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Support for FHIR version R4

This briefly details the support for FHIR R4 Questionnaire and QuestionnaireResponse. Note that we have also support for FHIR STU3 for Questionnaire and QuestionnaireResponse, but that is not documented here.

Questionnaire

See https://www.hl7.org/fhir/questionnaire.html for a list of the fields in Questionnaire. For a list of core extensions, see https://www.hl7.org/fhir/questionnaire-profiles.html#extensions.

Supported

Top-level fields

All top-level (form-level) fields are supported, but since most of those fields do not affect the rendering of a Questionnaire, mostly that means that if a Questionnaire containing those fields is imported into LHC-Forms, and re-exported in FHIR Questionnaire, the fields are preserved.

For "status", if it was not previously set at import, it will be set to "draft" on export.

Item-level fields

  • linkId
  • code
  • prefix
  • text
  • type: All types except reference, and with partial support for date, dateTime, and time. (See "not yet supported" for details.)
  • enableWhen: Supported, but has a couple of known bugs:
    • Does not support > on strings or dates.
    • For multi-select lists, the "exists" continues to return true after all selected values are removed.
  • enableWhenBehavior
  • required
  • repeats
  • readOnly
  • maxLength
  • answerValueSet: Supported, with the exception "contained" ValueSets are required to include an expansion.
  • answerOption: Except answerOption.initialSelected. (See below.)
  • initial

Extensions

  • maxSize
  • maxValue
  • mimeType
  • minLength
  • minValue
  • ordinalValue
  • choiceOrientation
  • hidden
  • itemControl: Support for types: gtable, table, drop-down, autocomplete, radio-button, check-box, help. Note that type "list", "inline", and "text-box" are default behavior, so those are supported, and the extension is not needed for those cases.
  • maxOccurs
  • minOccurs
  • unitOption
  • regex
  • variable

The following extensions seem to be out of scope for a form renderer, but they are "supported" in the sense that if a Questionnaire using them is re-exported from LHC-Forms, the extensions will still be present.

  • 11179-permitted-value-conceptmap
  • 11179-permitted-value-valueset
  • designNote
  • replaces
  • baseType

Not yet supported

Item-level fields

  • item.definition
  • item.type: No support for type=reference. Also, there are the following limitations on the support for types "date", "dateTime", and "time":
    • The date in "date" "dateTime" must be complete dates. No timezone is shown or selectable for "dateTime". When entering a dateTime the local timezone is assumed.
    • The time in "time" and "dateTime" must have both hours and minutes, only. Seconds and milliseconds cannot be entered.
    • We have not tested what happens if you load a QuestionnaireResponse with data that violates the above restrictions. We are planning to correct these deficiencies when we can find a suitable UI package that is more flexible about entry of dates and times. Possibly we will need to write our own.
  • answerValueSet: "contained" ValueSets without expansions are unsupported
  • answerOption.initialSelected: For now you need to use item.intial.value[x] instead, despite the contraint that says, "answerOption.empty() or initial.empty()".

Extensions

Note that non-supported extensions are simply ignored, but are also retained on a re-export to Questionnaire.

  • maxDecimalPlaces
  • constraint
  • displayCategory
  • itemControl: See above for supported types. Unsupported: htable, header, footer, lower, upper, flyover, lookup, slider, spinner. Type "unit" is unsupported, but is also unnecessary with LHC-Forms if "questionnaire-unit" is used. Type "prompt" is also unsupported but is being removed in R5 (https://jira.hl7.org/browse/FHIR-21023).
  • unitValueSet
  • usageMode

QuestionnaireResponse

See https://www.hl7.org/fhir/questionnaireresponse.html for a list of the fields in QuestionnaireResponse.

For a list of core extensions, see https://www.hl7.org/fhir/questionnaireresponse-profiles.html. LHC-Forms does not output any of those extensions when creating a QuestionnaireResponse, and they do not affect the display of the form if a QuestionnaireResponse containing them is imported.

Fields in QuestionnaireResponse

Because many of the fields in QuestionnaireResponse are either not relevant for rendering a form, or when exporting to a QuestionnaireResponse are left for the application to set, the following list is not broken out into supported and unsupported sub-sections as for Questionnaire.

  • identifier: Not used on import, and not set on export.
  • basedOn: Out of scope; this would be something for the application to set
  • partOf: Out of scope; this would be something for the application to set
  • questionnaire: LHC-Forms currently leaves it up the application to set this field, though in the future we plan to set it with value of Questionnaire.url.
  • status: LHC-Forms sets this to "completed", but the application should change this value it knows that it should be something else (e.g. "amended").
  • subject: The application can pass in the subject value as an option when exporting the QuestionnaireResponse, or it can set it afterward.
  • encounter: Left for the application to set. LHC-Forms would not know this except in certain cases.
  • authored: Set by LHC-Forms to the date and time at which the QuestionnaireResponse is exported.
  • author: Left for the application to set. LHC-Forms would not know this except in certain cases.
  • source: Left for the application to set. LHC-Forms would not know this except in certain cases.
  • item.linkId: Supported
  • item.definition: Not supported
  • item.text: LHC-Forms does not currently export this field, though we might change that in the future. It is not necessary, since it is present in the Questionnaire, but it makes it easier to read a QuestionnaireResponse by itself.
  • item.answer.value[x]: All types are supported except valueReference.
  • item.item: Supported