is one step to far.  US  Core will not disallow using Questionnaire and QuestionnaireResponse. See FHIR-39495 further details. In addition, unchanged from version 5.0.1, the Observation profile will: a) maintain a must support Observation.derivedFrom US CoreQuestionnaire Response   b)  add an item to Observation Survey's Profile specific implementation guidance that Although both `Reference(US Core Observation Survey Profile)` or `Reference(US Core QuestionnaireResponse Profile)` are marked as MustSupport for Observation.derivedFrom, the server system are not required to support both, but  SHALL  support at least one. c)  Add a US Core v5.0.1 Patch   2) Regarding the comment: I propose that US core states that it specifies/defines the way that the results (answers) to the questionnaires who's support is required by US core are stored. This would be the Observation resources. US Core will provide the following guidance on storing responses: US Core Profile 5.0.1 6.0.0 The US Core Observation Screening Assessment Profile SHALL(US Core Observation SDOH Assessment Profile) SHALL SDC Base Questionnaire undefined SHOULD US Core QuestionnaireResponse Profile MAY SHOULD and fully documented in the Screening and Assessments page 3) Regarding the comment: US core should leave open whether the source questions and answers are stored using Questionnaire and QuestionnaireResponse resources for systems that choose to do so. We agree see 2) as well as FHIR-39495 for further details.      
    • Eric Haas / Jason Vogt : 13-0-0
    • Clarification
    • Compatible, substantive
    • Yes

    Description

      This section indicates the rationale for using Observations instead of QuestionnaireResponse. 

      FHIR, for very good reasons, choose to separate the template in which to gather data (Questionnaire) from the answers (QuestionnaireResponse) and the resulting clinical resources (Observations and others).

      The rationale given by US core indicates that US core wants to document the clinical results of specific questionnaires as clinical Observations. This is valid and the structure defined by US core for doing so can be used for this purpose.

      The current text leans towards disallowing the use of Questionnaire and QuestionnaireResponse in US core compatible systems. I think this is one step to far. 

      I propose that US core states that it specifies/defines the way that the results (answers) to the questionnaires who's support is required by US core are stored. This would be the Observation resources.

      US core should leave open whether the source questions and answers are stored using Questionnaire and QuestionnaireResponse resources for systems that choose to do so.

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            Unassigned Unassigned
            bvdh Bas van den Heuvel
            Bas van den Heuvel
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              Updated:
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