1.7.1 - release

SHINNYHRSN - Local Development build (v1.7.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: SHINNYQuestionnaireProfile - XML Profile

Active as of 2025-12-09

XML representation of the shinny-questionnaire resource profile.

Raw xml | Download

    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="shinny-questionnaire"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition shinny-questionnaire</b></p><a name="shinny-questionnaire"> </a><a name="hcshinny-questionnaire"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-shinny-questionnaire-definitions.html#Questionnaire">Questionnaire</a><a name="Questionnaire"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire.html">SDCBaseQuestionnaire</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">A structured set of questions</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-shinny-questionnaire-definitions.html#Questionnaire.id">id</a><a name="Questionnaire.id"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#id">id</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-shinny-questionnaire-definitions.html#Questionnaire.meta">meta</a><a name="Questionnaire.meta"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-SHINNYMeta.html" title="Meta">SHINNYMeta</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Metadata about the resource</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-shinny-questionnaire-definitions.html#Questionnaire.language">language</a><a name="Questionnaire.language"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Language of the resource content</span><br class="binding"/><span style="font-weight:bold" title="null" class="binding">Binding: </span><a href="ValueSet-SHINNYLanguageVS.html" title="http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS" class="binding">SHINNYLanguageVS</a><span title="null" class="binding"> (</span><a href="http://hl7.org/fhir/R4/terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes but are not required to do so to be considered conformant." class="binding">preferred</a><span title="null" class="binding">)</span></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <url
           value="http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-questionnaire"/>
      <version value="1.7.1"/>
      <name value="SHINNYQuestionnaireProfile"/>
      <title value="SHINNY Questionnaire Profile"/>
      <status value="active"/>
      <date value="2025-12-09T09:01:49-05:00"/>
      <publisher value="shinny"/>
      <contact>
        <name value="shinny"/>
        <telecom>
          <system value="url"/>
          <value value="https://test.shinny.org/us/ny/hrsn.index.html"/>
        </telecom>
      </contact>
      <description
                   value="* SHINNY HRSN: Needed for Referrals and Assessments. Include in Questionnaire and Referral bundles.
    * Profiled off of the [SDC Base Questionnaire](https://build.fhir.org/ig/HL7/sdc/StructureDefinition-sdc-questionnaire.html): A structured set of questions intended to guide the collection of answers from end-users. Questionnaires provide detailed control over order, presentation, phraseology and grouping to allow coherent, consistent data collection."/>
      <fhirVersion value="4.0.1"/>
      <mapping>
        <identity value="workflow"/>
        <uri value="http://hl7.org/fhir/workflow"/>
        <name value="Workflow Pattern"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <uri value="http://hl7.org/v3"/>
        <name value="RIM Mapping"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <uri value="http://hl7.org/fhir/fivews"/>
        <name value="FiveWs Pattern Mapping"/>
      </mapping>
      <mapping>
        <identity value="objimpl"/>
        <uri value="http://hl7.org/fhir/object-implementation"/>
        <name value="Object Implementation Information"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <uri value="http://hl7.org/v2"/>
        <name value="HL7 v2 Mapping"/>
      </mapping>
      <kind value="resource"/>
      <abstract value="false"/>
      <type value="Questionnaire"/>
      <baseDefinition
                      value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"/>
      <derivation value="constraint"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="3.0.0"/>
        </extension>
        <element id="Questionnaire">
          <path value="Questionnaire"/>
          <short value="A structured set of questions"/>
          <definition
                      value="Sets minimum expectations for questionnaire support for SDC-conformant systems, regardless of which SDC capabilities they're making use of."/>
          <alias value="Form"/>
          <alias value="CRF"/>
          <alias value="Survey"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <constraint>
            <key value="dom-2"/>
            <severity value="error"/>
            <human
                   value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
            <expression value="contained.contained.empty()"/>
            <xpath value="not(parent::f:contained and f:contained)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-3"/>
            <severity value="error"/>
            <human
                   value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/>
            <expression
                        value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
            <xpath
                   value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-4"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
            <expression
                        value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
            <xpath
                   value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-5"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
            <expression value="contained.meta.security.empty()"/>
            <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
              <valueBoolean value="true"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
              <valueMarkdown
                             value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
            </extension>
            <key value="dom-6"/>
            <severity value="warning"/>
            <human
                   value="A resource should have narrative for robust management"/>
            <expression value="text.`div`.exists()"/>
            <xpath value="exists(f:text/h:div)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="que-0"/>
            <severity value="warning"/>
            <human
                   value="Name should be usable as an identifier for the module by machine processing applications such as code generation"/>
            <expression value="name.matches('[A-Z]([A-Za-z0-9_]){0,254}')"/>
            <xpath
                   value="not(exists(f:name/@value)) or matches(f:name/@value, '[A-Z]([A-Za-z0-9_]){0,254}')"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-2"/>
            <severity value="error"/>
            <human
                   value="The link ids for groups and questions must be unique within the questionnaire"/>
            <expression value="descendants().linkId.isDistinct()"/>
            <xpath
                   value="count(descendant::f:linkId/@value)=count(distinct-values(descendant::f:linkId/@value))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Entity. Role, or Act"/>
          </mapping>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="Observation[moodCode=DEF]"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="Form_Package"/>
          </mapping>
        </element>
        <element id="Questionnaire.id">
          <path value="Questionnaire.id"/>
          <short
                 value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
          <definition
                      value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
          <comment
                   value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Resource.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="id"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Questionnaire.meta">
          <path value="Questionnaire.meta"/>
          <short value="Metadata about the resource"/>
          <definition
                      value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Resource.meta"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Meta"/>
            <profile
                     value="http://test.shinny.org/us/ny/hrsn/StructureDefinition/SHINNYMeta"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Questionnaire.implicitRules">
          <path value="Questionnaire.implicitRules"/>
          <short value="A set of rules under which this content was created"/>
          <definition
                      value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
          <comment
                   value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.implicitRules"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/>
          <isSummary value="true"/>
        </element>
        <element id="Questionnaire.language">
