Data Exchange For Quality Measures Implementation Guide
3.1.0 - STU 3.1.0 US

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v3.1.0: STU 3) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Extension: DEQMAlternateScoreTypeExtension - TTL Profile

Active as of 2018-06-19

TTL representation of the extension-alternateScoreType extension.

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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 xsd: <http://www.w3.org/2001/XMLSchema#> .

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

 a fhir:StructureDefinition;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "extension-alternateScoreType"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Minimum and Maximum # of times the the element can appear in the instance\">Card.</a></th><th style=\"width: 100px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-extension-alternateScoreType-definitions.html#Extension\" title=\"Possible value types for the measureScore elements *in addition to* the standard [Quantity](http://hl7.org/fhir/R4/datatypes.html#Quantity) type. The alternate type is determined by the Quality Measure [Aggregate Method](http://hl7.org/fhir/us/cqfmeasures/STU3/StructureDefinition-cqfm-aggregateMethod.html) extension used on the Measure.   The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation.\">Extension</a><a name=\"Extension\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/extensibility.html#Extension\">Extension</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Possible additional measureScore value types</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><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_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-extension-alternateScoreType-definitions.html#Extension.url\">url</a><a name=\"Extension.url\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"color: darkgreen\">&quot;http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-alternateScoreType&quot;</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><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_choice.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Choice of Types\" class=\"hierarchy\"/> <a href=\"StructureDefinition-extension-alternateScoreType-definitions.html#Extension.value[x]\">value[x]</a><a name=\"Extension.value_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Value of extension</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <span title=\"Base StructureDefinition for dateTime Type: A date, date-time or partial date (e.g. just year or year + month).  If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored.                 Dates SHALL be valid dates.\">valueDateTime</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <span title=\"Base StructureDefinition for CodeableConcept Type: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.\">valueCodeableConcept</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <span title=\"Base StructureDefinition for Period Type: A time period defined by a start and end date and optionally time.\">valuePeriod</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Period\">Period</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <span title=\"Base StructureDefinition for Range Type: A set of ordered Quantities defined by a low and high limit.\">valueRange</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Range\">Range</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <span title=\"Base StructureDefinition for Duration Type: A length of time.\">valueDuration</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Duration\">Duration</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
  ];
  fhir:StructureDefinition.url [ fhir:value "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-alternateScoreType"];
  fhir:StructureDefinition.version [ fhir:value "3.1.0"];
  fhir:StructureDefinition.name [ fhir:value "DEQMAlternateScoreTypeExtension"];
  fhir:StructureDefinition.title [ fhir:value "DEQM Alternate Score Type Extension"];
  fhir:StructureDefinition.status [ fhir:value "active"];
  fhir:StructureDefinition.experimental [ fhir:value "false"^^xsd:boolean];
  fhir:StructureDefinition.date [ fhir:value "2018-06-19T00:00:00-07:00"^^xsd:dateTime];
  fhir:StructureDefinition.publisher [ fhir:value "HL7 International - Clinical Quality Information Work Group"];
  fhir:StructureDefinition.contact [
     fhir:index 0;
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/cqi" ]     ]
  ];
  fhir:StructureDefinition.description [ fhir:value "Possible value types for the measureScore elements *in addition to* the standard [Quantity](http://hl7.org/fhir/R4/datatypes.html#Quantity) type. The alternate type is determined by the Quality Measure [Aggregate Method](http://hl7.org/fhir/us/cqfmeasures/STU3/StructureDefinition-cqfm-aggregateMethod.html) extension used on the Measure.   The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation. This extension corresponds to the measureScore types in the FHIR R5 version of MeasureReport."];
  fhir:StructureDefinition.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ]     ]
  ];
