Overview
The FHIR Questionnaire resource represents structured forms and surveys in standardized, machine-readable format. Questionnaires support diverse use cases: clinical assessments (PHQ-9 depression screening, GAD-7 anxiety screening, fall risk assessment), patient-reported outcomes (quality of life surveys, symptom questionnaires, satisfaction surveys), intake forms (registration, history forms, pre-visit questionnaires), payer data collection (prior authorization questions, HEDIS measure validation), and research data capture. Combined with QuestionnaireResponse resources, Questionnaires enable programmatic form workflow including validation, scoring, and integration with clinical decision support.
Resource structure: A Questionnaire resource includes: identifier and URL for the questionnaire itself, title and description, status (draft, active, retired), subject type (patient, practitioner, etc.), item collection (the questions, grouped hierarchically), and various metadata. Each item has a linkId (unique identifier), type (group, boolean, decimal, integer, date, string, text, choice, open-choice, attachment, reference, quantity), text (the question text), enableWhen and enableBehavior (conditional logic controlling when the item is shown), required flag, and repeats flag (for repeatable items).
Advanced Questionnaire features support complex form logic: nested item groups create structured sections, enableWhen rules create dynamic forms where questions appear based on prior answers, answerValueSet restricts multiple-choice answers to standard codesets (e.g., ICD-10, LOINC), calculation extensions enable derived values (total scores, averages), and definition extensions link items to standard data elements (LOINC codes for standardized clinical questions).
QuestionnaireResponse resources capture the responses to a Questionnaire. The response mirrors the Questionnaire's structure with answers at each linkId. FHIR QuestionnaireResponse supports partial responses (draft state), completed responses, and amended responses. Responses can be linked to the patient, encounter, and subject; responses can be queried, analyzed, and used for clinical decision support.
Structured Data Capture (SDC) Implementation Guide extends Questionnaire with advanced capabilities: form pre-population from FHIR data (population of name, DOB, problem list from existing FHIR resources), form logic and expressions (complex conditional display and calculation), scoring calculations (automated scoring for standardized assessments), and data extraction to FHIR resources (responses automatically transformed into structured FHIR Observations, Conditions, or other resources).
For clinical workflow, FHIR Questionnaires enable modern form experiences: standardized assessments captured consistently across visits, pre-visit questionnaires completed by patients in portal or on kiosk, point-of-care assessments integrated with clinical decision support, and post-visit follow-up questionnaires for outcomes tracking. Scoring happens automatically; integration with clinical decision support triggers appropriate alerts; data flows into structured clinical documentation.
For RCM operations, FHIR Questionnaires support several use cases. Intake and registration forms become structured FHIR-based workflows. Prior authorization data collection via Da Vinci DTR (Documentation Templates and Rules) uses FHIR Questionnaires to capture required clinical information in payer-specified structure. Patient-reported outcome measures for value-based arrangements capture standardized data. HEDIS measure validation questionnaires support quality reporting.
Interoperability benefits: Standardized Questionnaires can be shared across organizations. A validated depression screening Questionnaire developed by one organization can be reused by others. Payer-specific prior auth Questionnaires distributed through Da Vinci CRD/DTR workflows are implemented once by the payer and consumed by all providers. This reuse avoids duplicative form development while ensuring consistency in data capture.
Implementation considerations include: authoring environment (tools to create and maintain Questionnaires), rendering (web, mobile, clinician-facing vs. patient-facing), pre-population (connecting to existing FHIR data), response storage and retrieval, scoring and analysis, and integration with clinical workflow. Vendor implementations of FHIR Questionnaire capability continue to mature; modern EHRs and forms platforms increasingly offer robust Questionnaire support.
Industry benchmark
FHIR Questionnaire use cases: clinical assessments, PROs, intake, prior auth (Da Vinci DTR), HEDIS. SDC extension: advanced capabilities. Interop benefit: standardized, reusable forms.
Worked example
A primary care practice uses a FHIR Questionnaire for PHQ-9 depression screening. The Questionnaire resource is reused across 12 clinics. At visit, the patient completes the Questionnaire on a tablet; responses populate a QuestionnaireResponse resource. Automated scoring calculates a PHQ-9 total; scores ≥10 trigger a clinical decision support alert suggesting further evaluation. Structured response data flows into the patient's record as FHIR Observations. The Questionnaire is also used in the patient portal for interim reassessment between visits.
Frequently asked questions — FHIR Questionnaire Resource
What's the difference between Questionnaire and QuestionnaireResponse?
Questionnaire defines the form structure (questions, types, logic). QuestionnaireResponse captures the answers to a specific administration. Questionnaires are reusable templates; Responses are specific instances.
Can Questionnaires pre-populate from EHR data?
Yes, through the Structured Data Capture (SDC) Implementation Guide. SDC extends Questionnaires with pre-population logic pulling data from existing FHIR resources (demographics, problems, medications).
How are Questionnaires used for prior authorization?
Da Vinci DTR uses FHIR Questionnaires to capture clinical information required for prior authorization in payer-specified structure. Providers complete payer-specific Questionnaires; responses support authorization review.
Disclaimer
This glossary entry is operational reference for revenue-cycle and medical-billing professionals. It is not legal, clinical, or contractual advice. Industry benchmarks cite named public sources where available; always verify against the current guidance from the authority body before relying on a number in a contract, policy, or compliance filing.