          <path value="Questionnaire.language"/>
          <short value="Language of the resource content"/>
          <definition
                      value="The base language in which the resource is written."/>
          <comment
                   value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.language"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <strength value="preferred"/>
            <valueSet
                      value="http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS"/>
          </binding>
        </element>
        <element id="Questionnaire.text">
          <path value="Questionnaire.text"/>
          <short value="Text summary of the resource, for human interpretation"/>
          <definition
                      value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
          <comment
                   value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
          <alias value="narrative"/>
          <alias value="html"/>
          <alias value="xhtml"/>
          <alias value="display"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Narrative"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Act.text?"/>
          </mapping>
        </element>
        <element id="Questionnaire.contained">
          <path value="Questionnaire.contained"/>
          <short value="Contained, inline Resources"/>
          <definition
                      value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
          <comment
                   value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
          <alias value="inline resources"/>
          <alias value="anonymous resources"/>
          <alias value="contained resources"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.contained"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Resource"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.extension">
          <path value="Questionnaire.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="open"/>
          </slicing>
          <short value="Extension"/>
          <definition value="An Extension"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Questionnaire.extension:designNote">
          <path value="Questionnaire.extension"/>
          <sliceName value="designNote"/>
          <short value="Design comments"/>
          <definition
                      value="Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users."/>
          <comment
                   value="Allows capture of todos, rationale for design decisions, etc.  It can also be used to capture comments about the completion of the form in general. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the &quot;data&quot; of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use [[[Observation]]]."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile value="http://hl7.org/fhir/StructureDefinition/designNote"/>
          </type>
          <condition value="ele-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
        </element>
        <element id="Questionnaire.extension:terminologyServer">
          <path value="Questionnaire.extension"/>
          <sliceName value="terminologyServer"/>
          <short value="Preferred terminology server"/>
          <definition
                      value="Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears).  If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository."/>
          <comment
                   value="This includes those referenced by answerValueSet as well as the unitValueSet extension."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer"/>
          </type>
          <condition value="ele-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
        </element>
        <element id="Questionnaire.extension:performerType">
          <path value="Questionnaire.extension"/>
          <sliceName value="performerType"/>
          <short value="Resource that can record answers to this Questionnaire"/>
          <definition
                      value="Indicates the types of resources that can record answers to a Questionnaire. Open Issue: Should this extension be moved to core?"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-performerType"/>
          </type>
          <condition value="ele-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
        </element>
        <element id="Questionnaire.extension:assemble-expectation">
          <path value="Questionnaire.extension"/>
          <sliceName value="assemble-expectation"/>
          <short value="Questionnaire is modular"/>
          <definition
                      value="If present, indicates that this questionnaire has expectations with respect to assembly.  Specifically, indicates whether this form requires assembly (i.e. it can't be used directly without invoking the [$assemble](http://hl7.org/fhir/uv/sdc/STU3/OperationDefinition-Questionnaire-assemble.html) operation operation on it) and/or whether it is intended for use only as a 'child' in an assembly process.  The assembly processs might mean filling in item metadata based on information looked up from item.definitions and/or retrieving sub-questionnaires pointed to by [sub-questionnaire](http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-subQuestionnaire.html) extensions."/>
          <comment
                   value="SDC-conformant Questionnaires **SHALL** declare this extension if they require an assembly process prior to use.  If not declared, then the Questionnaire is not necessarily safe for use as a child form and does not require assembly prior to use."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-assemble-expectation"/>
          </type>
          <condition value="ele-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
        </element>
        <element id="Questionnaire.modifierExtension">
          <path value="Questionnaire.modifierExtension"/>
          <short value="Extensions that cannot be ignored"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.url">
          <path value="Questionnaire.url"/>
          <short
                 value="Canonical identifier for this questionnaire, represented as a URI (globally unique)"/>
          <definition
                      value="An absolute URI that is used to identify this questionnaire when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this questionnaire is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the questionnaire is stored on different servers."/>
          <comment
                   value="The name of the referenced questionnaire can be conveyed using the http://hl7.org/fhir/StructureDefinition/display extension."/>
          <requirements
                        value="…  This is the id that will be used to link a QuestionnaireResponse to the Questionnaire the response is for."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.url"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.url"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.identifier"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".identifier[scope=BUSN;reliability=ISS]"/>
          </mapping>
        </element>
        <element id="Questionnaire.identifier">
          <path value="Questionnaire.identifier"/>
          <short value="Additional identifier for the questionnaire"/>
          <definition
                      value="A formal identifier that is used to identify this questionnaire when it is represented in other formats, or referenced in a specification, model, design or an instance."/>
          <comment
                   value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this questionnaire outside of FHIR, where it is not possible to use the logical URI."/>
          <requirements
                        value="Allows externally provided and/or usable business identifiers to be easily associated with the module."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.identifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Identifier"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.identifier"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.identifier"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".identifier"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="Questionnaire.version">
          <path value="Questionnaire.version"/>
          <short value="Business version of the questionnaire"/>
          <definition
                      value="The identifier that is used to identify this version of the questionnaire when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the questionnaire author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence."/>
          <comment
                   value="There may be different questionnaire instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a reference to a particular business version of the questionnaire with the format [url]|[version]."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.version"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.version"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.version"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A (to add?)"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="Not currently in schema"/>
