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="OswestryDisabilityIndexExample"/>
<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>Oswestry Disability Index QuestionnaireResponse for John Doe. Score: 36.</p></div>
</text>
<questionnaire
value="http://example.org/Questionnaire/OswestryDisabilityIndexQuestionnaire"/>
<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="odi-1"/>
<text value="Pain intensity"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<display value="The pain is moderate at the moment."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-2"/>
<text value="Personal care (washing, dressing, etc.)"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<display
value="I can look after myself normally but it is very painful."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-3"/>
<text value="Lifting"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<display
value="Pain prevents me lifting heavy weights off the floor, but I can manage if they are conveniently placed e.g. on a table."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-4"/>
<text value="Walking"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<display value="Pain prevents me from walking more than one mile."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-5"/>
<text value="Sitting"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<display
value="Pain prevents me from sitting for more than one hour."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-6"/>
<text value="Standing"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<display
value="Pain prevents me from standing for more than 1 hour."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-7"/>
<text value="Sleeping"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="1"/>
</extension>
<display value="My sleep is occasionally interrupted by pain."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-8"/>
<text value="Sex life (if applicable)"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<display value="My sex life is nearly normal but is very painful."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-9"/>
<text value="Social life"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="3"/>
</extension>
<display
value="Pain has restricted my social life and I do not go out as often."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="odi-10"/>
<text value="Traveling"/>
<answer>
<valueCoding>
<extension
url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
<valueDecimal value="2"/>
</extension>
<display
value="Pain is bad but I am able to manage trips over two hours."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="score"/>
<answer>
<valueDecimal value="36"/>
</answer>
</item>
</QuestionnaireResponse>