Guide d’Implémentation FHIR – Pré-admission Hospitalière en Ligne
1.0.0-ballot - ballot France (la)

This page is part of the Guide d'Implémentation FHIR – Pré-admission Hospitalière en Ligne (v1.0.0-ballot: draft Ballot 1) 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

: Reponse Questionnaire préadmission IRM

Active as of 2026-10-21

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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="questionnaire-irm"/>
  <language value="en"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire questionnaire-irm</b></p><a name="questionnaire-irm"> </a><a name="hcquestionnaire-irm"> </a><table border="1" cellpadding="0" cellspacing="0" class="xhtTableBorder1"><tr class="xhtRowBorder2"><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="" style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> </td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Questionnaire</td><td style="" class="hierarchy xhtCellBorder1">https://hl7.fr/ig/fhir/preadmission/Questionnaire/questionnaire-irm#1.0.0-ballot</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck10.png)" id="item.implant" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="boolean" class="hierarchy"/> implant</td><td style="" class="hierarchy xhtCellBorder1">Avez-vous un implant métallique ou un pacemaker ?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck10.png)" id="item.grossesse" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="" style="background-color: white; background-color: inherit" title="boolean" class="hierarchy"/> grossesse</td><td style="" class="hierarchy xhtCellBorder1">Êtes-vous actuellement enceinte ?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck10.png)" id="item.allergies" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="boolean" class="hierarchy"/> allergies</td><td style="" class="hierarchy xhtCellBorder1">Avez-vous des allergies connues ?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck00.png)" id="item.medications" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="" style="background-color: white; background-color: inherit" title="boolean" class="hierarchy"/> medications</td><td style="" class="hierarchy xhtCellBorder1">Prenez-vous des médicaments régulièrement ?</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="https://hl7.fr/ig/fhir/preadmission/Questionnaire/questionnaire-irm"/>
  <version value="1.0.0-ballot"/>
  <title value="Questionnaire IRM - Préadmission"/>
  <status value="active"/>
  <subjectType value="Appointment"/>
  <date value="2026-10-21T10:07:38+00:00"/>
  <publisher value="Interop'Santé"/>
  <contact>
    <name value="Interop'Santé"/>
    <telecom>
      <system value="url"/>
      <value value="http://interopsante.org/"/>
    </telecom>
  </contact>
  <contact>
    <name value="InteropSanté"/>
    <telecom>
      <system value="email"/>
      <value value="fhir@interopsante.org"/>
      <use value="work"/>
    </telecom>
  </contact>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="FR"/>
      <display value="France (la)"/>
    </coding>
  </jurisdiction>
  <item>
    <linkId value="implant"/>
    <text value="Avez-vous un implant métallique ou un pacemaker ?"/>
    <type value="boolean"/>
  </item>
  <item>
    <linkId value="grossesse"/>
    <text value="Êtes-vous actuellement enceinte ?"/>
    <type value="boolean"/>
  </item>
  <item>
    <linkId value="allergies"/>
    <text value="Avez-vous des allergies connues ?"/>
    <type value="boolean"/>
  </item>
  <item>
    <linkId value="medications"/>
    <text value="Prenez-vous des médicaments régulièrement ?"/>
    <type value="boolean"/>
  </item>
</Questionnaire>