{
  "resourceType" : "Bundle",
  "id" : "MSKReportDataBundleExample",
  "meta" : {
    "profile" : ["https://dsacms.github.io/cmmi-access-model/StructureDefinition/access-data-reporting-bundle"]
  },
  "language" : "en",
  "identifier" : {
    "system" : "http://example.org/data-bundle-id",
    "value" : "bundle-msk-001"
  },
  "type" : "document",
  "timestamp" : "2026-01-26T12:00:00Z",
  "entry" : [{
    "fullUrl" : "http://example.org/Composition/MSKReportDataCompositionExample",
    "resource" : {
      "resourceType" : "Composition",
      "id" : "MSKReportDataCompositionExample",
      "meta" : {
        "profile" : ["https://dsacms.github.io/cmmi-access-model/StructureDefinition/access-data-reporting-composition"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"Composition_MSKReportDataCompositionExample\"> </a><h3>ACCESS MSK Track Data Report</h3><p>Patient: John Doe (MBI: 1EG4TE5MK73)</p><p>Report Date: 2026-01-26</p><p>Author: Jane Smith</p></div>"
      },
      "status" : "final",
      "type" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "74465-6",
          "display" : "Questionnaire response Document"
        }]
      },
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "date" : "2026-01-26T12:00:00Z",
      "author" : [{
        "reference" : "Practitioner/PractitionerExample"
      }],
      "title" : "ACCESS MSK Track Data Report",
      "custodian" : {
        "reference" : "Organization/OrganizationExample"
      },
      "section" : [{
        "title" : "Data reporting for MSK track",
        "code" : {
          "coding" : [{
            "system" : "https://dsacms.github.io/cmmi-access-model/CodeSystem/ACCESSTrackCS",
            "code" : "MSK"
          }]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><p>Musculoskeletal Track Data Reporting including pain assessments and patient-reported outcomes.</p></div>"
        },
        "section" : [{
          "title" : "PROMIS Physical Function Short Form 6b",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "76804-4"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/PROMISPhysicalFunctionExample"
          }]
        },
        {
          "title" : "PROMIS Physical Function CAT",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "91722-9"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/PROMISPhysicalFunctionCATExample"
          }]
        },
        {
          "title" : "PROMIS Pain Interference Short Form 6a",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "90973-9"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/PROMISPainInterferenceSFExample"
          }]
        },
        {
          "title" : "PROMIS Pain Interference CAT",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "89923-7"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/PROMISPainInterferenceCATExample"
          }]
        },
        {
          "title" : "Oswestry Disability Index",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "97908-8"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/OswestryDisabilityIndexExample"
          }]
        },
        {
          "title" : "Neck Disability Index",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "82226-2"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/NeckDisabilityIndexExample"
          }]
        },
        {
          "title" : "QuickDASH",
          "code" : {
            "coding" : [{
              "system" : "https://dsacms.github.io/cmmi-access-model/CodeSystem/ACCESSReportDataCompositionSectionCS",
              "code" : "QuickDASH"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/QuickDASHExample"
          }]
        },
        {
          "title" : "Patient's Global Impression of Change",
          "code" : {
            "coding" : [{
              "system" : "https://dsacms.github.io/cmmi-access-model/CodeSystem/ACCESSReportDataCompositionSectionCS",
              "code" : "PGIC"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/MSKPGICExample"
          }]
        },
        {
          "title" : "KOOS JR",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "82324-5"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/KOOSJRExample"
          }]
        },
        {
          "title" : "HOOS JR",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "82316-1"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/HOOSJRExample"
          }]
        },
        {
          "title" : "PROMIS Pain Intensity NRS",
          "code" : {
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "72514-3"
            }]
          },
          "entry" : [{
            "reference" : "QuestionnaireResponse/PROMISNRSExample"
          }]
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/Patient/PatientExample",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "PatientExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"Patient_PatientExample\"> </a>Patient John Doe, male, born 1950-01-01, Medicare ID: 1EG4TE5MK73</div>"
      },
      "identifier" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MC"
          }]
        },
        "system" : "http://terminology.hl7.org/NamingSystem/cmsMBI",
        "value" : "1EG4TE5MK73"
      }],
      "name" : [{
        "family" : "Doe",
        "given" : ["John"]
      }],
      "gender" : "male",
      "birthDate" : "1950-01-01"
    }
  },
  {
    "fullUrl" : "http://example.org/Practitioner/PractitionerExample",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "PractitionerExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"Practitioner_PractitionerExample\"> </a>Practitioner Jane Smith, NPI: 1234567893</div>"
