CMS ACCESS Model API
0.9.8 - draft
US
This page is part of the ACCESS Model IG v0.9.8 DRAFT (v0.9.8: Releases Draft) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<id value="DepressionPHQ9Example"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse|6.1.0"/>
</meta>
<language value="en"/>
<text>
<status value="generated"/>
<div xml:lang="en" xmlns="http://www.w3.org/1999/xhtml" lang="en"><p>PHQ-9 QuestionnaireResponse for John Doe. Total score: 7.</p></div>
</text>
<questionnaire value="http://example.org/Questionnaire/PHQ9Questionnaire"/>
<status value="completed"/>
<subject>🔗
<reference value="Patient/PatientExample"/>
</subject>
<authored value="2026-01-15T10:30:00Z"/>
<author>🔗
<reference value="Patient/PatientExample"/>
</author>
<item>
<linkId value="phq9-1"/>
<text value="Little interest or pleasure in doing things"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6569-3"/>
<display value="Several days"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-2"/>
<text value="Feeling down, depressed, or hopeless"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6569-3"/>
<display value="Several days"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-3"/>
<text value="Trouble falling or staying asleep, or sleeping too much"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6570-1"/>
<display value="More than half the days"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-4"/>
<text value="Feeling tired or having little energy"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6569-3"/>
<display value="Several days"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-5"/>
<text value="Poor appetite or overeating"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-6"/>
<text
value="Feeling bad about yourself — or that you are a failure or have let yourself or your family down"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6569-3"/>
<display value="Several days"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-7"/>
<text
value="Trouble concentrating on things, such as reading the newspaper or watching television"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6569-3"/>
<display value="Several days"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-8"/>
<text
value="Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-9"/>
<text
value="Thoughts that you would be better off dead, or of hurting yourself in some way"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="0"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6568-5"/>
<display value="Not at all"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="phq9-10"/>
<text
value="How difficult have these made it for you to do your work, take care of things at home, or get along with other people?"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<system value="http://loinc.org"/>
<code value="LA6573-5"/>
<display value="Somewhat difficult"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="total-score"/>
<answer>
<valueDecimal value="7"/>
</answer>
</item>
</QuestionnaireResponse>