MedicationDispense | I | | MedicationDispense | Element IdShort description 指定された患者への注射薬剤の払い出し Definition 指定された患者・個人へ注射薬剤が払い出されたか払い出される予定のものを示す。これには(供給される)提供される製品についての説明や薬剤の服用に関する指示も含まれる。薬剤払い出しは注射オーダーに対して薬局システムが対応した結果となる。
Data Type MedicationDispense Constraints- dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-6:A resource should have narrative for robust management
text.`div`.exists() - dom-5:If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - mdd-1:whenHandedOver cannot be before whenPrepared
whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
Mappings- rim:Entity. Role, or Act
- workflow:Event
- rim:Supply[moodCode=EVN]
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdMedicationDispense.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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.
Comments 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.
Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
Preparation | I | 0..* | Extension(stringCodeableConcept) | There are no (further) constraints on this element Element IdMedicationDispense.extension:Preparation Short description 調剤結果 Alternate names extensions, user content Definition Comments 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.
Data Type Extension(stringCodeableConcept) Extension URL http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationDispense_Preparation Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
identifier | | 0..* | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.identifier Short description External identifier Definition 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.
Comments This is a business identifier, not a resource identifier.
Data Type Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- workflow:Event.identifier
- w5:FiveWs.identifier
- rim:.id
- rx-dispense-rmim:CombinedMedicationDispense.id
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partOf | I | 0..* | Reference(Procedure) | There are no (further) constraints on this element Element IdMedicationDispense.partOf Short description Event that dispense is part of 親イベントへの参照 Definition 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。
Comments 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.
Data Type Reference(Procedure) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.partOf
- rim:.outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.status Short description preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown Definition 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。
Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Data Type code Binding A coded concept specifying the state of the dispense event. MedicationDispense Status Codes (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- workflow:Event.status
- w5:FiveWs.status
- rim:.statusCode
- rx-dispense-rmim:CombinedMedicationDispense.SupplyEvent.statusCode
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statusReason[x] | | 0..1 | | There are no (further) constraints on this element Element IdMedicationDispense.statusReason[x] Short description Why a dispense was not performed 調剤が実行されなかった理由 Definition Indicates the reason why a dispense was not performed.
調剤が実行されなかった理由を示します。
Binding A code describing why a dispense was not performed. MedicationDispense Status Reason Codes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- workflow:Event.statusReason
- rim:.outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value
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statusReasonCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data Type CodeableConcept |
statusReasonReference | | | Reference(DetectedIssue) | There are no (further) constraints on this element Data Type Reference(DetectedIssue) |
category | | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.category Short description Type of medication dispense 調剤タイプ Definition 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。
Comments 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.
Data Type CodeableConcept Binding A code describing where the dispensed medication is expected to be consumed or administered. MedicationDispense Category Codes (preferred)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim:.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value
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medication[x] | S Σ | 1..1 | | There are no (further) constraints on this element Element IdMedicationDispense.medication[x] Short description What medication was supplied 医薬品 Definition Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
投与された薬剤を識別する。既知の薬のリストから薬を識別するコード情報を設定する。
Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
【JP-CORE】
ひとつのtext要素と、複数のcoding 要素を記述できる。処方オーダ時に選択または入力し、実際に処方箋に印字される文字列を必ずtext要素に格納した上で、それをコード化した情報を1個以上のcoding 要素に記述する。
厚生労働省標準であるHOT9コード(販社指定が不要な場合にはHOT7コード)または広く流通しているYJコードを用いるか、一般名処方の場合には厚生労働省保険局一般名処方マスタのコードを使用して、Coding要素(コードsystemを識別するURI、医薬品のコード、そのコード表における医薬品の名称の3つからなる)で記述する。
なお、上記のいずれの標準的コードも付番されていない医薬品や医療材料の場合には、薬機法の下で使用されているGS1標準の識別コードであるGTIN(Global Trade Item Number)の調剤包装単位(最少包装単位、個別包装単位)14桁を使用する。
ひとつの処方薬、医療材料を複数のコード体系のコードで記述してもよく、その場合にcoding 要素を繰り返して記述する。
ただし、ひとつの処方薬を複数のコードで繰り返し記述する場合には、それらのコードが指し示す処方薬、医療材料は当然同一でなければならない。
また、処方を発行した医療機関内でのデータ利用のために、医療機関固有コード体系によるコード(ハウスコード、ローカルコード)の記述を含めてもよいが、その場合でも上述したいずれかの標準コードを同時に記述することが必要である。
Binding A coded concept identifying which substance or product can be dispensed. SNOMEDCTMedicationCodes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- workflow:Event.code
- w5:FiveWs.what[x]
- v2:RXD-2-Dispense/Give Code
- rim:.participation[typeCode=PRD].role
- rx-dispense-rmim:CombinedMedicationRequest.component1.AdministrationRequest.consumable
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medicationCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data Type CodeableConcept |
coding | Σ | 1..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].coding Short description Code defined by a terminology system コード集で定義された医薬品コード Definition A reference to a code defined by a terminology system.