      },
      "identifier" : [{
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "1234567893"
      }],
      "name" : [{
        "family" : "Smith",
        "given" : ["Jane"]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/Organization/OrganizationExample",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "OrganizationExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"Organization_OrganizationExample\"> </a>Example Healthcare Organization, ACCESS Participant ID: ACCES12345</div>"
      },
      "identifier" : [{
        "system" : "https://dsacms.github.io/cmmi-access-model/participant-id",
        "value" : "ACCES12345"
      }],
      "active" : true,
      "name" : "Example Healthcare Organization"
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/PROMISPhysicalFunctionExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "PROMISPhysicalFunctionExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_PROMISPhysicalFunctionExample\"> </a><p>PROMIS Physical Function (Short Form 6b) QuestionnaireResponse for John Doe. T-score: 36.8.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/PROMISPhysicalFunctionQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "pf6b-1",
        "text" : "Are you able to do chores such as vacuuming or yard work?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 4
            }],
            "system" : "http://loinc.org",
            "code" : "LA13918-0",
            "display" : "With a little difficulty"
          }
        }]
      },
      {
        "linkId" : "pf6b-2",
        "text" : "Are you able to go up and down stairs at a normal pace?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA13920-6",
            "display" : "With some difficulty"
          }
        }]
      },
      {
        "linkId" : "pf6b-3",
        "text" : "Are you able to go for a walk of at least 15 minutes?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA13920-6",
            "display" : "With some difficulty"
          }
        }]
      },
      {
        "linkId" : "pf6b-4",
        "text" : "Are you able to run errands and shop?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 4
            }],
            "system" : "http://loinc.org",
            "code" : "LA13918-0",
            "display" : "With a little difficulty"
          }
        }]
      },
      {
        "linkId" : "pf6b-5",
        "text" : "Does your health now limit you in doing two hours of physical labor?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "system" : "http://loinc.org",
            "code" : "LA13868-7",
            "display" : "Cannot do"
          }
        }]
      },
      {
        "linkId" : "pf6b-6",
        "text" : "Does your health now limit you in doing moderate work around the house like vacuuming, sweeping floors or carrying in groceries?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA11911-7",
            "display" : "Quite a lot"
          }
        }]
      },
      {
        "linkId" : "raw_score",
        "answer" : [{
          "valueDecimal" : 17
        }]
      },
      {
        "linkId" : "tscore",
        "answer" : [{
          "valueDecimal" : 36.8
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/PROMISPhysicalFunctionCATExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "PROMISPhysicalFunctionCATExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_PROMISPhysicalFunctionCATExample\"> </a><p>PROMIS Physical Function (CAT) QuestionnaireResponse for John Doe. T-score: 38.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/PROMISPhysicalFunctionCATQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "pf-cat-1",
        "text" : "Does your health now limit you in doing two hours of physical labor?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA11911-7",
            "display" : "Quite a lot"
          }
        }]
      },
      {
        "linkId" : "pf-cat-2",
        "text" : "Are you able to do chores such as vacuuming or yard work?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA13920-6",
            "display" : "With some difficulty"
          }
        }]
      },
      {
        "linkId" : "pf-cat-3",
        "text" : "To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA13939-6",
            "display" : "Moderately"
          }
        }]
      },
      {
        "linkId" : "pf-cat-4",
        "text" : "Does your health now limit you in walking more than a mile?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA11911-7",
            "display" : "Quite a lot"
          }
        }]
      },
      {
        "linkId" : "tscore",
        "answer" : [{
          "valueDecimal" : 38
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/PROMISPainInterferenceSFExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "PROMISPainInterferenceSFExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_PROMISPainInterferenceSFExample\"> </a><p>PROMIS Pain Interference (Short Form 6a) QuestionnaireResponse for John Doe. T-score: 58.6.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/PROMISPainInterferenceSFQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "pi6a-1",
        "text" : "In the past 7 days: How much did pain interfere with your day to day activities?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }]
      },
      {
        "linkId" : "pi6a-2",
        "text" : "In the past 7 days: How much did pain interfere with work around the home?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }]
      },
      {
        "linkId" : "pi6a-3",
