2.1.2.5. JP Core MedicationDispense Injection（注射薬剤処方調剤・払い出し記録）プロファイル

薬剤単位の調剤結果

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 Dispense 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.

This is a business identifier, not a resource identifier.

The procedure that trigger the dispense.

この調剤の契機となったProcedureリソースへの参照。

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.

A code specifying the state of the set of dispense events.

一連の調剤イベントの状態を指定するコード。

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

Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

投薬のタイプを示します（たとえば、薬剤が消費または投与されると予想される場所（つまり、入院患者または外来患者））。　入院、外来、退院、自宅など。

The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.

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.

The person or animal or group receiving the medication.

投与を受ける患者

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。

The encounter or episode of care that establishes the context for this event.

調剤ベントに関連するエンカウンターやエピソードへの参照。

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 that supports the medication being dispensed.

調剤される薬剤をサポートする追加情報への任意のリソースへの参照。

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。

Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

Allows disambiguation of the types of involvement of different performers.

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 device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

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.

The principal physical location where the dispense was performed.

調剤が実施された場所を示すLocationリソースへの参照。

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。

Indicates the medication order that is being dispensed against. 調剤の元になった処方オーダを表すMedicationRequestリソースへの参照。

Maps to basedOn in Event logical model.

Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. 実行される調剤イベントのタイプを示します。たとえば、トライアルフィル、トライアルの完了、部分フィル、緊急フィル、サンプルなどです。

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。

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Precision is handled implicitly in almost all cases of measurement.

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

A human-readable form of the unit.

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Note that FHIR strings SHALL NOT exceed 1MB in size

The identification of the system that provides the coded form of the unit.

Need to know the system that defines the coded form of the unit.

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

A computer processable form of the unit in some unit representation system.

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

The amount of medication expressed as a timing amount.

タイミングとして表される投薬量。すなわち、XX日分、XX回分などの数量。

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

使用状況によって、これがどのような量であるか、したがってどのような単位を使用できるかが定義される場合がかなりあります。使用状況によっては、比較演算子の値も制限される場合がある。

The time when the dispensed product was packaged and reviewed.

調剤がパッケージ化され、レビューされた日時

The time the dispensed product was provided to the patient or their representative.

【JP Core】 必須。 患者あるいはその代理人に払い出される薬剤が提供された日時。

Identification of the facility/location where the medication was shipped to, as part of the dispense event.

調剤イベントの一環として、薬剤が出荷された行先先の施設/場所のLocarionリソースへの参照。

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。

Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

薬を受け取った人を識別する。これは通常、患者またはその介護者だが、医療専門家になる場合もある。

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 dispense that could not be conveyed in the other attributes.

他の要素では伝達できなかった調剤に関する追加情報。

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（アノテーション）を持たないシステムの場合、作成者や時間なしで単一の注釈を簡単に伝達できる。情報を変更する可能性があるため、この要素をナラティブに含める必要がある場合があります。 注釈は、計算機処理れきる「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です）。

投与機器の情報を記述する拡張。

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.

投与ラインの情報を記述する拡張。

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.

Indicates the order in which the dosage instructions should be applied or interpreted.

投与量の指示が適用または解釈されるべき順序を示す。

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

複数の投与量のシーケンス番号が同じである場合、命令は同時として扱われることを意味する。シーケンス番号が異なる場合、投与量は連続するように意図されています。

32 bit number; for values larger than this, use decimal

Free text dosage instructions e.g. SIG.　フリーテキストの投与方法の説明　SIG:用法

【JP-CORE】 フリーテキストの用法指示であり、JP Coreでは必須である。

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

指示が複雑すぎてコーディングできない場合は、フリーテキストの投与指示を使用できる。この属性の内容には、薬の名前や説明は含まれない。コード化された指示が存在する場合、フリーテキストの指示は、薬を服用または投与している人間に表示するために存在している場合がある。テキストの指示は常に入力されることが期待されます。 dose.timing属性も同時に入力されている場合、dudgement.textはタイミングと同じ情報を反映している必要があり、薬の投与または準備に関する追加情報をテキストとして含める必要がある。

Note that FHIR strings SHALL NOT exceed 1MB in size

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

薬の服用方法に関する補足的な指示（例：「食事と一緒に」または「食事の30分から1時間前に服用」）または薬に関する患者への警告（例：「眠気を引き起こす可能性がある」または「皮膚の露出を避ける」直射日光またはサンランプ」）。

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Instructions in terms that are understood by the patient or consumer.

