Questionnaire Profile

Canonical	../StructureDefinition/nexus-emr-core-questionnaire
Status	draft (experimental) · 1.26.0
Base	Questionnaire (constraint)
Source	FSH · JSON

A Nexus EMR form definition: what it asks, what it produces, and where its answers land in the chart.

Examples

Diabetes Annual Review Form Definition · Tobacco Use Form Definition

Tobacco Use Form Definition

A form definition demonstrating the three things that distinguish a Nexus form from a bare R4 Questionnaire -- canonical identity (url + version), a CONTAINED prototype of the resource it produces wired up by SDC template extraction, and the form-to-chart binding on each item (item.definition names the element an answer populates, item.code names the concept it asks about). The prototype carries no subject, because a form is about no patient until it is answered, and no placeholder date -- a sentinel that survives a missing fill step is worse than an absent value. Note that templateExtract is a COMPLEX extension: the reference to the prototype rides its template sub-extension, not a valueReference on the extension itself

Questionnaire/nexus-emr-questionnaire-tobacco-use — claims conformance to Questionnaire Profile

{
  "resourceType": "Questionnaire",
  "id": "nexus-emr-questionnaire-tobacco-use",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-questionnaire"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p>Tobacco Use intake form. One prototype -- the smoking-status Observation the form produces -- carried as the single entry of a contained transaction Bundle, with the POST that extracting performs. The prototype has no subject, because a form is about no patient until it is answered.</p></div>"
  },
  "contained": [
    {
      "resourceType": "Bundle",
      "id": "tobacco-bundle",
      "type": "transaction",
      "entry": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractContext",
              "valueString": "item.where(linkId = 'smoking-status')"
            }
          ],
          "fullUrl": "urn:uuid:1a7d4e90-0000-4000-8000-000000000001",
          "resource": {
            "resourceType": "Observation",
            "text": {
              "status": "generated",
              "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p>Prototype of the tobacco smoking status this form produces.</p></div>"
            },
            "status": "final",
            "category": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "social-history",
                    "display": "Social History"
                  }
                ]
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "72166-2",
                  "display": "Tobacco smoking status"
                }
              ],
              "text": "Tobacco smoking status"
            }
          },
          "request": {
            "method": "POST",
            "url": "Observation"
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractBundle",
      "valueReference": {
        "reference": "#tobacco-bundle"
      }
    }
  ],
  "url": "../Questionnaire/nexus-emr-questionnaire-tobacco-use",
  "version": "1.0.0",
  "name": "TobaccoUseIntake",
  "title": "Tobacco Use",
  "status": "active",
  "experimental": false,
  "subjectType": [
    "Patient"
  ],
  "date": "2026-08-23T09:00:00Z",
  "publisher": "Cedarbrook Family Health",
  "description": "Intake form capturing tobacco smoking status and, for current smokers, daily consumption. Produces one social-history Observation.",
  "effectivePeriod": {
    "start": "2026-08-23"
  },
  "item": [
    {
      "linkId": "smoking-status",
      "text": "Do you currently smoke tobacco, or have you in the past?",
      "type": "choice",
      "required": true,
      "repeats": false,
      "code": [
        {
          "system": "http://loinc.org",
          "code": "72166-2",
          "display": "Tobacco smoking status"
        }
      ],
      "definition": "../StructureDefinition/nexus-emr-core-observation#Observation.value[x]",
      "answerOption": [
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "449868002",
            "display": "Smokes tobacco daily"
          }
        },
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "8517006",
            "display": "Ex-smoker"
          }
        },
        {
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "266919005",
            "display": "Never smoked tobacco"
          }
        }
      ]
    },
    {
      "linkId": "cigarettes-per-day",
      "text": "On a typical day, how many cigarettes do you smoke?",
      "type": "integer",
      "required": false,
      "readOnly": false,
      "enableWhen": [
        {
          "question": "smoking-status",
          "operator": "=",
          "answerCoding": {
            "system": "http://snomed.info/sct",
            "code": "449868002",
            "display": "Smokes tobacco daily"
          }
        }
      ],
      "enableBehavior": "all",
      "definition": "../StructureDefinition/nexus-emr-core-observation#Observation.component.value[x]",
      "code": [
        {
          "system": "http://loinc.org",
          "code": "8663-7",
          "display": "Cigarettes smoked current (pack per day) - Reported"
        }
      ]
    }
  ]
}