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
{
"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\"><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
}
]
}
]
}