  fhir:StructureDefinition.fhirVersion [ fhir:value "4.0.1"];
  fhir:StructureDefinition.mapping [
     fhir:index 0;
     fhir:StructureDefinition.mapping.identity [ fhir:value "rim" ];
     fhir:StructureDefinition.mapping.uri [ fhir:value "http://hl7.org/v3" ];
     fhir:StructureDefinition.mapping.name [ fhir:value "RIM Mapping" ]
  ];
  fhir:StructureDefinition.kind [ fhir:value "complex-type"];
  fhir:StructureDefinition.abstract [ fhir:value "false"^^xsd:boolean];
  fhir:StructureDefinition.context [
     fhir:index 0;
     fhir:StructureDefinition.context.type [ fhir:value "element" ];
     fhir:StructureDefinition.context.expression [ fhir:value "MeasureReport.group.measureScore" ]
  ], [
     fhir:index 1;
     fhir:StructureDefinition.context.type [ fhir:value "element" ];
     fhir:StructureDefinition.context.expression [ fhir:value "MeasureReport.group.stratifier.stratum.measureScore" ]
  ];
  fhir:StructureDefinition.type [ fhir:value "Extension"];
  fhir:StructureDefinition.baseDefinition [
     fhir:value "http://hl7.org/fhir/StructureDefinition/Extension";
     fhir:link <http://hl7.org/fhir/StructureDefinition/Extension>
  ];
  fhir:StructureDefinition.derivation [ fhir:value "constraint"];
  fhir:StructureDefinition.snapshot [
     fhir:StructureDefinition.snapshot.element [
       fhir:index 0;
       fhir:Element.id [ fhir:value "Extension" ];
       fhir:ElementDefinition.path [ fhir:value "Extension" ];
       fhir:ElementDefinition.short [ fhir:value "Possible additional measureScore value types" ];
       fhir:ElementDefinition.definition [ fhir:value "Possible value types for the measureScore elements *in addition to* the standard [Quantity](http://hl7.org/fhir/R4/datatypes.html#Quantity) type. The alternate type is determined by the Quality Measure [Aggregate Method](http://hl7.org/fhir/us/cqfmeasures/STU3/StructureDefinition-cqfm-aggregateMethod.html) extension used on the Measure.   The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation." ];
       fhir:ElementDefinition.comment [ fhir:value "This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport." ];
       fhir:ElementDefinition.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
       fhir:ElementDefinition.max [ fhir:value "1" ];
       fhir:ElementDefinition.base [
         fhir:ElementDefinition.base.path [ fhir:value "Extension" ];
         fhir:ElementDefinition.base.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
         fhir:ElementDefinition.base.max [ fhir:value "*" ]       ];
       fhir:ElementDefinition.condition [
         fhir:value "ele-1";
         fhir:index 0       ];
       fhir:ElementDefinition.constraint [
         fhir:index 0;
         fhir:ElementDefinition.constraint.key [ fhir:value "ele-1" ];
         fhir:ElementDefinition.constraint.severity [ fhir:value "error" ];
         fhir:ElementDefinition.constraint.human [ fhir:value "All FHIR elements must have a @value or children" ];
         fhir:ElementDefinition.constraint.expression [ fhir:value "hasValue() or (children().count() > id.count())" ];
         fhir:ElementDefinition.constraint.xpath [ fhir:value "@value|f:*|h:div" ];
         fhir:ElementDefinition.constraint.source [
           fhir:value "http://hl7.org/fhir/StructureDefinition/Element";
           fhir:link <http://hl7.org/fhir/StructureDefinition/Element>         ]       ], [
         fhir:index 1;
         fhir:ElementDefinition.constraint.key [ fhir:value "ext-1" ];
         fhir:ElementDefinition.constraint.severity [ fhir:value "error" ];
         fhir:ElementDefinition.constraint.human [ fhir:value "Must have either extensions or value[x], not both" ];
         fhir:ElementDefinition.constraint.expression [ fhir:value "extension.exists() != value.exists()" ];
         fhir:ElementDefinition.constraint.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" ];
         fhir:ElementDefinition.constraint.source [
           fhir:value "http://hl7.org/fhir/StructureDefinition/Extension";
           fhir:link <http://hl7.org/fhir/StructureDefinition/Extension>         ]       ];
       fhir:ElementDefinition.isModifier [ fhir:value "false"^^xsd:boolean ]     ], [
       fhir:index 1;
       fhir:Element.id [ fhir:value "Extension.id" ];
       fhir:ElementDefinition.path [ fhir:value "Extension.id" ];
       fhir:ElementDefinition.representation [
         fhir:value "xmlAttr";
         fhir:index 0       ];
       fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ];
       fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ];
       fhir:ElementDefinition.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
       fhir:ElementDefinition.max [ fhir:value "1" ];
       fhir:ElementDefinition.base [
         fhir:ElementDefinition.base.path [ fhir:value "Element.id" ];
         fhir:ElementDefinition.base.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
         fhir:ElementDefinition.base.max [ fhir:value "1" ]       ];
       fhir:ElementDefinition.type [
         fhir:index 0;
         fhir:Element.extension [
           fhir:index 0;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ];
