Situational Awareness for Novel Epidemic Response
1.0.1 - STU Release

Situational Awareness for Novel Epidemic Response, published by HL7 International Public Health Workgroup. This is not an authorized publication; it is the continuous build for version 1.0.1). This version is based on the current content of https://github.com/HL7/fhir-saner/ and changes regularly. See the Directory of published versions

: Patients By Risk Factor - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Measure;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "PatientsByRiskFactorWithSupplementalData"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/uv/saner/StructureDefinition/PublicHealthMeasure";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/uv/saner/StructureDefinition/PublicHealthMeasure>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource \"PatientsByRiskFactorWithSupplementalData\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-PublicHealthMeasure.html\">Public Health Measure</a></p></div><p><b>Enables specification of proposed measure reporting</b>: Do Once per 1 days</p><p><b>url</b>: <code>http://hl7.org/fhir/uv/saner/Measure/PatientsByRiskFactorWithSupplementalData</code></p><p><b>version</b>: 1.0.1</p><p><b>name</b>: PatientsByRiskFactor</p><p><b>title</b>: COVID-19 Patients By Risk Factor</p><p><b>status</b>: draft</p><p><b>experimental</b>: true</p><p><b>date</b>: 2021-12-17T18:59:45Z</p><p><b>publisher</b>: HL7 International Public Health Workgroup</p><p><b>contact</b>: <a href=\"http://hl7.org/Special/committees/pher\">http://hl7.org/Special/committees/pher</a>, <a href=\"mailto:pher@lists.hl7.org\">pher@lists.hl7.org</a>, Keith W. Boone: <a href=\"mailto:mailto:kboone@ainq.com\">mailto:kboone@ainq.com</a></p><p><b>jurisdiction</b>: World <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (m49.htm#001)</span></p><p><b>author</b>: Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN): <a href=\"mailto:mailto:nhsn@cdc.gov\">mailto:nhsn@cdc.gov</a></p><p><b>library</b>: <a href=\"http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary\">http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary</a></p><blockquote><p><b>group</b></p><blockquote><p><b>Attributes describing a group of measures</b></p><p><b>value</b>: Patient in room <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Encounter; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#398284004)</span></p><p><b>value</b>: Queue Length <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-PublicHealthMeasureScoring.html\">Public Health Measure Scoring</a>#queue-length)</span></p><p><b>value</b>: Structure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-type.html\">MeasureType</a>#structure)</span></p><p><b>value</b>: Decreased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#decrease)</span></p><p><b>value</b>: point-in-time</p></blockquote><p><b>code</b>: Hospital COVID-19 Patient Encounters Reporting <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-MeasureGroupSystem.html\">Measure Group System</a>#Encounters \"Encounters\")</span></p><blockquote><p><b>population</b></p><p><b>code</b>: Patients with confirmed COVID-19 in any location. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-MeasuredValues.html\">Measured Values in Sample Measures</a>#confirmedC19Pats \"All Confirmed COVID-19 Patients\"; <a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-population.html\">MeasurePopulationType</a>#initial-population)</span></p><p><b>description</b>: Active encounters where the encounter diagnosis is suspected or confirmed COVID-19,\nor a Condition of confirmed COVID-19 was created during that encounter.  This includes the patients with laboratory-confirmed\nor clinically diagnosed COVID-19.</p></blockquote><blockquote><p><b>stratifier</b></p><p><b>code</b>: By Risk Factor <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>description</b>: Stratifies the population by Condition/RiskFactor</p></blockquote></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Encounter <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Encounter)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The patient encounter</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Patient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Patient)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The patient</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Location <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Location)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The patient location</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Condition <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Condition)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: The encounter and other diagnosis</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: MedicationRequest <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#MedicationRequest; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#MedicationAdministration; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Immunization)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: Medications/Immunizations given during the encounter</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Observation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Observation)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: COVID-19 Lab Results</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: DiagnosticReport <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#DiagnosticReport; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#DocumentReference; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Observation; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#ServiceRequest)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: VTE Diagnostic Results</p></blockquote><blockquote><p><b>supplementalData</b></p><p><b>code</b>: Procedure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#Procedure; <a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">ResourceType</a>#ServiceRequest)</span></p><p><b>usage</b>: Supplemental Data <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-measure-data-usage.html\">MeasureDataUsage</a>#supplemental-data)</span></p><p><b>description</b>: Isolation Precautions</p></blockquote></div>"
  ];
  fhir:DomainResource.extension [
     fhir:index 0;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/saner/StructureDefinition/ReportingPeriod" ];
     fhir:Extension.valueTiming [
       fhir:Timing.repeat [
         fhir:Timing.repeat.frequency [ fhir:value "1"^^xsd:positiveInteger ];
         fhir:Timing.repeat.period [ fhir:value "1"^^xsd:decimal ];
         fhir:Timing.repeat.periodUnit [ fhir:value "d" ]       ]     ]
  ];
  fhir:Measure.url [ fhir:value "http://hl7.org/fhir/uv/saner/Measure/PatientsByRiskFactorWithSupplementalData"];
  fhir:Measure.version [ fhir:value "1.0.1"];
  fhir:Measure.name [ fhir:value "PatientsByRiskFactor"];
  fhir:Measure.title [ fhir:value "COVID-19 Patients By Risk Factor"];
  fhir:Measure.status [ fhir:value "draft"];
  fhir:Measure.experimental [ fhir:value "true"^^xsd:boolean];
  fhir:Measure.date [ fhir:value "2021-12-17T18:59:45+00:00"^^xsd:dateTime];
  fhir:Measure.publisher [ fhir:value "HL7 International Public Health Workgroup"];
  fhir:Measure.contact [
     fhir:index 0;
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://hl7.org/Special/committees/pher" ]     ]
  ], [
     fhir:index 1;
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "email" ];
       fhir:ContactPoint.value [ fhir:value "pher@lists.hl7.org" ]     ]
  ], [
     fhir:index 2;
     fhir:ContactDetail.name [ fhir:value "Keith W. Boone" ];
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "email" ];
       fhir:ContactPoint.value [ fhir:value "mailto:kboone@ainq.com" ]     ]
  ];
  fhir:Measure.useContext [
     fhir:index 0;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
       fhir:Coding.code [ fhir:value "focus" ]     ];
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a sct:840539006;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "840539006" ];
         fhir:Coding.display [ fhir:value "COVID-19" ]       ]     ]
  ];
  fhir:Measure.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://unstats.un.org/unsd/methods/m49/m49.htm" ];
       fhir:Coding.code [ fhir:value "001" ]     ]
  ];
  fhir:Measure.author [
     fhir:index 0;
     fhir:ContactDetail.name [ fhir:value "Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN)" ];
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "email" ];
       fhir:ContactPoint.value [ fhir:value "mailto:nhsn@cdc.gov" ]     ]
  ];
  fhir:Measure.relatedArtifact [
     fhir:index 0;
     fhir:RelatedArtifact.type [ fhir:value "documentation" ];
     fhir:RelatedArtifact.label [ fhir:value "NHSN COVID-19 Reporting" ];
     fhir:RelatedArtifact.display [ fhir:value "CDC/NHSN COVID-19 Patient Impact & Hospital Capacity Module Home Page" ];
     fhir:RelatedArtifact.url [ fhir:value "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/" ]
  ], [
     fhir:index 1;
     fhir:RelatedArtifact.type [ fhir:value "documentation" ];
     fhir:RelatedArtifact.label [ fhir:value "How to import COVID-19 Summary Data" ];
     fhir:RelatedArtifact.display [ fhir:value "Importing COVID-19 Patient Module Denominator data for Patient Safety Component" ];
     fhir:RelatedArtifact.url [ fhir:value "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf" ]