患者または消費者が理解できる用語での指示。

Note that FHIR strings SHALL NOT exceed 1MB in size

Identifies specific times when the event occurs.

In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

Repetitions may be limited by end time or total occurrences.

If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

32 bit number; for values larger than this, use decimal

How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

Some activities are not instantaneous and need to be maintained for a period of time.

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

Some activities are not instantaneous and need to be maintained for a period of time.

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

The units of time for the duration, in UCUM units.

Note that FHIR strings SHALL NOT exceed 1MB in size

The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

32 bit number; for values larger than this, use decimal

If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this

If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

32 bit number; for values larger than this, use decimal

Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)

If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)

The units of time for the period in UCUM units.

Note that FHIR strings SHALL NOT exceed 1MB in size

If one or more days of week is provided, then the action happens only on the specified day(s).

If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

Specified time of day for action to take place.

When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

Timings are frequently determined by occurrences such as waking, eating and sleep.

When more than one event is listed, the event is tied to the union of the specified events.

The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

32 bit number; for values larger than this, use decimal

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.

Body site to administer to.　 投与部位（人体の部位）

A coded specification of the anatomic site where the medication first enters the body.

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

ユースケースでBodySiteリソースの属性が必要な場合（たとえば、個別に識別して追跡するため）、標準の拡張機能[bodySite]（extension-bodysite.html）を使用する。要約コード、または場所の非常に正確な定義への参照、あるいはその両方である可能性がある。

How drug should enter body. 薬が身体に入る経路

【JP-CORE】 HL7 V2(HL7表0162)

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

患者の体内または体内へ​​の治療薬の投与経路または生理学的経路を指定するコード。

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。

Technique for administering medication.

投与手技 【JP-CORE】 JAMI処方・注射オーダ標準用法規格(用法詳細区分)。

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Terminologies used often pre-coordinate this term with the route and or form of administration.

The kind of dose or rate specified, for example, ordered or calculated.

If the type is not populated, assume to be "ordered".

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.

Upper limit on medication per unit of time.

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Upper limit on medication per administration.

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

Upper limit on medication per lifetime of the patient.

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

True if the dispenser dispensed a different drug or product from what was prescribed. 処方されたものとは異なる薬剤または製品を調剤した場合に、'true'を設定する。

A code signifying whether a different drug was dispensed from what was prescribed.

処方されたものとは異なる薬が調剤されたかどうかを示すコード。 【JP-CORE】 HL7 v3 Value Set ActSubstanceAdminSubstitutionCode　から以下のコードが使用できる。 E: 別の生物学的同等および治療的に同等の製品で置換が行われたか、許可された。 EC: 代替品が発生したか、次のような別の製品で許可されています：同じ有効成分を含むが異なる塩で処方された代替医薬品、同じ有効成分を持つエステル医薬品同等物、強度、剤形、投与経路. BC: 代替が発生したか、同等のブランド間で許可されていますが、ジェネリックでは許可されない。 G: 代替が発生したか、同等のジェネリック間で許可されていますが、ブランド間では許可されていません。 TE:同じ治療目的と安全性プロファイルを持つ別の製品で代替が発生したか、許可された。 TB:ジェネリック医薬品ではなく、治療的に同等のブランド間で代替品が発生したか、許可されています TG:治療的に同等のジェネリック間で置換が発生したか、許可されていますが、ブランドは許可されない。 F:処方ガイドラインに準拠。 N:置換は発生しなかったか、許可されていない。

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 the reason for the substitution (or lack of substitution) from what was prescribed.

処方されたものからの置換（または置換の欠如）の理由を示します。 HL7 v3 Value Set SubstanceAdminSubstitutionReason　では以下のコードが定義されている。 CT:治療継続性確保のため、FP:処方方針、 OS: 在庫欠品、 RR:代替えを義務付けまたは禁止する規制要件に従った

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。

The person or organization that has primary responsibility for the substitution.

置換の主な責任を負う個人または組織。Practitioner PractitionerRole リソースへの参照。

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。

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

患者に対する1つまたは複数のアクティブまたは提案された臨床アクションを伴う、またはそれらの間の実際のまたは潜在的な臨床問題を示す。例えば薬物間相互作用、重複治療、投与量アラートなど。 DetectedIssue リソースへの参照。

This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

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

調剤が確認されたときなど、発生した対象のイベントのサマリー。

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.).