          </mapping>
        </element>
        <element id="Questionnaire.name">
          <path value="Questionnaire.name"/>
          <short value="Name for this questionnaire (computer friendly)"/>
          <definition
                      value="A natural language name identifying the questionnaire. This name should be usable as an identifier for the module by machine processing applications such as code generation."/>
          <comment
                   value="The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly."/>
          <requirements value="Support human navigation and code generation."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.name"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <condition value="inv-0"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.title">
          <path value="Questionnaire.title"/>
          <short value="Name for this questionnaire (human friendly)"/>
          <definition
                      value="A short, descriptive, user-friendly title for the questionnaire."/>
          <comment
                   value="This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.title"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.title"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".title"/>
          </mapping>
        </element>
        <element id="Questionnaire.derivedFrom">
          <path value="Questionnaire.derivedFrom"/>
          <short value="Instantiates protocol or definition"/>
          <definition
                      value="The URL of a Questionnaire that this Questionnaire is based on."/>
          <requirements
                        value="Allows a Questionnaire to be created based on another Questionnaire."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.derivedFrom"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="canonical"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.derivedFrom"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=DRIV].target[classCode=OBS, moodCode=DEFN]"/>
          </mapping>
        </element>
        <element id="Questionnaire.status">
          <path value="Questionnaire.status"/>
          <short value="draft | active | retired | unknown"/>
          <definition
                      value="The status of this questionnaire. Enables tracking the life-cycle of the content."/>
          <comment
                   value="Allows filtering of questionnaires that are appropriate for use versus not."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.status"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="true"/>
          <isModifierReason
                            value="This is labeled as &quot;Is Modifier&quot; because applications should not use a retired {{title}} without due consideration"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="PublicationStatus"/>
            </extension>
            <strength value="required"/>
            <description value="The lifecycle status of an artifact."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/publication-status|4.0.1"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.status"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.status"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".status"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map
                 value="./administration_package/registration/state/registration_status"/>
          </mapping>
        </element>
        <element id="Questionnaire.experimental">
          <path value="Questionnaire.experimental"/>
          <short value="For testing purposes, not real usage"/>
          <definition
                      value="A Boolean value to indicate that this questionnaire is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage."/>
          <comment
                   value="Allows filtering of questionnaires that are appropriate for use versus not."/>
          <requirements
                        value="Enables experimental content to be developed following the same lifecycle that would be used for a production-level questionnaire."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.experimental"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.experimental"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.class"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.subjectType">
          <path value="Questionnaire.subjectType"/>
          <short value="Resource that can be subject of QuestionnaireResponse"/>
          <definition
                      value="The types of subjects that can be the subject of responses created for the questionnaire."/>
          <comment value="If none are specified, then the subject is unlimited."/>
          <requirements
                        value="A Questionnaire SHOULD specify the subject. However, it is optional to support legacy questionnaires."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.subjectType"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ResourceType"/>
            </extension>
            <strength value="required"/>
            <description
                         value="One of the resource types defined as part of this version of FHIR."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.subject[x]"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=META].target[classCode=OBS, moodCode=DEFN, isCriterion=true].participation.role.classCode"/>
          </mapping>
        </element>
        <element id="Questionnaire.date">
          <path value="Questionnaire.date"/>
          <short value="Date last changed"/>
          <definition
                      value="The date  (and optionally time) when the questionnaire was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the questionnaire changes."/>
          <comment
                   value="Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the questionnaire. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource."/>
          <alias value="Revision Date"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.date"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="dateTime"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.date"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.recorded"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".participation[typeCode=AUT].time"/>
          </mapping>
        </element>
        <element id="Questionnaire.publisher">
          <path value="Questionnaire.publisher"/>
          <short value="Name of the publisher (organization or individual)"/>
          <definition
                      value="The name of the organization or individual that published the questionnaire."/>
          <comment
                   value="Usually an organization but may be an individual. The publisher (or steward) of the questionnaire is the organization or individual primarily responsible for the maintenance and upkeep of the questionnaire. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the questionnaire. This item SHOULD be populated unless the information is available from context."/>
          <requirements
                        value="Helps establish the &quot;authority/credibility&quot; of the questionnaire.  May also allow for contact."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.publisher"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.publisher"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.witness"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".participation[typeCode=AUT].role"/>
          </mapping>
        </element>
        <element id="Questionnaire.contact">
          <path value="Questionnaire.contact"/>
          <short value="Contact details for the publisher"/>
          <definition
                      value="Contact details to assist a user in finding and communicating with the publisher."/>
          <comment
                   value="May be a web site, an email address, a telephone number, etc."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.contact"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="ContactDetail"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.contact"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".participation[typeCode=CALLBCK].role"/>
          </mapping>
        </element>
        <element id="Questionnaire.description">
          <path value="Questionnaire.description"/>
          <short value="Natural language description of the questionnaire"/>
          <definition
                      value="A free text natural language description of the questionnaire from a consumer's perspective."/>
          <comment
                   value="This description can be used to capture details such as why the questionnaire was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the questionnaire as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the questionnaire is presumed to be the predominant language in the place the questionnaire was created)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.description"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.description"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".text"/>
