Questionnaire/Response Interaction

As a response to a ServiceDefinition.$evaluate operation to request clinical support guidance, a selected CDSS returns a GuidanceResponse resource to the EMS.
If further evaluation is required in the current triage journey, the CDSS will create a Questionnaire resource to contain a relevant question based on information received from the EMS.
The GuidanceResponse resource will carry a reference to the Questionnaire resource in its dataRequirement element in order to return it to the EMS.

As a response to a Questionnaire, the EMS will create and populate a QuestionnaireResponse to carry the answers from the EMS user.

Request Headers

The following HTTP request headers are supported for this interaction:

Create Questionnaire

This action is performed by the CDSS and it occurs in response to a ServiceDefinition.$evaluate operation posted by the EMS when the inputData element received does not contain all the information needed to complete the triage journey.
It is done using the FHIR RESTful create interaction as below:

The new resource is created in a server-assigned location.

Response

Success

• MUST return a 201 CREATED HTTP status code on successful execution of the interaction.
• MUST return a response body containing a payload with an OperationOutcome resource that conforms to the Operation Outcome FHIR resource.
• MUST return an HTTP Location response header containing the full resolvable URL to the newly created Questionnaire.
  • The URL will contain the ‘server’ assigned logical Id of the new Questionnaire resource.
  • The URL format MUST be: https://[host]/[path]?_id=[id].
  • When a resource has been created it will have a versionId of 1.

The table below summarises the create interaction HTTP response code and the values expected to be conveyed in the successful response body OperationOutcome payload:

Failure

The following errors can be triggered when performing this operation:

• Invalid Request Message
• Invalid Resource

Get Questionnaire

This action is performed by the EMS in order to get a Questionnaire from a selected CDSS.
The EMS will get the Questionnaire returned by the CDSS, using as a parameter its returned logical id.
The interaction is performed by an FHIR RESTful read interaction.

This read interaction accesses the current contents of the selected Questionnaire.

Parameters

_id

The parameter _id refers to the logical id of the Questionnaire resource and can be used when the context specifies the Questionnaire resource type.
This read request finds the Questionnaire resource with the given id (there can only be one resource for a given id).

Further details relating to the search parameter _id are available.

Read Response

Success

• MUST return a 200 OK HTTP status code on successful execution of the interaction.
• The returned resource MUST have an id element with a value that is the [id].

Failure

The following errors can be triggered when performing this operation:

• Invalid parameter (if using the ‘_format’ parameter without a mime type recognised by a CDSS or EMS server).
• Resource not found

Questionnaire: Implementation Guidance

View CDS implementation guidance for a Questionnaire.

QuestionnaireResponse

On presenting the questions contained in the returned Questionnaire to the user, the EMS will create and populate an answering QuestionnaireResponse based upon the user’s response(s).
The latter resource will be referenced in the inputData parameter of the next ServiceDefinition.$evaluate sent to the CDSS.

The EMS will create the QuestionnaireResponse using the same FHIR RESTful create interaction as outlined above for the creation of a Questionnaire. The CDSS can request this resource from the EMS using the HTTP GET verb and _id parameter as outlined above for the request of a Questionnaire.

QuestionnaireResponse: Implementation Guidance

View CDS implementation guidance for a QuestionnaireResponse.

Observation

On receipt of the QuestionnaireResponse, the CDSS will use its contents to create an assertion, typically as an Observation resource, a reference to which is added to the GuidanceResponse.outputParameters returned to the EMS. Note that QuestionnaireResponse and assertions will typically be one to one, but do not have to be. A CDSS can create multiple assertions from a single QuestionnaireResponse, and may also use multiple QuestionnaireResponses to be sure of a single assertion.

The CDSS will create the Observation (or other resource appropriate for the assertion) using the same FHIR RESTful create interaction as outlined above for the creation of a Questionnaire.