コード集で定義された医薬品コードへの情報
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments 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.
【JP-CORE】
Data Type Coding Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim:CV
- orim:fhir:Coding rdfs:subClassOf dt:CDCoding
- v2:C*E.1-8, C*E.10-22
- rim:union(., ./translation)
- orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments 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.
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.3
- rim:./codeSystem
- orim:fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].coding.version Short description Version of the system - if relevant Definition 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.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.7
- rim:./codeSystemVersion
- orim:fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].coding.code Short description Symbol in syntax defined by the system Definition 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).
Requirements Need to refer to a particular code in the system.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type code Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.1
- rim:./code
- orim:fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.2 - but note this is not well followed
- rim:CV.displayName
- orim:fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements 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.
Comments 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.
Data Type boolean Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:Sometimes implied by being first
- rim:CD.codingRationale
- orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].text Short description Plain text representation of the concept Definition 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.
Requirements 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.
Comments Very often the text is the same as a displayName of one of the codings.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.9. But note many systems use C*E.2 for this
- rim:./originalText[mediaType/code="text/plain"]/data
- orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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subject | S Σ I | 0..1 | Reference(Patient | Group) | There are no (further) constraints on this element Element IdMedicationDispense.subject Short description Who received medication 投与対象患者 Definition The person or animal or group receiving the medication.
投与を受ける患者
Comments 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。
Data Type Reference(Patient | Group) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.subject
- w5:FiveWs.subject[x]
- v2:PID-3-Patient ID List
- rim:.participation[typeCode=SBJ].role[classCode=PAT]
- w5:FiveWs.subject
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdMedicationDispense.context Short description Encounter / Episode associated with event 調剤ベントに関連するエンカウンターやエピソード Definition 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。
Comments 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。
Data Type Reference(Encounter | EpisodeOfCare) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.context
- rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
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supportingInformation | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdMedicationDispense.supportingInformation Short description Information that supports the dispensing of the medication 薬の調剤をサポートする情報 Definition 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。
Comments 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。
Data Type Reference(Resource) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- w5:FiveWs.context
- rim:.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
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performer | | 0..* | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.performer Short description Who performed event 調剤を実施した人 Definition Indicates who or what performed the event.
調剤した人を示す
Data Type BackboneElement Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- workflow:Event.performer
- rim:.participation[typeCode=PRF]
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function | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.performer.function Short description Who performed the dispense and what they did Definition Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.
Requirements Allows disambiguation of the types of involvement of different performers.
Comments 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.
Data Type CodeableConcept Binding A code describing the role an individual played in dispensing a medication. MedicationDispense Performer Function Codes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim:participation[typeCode=PRF].functionCode
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actor | I | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.
Comments 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.