          </mapping>
        </element>
        <element id="Questionnaire.useContext">
          <path value="Questionnaire.useContext"/>
          <short value="The context that the content is intended to support"/>
          <definition
                      value="The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate questionnaire instances."/>
          <comment
                   value="When multiple useContexts are specified, there is no expectation that all or any of the contexts apply."/>
          <requirements value="Assist in searching for appropriate content."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.useContext"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="UsageContext"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.useContext"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A (to add?)"/>
          </mapping>
        </element>
        <element id="Questionnaire.jurisdiction">
          <path value="Questionnaire.jurisdiction"/>
          <short value="Intended jurisdiction for questionnaire (if applicable)"/>
          <definition
                      value="A legal or geographic region in which the questionnaire is intended to be used."/>
          <comment
                   value="It may be possible for the questionnaire to be used in jurisdictions other than those for which it was originally designed or intended."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.jurisdiction"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Jurisdiction"/>
            </extension>
            <strength value="extensible"/>
            <description
                         value="Countries and regions within which this artifact is targeted for use."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/jurisdiction"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.jurisdiction"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A (to add?)"/>
          </mapping>
        </element>
        <element id="Questionnaire.purpose">
          <path value="Questionnaire.purpose"/>
          <short value="Why this questionnaire is defined"/>
          <definition
                      value="Explanation of why this questionnaire is needed and why it has been designed as it has."/>
          <comment
                   value="This element does not describe the usage of the questionnaire. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this questionnaire."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.purpose"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.purpose"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.why[x]"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".reasonCode.text"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="Questionnaire.copyright">
          <path value="Questionnaire.copyright"/>
          <short value="Use and/or publishing restrictions"/>
          <definition
                      value="A copyright statement relating to the questionnaire and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the questionnaire."/>
          <requirements
                        value="Consumers must be able to determine any legal restrictions on the use of the questionnaire and/or its content."/>
          <alias value="License"/>
          <alias value="Restrictions"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.copyright"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="markdown"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.copyright"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A (to add?)"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="Questionnaire.approvalDate">
          <path value="Questionnaire.approvalDate"/>
          <short value="When the questionnaire was approved by publisher"/>
          <definition
                      value="The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage."/>
          <comment
                   value="The 'date' element may be more recent than the approval date because of minor changes or editorial corrections."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.approvalDate"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="date"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.approvalDate"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;approval&quot;].effectiveTime"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="Questionnaire.lastReviewDate">
          <path value="Questionnaire.lastReviewDate"/>
          <short value="When the questionnaire was last reviewed"/>
          <definition
                      value="The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date."/>
          <comment
                   value="If specified, this date follows the original approval date."/>
          <requirements
                        value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.lastReviewDate"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="date"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.lastReviewDate"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=&quot;SUBJ&quot;; subsetCode=&quot;RECENT&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;review&quot;].effectiveTime"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="Questionnaire.effectivePeriod">
          <path value="Questionnaire.effectivePeriod"/>
          <short value="When the questionnaire is expected to be used"/>
          <definition
                      value="The period during which the questionnaire content was or is planned to be in active use."/>
          <comment
                   value="The effective period for a questionnaire  determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015."/>
          <requirements
                        value="Allows establishing a transition before a resource comes into effect and also allows for a sunsetting  process when new versions of the questionnaire are or are expected to be used instead."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.effectivePeriod"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Period"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Definition.effectivePeriod"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A (to add?)"/>
          </mapping>
          <mapping>
            <identity value="objimpl"/>
            <map value="no-gen-base"/>
          </mapping>
        </element>
        <element id="Questionnaire.code">
          <path value="Questionnaire.code"/>
          <short value="Concept that represents the overall questionnaire"/>
          <definition
                      value="An identifier for this question or group of questions in a particular terminology such as LOINC."/>
          <requirements
                        value="Allows linking of the complete Questionnaire resources to formal terminologies.  It's common for &quot;panels&quot; of questions to be identified by a code."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.code"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Coding"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="QuestionnaireConcept"/>
            </extension>
            <strength value="example"/>
            <description
                         value="Codes for questionnaires, groups and individual questions."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/questionnaire-questions"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value=".code"/>
          </mapping>
        </element>
        <element id="Questionnaire.item">
          <path value="Questionnaire.item"/>
          <short value="Questions and sections within the Questionnaire"/>
          <definition
                      value="A particular question, question grouping or display text that is part of the questionnaire."/>
          <comment
                   value="The content of the questionnaire is constructed from an ordered, hierarchical collection of items."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.item"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <condition value="que-3"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="que-1"/>
            <severity value="error"/>
            <human
                   value="Group items must have nested items, display items cannot have nested items"/>
            <expression
                        value="(type='group' implies item.empty().not()) and (type.trace('type')='display' implies item.trace('item').empty())"/>
            <xpath
                   value="not((f:type/@value='group' and not(f:item)) or (f:type/@value='display' and f:item))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-3"/>
            <severity value="error"/>
            <human value="Display items cannot have a &quot;code&quot; asserted"/>
            <expression value="type!='display' or code.empty()"/>
            <xpath value="not(f:type/@value='display' and f:code)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-4"/>