  ], [
     fhir:index 2;
     fhir:RelatedArtifact.type [ fhir:value "documentation" ];
     fhir:RelatedArtifact.label [ fhir:value "Table of Instructions" ];
     fhir:RelatedArtifact.display [ fhir:value "Instructions for Completion of the COVID-19 Patient Impact and Hospital Capacity Module Form (CDC 57.130)" ];
     fhir:RelatedArtifact.url [ fhir:value "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf" ]
  ], [
     fhir:index 3;
     fhir:RelatedArtifact.type [ fhir:value "documentation" ];
     fhir:RelatedArtifact.label [ fhir:value "CSV File Template" ];
     fhir:RelatedArtifact.display [ fhir:value "CDC/NHSN COVID-19 Reporting CSV File Template" ];
     fhir:RelatedArtifact.url [ fhir:value "https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv" ]
  ];
  fhir:Measure.library [
     fhir:value "http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary";
     fhir:index 0;
     fhir:link <http://hl7.org/fhir/uv/saner/Library/ComputableNHSNMeasureLibrary>
  ];
  fhir:Measure.group [
     fhir:index 0;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Element.extension [
         fhir:index 0;
         fhir:Extension.url [ fhir:value "subject" ];
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index 0;
             fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
             fhir:Coding.code [ fhir:value "Encounter" ]           ], [
             fhir:index 1;
             a sct:398284004;
             fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
             fhir:Coding.code [ fhir:value "398284004" ];
             fhir:Coding.display [ fhir:value "Patient in room" ]           ];
           fhir:CodeableConcept.text [ fhir:value "Patient in room" ]         ]       ], [
         fhir:index 1;
         fhir:Extension.url [ fhir:value "scoring" ];
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index 0;
             fhir:Coding.system [ fhir:value "http://hl7.org/fhir/uv/saner/CodeSystem/PublicHealthMeasureScoring" ];
             fhir:Coding.code [ fhir:value "queue-length" ]           ]         ]       ], [
         fhir:index 2;
         fhir:Extension.url [ fhir:value "type" ];
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index 0;
             fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-type" ];
             fhir:Coding.code [ fhir:value "structure" ]           ]         ]       ], [
         fhir:index 3;
         fhir:Extension.url [ fhir:value "improvementNotation" ];
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index 0;
             fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-improvement-notation" ];
             fhir:Coding.code [ fhir:value "decrease" ]           ]         ]       ], [
         fhir:index 4;
         fhir:Extension.url [ fhir:value "rateAggregation" ];
         fhir:Extension.valueString [ fhir:value "point-in-time" ]       ];
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/saner/StructureDefinition/MeasureGroupAttributes" ]     ];
     fhir:Measure.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystem" ];
         fhir:Coding.code [ fhir:value "Encounters" ];
         fhir:Coding.display [ fhir:value "Encounters" ]       ];
       fhir:CodeableConcept.text [ fhir:value "Hospital COVID-19 Patient Encounters Reporting" ]     ];
     fhir:Measure.group.population [
       fhir:index 0;
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValues" ];
           fhir:Coding.code [ fhir:value "confirmedC19Pats" ];
           fhir:Coding.display [ fhir:value "All Confirmed COVID-19 Patients" ]         ], [
           fhir:index 1;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "initial-population" ]         ];
         fhir:CodeableConcept.text [ fhir:value "Patients with confirmed COVID-19 in any location." ]       ];
       fhir:Measure.group.population.description [ fhir:value "Active encounters where the encounter diagnosis is suspected or confirmed COVID-19,\nor a Condition of confirmed COVID-19 was created during that encounter.  This includes the patients with laboratory-confirmed\nor clinically diagnosed COVID-19." ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.description [ fhir:value "This expression finds encounters that were active or finished in the reporting period, and their referenced Patient, Condition\nand Observation resources. It filters these based on cases where Encounter reports a reason or condition in the\nConfirmedCOVID19Diagnoses value set, or where a positive lab test from the Covid19Labs valueset, or where the patient\nhas any such associated Condition or Observation resources in the prior two weeks." ];
         fhir:Expression.name [ fhir:value "ConfirmedC19Pats" ];