           fhir:Extension.valueUrl [ fhir:value "string" ]         ];
         fhir:ElementDefinition.type.code [ fhir:value "http://hl7.org/fhirpath/System.String" ]       ];
       fhir:ElementDefinition.isModifier [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.isSummary [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.mapping [
         fhir:index 0;
         fhir:ElementDefinition.mapping.identity [ fhir:value "rim" ];
         fhir:ElementDefinition.mapping.map [ fhir:value "n/a" ]       ]     ], [
       fhir:index 2;
       fhir:Element.id [ fhir:value "Extension.extension" ];
       fhir:ElementDefinition.path [ fhir:value "Extension.extension" ];
       fhir:ElementDefinition.slicing [
         fhir:ElementDefinition.slicing.discriminator [
           fhir:index 0;
           fhir:ElementDefinition.slicing.discriminator.type [ fhir:value "value" ];
           fhir:ElementDefinition.slicing.discriminator.path [ fhir:value "url" ]         ];
         fhir:ElementDefinition.slicing.description [ fhir:value "Extensions are always sliced by (at least) url" ];
         fhir:ElementDefinition.slicing.rules [ fhir:value "open" ]       ];
       fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ];
       fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ];
       fhir:ElementDefinition.comment [ fhir:value "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ];
       fhir:ElementDefinition.alias [
         fhir:value "extensions";
         fhir:index 0       ], [
         fhir:value "user content";
         fhir:index 1       ];
       fhir:ElementDefinition.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
       fhir:ElementDefinition.max [ fhir:value "*" ];
       fhir:ElementDefinition.base [
         fhir:ElementDefinition.base.path [ fhir:value "Element.extension" ];
         fhir:ElementDefinition.base.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
         fhir:ElementDefinition.base.max [ fhir:value "*" ]       ];
       fhir:ElementDefinition.type [
         fhir:index 0;
         fhir:ElementDefinition.type.code [ fhir:value "Extension" ]       ];
       fhir:ElementDefinition.constraint [
         fhir:index 0;
         fhir:ElementDefinition.constraint.key [ fhir:value "ele-1" ];
         fhir:ElementDefinition.constraint.severity [ fhir:value "error" ];
         fhir:ElementDefinition.constraint.human [ fhir:value "All FHIR elements must have a @value or children" ];
         fhir:ElementDefinition.constraint.expression [ fhir:value "hasValue() or (children().count() > id.count())" ];
         fhir:ElementDefinition.constraint.xpath [ fhir:value "@value|f:*|h:div" ];
         fhir:ElementDefinition.constraint.source [
           fhir:value "http://hl7.org/fhir/StructureDefinition/Element";
           fhir:link <http://hl7.org/fhir/StructureDefinition/Element>         ]       ], [
         fhir:index 1;
         fhir:ElementDefinition.constraint.key [ fhir:value "ext-1" ];
         fhir:ElementDefinition.constraint.severity [ fhir:value "error" ];
         fhir:ElementDefinition.constraint.human [ fhir:value "Must have either extensions or value[x], not both" ];
         fhir:ElementDefinition.constraint.expression [ fhir:value "extension.exists() != value.exists()" ];
         fhir:ElementDefinition.constraint.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ];
         fhir:ElementDefinition.constraint.source [
           fhir:value "http://hl7.org/fhir/StructureDefinition/Extension";
           fhir:link <http://hl7.org/fhir/StructureDefinition/Extension>         ]       ];
       fhir:ElementDefinition.isModifier [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.isSummary [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.mapping [
         fhir:index 0;
         fhir:ElementDefinition.mapping.identity [ fhir:value "rim" ];
         fhir:ElementDefinition.mapping.map [ fhir:value "n/a" ]       ]     ], [
       fhir:index 3;
       fhir:Element.id [ fhir:value "Extension.url" ];
       fhir:ElementDefinition.path [ fhir:value "Extension.url" ];
       fhir:ElementDefinition.representation [
         fhir:value "xmlAttr";
         fhir:index 0       ];
       fhir:ElementDefinition.short [ fhir:value "identifies the meaning of the extension" ];
       fhir:ElementDefinition.definition [ fhir:value "Source of the definition for the extension code - a logical name or a URL." ];
       fhir:ElementDefinition.comment [ fhir:value "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." ];
       fhir:ElementDefinition.min [ fhir:value "1"^^xsd:nonNegativeInteger ];
       fhir:ElementDefinition.max [ fhir:value "1" ];
       fhir:ElementDefinition.base [
         fhir:ElementDefinition.base.path [ fhir:value "Extension.url" ];
         fhir:ElementDefinition.base.min [ fhir:value "1"^^xsd:nonNegativeInteger ];
         fhir:ElementDefinition.base.max [ fhir:value "1" ]       ];
       fhir:ElementDefinition.type [
         fhir:index 0;
         fhir:ElementDefinition.type.code [ fhir:value "uri" ]       ];
       fhir:ElementDefinition.fixedUri [ fhir:value "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-alternateScoreType" ];