            <severity value="error"/>
            <human
                   value="A question cannot have both answerOption and answerValueSet"/>
            <expression value="answerOption.empty() or answerValueSet.empty()"/>
            <xpath value="not(f:answerValueSet and f:answerOption)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-5"/>
            <severity value="error"/>
            <human
                   value="Only 'choice' and 'open-choice' items can have answerValueSet"/>
            <expression
                        value="(type ='choice' or type = 'open-choice' or type = 'decimal' or type = 'integer' or type = 'date' or type = 'dateTime' or type = 'time' or type = 'string' or type = 'quantity') or (answerValueSet.empty() and answerOption.empty())"/>
            <xpath
                   value="f:type/@value=('choice','open-choice','decimal','integer','date','dateTime','time','string','quantity',') or not(f:answerOption or f:answerValueSet)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-6"/>
            <severity value="error"/>
            <human
                   value="Required and repeat aren't permitted for display items"/>
            <expression
                        value="type!='display' or (required.empty() and repeats.empty())"/>
            <xpath
                   value="not(f:type/@value='display' and (f:required or f:repeats))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-8"/>
            <severity value="error"/>
            <human
                   value="Initial values can't be specified for groups or display items"/>
            <expression
                        value="(type!='group' and type!='display') or initial.empty()"/>
            <xpath
                   value="not(f:type/@value=('group', 'display') and f:*[starts-with(local-name(.), 'initial')])"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-9"/>
            <severity value="error"/>
            <human
                   value="Read-only can't be specified for &quot;display&quot; items"/>
            <expression value="type!='display' or readOnly.empty()"/>
            <xpath
                   value="not(f:type/@value=('group', 'display') and f:*[starts-with(local-name(.), 'initial')])"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-10"/>
            <severity value="error"/>
            <human
                   value="Maximum length can only be declared for simple question types"/>
            <expression
                        value="(type in ('boolean' | 'decimal' | 'integer' | 'string' | 'text' | 'url' | 'open-choice')) or maxLength.empty()"/>
            <xpath
                   value="f:type/@value=('boolean', 'decimal', 'integer', 'open-choice', 'string', 'text', 'url') or not(f:maxLength)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-11"/>
            <severity value="error"/>
            <human
                   value="If one or more answerOption is present, initial[x] must be missing"/>
            <expression value="answerOption.empty() or initial.empty()"/>
            <xpath
                   value="not(f:answerOption) or not(count(f:*[starts-with(local-name(.), 'initial')]))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-12"/>
            <severity value="error"/>
            <human
                   value="If there are more than one enableWhen, enableBehavior must be specified"/>
            <expression
                        value="enableWhen.count() &gt; 2 implies enableBehavior.exists()"/>
            <xpath
                   value="not(f:answerOption) or not(count(f:*[starts-with(local-name(.), 'initial')]))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="que-13"/>
            <severity value="error"/>
            <human
                   value="Can only have multiple initial values for repeating items"/>
            <expression value="repeats=true or initial.count() &lt;= 1"/>
            <xpath value="f:repeats/@value='true' or count(f:initial)&lt;=1"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
          </constraint>
          <constraint>
            <key value="sdc-1"/>
            <severity value="error"/>
            <human
                   value="An item cannot have an answerExpression if answerOption or answerValueSet is already present."/>
            <expression
                        value="extension('http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression').empty().not() implies (answerOption.empty() and answerValueSet.empty())"/>
            <xpath
                   value="f:extension[@url='http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-answerExpression'] and (not(f:answerOption) and not(f:answerValueSet))"/>
            <source
                    value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=COMP].target[classCode=OBS, moodCode=DEF]"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map
                 value="./form_design/*[self::header or self::footer or self::section]"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.id">
          <path value="Questionnaire.item.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.extension">
          <path value="Questionnaire.item.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="open"/>
          </slicing>
          <short value="Extension"/>
          <definition value="An Extension"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Questionnaire.item.extension:designNote">
          <path value="Questionnaire.item.extension"/>
          <sliceName value="designNote"/>
          <short value="Design comments"/>
          <definition
                      value="Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users."/>
          <comment
                   value="Allows capture of todos, rationale for design decisions, etc.  It can also be used to capture comments about specific groups or questions within it. Allows commentary to be captured during the process of answering a questionnaire (if not already supported by the form design) as well as after the form is completed. Comments are not part of the &quot;data&quot; of the form. If a form prompts for a comment, this should be captured in an answer, not in this element. Formal assessments of the QuestionnareResponse would use [[[Observation]]]."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile value="http://hl7.org/fhir/StructureDefinition/designNote"/>
          </type>
          <condition value="ele-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
        </element>
        <element id="Questionnaire.item.extension:terminologyServer">
          <path value="Questionnaire.item.extension"/>
          <sliceName value="terminologyServer"/>
          <short value="Preferred terminology server"/>
          <definition
                      value="Indicates the terminology server(s) that are known to be capable of returning and potentially expanding the value set(s) associated with the whole questionnaire or a particular group or question within the questionnaire (depending on where the extension appears).  If a full URL is not provided AND the requested query is a terminology operation (e.g. $lookup or $expand) the client SHOULD execute the operation against the preferredTerminologyServer rather than the local repository."/>
          <comment
                   value="This includes those referenced by answerValueSet as well as the unitValueSet extension."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-preferredTerminologyServer"/>
          </type>
          <condition value="ele-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
        </element>
        <element id="Questionnaire.item.modifierExtension">
          <path value="Questionnaire.item.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.linkId">
          <path value="Questionnaire.item.linkId"/>
          <short value="Unique id for item in questionnaire"/>
          <definition
                      value="An identifier that is unique within the Questionnaire allowing linkage to the equivalent item in a QuestionnaireResponse resource."/>
          <comment
                   value="This ''can'' be a meaningful identifier (e.g. a LOINC code) but is not intended to have any meaning.  GUIDs or sequential numbers are appropriate here."/>
          <requirements
                        value="[QuestionnaireResponse](http://hl7.org/fhir/R4/questionnaireresponse.html#) does not require omitted items to be included and may have some items that repeat, so linkage based on position alone is not sufficient."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.linkId"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value=".id"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="./section_identifier"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.definition">
          <path value="Questionnaire.item.definition"/>
          <short value="ElementDefinition - details for the item"/>
          <definition