         fhir:Expression.language [ fhir:value "text/fhirpath" ];
         fhir:Expression.expression [ fhir:value "findAll('Encounter',\n    including('subject','condition','reasonReference'),\n    with('status').equalTo('in-progress,finished'),\n    with('date').within(%ReportingPeriod)\n ).onServers(%Base).\n where(\n   iif(\n     (Encounter.reasonCode | Condition.code).member0f(%ConfirmedCOVID19Diagnoses.url) |\n     Observation.where(code.member0f(%Covid19Labs.url) and value.member0f(%PositiveResults.url)),\n     true,\n     iif(\n       Patient.distinct()\n          .whereExists('Observation',\n            for('patient', $this.id),\n            with('status').equalTo(\n                'registered,preliminary,final,amended,corrected'),\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%Covid19Labs),\n            with('value-concept').in(%PositiveResults)\n       ).onServers(%Base),\n       true,\n       Patient.distinct()\n          .whereExists('Condition',\n            for('patient', $this.id),\n            with('verification-status').notEqualTo('refuted,entered-in-error').\n            with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n            with('code').in(%ConfirmedCOVID19Diagnoses.url)\n       ).onServers(%Base)\n     )\n  )\n)\n.ofType(Encounter)\n.distinct()\n.aggregate(\n  iif($total.subject contains $this.subject, $total, $total | $this )\n)" ]       ]     ];
     fhir:Measure.group.stratifier [
       fhir:index 0;
       fhir:Measure.group.stratifier.code [
         fhir:CodeableConcept.text [ fhir:value "By Risk Factor" ]       ];
       fhir:Measure.group.stratifier.description [ fhir:value "Stratifies the population by Condition/RiskFactor" ];
       fhir:Measure.group.stratifier.criteria [
         fhir:Expression.description [ fhir:value "Final all conditions for each patient in the AllCOVID19RiskFactors ValueSet\nand stratify by membership in subsets of that value set.  NOTE: A patient\ncan belong to multiple strata in this example." ];
         fhir:Expression.language [ fhir:value "text/fhirpath" ];
         fhir:Expression.expression [ fhir:value "findAll('Condition',\n	for('patient', $this.subject),\n	with('code').in(%AllCOVID19RiskFactors.url),\n       with('onset-date').greaterThan(%ReportingPeriod.start - 1 'year')\n   ).onServers(%Base).select(\n   	iif(code.member0f(%NeoplasticCOVID19RiskFactors.url), 'Neoplastic Disease', {}) |\n   	iif(code.member0f(%COPDCOVID19RiskFactors.url), 'COPD', {}) |\n   	iif(code.member0f(%TobaccoCOVID19RiskFactors.url), 'Tobacco User', {}) |\n   	iif(code.member0f(%HypertensionCOVID19RiskFactors.url), 'Hypertension', {}) |	// Calling out Hypertension separately for reasons\n   	iif(code.member0f(%CardiovascularCOVID19RiskFactors.url), 'Cardiovascular Disease', {}) |	// Even though it isa Cardiovascular disease\n   	iif(code.member0f(%ObesityCOVID19RiskFactors.url), 'Obesity', {}) |\n   	iif(code.member0f(%SickleCellCOVID19RiskFactors.url), 'Sickle cell Disease', {}) |\n   	iif(code.member0f(%KidneyDiseaseCOVID19RiskFactors.url), 'Chronic Kidney Disease', {}) |\n   	iif(code.member0f(%PregnancyCOVID19RiskFactors.url), 'Pregnant', {}) |\n   	iif(code.member0f(%DiabetesCOVID19RiskFactors.url), 'Diabetes', {})\n   )" ]       ]     ]
  ];
  fhir:Measure.supplementalData [
     fhir:index 0;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Encounter" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "The patient encounter" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "Encounter dates, reason (e.g., Chief Complaint), discharge disposition" ];
       fhir:Expression.name [ fhir:value "Encounter" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "Encounter" ]     ]
  ], [
     fhir:index 1;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Patient" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "The patient" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "The Patient, including sex, dob, race and ethnicity" ];
       fhir:Expression.name [ fhir:value "Patient" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "Encounter.subject.resolve()" ]     ]
  ], [
     fhir:index 2;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Location" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "The patient location" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "The Patient Location" ];
       fhir:Expression.name [ fhir:value "PatientLocation" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "Encounter.location.location.resolve()" ]     ]
  ], [
     fhir:index 3;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Condition" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "The encounter and other diagnosis" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "Retrieves all conditions associated with the encounter" ];