Data Type Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.performer.actor
- rim:.role
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location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.location Short description Where the dispense occurred 調剤実施場所 Definition 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。
Comments 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。
Data Type Reference(Location) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim:.participation[typeCode=LOC].role
|
authorizingPrescription | I | 0..* | Reference(MedicationRequest) | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription Short description Medication order that authorizes the dispense 調剤を正当化する元の処方オーダ Definition 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。
Comments Maps to basedOn in Event logical model.
Data Type Reference(MedicationRequest) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.basedOn
- v2:ORC-2 Placer Order Number
- rim:.outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
- rx-dispense-rmim:CombinedMedicationDispense.inFulfillmentOf
|
type | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdShort description Trial fill, partial fill, emergency fill, etc. Definition 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。
Comments 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。
Data Type CodeableConcept Binding Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. v3.ActPharmacySupplyType (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:RXD-33-Dispense Type
- rim:.code
- rx-dispense-rmim:CombinedMedicationDispense.SupplyEvent.code
|
quantity | S I | 1..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.quantity Short description 払い出される薬剤の量 Definition 調剤総量。
JP Coreでは必須
払い出される薬剤の量。計測単位を含む。
Comments 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。
Data Type SimpleQuantity Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()
Mappings- rim:n/a
- v2:SN (see also Range) or CQ
- rim:PQ, IVL<PQ>, MO, CO, depending on the values
- v2:RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
- rim:.quantity
- rx-dispense-rmim:CombinedMedicationDispense.SupplyEvent.quantity
|
value | Σ | 1..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.quantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Requirements Precision is handled implicitly in almost all cases of measurement.
Comments 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).
Data Type decimal Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:SN.2 / CQ - N/A
- rim:PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
|
comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.quantity.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context
Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Meaning When Missing If there is no comparator, then there is no modification of the value
Data Type code Binding How the Quantity should be understood and represented. QuantityComparator (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:SN.1 / CQ.1
- rim:IVL properties
|
unit | Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.quantity.unit Short description Unit representation Definition A human-readable form of the unit.
Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:(see OBX.6 etc.) / CQ.2
- rim:PQ.unit
|
system | Σ I | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.quantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit.
Requirements Need to know the system that defines the coded form of the unit.
Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:(see OBX.6 etc.) / CQ.2
- rim:CO.codeSystem, PQ.translation.codeSystem
|
code | Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.quantity.code Short description 単位についてのコード形式 Definition A computer processable form of the unit in some unit representation system.
Requirements 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.
Comments 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.
Data Type code Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:(see OBX.6 etc.) / CQ.2
- rim:PQ.code, MO.currency, PQ.translation.code
|
daysSupply | I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply Short description Amount of medication expressed as a timing amount タイミングとして表される投薬量 Definition 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。
Comments 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。
Data Type SimpleQuantity Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()
Mappings- rim:n/a
- v2:SN (see also Range) or CQ
- rim:PQ, IVL<PQ>, MO, CO, depending on the values
- v2:TQ1.6 Timing/Quantity Segment Service Duration.
Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply”
From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^
For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6
- rim:effectiveUseTime
|
whenPrepared | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenPrepared Short description When 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 Definition 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
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:RXD-3-Date/Time Dispensed
- rim:.effectiveTime[xmi:type=IVL_TS].low
- rx-dispense-rmim:CombinedMedicationDispense.SupplyEvent.effectiveTime
|
whenHandedOver | S | 1..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenHandedOver Short description Medication order that authorizes the dispense 払い出された日時 Definition 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。
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- workflow:Event.occurrence[x]
- v2:RXD-3-Date/Time Dispensed
- rim:.effectiveTime[xmi:type=IVL_TS].high
- rx-dispense-rmim:CombinedMedicationDispense.SupplyEvent.effectiveTime
|
destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.destination Short description Where the medication was sent 薬が送られた場所 Definition 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。
Comments 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。
Data Type Reference(Location) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2:RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address
- rim:.participation[typeCode=DST].role
- rx-dispense-rmim:CombinedMedicationDispense.SupplyEvent.destination
|
receiver | I | 0..* | Reference(Patient | Practitioner) | There are no (further) constraints on this element Element IdMedicationDispense.receiver Short description Who collected the medication 薬を受け取った人 Definition 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。
Comments 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。
Data Type Reference(Patient | Practitioner) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim:.participation[typeCode=RCV].role
- rx-dispense-rmim:CombinedMedicationDispense.SupplyEvent.receiver
|
note | | 0..* | Annotation | There are no (further) constraints on this element Element IdShort description Information about the dispense 調剤に関する備考 Definition 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。
Comments 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)。
Data Type Annotation Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act
- workflow:Event.note
- v2:RXD-9 Dispense Notes
- rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]
|
dosageInstruction | | 0..* | Dosage | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction Short description How the medication is to be used by the patient or administered by the caregiver 薬が患者によってどのように使用されるか、または介護者によってどのように投与されるか Definition Indicates how the medication is to be used by the patient.