                      value="This element is a URI that refers to an [ElementDefinition](http://hl7.org/fhir/R4/elementdefinition.html) that provides information about this item, including information that might otherwise be included in the instance of the Questionnaire resource. A detailed description of the construction of the URI is shown in Comments, below. If this element is present then the following element values MAY be derived from the Element Definition if the corresponding elements of this Questionnaire resource instance have no value:

    * code (ElementDefinition.code)
    * type (ElementDefinition.type)
    * required (ElementDefinition.min)
    * repeats (ElementDefinition.max)
    * maxLength (ElementDefinition.maxLength)
    * answerValueSet (ElementDefinition.binding)
    * options (ElementDefinition.binding)."/>
          <comment
                   value="The uri refers to an ElementDefinition in a [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) and always starts with the [canonical URL](http://hl7.org/fhir/R4/references.html#canonical) for the target resource. When referring to a StructureDefinition, a fragment identifier is used to specify the element definition by its id [Element.id](http://hl7.org/fhir/R4/element-definitions.html#Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. In the absence of a fragment identifier, the first/root element definition in the target is the matching element definition."/>
          <requirements
                        value="A common pattern is to define a set of data elements and then build multiple questionnaires for different circumstances to gather the data. This element provides traceability to the common definition and allows the content for the question to come from the underlying definition."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.definition"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=INST].target[classCode=OBS, moodCode=DEF]"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.code">
          <path value="Questionnaire.item.code"/>
          <short value="Corresponding concept for this item in a terminology"/>
          <definition
                      value="A terminology code that corresponds to this group or question (e.g. a code from LOINC, which defines many questions and answers)."/>
          <comment
                   value="The value may come from the ElementDefinition referred to by .definition."/>
          <requirements
                        value="Allows linking of groups of questions to formal terminologies."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.item.code"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Coding"/>
          </type>
          <condition value="que-3"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="QuestionnaireConcept"/>
            </extension>
            <strength value="example"/>
            <description
                         value="Codes for questionnaires, groups and individual questions."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/questionnaire-questions"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value=".code"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.prefix">
          <path value="Questionnaire.item.prefix"/>
          <short value="E.g. &quot;1(a)&quot;, &quot;2.5.3&quot;"/>
          <definition
                      value="A short label for a particular group, question or set of display text within the questionnaire used for reference by the individual completing the questionnaire."/>
          <comment
                   value="These are generally unique within a questionnaire, though this is not guaranteed. Some questionnaires may have multiple questions with the same label with logic to control which gets exposed.  Typically, these won't be used for &quot;display&quot; items, though such use is not prohibited.  Systems SHOULD NOT generate their own prefixes if prefixes are defined for any items within a Questionnaire."/>
          <requirements
                        value="Separating the label from the question text allows improved rendering.  Also, instructions will often refer to specific prefixes, so there's a need for the questionnaire design to have control over what labels are used."/>
          <alias value="label"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.prefix"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Not supported"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="./section_number/label"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.text">
          <path value="Questionnaire.item.text"/>
          <short value="Primary text for the item"/>
          <definition
                      value="The name of a section, the text of a question or text content for a display item."/>
          <comment
                   value="When using this element to represent the name of a section, use group type item and also make sure to limit the text element to a short string suitable for display as a section heading.  Group item instructions should be included as a display type item within the group."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value=".text"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map
                 value="Form Design/designation[context=&quot;primary?&quot;/definition/  ./section_instruction/label"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.type">
          <path value="Questionnaire.item.type"/>
          <short
                 value="group | display | boolean | decimal | integer | date | dateTime +"/>
          <definition
                      value="The type of questionnaire item this is - whether text for display, a grouping of other items or a particular type of data to be captured (string, integer, coded choice, etc.)."/>
          <comment
                   value="Time is handled using &quot;string&quot;.  File is handled using Attachment.  (Content can be sent as a contained binary)."/>
          <requirements
                        value="Defines the format in which the user is to be prompted for the answer."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.type"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="QuestionnaireItemType"/>
            </extension>
            <strength value="required"/>
            <description
                         value="Distinguishes groups from questions and display text and indicates data type for questions."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/item-type|4.0.1"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="./*/datatype"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableWhen">
          <path value="Questionnaire.item.enableWhen"/>
          <short value="Only allow data when"/>
          <definition
                      value="A constraint indicating that this item should only be enabled (displayed/allow answers to be captured) when the specified condition is true."/>
          <comment
                   value="If multiple repetitions of this extension are present, the item should be enabled when the condition for *any* of the repetitions is true.  I.e. treat &quot;enableWhen&quot;s as being joined by an &quot;or&quot; clause.  This element is a modifier because if enableWhen is present for an item, &quot;required&quot; is ignored unless one of the enableWhen conditions is met. When an item is disabled, all of its descendants are disabled, regardless of what their own enableWhen logic might evaluate to."/>
          <requirements
                        value="Allows questionnaires to adapt based on answers to other questions. E.g. If physical gender is specified as a male, no need to capture pregnancy history.  Also allows conditional display of instructions or groups of questions."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.item.enableWhen"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="que-7"/>
            <severity value="error"/>
            <human
                   value="If the operator is 'exists', the value must be a boolean"/>
            <expression value="operator = 'exists' implies (answer is Boolean)"/>
            <xpath
                   value="f:operator/@value != 'exists' or exists(f:answerBoolean)"/>
            <source
                    value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="If enableWhen is present and the condition evaluates to false, then the Questionnaire behaves as though the elements weren't actually present"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableWhen.id">
          <path value="Questionnaire.item.enableWhen.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableWhen.extension">
          <path value="Questionnaire.item.enableWhen.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableWhen.modifierExtension">
          <path value="Questionnaire.item.enableWhen.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableWhen.question">
          <path value="Questionnaire.item.enableWhen.question"/>
          <short value="Question that determines whether item is enabled"/>
          <definition
                      value="The linkId for the question whose answer (or lack of answer) governs whether this item is enabled."/>