       fhir:Expression.name [ fhir:value "EncounterDiagnosis" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "(Encounter.reasonReference|Encounter.diagnosis.condition).resolve() |\nfindAll('Condition',\n	for('patient', $this.subject),\n	with('encounter').equalTo($this.id)\n).onServers(%Base)" ]     ]
  ], [
     fhir:index 4;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "MedicationRequest" ]       ], [
         fhir:index 1;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "MedicationAdministration" ]       ], [
         fhir:index 2;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Immunization" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "Medications/Immunizations given during the encounter" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "Retrieves all medications/immunizations associated with the encounter" ];
       fhir:Expression.name [ fhir:value "EncounterMeds" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "findAll('MedicationRequest',\n	for('patient', $this.subject),\n	with('encounter').equalTo($this.id)  // alternately, this could be within encounter dates\n).onServers(%Base) |\nfindAll('MedicationAdministration',\n	for('patient', $this.subject),\n	with('effective-time').within(%ReportingPeriod)\n).onServers(%Base) |\nfindAll('Immunization',\n	for('patient', $this.subject),\n	with('date').within(%ReportingPeriod)\n).onServers(%Base)" ]     ]
  ], [
     fhir:index 5;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Observation" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "COVID-19 Lab Results" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "Retrieves all Observations associated with COVID-19 Labs" ];
       fhir:Expression.name [ fhir:value "COVID19Labs" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "findAll('Observation',\n	for('patient', $this.subject),\n	with('code').in(%Covid19Labs.url),\n	with('date').greaterThan(%ReportingPeriod.start - 1 'year')\n).onServers(%Base)" ]     ]
  ], [
     fhir:index 6;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "DiagnosticReport" ]       ], [
         fhir:index 1;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "DocumentReference" ]       ], [
         fhir:index 2;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Observation" ]       ], [
         fhir:index 3;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "ServiceRequest" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "VTE Diagnostic Results" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "Retrieves diagnostics associated with VTE" ];
       fhir:Expression.name [ fhir:value "VTEDiagnostics" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "findAll('DiagnosticReport',\n	for('patient', $this.subject),\n	including('result', 'media'), // what else?\n	with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n	with('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('DocumentReference',\n	for('patient', $this.subject),\n	including('related'), // what else?\n	with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n	with('type').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('Observation',\n	for('patient', $this.subject),\n	including('based-on'), // what else?\n	with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n	with('code').in(%VTEReports.url)\n).onServers(%Base) |\nfindAll('ServiceRequest',\n	for('patient', $this.subject),\n	including('based-on'), // what else?\n	with('date').greaterThan(%ReportingPeriod.start - 1 'year'),\n	with('code').in(%VTEReports.url)\n).onServers(%Base)" ]     ]
  ], [
     fhir:index 7;
     fhir:Measure.supplementalData.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "Procedure" ]       ], [
         fhir:index 1;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
         fhir:Coding.code [ fhir:value "ServiceRequest" ]       ]     ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.description [ fhir:value "Isolation Precautions" ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.description [ fhir:value "Retrieves orders or procedures associated with Isolation Precautions" ];
       fhir:Expression.name [ fhir:value "IsolationOrders" ];
       fhir:Expression.language [ fhir:value "text/fhirpath" ];
       fhir:Expression.expression [ fhir:value "findAll('ServiceRequest',\n	for('patient', $this.subject),\n	for('encounter', $this.id),\n	with('code').in(%IsolationPrecautions.url)\n).onServers(%Base) |\nfindAll('Procedure',\n	for('patient', $this.subject),\n	for('encounter', $this.id),\n	with('code').in(%IsolationPrecautions.url)\n).onServers(%Base)" ]     ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.