2.1.2.7. JP Core MedicationAdministration Injection（注射薬剤処方投与実施情報）プロファイル

依頼科を格納するための拡張

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.

依頼医を格納するための拡張。 依頼医を記述した Practitioner リソースへの参照。

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.

依頼日時を格納するための拡張

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.

実施場所を格納するための拡張。 実施場所を記述した Locationリソースへの参照。

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.

Identifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

ビジネスプロセスによって定義され、リソース自体への直接URL参照が適切でない場合にそれを参照するために使用される、この投薬管理に関連付けられた識別子。これらは、実行者または他のシステムによってこのリソースに割り当てられたビジネスIDであり、リソースが更新されてサーバーからサーバーに伝播される間、一定のままである。

This is a business identifier, not a resource identifier.

A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event.

このイベントによって全体的または部分的に順守されたプロトコル、ガイドライン、オーダーセット、またはその他の定義。

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

A larger event of which this particular event is a component or step.

この特定のイベントがコンポーネントまたはステップであるようなより大きな親イベント。

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Will generally be set to show that the administration has been completed. For some long running administrations such as infusions, it is possible for an administration to be started but not completed or it may be paused while some other process is under way.

通常、管理が完了したことを示すように設定される。輸液などの長期にわたる投与では、投与を開始しても完了しない場合や、他のプロセスの進行中に一時停止する場合がある。

【JP-CORE】　completed or stopped に限定される。

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

A code indicating why the administration was not performed.　投与が実施されていない理由を示すコード

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

すべてのターミノロジーの使用がこの一般的なパターンに適合するわけではない。場合によっては、モデルはCodeableConceptを使用せず、コーディングを直接使用して、テキスト、コーディング、翻訳、および要素間の関係とpre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。

Indicates where the medication is expected to be consumed or administered.

薬が消費または投与されると予想される場所区分(入院、外来、家庭等)を示す。 inpatient | outpatient | community (http://terminology.hl7.org/CodeSystem/medication-admin-category)

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

The identification of the code system that defines the meaning of the symbol in the code.

Need to be unambiguous about the source of the definition of the symbol.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

Note that FHIR strings SHALL NOT exceed 1MB in size

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Note that FHIR strings SHALL NOT exceed 1MB in size

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Very often the text is the same as a displayName of one of the codings.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

他のリソースが見つかった場合そのいリソース箇所への参照。参照は相対参照である場合がある。その場合、参照はサービスベースURLに相対的であるか、リソースが見つかった場所を解決する絶対URL。参照はバージョン固有である場合とそうでない場合がある。参照がFHIR　RESTfulサーバーを参照していない場合は、バージョン固有であると見なす必要がある。内部フラグメント参照（「＃」で始まる）は、含まれているリソースを参照する。

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

参照のターゲットの予想されるタイプ。 Reference.typeとReference.referenceの両方が入力され、Reference.referenceがFHIR URLである場合、両方が一貫している必要がある。 タイプは、この参照が参照するタイプであるリソース定義の正規URLです。参照は、http：//hl7.org/fhir/StructureDefinition/に関連するURLとなる。例： 「患者」リソースの場合は、http://hl7.org/fhir/StructureDefinition/Patient　となる。絶対URLは、論理モデルでのみ許可されます（また、論理モデルの参照でのみ使用でき、リソースでは使用できません）。

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

ターゲットリソースの識別子。これは、他のリソースを直接参照する方法がない場合に使用される。これは、リソースが表すエンティティがFHIRサーバーを介して利用できないため、またはリソースの作成者が既知の識別子を実際の場所に変換する方法がないためである 。 Reference.identifierが実際にFHIRインスタンスとして公開されているものを指している必要はないが、FHIRインスタンスとして公開されることが期待されるビジネス概念を指している必要があり、そのインスタンスは参照で許可されているFHIRリソースタイプとなる。

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

参照の代わりに識別子が提供される場合、参照を処理するシステムは、識別子が使用されるビジネスコンテキストを理解している場合にのみ、識別子を参照に解決できる。これはグローバルな場合もあるが（たとえば、国民ID）、そうでない場合もある。このため、参照を操作するために説明されている便利なメカニズム（チェーン、インクルードなど）はどれも不可能であり、サーバーが参照を解決できると期待されるべきではない。サーバーは、識別子ベースの参照をそのまま受け入れ、解決したり、拒否したりする場合がある。CapabilityStatement.rest.resource.referencePolicyを参照。

識別子とリテラル参照の両方が提供されている場合は、リテラル参照が優先される。リソースを処理するアプリケーションは、識別子がリテラル参照と一致することを確認できるが、確認することは必須ではない。