        "text" : "In the past 7 days: How much did pain interfere with your ability to participate in social activities?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA13909-9",
            "display" : "Somewhat"
          }
        }]
      },
      {
        "linkId" : "pi6a-4",
        "text" : "In the past 7 days: How much did pain interfere with your household chores?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA13863-8",
            "display" : "A little bit"
          }
        }]
      },
      {
        "linkId" : "pi6a-5",
        "text" : "In the past 7 days: How much did pain interfere with the things you usually do for fun?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA13909-9",
            "display" : "Somewhat"
          }
        }]
      },
      {
        "linkId" : "pi6a-6",
        "text" : "In the past 7 days: How much did pain interfere with your enjoyment of social activities?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA13909-9",
            "display" : "Somewhat"
          }
        }]
      },
      {
        "linkId" : "raw_score",
        "answer" : [{
          "valueDecimal" : 15
        }]
      },
      {
        "linkId" : "tscore",
        "answer" : [{
          "valueDecimal" : 58.6
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/PROMISPainInterferenceCATExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "PROMISPainInterferenceCATExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_PROMISPainInterferenceCATExample\"> </a><p>PROMIS Pain Interference (CAT) QuestionnaireResponse for John Doe. T-score: 70.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/PROMISPainInterferenceCATQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "pi-cat-1",
        "text" : "In the past 7 days: How much did pain interfere with your day to day activities?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 4
            }],
            "system" : "http://loinc.org",
            "code" : "LA13902-4",
            "display" : "Quite a bit"
          }
        }]
      },
      {
        "linkId" : "pi-cat-2",
        "text" : "In the past 7 days: How much did pain interfere with your ability to participate in social activities?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 5
            }],
            "system" : "http://loinc.org",
            "code" : "LA13914-9",
            "display" : "Very much"
          }
        }]
      },
      {
        "linkId" : "pi-cat-3",
        "text" : "In the past 7 days: How much did pain interfere with your enjoyment of social activities?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 4
            }],
            "system" : "http://loinc.org",
            "code" : "LA13902-4",
            "display" : "Quite a bit"
          }
        }]
      },
      {
        "linkId" : "pi-cat-4",
        "text" : "In the past 7 days: How much did pain interfere with work around the home?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 5
            }],
            "system" : "http://loinc.org",
            "code" : "LA13914-9",
            "display" : "Very much"
          }
        }]
      },
      {
        "linkId" : "tscore",
        "answer" : [{
          "valueDecimal" : 70
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/OswestryDisabilityIndexExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "OswestryDisabilityIndexExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_OswestryDisabilityIndexExample\"> </a><p>Oswestry Disability Index QuestionnaireResponse for John Doe. Score: 36.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/OswestryDisabilityIndexQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "odi-1",
        "text" : "Pain intensity",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "The pain is moderate at the moment."
          }
        }]
      },
      {
        "linkId" : "odi-2",
        "text" : "Personal care (washing, dressing, etc.)",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "display" : "I can look after myself normally but it is very painful."
          }
        }]
      },
      {
        "linkId" : "odi-3",
        "text" : "Lifting",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "display" : "Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed e.g. on a table."
          }
        }]
      },
      {
        "linkId" : "odi-4",
        "text" : "Walking",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "display" : "Pain prevents me from walking more than one mile."
          }
        }]
      },
      {
        "linkId" : "odi-5",
        "text" : "Sitting",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "Pain prevents me from sitting for more than one hour."
          }
        }]
      },
      {
        "linkId" : "odi-6",
        "text" : "Standing",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "Pain prevents me from standing for more than 1 hour."
          }
        }]
      },
      {
        "linkId" : "odi-7",
        "text" : "Sleeping",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "display" : "My sleep is occasionally interrupted by pain."
          }
        }]
      },
      {
        "linkId" : "odi-8",
        "text" : "Sex life (if applicable)",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "My sex life is nearly normal but is very painful."
          }
        }]
      },
      {
        "linkId" : "odi-9",
        "text" : "Social life",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "display" : "Pain has restricted my social life and I do not go out as often."