薬が患者によってどのように使用されるか、または介護者によってどのように投与されるか。
Comments When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates.
The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.
投与量または投与量が投与期間全体にわたって変更されることを意図している場合(例えば、漸減投与量処方)、異なる投与量/投与量を伝えるために投与指示の複数のインスタンスを提供する必要があります。
薬剤師は、調剤する前に投薬順序を確認し、調剤される実際の製品に基づいて投薬指示を更新します。
Data Type Dosage Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
|
extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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.
Comments 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.
Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
UsageDuration | I | 0..0 | Extension(Duration) | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.extension:UsageDuration Short description 実服用日数 Alternate names extensions, user content Definition 実服用日数を格納する拡張。
実服用日数(実投与日数)とは、投与期間において実際に服用(投与)が行われる実日数であり、休薬日を含まない。
全期間が7日で、用法が隔日投与の場合には、1日目、3日目、5日目、7日目の4日間に服用することになるので、実服用日数は4日となる。
Comments 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.
Data Type Extension(Duration) Extension URL http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationRequest_DosageInstruction_UsageDuration Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
PeriodOfUse | I | 0..0 | Extension(Period) | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.extension:PeriodOfUse Short description 投与期間 Alternate names extensions, user content Definition 投与期間を明示的に記述する拡張。
この拡張を使用する場合には、開始日は必須。
Comments 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.
Data Type Extension(Period) Extension URL http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationRequest_DosageInstruction_PeriodOfUse Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
Device | I | 0..* | Extension(Reference()) | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.extension:Device Short description 投与機器の情報 Alternate names extensions, user content Definition Comments 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.
Data Type Extension(Reference()) Extension URL http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationRequest_DosageInstruction_Device Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
Line | I | 0..* | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.extension:Line Short description 投与ラインの情報 Alternate names extensions, user content Definition Comments 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.
Data Type Extension(CodeableConcept) Extension URL http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationRequest_DosageInstruction_Line Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
sequence | Σ | 0..1 | integer | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.sequence Short description The order of the dosage instructions 投与量の指示の順序 Definition 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。
Requirements 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。
Comments 32 bit number; for values larger than this, use decimal
Data Type integer Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
text | Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.text Short description 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 Definition 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。
Requirements 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。
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:RXO-6; RXE-21
- rim:.text
|
additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction Short description Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" 患者への補足的な指示または警告-例: 「食事と一緒に」、「眠気を引き起こす可能性があります」 Definition 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」)。
Requirements 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.
Comments 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.
Data Type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:RXO-7
- rim:.text
|
patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.patientInstruction Short description Patient or consumer oriented instructions 患者または消費者向けの指示 Definition 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。
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
timing | S Σ | 1..1 | Timing | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing Short description When medication should be administered 投与日時 Definition When medication should be administered.
投与日時、服用タイミング。
【JP-CORE】
必須。dosageInstruction.timing.code.coding.code, dosageInstruction.timing.code.coding.system が必ず存在しなければならない。
Requirements The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
Data Type Timing Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:QSET<TS> (GTS)
- rim:.effectiveTime
|
event | Σ | 0..* | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs.
