Background

Based on FHIR-39495, US Core will keep the version 5.0.1 US Core QuestionnaireResponse Profile.  This profile has a must support on `meta.tag` to indicate context like "sdoh" with a binding to US Core Tags ValueSet. The intent of this element was to mimic a category element like `Observation.category` without adding an extension to support filtering and searching by category. However this MS element is problematic since meta.tags are server-specific and not expected to span servers like category elements such as `Observation.category`.

In version 6, we recommend supporting both SDC Questionnaire and US Core QuestionnaireResponse Profiles and since the context is typically provided by the Questionnaire (specifically using `Questionnaire.useContext`).

Proposal

1) Remove the MS on meta.tag and the US Core Tags ValueSet
2) Remove the QuestionnaireResponse tag SeachParameter combo from the SHOULD in the QuickStart and Capstatement
3) Add guidance to use `Questionnaire.useContext` with a useContext with code="focus" and valueCodeableConcept of SDOH/functionalStatus/etc.

• this context could includes all the USCDI contexts for assessments which are defined in US Core Category which Simple Observation and Screening and Assessments Observation currently use.
  • sdoh
  • functional-status
  • disability-status
  • cognitive-status

Searching for all QRs for a patient whose Questionnaire has a specific context could be accomplished using a chained search:

GET [base]/QuestionnaireResponse?subject=Patient/123&questionnaire.context-type-value=focus$sdoh

4) provide examples

 
Note:

• useContext is not part of the SDC Base Questionnaire Profile, and we are not proposing a new Questionnaire Profile
• this is not a breaking change, but search functionality may not be supported in future versions.