          }
        }]
      },
      {
        "linkId" : "odi-10",
        "text" : "Traveling",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "Pain is bad but I am able to manage trips over two hours."
          }
        }]
      },
      {
        "linkId" : "score",
        "answer" : [{
          "valueDecimal" : 36
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/NeckDisabilityIndexExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "NeckDisabilityIndexExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_NeckDisabilityIndexExample\"> </a><p>Neck Disability Index QuestionnaireResponse for John Doe. Total score: 40.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/NeckDisabilityIndexQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "ndi-1",
        "text" : "Pain intensity",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25855-0",
            "display" : "The pain is moderate at the moment."
          }
        }]
      },
      {
        "linkId" : "ndi-2",
        "text" : "Personal care (washing, dressing, etc.)",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "system" : "http://loinc.org",
            "code" : "LA25860-0",
            "display" : "I can look after myself normally but it causes extra pain."
          }
        }]
      },
      {
        "linkId" : "ndi-3",
        "text" : "Lifting",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25867-5",
            "display" : "Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed, for example on a table."
          }
        }]
      },
      {
        "linkId" : "ndi-4",
        "text" : "Reading",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25873-3",
            "display" : "I can read as much as I want with moderate pain in my neck."
          }
        }]
      },
      {
        "linkId" : "ndi-5",
        "text" : "Headaches",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA26367-5",
            "display" : "I have moderate headaches, which come frequently."
          }
        }]
      },
      {
        "linkId" : "ndi-6",
        "text" : "Concentration",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25880-8",
            "display" : "I have a fair degree of difficulty in concentrating when I want to."
          }
        }]
      },
      {
        "linkId" : "ndi-7",
        "text" : "Work",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25886-5",
            "display" : "I can do most of my usual work, but no more."
          }
        }]
      },
      {
        "linkId" : "ndi-8",
        "text" : "Driving",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25892-3",
            "display" : "I can drive my car as long as I want with moderate pain in my neck."
          }
        }]
      },
      {
        "linkId" : "ndi-9",
        "text" : "Sleeping",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25898-0",
            "display" : "My sleep is mildly disturbed (1-2 hrs sleepless)."
          }
        }]
      },
      {
        "linkId" : "ndi-10",
        "text" : "Recreation",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA25904-6",
            "display" : "I am able to engage in most, but not all of my usual recreation activities because of pain in my neck."
          }
        }]
      },
      {
        "linkId" : "total-score",
        "answer" : [{
          "valueDecimal" : 40
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/QuickDASHExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "QuickDASHExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_QuickDASHExample\"> </a><p>QuickDASH QuestionnaireResponse for John Doe. Score: 50.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/QuickDASHQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "qd-1",
        "text" : "Open a tight or new jar.",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "display" : "Moderate difficulty"
          }
        }]
      },
      {
        "linkId" : "qd-2",
        "text" : "Do heavy household chores (e.g., wash walls, wash floors).",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 4
            }],
            "display" : "Severe difficulty"
          }
        }]
      },
      {
        "linkId" : "qd-3",
        "text" : "Carry a shopping bag or briefcase.",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "display" : "Moderate difficulty"
          }
        }]
      },
      {
        "linkId" : "qd-4",
        "text" : "Wash your back.",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "Mild difficulty"
          }
        }]
      },
      {
        "linkId" : "qd-5",
        "text" : "Use a knife to cut food.",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "Mild difficulty"
          }
        }]
      },
      {
        "linkId" : "qd-6",
        "text" : "Recreational activities in which you take some force or impact through your arm, shoulder, or hand (e.g., golf, hammering, tennis, etc.).",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 4
            }],
            "display" : "Severe difficulty"
          }
        }]
      },
      {
        "linkId" : "qd-7",
        "text" : "During the past week, to what extent has your arm, shoulder, or hand problem interfered with your normal social activities with family, friends, neighbors, or groups?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "display" : "Moderately"
          }
        }]
      },
      {
        "linkId" : "qd-8",
        "text" : "During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder, or hand problem?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 4
            }],
            "display" : "Very limited"
          }
        }]
      },
      {
        "linkId" : "qd-9",
        "text" : "Arm, shoulder, or hand pain",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "qd-10",