論理参照をリテラル参照に変換するアプリケーションは、論理参照を存在させたままにするか、削除するかを選択できる。

参照は、FHIRリソースとして表現できる可能性のある構造を指すことを目的としているが、実際のFHIRリソースインスタンスとして存在する必要はない。ただし、アプリケーションが参照のターゲットを実際に見つけたい場合を除く。識別子と呼ばれるコンテンツは、参照に許可されるリソースタイプの制限によって暗示される論理的な制約を満たす必要がある。たとえば、タイプがReference（Observation | DiagnosticReport）の場合、薬の処方箋の識別子を送信することは正当ではない。 Reference.identifierのユースケースの1つは、FHIR表現が存在しない状況である（タイプはReference（Any）である）。

Plain text narrative that identifies the resource in addition to the resource reference.

リソース参照に加えてリソースを識別するプレーンテキストの説明。

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

これは通常、参照されるリソースのResource.textと同じではありません。目的は、参照されているものを特定することであり、完全に説明することではありません。

The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.

投薬が行われた患者と医療提供者の間の訪問、入院、またはその他の接触。 受診情報や入院情報を表すエンカウンターへの参照。

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能（内容に到達可能）である必要がある（アクセス制御、一時的な使用不可などを考慮に入れる）。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

Additional information (for example, patient height and weight) that supports the administration of the medication.

薬の投与をサポートする追加情報（たとえば、患者の身長や体重）。

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能（内容に到達可能）である必要がある（アクセス制御、一時的な使用不可などを考慮に入れる）。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

Distinguishes the type of involvement of the performer in the medication administration.

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Indicates who or what performed the medication administration.

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

A code indicating why the medication was given. 投薬が実施された理由を示すコード

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Condition or observation that supports why the medication was administered.

薬が投与された理由を裏付ける状態または観察

This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

これは、投薬要求の理由である状態への参照。コードのみが存在する場合は、reasonCodeを使用する。

The original request, instruction or authority to perform the administration.

投与を実行する元になった投与指示や権限への参照情報。

これは、インテント（意図）がorderまたはinstance-orderのいずれかであるMedicationRequestへの参照である。 インテントが他の値である場合は、MedicationRequestsを参照しないこと。

This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.

これは、orderまたはinstance-orderのいずれかであるMedicationRequestへの参照。インテントが他の値である場合は、MedicationRequestsを参照しないでください。

The device used in administering the medication to the patient. For example, a particular infusion pump.

患者に薬を投与する際に使用されるデバイスへの参照。たとえば、特定の輸液ポンプ。

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能（内容に到達可能）である必要がある（アクセス制御、一時的な使用不可などを考慮に入れる）。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

Extra information about the medication administration that is not conveyed by the other attributes.

他の属性では伝えられない投薬管理に関する追加情報。

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

構造化された注釈情報がないシステムの場合、この要素によって作成者や作成時刻情報なしで単一の注釈を簡単に伝達できる。投与情報に付帯する潜在的な情報や修飾的な情報を伝えるために、この要素に叙述的な記述でそれらを含める必要がある場合がある。 注釈は、計算可能な「変更」情報を伝達するために使用されるべきではない。 （ユーザーの行動を強制することはほとんど不可能であるため、これはSHOULDである）。

Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

The dosage instructions should reflect the dosage of the medication that was administered.

フリーテキストの投与量用法は、投与される投与量や用法が複雑すぎてコーディングできない場合に使用できる。コード化された投与量や用法が存在する場合、フリーテキストの投与量や用法は、人間に表示するためにまだ存在している可能性がある。 投与量や用法のこの指示は、実際に投与される薬の投与量や用法を反映する必要があります。

Note that FHIR strings SHALL NOT exceed 1MB in size

A reference to a code defined by a terminology system.

Allows for alternative encodings within a code system, and translations to other code systems.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Very often the text is the same as a displayName of one of the codings.

A reference to a code defined by a terminology system.

Allows for alternative encodings within a code system, and translations to other code systems.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Very often the text is the same as a displayName of one of the codings.

A reference to a code defined by a terminology system.

Allows for alternative encodings within a code system, and translations to other code systems.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Very often the text is the same as a displayName of one of the codings.

The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

1回の投与イベントで投与される薬剤の量。この値は、投与が錠剤の飲み込みや注射などの本質的に瞬間的なイベントである場合に使用する。

If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.

A summary of the events of interest that have occurred, such as when the administration was verified.

投与が確認されたときなど、発生した関連のあるベントのサマリー。

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.