       fhir:ElementDefinition.isModifier [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.isSummary [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.mapping [
         fhir:index 0;
         fhir:ElementDefinition.mapping.identity [ fhir:value "rim" ];
         fhir:ElementDefinition.mapping.map [ fhir:value "N/A" ]       ]     ], [
       fhir:index 4;
       fhir:Element.id [ fhir:value "Extension.value[x]" ];
       fhir:ElementDefinition.path [ fhir:value "Extension.value[x]" ];
       fhir:ElementDefinition.short [ fhir:value "Value of extension" ];
       fhir:ElementDefinition.definition [ fhir:value "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)." ];
       fhir:ElementDefinition.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
       fhir:ElementDefinition.max [ fhir:value "1" ];
       fhir:ElementDefinition.base [
         fhir:ElementDefinition.base.path [ fhir:value "Extension.value[x]" ];
         fhir:ElementDefinition.base.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
         fhir:ElementDefinition.base.max [ fhir:value "1" ]       ];
       fhir:ElementDefinition.type [
         fhir:index 0;
         fhir:ElementDefinition.type.code [ fhir:value "dateTime" ]       ], [
         fhir:index 1;
         fhir:ElementDefinition.type.code [ fhir:value "CodeableConcept" ]       ], [
         fhir:index 2;
         fhir:ElementDefinition.type.code [ fhir:value "Period" ]       ], [
         fhir:index 3;
         fhir:ElementDefinition.type.code [ fhir:value "Range" ]       ], [
         fhir:index 4;
         fhir:ElementDefinition.type.code [ fhir:value "Duration" ]       ];
       fhir:ElementDefinition.constraint [
         fhir:index 0;
         fhir:ElementDefinition.constraint.key [ fhir:value "ele-1" ];
         fhir:ElementDefinition.constraint.severity [ fhir:value "error" ];
         fhir:ElementDefinition.constraint.human [ fhir:value "All FHIR elements must have a @value or children" ];
         fhir:ElementDefinition.constraint.expression [ fhir:value "hasValue() or (children().count() > id.count())" ];
         fhir:ElementDefinition.constraint.xpath [ fhir:value "@value|f:*|h:div" ];
         fhir:ElementDefinition.constraint.source [
           fhir:value "http://hl7.org/fhir/StructureDefinition/Element";
           fhir:link <http://hl7.org/fhir/StructureDefinition/Element>         ]       ];
       fhir:ElementDefinition.isModifier [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.isSummary [ fhir:value "false"^^xsd:boolean ];
       fhir:ElementDefinition.mapping [
         fhir:index 0;
         fhir:ElementDefinition.mapping.identity [ fhir:value "rim" ];
         fhir:ElementDefinition.mapping.map [ fhir:value "N/A" ]       ]     ]
  ];
  fhir:StructureDefinition.differential [
     fhir:StructureDefinition.differential.element [
       fhir:index 0;
       fhir:Element.id [ fhir:value "Extension" ];
       fhir:ElementDefinition.path [ fhir:value "Extension" ];
       fhir:ElementDefinition.short [ fhir:value "Possible additional measureScore value types" ];
       fhir:ElementDefinition.definition [ fhir:value "Possible value types for the measureScore elements *in addition to* the standard [Quantity](http://hl7.org/fhir/R4/datatypes.html#Quantity) type. The alternate type is determined by the Quality Measure [Aggregate Method](http://hl7.org/fhir/us/cqfmeasures/STU3/StructureDefinition-cqfm-aggregateMethod.html) extension used on the Measure.   The reported type of the measureScore for continuous variable measures is determined by the result type of the aggregate method operation." ];
       fhir:ElementDefinition.comment [ fhir:value "This extension corresponds to the additional MeasureScore type added to the R5 version of MeasureReport." ];
       fhir:ElementDefinition.min [ fhir:value "0"^^xsd:nonNegativeInteger ];
       fhir:ElementDefinition.max [ fhir:value "1" ]     ], [
       fhir:index 1;
       fhir:Element.id [ fhir:value "Extension.url" ];
       fhir:ElementDefinition.path [ fhir:value "Extension.url" ];
       fhir:ElementDefinition.type [
         fhir:index 0;
         fhir:ElementDefinition.type.code [ fhir:value "uri" ]       ];
       fhir:ElementDefinition.fixedUri [ fhir:value "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-alternateScoreType" ]     ], [
       fhir:index 2;
       fhir:Element.id [ fhir:value "Extension.value[x]" ];
       fhir:ElementDefinition.path [ fhir:value "Extension.value[x]" ];
       fhir:ElementDefinition.type [
         fhir:index 0;
         fhir:ElementDefinition.type.code [ fhir:value "dateTime" ]       ], [
         fhir:index 1;
         fhir:ElementDefinition.type.code [ fhir:value "CodeableConcept" ]       ], [
         fhir:index 2;
         fhir:ElementDefinition.type.code [ fhir:value "Period" ]       ], [
         fhir:index 3;
         fhir:ElementDefinition.type.code [ fhir:value "Range" ]       ], [
         fhir:index 4;
         fhir:ElementDefinition.type.code [ fhir:value "Duration" ]       ]     ]
  ].

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

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