Data Exchange For Quality Measures STU3 for FHIR R4
2.1.0 - Ballot

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v2.1.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

: Single Indv Col Obs Report - TTL Representation

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

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

 a fhir:Bundle;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "single-indv-col-obs-report"];
  fhir:Resource.meta [
     fhir:Meta.source [ fhir:value "http://example.org/fhir/server" ]
  ];
  fhir:Bundle.type [ fhir:value "transaction"];
  fhir:Bundle.entry [
     fhir:index 0;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57904" ];
     fhir:Bundle.entry.resource <urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57904>;
     fhir:Bundle.entry.request [
       fhir:Bundle.entry.request.method [ fhir:value "POST" ];
       fhir:Bundle.entry.request.url [ fhir:value "MeasureReport" ]     ]
  ], [
     fhir:index 1;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905" ];
     fhir:Bundle.entry.resource <urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905>;
     fhir:Bundle.entry.request [
       fhir:Bundle.entry.request.method [ fhir:value "POST" ];
       fhir:Bundle.entry.request.url [ fhir:value "Organization" ]     ]
  ], [
     fhir:index 2;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906" ];
     fhir:Bundle.entry.resource <urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906>;
     fhir:Bundle.entry.request [
       fhir:Bundle.entry.request.method [ fhir:value "POST" ];
       fhir:Bundle.entry.request.url [ fhir:value "Patient" ]     ]
  ], [
     fhir:index 3;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907" ];
     fhir:Bundle.entry.resource <urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907>;
     fhir:Bundle.entry.request [
       fhir:Bundle.entry.request.method [ fhir:value "POST" ];
       fhir:Bundle.entry.request.url [ fhir:value "Practitioner" ]     ]
  ], [
     fhir:index 4;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57908" ];
     fhir:Bundle.entry.resource <urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57908>;
     fhir:Bundle.entry.request [
       fhir:Bundle.entry.request.method [ fhir:value "POST" ];
       fhir:Bundle.entry.request.url [ fhir:value "Observation" ]     ]
  ].

<urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57904> a fhir:MeasureReport;
  fhir:Resource.id [ fhir:value "47709cc7-b3ec-4abc-9d26-3df3d3d57904"];
  fhir:Resource.meta [
     fhir:Meta.source [ fhir:value "http://example.org/fhir/server" ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/indv-measurereport-deqm>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: 47709cc7-b3ec-4abc-9d26-3df3d3d57904</p><p><b>meta</b>: </p><p><b>status</b>: complete</p><p><b>type</b>: individual</p><p><b>measure</b>: <a href=\"http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm130-FHIR\">http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm130-FHIR</a></p><p><b>subject</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57906\">See above (Patient/null)</a></p><p><b>date</b>: 2019-03-14</p><p><b>reporter</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57905\">See above (Organization/null)</a></p><p><b>period</b>: 2018-12-31 --&gt; 2019-01-01</p><p><b>improvementNotation</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-improvement-notation increase}\">Increased score indicates improvement</span></p><blockquote><p><b>group</b></p><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/ group-1}\">group-1</span></p><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population initial-population}\">Initial Population</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population numerator}\">Numerator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator}\">Denominator</span></p><p><b>count</b>: 1</p></blockquote><blockquote><p><b>population</b></p><p><b>code</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/measure-population denominator-exclusion}\">Denominator Exclusion</span></p><p><b>count</b>: 0</p></blockquote><p><b>measureScore</b>: 1</p></blockquote></div>"
  ];
  fhir:DomainResource.extension [
     fhir:index 0;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring" ];
     fhir:Extension.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-scoring" ];
         fhir:Coding.code [ fhir:value "proportion" ]       ]     ]
  ];
  fhir:MeasureReport.status [ fhir:value "complete"];
  fhir:MeasureReport.type [ fhir:value "individual"];
  fhir:MeasureReport.measure [
     fhir:value "http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm130-FHIR";
     fhir:link <http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm130-FHIR>
  ];
  fhir:MeasureReport.subject [
     fhir:Reference.reference [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906" ]
  ];
  fhir:MeasureReport.date [ fhir:value "2019-03-14"^^xsd:date];
  fhir:MeasureReport.reporter [
     fhir:Reference.reference [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905" ]
  ];
  fhir:MeasureReport.period [
     fhir:Period.start [ fhir:value "2018-12-31"^^xsd:date ];
     fhir:Period.end [ fhir:value "2019-01-01"^^xsd:date ]
  ];
  fhir:MeasureReport.improvementNotation [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-improvement-notation" ];
       fhir:Coding.code [ fhir:value "increase" ];
       fhir:Coding.display [ fhir:value "Increased score indicates improvement" ]     ]
  ];
  fhir:MeasureReport.group [
     fhir:index 0;
     fhir:MeasureReport.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://example.org/fhir/" ];
         fhir:Coding.code [ fhir:value "group-1" ];
         fhir:Coding.display [ fhir:value "group-1" ]       ]     ];
     fhir:MeasureReport.group.population [
       fhir:index 0;
       fhir:MeasureReport.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "initial-population" ];
           fhir:Coding.display [ fhir:value "Initial Population" ]         ]       ];
       fhir:MeasureReport.group.population.count [ fhir:value "1"^^xsd:integer ]     ], [
       fhir:index 1;
       fhir:MeasureReport.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "numerator" ];
           fhir:Coding.display [ fhir:value "Numerator" ]         ]       ];
       fhir:MeasureReport.group.population.count [ fhir:value "1"^^xsd:integer ]     ], [
       fhir:index 2;
       fhir:MeasureReport.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "denominator" ];
           fhir:Coding.display [ fhir:value "Denominator" ]         ]       ];
       fhir:MeasureReport.group.population.count [ fhir:value "1"^^xsd:integer ]     ], [
       fhir:index 3;
       fhir:MeasureReport.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "denominator-exclusion" ];
           fhir:Coding.display [ fhir:value "Denominator Exclusion" ]         ]       ];
       fhir:MeasureReport.group.population.count [ fhir:value "0"^^xsd:integer ]     ];
     fhir:MeasureReport.group.measureScore [
       fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ]     ]
  ].

<urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57905> a fhir:Organization;
  fhir:Resource.meta [
     fhir:Meta.source [ fhir:value "http://example.org/fhir/server" ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/organization-deqm>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>meta</b>: </p><p><b>identifier</b>: Tax ID number: 123456789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: DaVinciHospital01</p><p><b>telecom</b>: ph: (+1) 401-555-1212</p><p><b>address</b>: 73 Lakewood Street Warwick RI 02886 USA </p></div>"
  ];
  fhir:Organization.identifier [
     fhir:index 0;
     fhir:Identifier.use [ fhir:value "official" ];
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
         fhir:Coding.code [ fhir:value "TAX" ];
         fhir:Coding.display [ fhir:value "Tax ID number" ]       ]     ];
     fhir:Identifier.system [ fhir:value "urn:oid:2.16.840.1.113883.4.4" ];
     fhir:Identifier.value [ fhir:value "123456789" ];
     fhir:Identifier.assigner [
       fhir:Reference.display [ fhir:value "www.irs.gov" ]     ]
  ];
  fhir:Organization.active [ fhir:value "true"^^xsd:boolean];
  fhir:Organization.type [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/organization-type" ];
       fhir:Coding.code [ fhir:value "prov" ];
       fhir:Coding.display [ fhir:value "Healthcare Provider" ]     ]
  ];
  fhir:Organization.name [ fhir:value "DaVinciHospital01"];
  fhir:Organization.telecom [
     fhir:index 0;
     fhir:ContactPoint.system [ fhir:value "phone" ];
     fhir:ContactPoint.value [ fhir:value "(+1) 401-555-1212" ]
  ];
  fhir:Organization.address [
     fhir:index 0;
     fhir:Address.line [
       fhir:value "73 Lakewood Street";
       fhir:index 0     ];
     fhir:Address.city [ fhir:value "Warwick" ];
     fhir:Address.state [ fhir:value "RI" ];
     fhir:Address.postalCode [ fhir:value "02886" ];
     fhir:Address.country [ fhir:value "USA" ]
  ].

<urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906> a fhir:Patient;
  fhir:Resource.meta [
     fhir:Meta.source [ fhir:value "http://example.org/fhir/server" ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>meta</b>: </p><p><b>identifier</b>: Medical record number: 67890 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Thelma Webster (OFFICIAL)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1948-04-28</p><p><b>deceased</b>: false</p><p><b>address</b>: 7496 Beaver Ridge Ave Thornton NJ 07003 USA (HOME)</p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">Married</span></p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (Region=United States)</span></td><td>true</td></tr></table></div>"
  ];
  fhir:DomainResource.extension [
     fhir:index 0;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex" ];
     fhir:Extension.valueCode [ fhir:value "F" ]
  ], [
     fhir:index 1;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "ombCategory" ];
       fhir:Extension.valueCoding [
         fhir:Coding.system [ fhir:value "urn:oid:2.16.840.1.113883.6.238" ];
         fhir:Coding.code [ fhir:value "2106-3" ];
         fhir:Coding.display [ fhir:value "White" ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "text" ];
       fhir:Extension.valueString [ fhir:value "White" ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race" ]
  ], [
     fhir:index 2;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "ombCategory" ];
       fhir:Extension.valueCoding [
         fhir:Coding.system [ fhir:value "urn:oid:2.16.840.1.113883.6.238" ];
         fhir:Coding.code [ fhir:value "2186-5" ];
         fhir:Coding.display [ fhir:value "Not Hispanic or Latino" ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "text" ];
       fhir:Extension.valueString [ fhir:value "Not Hispanic or Latino" ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity" ]
  ];
  fhir:Patient.identifier [
     fhir:index 0;
     fhir:Identifier.use [ fhir:value "usual" ];
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
         fhir:Coding.code [ fhir:value "MR" ];
         fhir:Coding.display [ fhir:value "Medical record number" ]       ]     ];
     fhir:Identifier.system [ fhir:value "http://hospital.davinci.org" ];
     fhir:Identifier.value [ fhir:value "67890" ]
  ];
  fhir:Patient.active [ fhir:value "true"^^xsd:boolean];
  fhir:Patient.name [
     fhir:index 0;
     fhir:HumanName.use [ fhir:value "official" ];
     fhir:HumanName.family [ fhir:value "Webster" ];
     fhir:HumanName.given [
       fhir:value "Thelma";
       fhir:index 0     ]
  ];
  fhir:Patient.gender [ fhir:value "female"];
  fhir:Patient.birthDate [ fhir:value "1948-04-28"^^xsd:date];
  fhir:Patient.deceasedBoolean [ fhir:value "false"^^xsd:boolean];
  fhir:Patient.address [
     fhir:index 0;
     fhir:Address.use [ fhir:value "home" ];
     fhir:Address.line [
       fhir:value "7496 Beaver Ridge Ave";
       fhir:index 0     ];
     fhir:Address.city [ fhir:value "Thornton" ];
     fhir:Address.state [ fhir:value "NJ" ];
     fhir:Address.postalCode [ fhir:value "07003" ];
     fhir:Address.country [ fhir:value "USA" ]
  ];
  fhir:Patient.maritalStatus [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus" ];
       fhir:Coding.code [ fhir:value "M" ];
       fhir:Coding.display [ fhir:value "Married" ]     ]
  ];
  fhir:Patient.communication [
     fhir:index 0;
     fhir:Patient.communication.language [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ];
         fhir:Coding.code [ fhir:value "en-US" ];
         fhir:Coding.display [ fhir:value "English (Region=United States)" ]       ]     ];
     fhir:Patient.communication.preferred [ fhir:value "true"^^xsd:boolean ]
  ].

<urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907> a fhir:Practitioner;
  fhir:Resource.meta [
     fhir:Meta.source [ fhir:value "http://example.org/fhir/server" ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>meta</b>: </p><p><b>identifier</b>: Provider number: 123456789 (OFFICIAL)</p><p><b>active</b>: true</p><p><b>name</b>: Nia Akers </p><p><b>gender</b>: female</p></div>"
  ];
  fhir:Practitioner.identifier [
     fhir:index 0;
     fhir:Identifier.use [ fhir:value "official" ];
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
         fhir:Coding.code [ fhir:value "PRN" ];
         fhir:Coding.display [ fhir:value "Provider number" ]       ]     ];
     fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ];
     fhir:Identifier.value [ fhir:value "123456789" ]
  ];
  fhir:Practitioner.active [ fhir:value "true"^^xsd:boolean];
  fhir:Practitioner.name [
     fhir:index 0;
     fhir:HumanName.family [ fhir:value "Akers" ];
     fhir:HumanName.given [
       fhir:value "Nia";
       fhir:index 0     ];
     fhir:HumanName.suffix [
       fhir:value "MD";
       fhir:index 0     ]
  ];
  fhir:Practitioner.gender [ fhir:value "female"].

<urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57908> a fhir:Observation;
  fhir:Resource.meta [
     fhir:Meta.source [ fhir:value "http://example.org/fhir/server" ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>meta</b>: </p><p></p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 77353-1}\">Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative</span></p><p><b>subject</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57906\">See above (Patient/null)</a></p><p><b>effective</b>: 2018-06-22</p><p><b>performer</b>: <a href=\"#urnuuid47709cc7-b3ec-4abc-9d26-3df3d3d57907\">See above (Practitioner/null)</a></p></div>"
  ];
  fhir:Observation.status [ fhir:value "final"];
  fhir:Observation.category [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/observation-category" ];
       fhir:Coding.code [ fhir:value "laboratory" ];
       fhir:Coding.display [ fhir:value "Laboratory" ]     ]
  ];
  fhir:Observation.code [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       a loinc:77353-1;
       fhir:Coding.system [ fhir:value "http://loinc.org" ];
       fhir:Coding.code [ fhir:value "77353-1" ];
       fhir:Coding.display [ fhir:value "Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative" ]     ]
  ];
  fhir:Observation.subject [
     fhir:Reference.reference [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57906" ]
  ];
  fhir:Observation.effectiveDateTime [ fhir:value "2018-06-22"^^xsd:date];
  fhir:Observation.performer [
     fhir:index 0;
     fhir:Reference.reference [ fhir:value "urn:uuid:47709cc7-b3ec-4abc-9d26-3df3d3d57907" ]
  ].

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

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