        "text" : "Tingling (pins and needles) in your arm, shoulder, or hand",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "display" : "Mild"
          }
        }]
      },
      {
        "linkId" : "qd-11",
        "text" : "During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder, or hand?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "display" : "Moderate difficulty"
          }
        }]
      },
      {
        "linkId" : "score",
        "answer" : [{
          "valueDecimal" : 50
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/MSKPGICExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "MSKPGICExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_MSKPGICExample\"> </a><p>PGIC QuestionnaireResponse for John Doe. Response: Very much improved.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/MSKPGICQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "pgic-1",
        "text" : "Since beginning treatment, how would you describe your overall change in pain, function, and quality of life?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "display" : "Very much improved"
          }
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/KOOSJRExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "KOOSJRExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_KOOSJRExample\"> </a><p>KOOS JR QuestionnaireResponse for John Doe. Total interval score: 50.012.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/KOOSJRQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "koosjr-1",
        "text" : "How severe is your knee stiffness after first wakening in the morning?",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA6751-7",
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "koosjr-2",
        "text" : "Twisting/pivoting on your knee",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA6751-7",
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "koosjr-3",
        "text" : "Straightening knee fully",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "system" : "http://loinc.org",
            "code" : "LA6752-5",
            "display" : "Mild"
          }
        }]
      },
      {
        "linkId" : "koosjr-4",
        "text" : "Going up or down stairs",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA6750-9",
            "display" : "Severe"
          }
        }]
      },
      {
        "linkId" : "koosjr-5",
        "text" : "Standing upright",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA6751-7",
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "koosjr-6",
        "text" : "Rising from sitting",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA6751-7",
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "koosjr-7",
        "text" : "Bending to floor/picking up an object",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA6750-9",
            "display" : "Severe"
          }
        }]
      },
      {
        "linkId" : "total-interval-score",
        "answer" : [{
          "valueDecimal" : 50.012
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/HOOSJRExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "HOOSJRExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_HOOSJRExample\"> </a><p>HOOS JR QuestionnaireResponse for John Doe. Total interval score: 55.985.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/HOOSJRQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "hoosjr-1",
        "text" : "Going up or down stairs",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA6751-7",
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "hoosjr-2",
        "text" : "Walking on an uneven surface",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA6751-7",
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "hoosjr-3",
        "text" : "Rising from sitting",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 2
            }],
            "system" : "http://loinc.org",
            "code" : "LA6751-7",
            "display" : "Moderate"
          }
        }]
      },
      {
        "linkId" : "hoosjr-4",
        "text" : "Bending to the floor/picking up an object",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 3
            }],
            "system" : "http://loinc.org",
            "code" : "LA6750-9",
            "display" : "Severe"
          }
        }]
      },
      {
        "linkId" : "hoosjr-5",
        "text" : "Lying in bed",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "system" : "http://loinc.org",
            "code" : "LA6752-5",
            "display" : "Mild"
          }
        }]
      },
      {
        "linkId" : "hoosjr-6",
        "text" : "Sitting",
        "answer" : [{
          "valueCoding" : {
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/ordinalValue",
              "valueDecimal" : 1
            }],
            "system" : "http://loinc.org",
            "code" : "LA6752-5",
            "display" : "Mild"
          }
        }]
      },
      {
        "linkId" : "total-interval-score",
        "answer" : [{
          "valueDecimal" : 55.985
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/QuestionnaireResponse/PROMISNRSExample",
    "resource" : {
      "resourceType" : "QuestionnaireResponse",
      "id" : "PROMISNRSExample",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><a name=\"QuestionnaireResponse_PROMISNRSExample\"> </a><p>PROMIS Pain Intensity NRS QuestionnaireResponse for John Doe. Average pain (0-10): 6.</p></div>"
      },
      "questionnaire" : "http://example.org/Questionnaire/PROMISNRSQuestionnaire",
      "status" : "completed",
      "subject" : {
        "reference" : "Patient/PatientExample"
      },
      "authored" : "2026-01-15T10:30:00Z",
      "author" : {
        "reference" : "Patient/PatientExample"
      },
      "item" : [{
        "linkId" : "nrs-1",
        "text" : "In the past 7 days, how would you rate your pain on average? (0-10)",
        "answer" : [{
          "valueInteger" : 6
        }]
      }]
    }
  }]
}