Da Vinci - Documentation Templates and Rules
1.0.0 - STU 1
Da Vinci - Documentation Templates and Rules
1.0.0 - STU 1
This page is part of the Documentation Templates and Rules (v1.0.0: STU 1) 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 
@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:QuestionnaireResponse;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "home-o2-questionnaireresponse"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse-r4";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-questionnaireresponse-r4> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This completed form contains all of the information collected from the provider on Home Oxygen Therapy.</p></div>"
];
fhir:DomainResource.contained [
a fhir:Patient;
fhir:index 0;
fhir:Resource.id [ fhir:value "example1" ];
fhir:Patient.gender [ fhir:value "male" ];
fhir:Patient.birthDate [ fhir:value "1996-12-23"^^xsd:date ];
fhir:Patient.address [
fhir:index 0;
fhir:Address.use [ fhir:value "home" ];
fhir:Address.type [ fhir:value "both" ];
fhir:Address.state [ fhir:value "MA" ] ]
];
fhir:QuestionnaireResponse.questionnaire [ fhir:value "#Questionnaire/q045"];
fhir:QuestionnaireResponse.status [ fhir:value "completed"];
fhir:QuestionnaireResponse.subject [
fhir:Reference.reference [ fhir:value "#example1" ];
fhir:Reference.display [ fhir:value "Vlad" ]
];
fhir:QuestionnaireResponse.authored [ fhir:value "2019-07-18"^^xsd:date];
fhir:QuestionnaireResponse.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Patient Information" ];
fhir:QuestionnaireResponse.item.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "1.1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Last Name but Different This Time" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Quinton" ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "1.2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "First Name" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Vlad" ] ] ], [
fhir:index 2;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "1.3" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Middle Initial" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "A, N" ] ] ], [
fhir:index 3;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "1.4" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Date Of Birth" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "1956-12-01"^^xsd:date ] ] ], [
fhir:index 4;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "1.5" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Gender" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueCoding [
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/administrative-gender" ];
fhir:Coding.code [ fhir:value "male" ];
fhir:Coding.display [ fhir:value "Male" ] ] ] ], [
fhir:index 5;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "1.6" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Medicare ID" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "10A3D58WH22" ] ] ]
], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Provider who is performing face-to-face evaluation" ];
fhir:QuestionnaireResponse.item.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "2.1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Last Name" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Doe" ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "2.2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "First Name" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "Jane" ] ] ], [
fhir:index 2;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "2.3" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Middle Initial" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "B" ] ] ], [
fhir:index 3;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "2.4" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "NPI" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "1122334455" ] ] ], [
fhir:index 4;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "2.5" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Date of Face-To-Face Evaluation" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2019-07-18"^^xsd:date ] ] ]
], [
fhir:index 2;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "3" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Coverage Requirements" ];
fhir:QuestionnaireResponse.item.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "3.1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueCoding [
a sct:313296004;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "313296004" ];
fhir:Coding.display [ fhir:value "Mild chronic obstructive pulmonary disease" ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.answer.valueCoding [
a sct:389087006;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "389087006" ];
fhir:Coding.display [ fhir:value "Hypoxemia (disorder)" ] ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "3.2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Arterial oxygen saturation (Patient on room air while at rest and awake when tested)" ] ], [
fhir:index 2;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "3.3" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)" ] ], [
fhir:index 3;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "3.4" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Arterial oxygen saturation (Patient tested during exercise)" ] ], [
fhir:index 4;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "3.5" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)" ] ], [
fhir:index 5;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "3.6" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Is there a documented improvement of hypoxemia during exercise with oxygen?" ] ]
], [
fhir:index 3;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Prescribed Use" ];
fhir:QuestionnaireResponse.item.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Start date" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueDate [ fhir:value "2019-07-18"^^xsd:date ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Length of need: (months) (99 = lifetime)" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "99"^^xsd:integer ] ] ], [
fhir:index 2;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.4" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Peak Flow Rate" ];
fhir:QuestionnaireResponse.item.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.4.1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "LPM" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "2"^^xsd:integer ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.4.2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "oxygen %" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "98"^^xsd:integer ] ] ] ], [
fhir:index 3;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.5" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Average Flow Rate" ];
fhir:QuestionnaireResponse.item.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.5.1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "LPM" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "2"^^xsd:integer ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.5.2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "oxygen %" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueInteger [ fhir:value "97"^^xsd:integer ] ] ] ], [
fhir:index 4;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "4.6" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Frequency of use (choose all that apply)" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueCoding [
fhir:Coding.code [ fhir:value "At rest and awake" ];
fhir:Coding.display [ fhir:value "At rest and awake" ] ] ] ]
], [
fhir:index 4;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "5" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Oxygen Supply Order Details" ];
fhir:QuestionnaireResponse.item.item [
fhir:index 0;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "5.1" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Current Order Description" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueString [ fhir:value "HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental" ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "5.1b" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Current Order Is For A Portable Device" ] ], [
fhir:index 2;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "5.2" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Type" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueCoding [
fhir:Coding.code [ fhir:value "E0424" ];
fhir:Coding.display [ fhir:value "Compressed Gas" ] ] ] ], [
fhir:index 3;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "5.3" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Means of oxygen delivery and accessories" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueCoding [
fhir:Coding.code [ fhir:value "Mask" ];
fhir:Coding.display [ fhir:value "Mask" ] ] ], [
fhir:index 1;
fhir:QuestionnaireResponse.item.answer.valueCoding [
fhir:Coding.code [ fhir:value "Ventilator" ];
fhir:Coding.display [ fhir:value "Ventilator" ] ] ] ], [
fhir:index 4;
fhir:QuestionnaireResponse.item.linkId [ fhir:value "5.4" ];
fhir:QuestionnaireResponse.item.text [ fhir:value "Type of order" ];
fhir:QuestionnaireResponse.item.answer [
fhir:index 0;
fhir:QuestionnaireResponse.item.answer.valueCoding [
fhir:Coding.code [ fhir:value "Initial or original order for certification" ];
fhir:Coding.display [ fhir:value "Initial or original order for certification" ] ] ] ]
].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2020+ HL7 Clinical Decision Support Work Group. Package hl7.fhir.us.davinci-dtr#1.0.0 based on FHIR 4.0.1. Generated 2020-12-23
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