          <comment
                   value="If multiple question occurrences are present for the same question (same linkId), then this refers to the nearest question occurrence reachable by tracing first the &quot;ancestor&quot; axis and then the &quot;preceding&quot; axis and then the &quot;following&quot; axis."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.enableWhen.question"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableWhen.operator">
          <path value="Questionnaire.item.enableWhen.operator"/>
          <short value="exists | = | != | &gt; | &lt; | &gt;= | &lt;="/>
          <definition
                      value="Specifies the criteria by which the question is enabled."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.enableWhen.operator"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="QuestionnaireItemOperator"/>
            </extension>
            <strength value="required"/>
            <description value="The criteria by which a question is enabled."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/questionnaire-enable-operator|4.0.1"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableWhen.answer[x]">
          <path value="Questionnaire.item.enableWhen.answer[x]"/>
          <short value="Value for question comparison based on operator"/>
          <definition
                      value="A value that the referenced question is tested using the specified operator in order for the item to be enabled."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.enableWhen.answer[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <type>
            <code value="decimal"/>
          </type>
          <type>
            <code value="integer"/>
          </type>
          <type>
            <code value="date"/>
          </type>
          <type>
            <code value="dateTime"/>
          </type>
          <type>
            <code value="time"/>
          </type>
          <type>
            <code value="string"/>
          </type>
          <type>
            <code value="Coding"/>
          </type>
          <type>
            <code value="Quantity"/>
          </type>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource"/>
          </type>
          <condition value="que-7"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="QuestionnaireQuestionOption3"/>
            </extension>
            <strength value="example"/>
            <description value="Allowed values to answer questions."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.enableBehavior">
          <path value="Questionnaire.item.enableBehavior"/>
          <short value="all | any"/>
          <definition
                      value="Controls how multiple enableWhen values are interpreted -  whether all or any must be true."/>
          <comment
                   value="This element must be specified if more than one enableWhen value is provided."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.enableBehavior"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <condition value="que-12"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="EnableWhenBehavior"/>
            </extension>
            <strength value="required"/>
            <description
                         value="Controls how multiple enableWhen values are interpreted -  whether all or any must be true."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/questionnaire-enable-behavior|4.0.1"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.required">
          <path value="Questionnaire.item.required"/>
          <short value="Whether the item must be included in data results"/>
          <definition
                      value="An indication, if true, that the item must be present in a &quot;completed&quot; QuestionnaireResponse.  If false, the item may be skipped when answering the questionnaire."/>
          <comment
                   value="Questionnaire.item.required only has meaning for elements that are conditionally enabled with enableWhen if the condition evaluates to true.  If an item that contains other items is marked as required, that does not automatically make the contained elements required (though required groups must contain at least one child element). The value may come from the ElementDefinition referred to by .definition."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.required"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <meaningWhenMissing
                              value="Items are generally assumed not to be required unless explicitly specified. Systems SHOULD always populate this value"/>
          <condition value="que-6"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="./cardinality/minimum!=0"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.repeats">
          <path value="Questionnaire.item.repeats"/>
          <short value="Whether the item may repeat"/>
          <definition
                      value="An indication, if true, that a QuestionnaireResponse for this item may include multiple answers associated with a single instance of this item (for question-type items) or multiple repetitions of the item (for group-type items)"/>
          <comment
                   value="If a question is marked as repeats=true, then multiple answers can be provided for the question in the corresponding QuestionnaireResponse.  When rendering the questionnaire, it is up to the rendering software whether to render the question text for each answer repetition (i.e. &quot;repeat the question&quot;) or to simply allow entry/selection of multiple answers for the question (repeat the answers).  Which is most appropriate visually may depend on the type of answer as well as whether there are nested items.

    The resulting QuestionnaireResponse will be populated the same way regardless of rendering - one 'question' item with multiple answer values.

     The value may come from the ElementDefinition referred to by .definition."/>
          <requirements
                        value="Items may be used to create set of (related) questions that can be repeated to give multiple answers to such a set."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.repeats"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <meaningWhenMissing
                              value="Items are generally assumed not to repeat unless explicitly specified. Systems SHOULD always populate this value"/>
          <condition value="que-6"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="./cardinality/maximum!=1"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.readOnly">
          <path value="Questionnaire.item.readOnly"/>
          <short value="Don't allow human editing"/>
          <definition
                      value="An indication, when true, that the value cannot be changed by a human respondent to the Questionnaire."/>
          <comment
                   value="The value of readOnly elements can be established by asserting  extensions for defaultValues, linkages that support pre-population and/or extensions that support calculation based on other answers."/>
          <requirements
                        value="Allows certain information to be phrased (and rendered) as a question and an answer, while keeping users from changing it.  May also be useful for preventing changes to pre-populated portions of a questionnaire, for calculated values, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.readOnly"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <condition value="que-9"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map
                 value="./*_Field/default_value_read_only  ./default_element/read_only"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.maxLength">
          <path value="Questionnaire.item.maxLength"/>
          <short value="No more than this many characters"/>
          <definition
                      value="The maximum number of characters that are permitted in the answer to be considered a &quot;valid&quot; QuestionnaireResponse."/>
          <comment
                   value="For base64binary, reflects the number of characters representing the encoded data, not the number of bytes of the binary data. The value may come from the ElementDefinition referred to by .definition."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.maxLength"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="integer"/>
          </type>
          <condition value="que-10"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="N/A"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map
                 value="./*_Field/maximum_character_quantity | ./*_Field/datatype/string/maximum_characters"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.answerValueSet">
          <path value="Questionnaire.item.answerValueSet"/>
          <short value="Valueset containing permitted answers"/>
          <definition
                      value="A reference to a value set containing a list of codes representing permitted answers for a &quot;choice&quot; or &quot;open-choice&quot; question."/>
          <comment
                   value="LOINC defines many useful value sets for questionnaire responses. See [LOINC Answer Lists](http://hl7.org/fhir/R4/loinc.html#alist). The value may come from the ElementDefinition referred to by .definition."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.answerValueSet"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="canonical"/>
            <targetProfile
                           value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-valueset"/>
          </type>
          <condition value="que-4"/>
          <condition value="que-5"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="./list_field | ./lookup_field/endpoint"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.answerOption">
          <path value="Questionnaire.item.answerOption"/>
          <short value="Permitted answer"/>
          <definition
                      value="One of the permitted answers for a &quot;choice&quot; or &quot;open-choice&quot; question."/>
          <comment
                   value="This element can be used when the value set machinery of answerValueSet is deemed too cumbersome or when there's a need to capture possible answers that are not codes."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.item.answerOption"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <condition value="que-4"/>
          <condition value="que-5"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.answerOption.id">
          <path value="Questionnaire.item.answerOption.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.answerOption.extension">
          <path value="Questionnaire.item.answerOption.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.answerOption.modifierExtension">
          <path value="Questionnaire.item.answerOption.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.answerOption.value[x]">
          <path value="Questionnaire.item.answerOption.value[x]"/>
          <short value="Answer value"/>
          <definition
                      value="A potential answer that's allowed as the answer to this question."/>
          <comment
                   value="The data type of the value must agree with the item.type."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.answerOption.value[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="integer"/>
          </type>
          <type>
            <code value="date"/>
          </type>
          <type>
            <code value="time"/>
          </type>
          <type>
            <code value="string"/>
          </type>
          <type>
            <code value="Coding"/>
          </type>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="QuestionnaireQuestionOption"/>
            </extension>
            <strength value="example"/>
            <description value="Allowed values to answer questions."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.answerOption.initialSelected">
          <path value="Questionnaire.item.answerOption.initialSelected"/>
          <short value="Whether option is selected by default"/>
          <definition
                      value="Indicates whether the answer value is selected when the list of possible answers is initially shown."/>
          <comment
                   value="Use this instead of initial[v] if answerValueSet is present."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.answerOption.initialSelected"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <meaningWhenMissing
                              value="Only selected items explicitly marked to be selected"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.initial">
          <path value="Questionnaire.item.initial"/>
          <short value="Initial value(s) when item is first rendered"/>
          <definition
                      value="One or more values that should be pre-populated in the answer when initially rendering the questionnaire for user input."/>
          <comment
                   value="The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created.  Note that initial values can influence results.  The data type of initial[x] must agree with the item.type, and only repeating items can have more then one initial value."/>
          <requirements value="In some workflows, having defaults saves time."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.item.initial"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <condition value="que-8"/>
          <condition value="que-13"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.initial.id">
          <path value="Questionnaire.item.initial.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.initial.extension">
          <path value="Questionnaire.item.initial.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.initial.modifierExtension">
          <path value="Questionnaire.item.initial.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.initial.value[x]">
          <path value="Questionnaire.item.initial.value[x]"/>
          <short value="Actual value for initializing the question"/>
          <definition value="The actual value to for an initial answer."/>
          <comment
                   value="The type of the initial value must be consistent with the type of the item."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Questionnaire.item.initial.value[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <type>
            <code value="decimal"/>
          </type>
          <type>
            <code value="integer"/>
          </type>
          <type>
            <code value="date"/>
          </type>
          <type>
            <code value="dateTime"/>
          </type>
          <type>
            <code value="time"/>
          </type>
          <type>
            <code value="string"/>
          </type>
          <type>
            <code value="uri"/>
          </type>
          <type>
            <code value="Attachment"/>
          </type>
          <type>
            <code value="Coding"/>
          </type>
          <type>
            <code value="Quantity"/>
          </type>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="QuestionnaireQuestionOption2"/>
            </extension>
            <strength value="example"/>
            <description value="Allowed values to answer questions."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/questionnaire-answers"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="N/A - MIF rather than RIM level"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map
                 value="./default_value  ./default_element/default/value  ./default_element/list_item_identifier (resolve)"/>
          </mapping>
        </element>
        <element id="Questionnaire.item.item">
          <path value="Questionnaire.item.item"/>
          <short value="Nested questionnaire items"/>
          <definition
                      value="Text, questions and other groups to be nested beneath a question or group."/>
          <comment
                   value="There is no specified limit to the depth of nesting.  However, Questionnaire authors are encouraged to consider the impact on the user and user interface of overly deep nesting."/>
          <requirements value="Reports can consist of complex nested groups."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Questionnaire.item.item"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <contentReference
                            value="http://hl7.org/fhir/StructureDefinition/Questionnaire#Questionnaire.item"/>
          <condition value="que-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <mustSupport value="true"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value=".outboundRelationship[typeCode=COMP].target"/>
          </mapping>
          <mapping>
            <identity value="ihe-sdc"/>
            <map value="./contained_section"/>
          </mapping>
        </element>
      </snapshot>
      <differential>
        <element id="Questionnaire">
          <path value="Questionnaire"/>
        </element>
        <element id="Questionnaire.id">
          <path value="Questionnaire.id"/>
          <short
                 value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
          <min value="1"/>
          <mustSupport value="true"/>
        </element>
        <element id="Questionnaire.meta">
          <path value="Questionnaire.meta"/>
          <min value="1"/>
          <type>
            <code value="Meta"/>
            <profile
                     value="http://test.shinny.org/us/ny/hrsn/StructureDefinition/SHINNYMeta"/>
          </type>
          <mustSupport value="true"/>
        </element>
        <element id="Questionnaire.language">
          <path value="Questionnaire.language"/>
          <binding>
            <strength value="preferred"/>
            <valueSet
                      value="http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS"/>
          </binding>
        </element>
      </differential>
    </StructureDefinition>