Requirements In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
repeat | Σ I | 0..1 | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat Short description When the event is to occur Definition A set of rules that describe when the event is scheduled.
Requirements Many timing schedules are determined by regular repetitions.
Data Type Element Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - tim-9:If there's an offset, there must be a when (and not C, CM, CD, CV)
offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) - tim-5:period SHALL be a non-negative value
period.exists() implies period >= 0 - tim-6:If there's a periodMax, there must be a period
periodMax.empty() or period.exists() - tim-7:If there's a durationMax, there must be a duration
durationMax.empty() or duration.exists() - tim-8:If there's a countMax, there must be a count
countMax.empty() or count.exists() - tim-1:if there's a duration, there needs to be duration units
duration.empty() or durationUnit.exists() - tim-10:If there's a timeOfDay, there cannot be a when, or vice versa
timeOfDay.empty() or when.empty() - tim-2:if there's a period, there needs to be period units
period.empty() or periodUnit.exists() - tim-4:duration SHALL be a non-negative value
duration.exists() implies duration >= 0
Mappings- rim:n/a
- rim:Implies PIVL or EIVL
|
bounds[x] | Σ | 0..1 | | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.bounds[x] Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:IVL(TS) used in a QSI
|
boundsDuration | | | Duration | There are no (further) constraints on this element Data Type Duration |
boundsRange | | | Range | There are no (further) constraints on this element Data Type Range |
boundsPeriod | | | Period | There are no (further) constraints on this element Data Type Period |
count | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.count Short description Number of times to repeat Definition 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.
Requirements Repetitions may be limited by end time or total occurrences.
Comments If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
Data Type positiveInt Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
countMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.countMax Short description Maximum number of times to repeat Definition If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.
Comments 32 bit number; for values larger than this, use decimal
Data Type positiveInt Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
duration | Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.duration Short description How long when it happens Definition 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.
Requirements Some activities are not instantaneous and need to be maintained for a period of time.
Comments 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).
Data Type decimal Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
durationMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.
Requirements Some activities are not instantaneous and need to be maintained for a period of time.
Comments 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).
Data Type decimal Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
durationUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationUnit Short description s | min | h | d | wk | mo | a - unit of time (UCUM) Definition The units of time for the duration, in UCUM units.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:PIVL.phase.unit
|
frequency | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequency Short description Event occurs frequency times per period Definition 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.
Comments 32 bit number; for values larger than this, use decimal
Meaning When Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
Data Type positiveInt Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
frequencyMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequencyMax Short description Event occurs up to frequencyMax times per period Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.
Comments 32 bit number; for values larger than this, use decimal
Data Type positiveInt Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
period | Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.period Short description Event occurs frequency times per period Definition 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.
Comments 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)
Data Type decimal Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
periodMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.periodMax Short description Upper limit of period (3-4 hours) Definition 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.
Comments 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)
Data Type decimal Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
periodUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.periodUnit Short description s | min | h | d | wk | mo | a - unit of time (UCUM) Definition The units of time for the period in UCUM units.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type code Binding A unit of time (units from UCUM). UnitsOfTime (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:PIVL.phase.unit
|
dayOfWeek | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.dayOfWeek Short description mon | tue | wed | thu | fri | sat | sun Definition If one or more days of week is provided, then the action happens only on the specified day(s).
Comments 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.
Data Type code Binding DaysOfWeek (required) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
timeOfDay | Σ | 0..* | time | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.timeOfDay Short description Time of day for action Definition Specified time of day for action to take place.
Comments 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.
Data Type time Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
when | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.when Short description Code for time period of occurrence Definition An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.
Requirements Timings are frequently determined by occurrences such as waking, eating and sleep.
Comments When more than one event is listed, the event is tied to the union of the specified events.
Data Type code Binding Real world event relating to the schedule. EventTiming (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
offset | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.offset Short description Minutes from event (before or after) Definition 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.
Comments 32 bit number; for values larger than this, use decimal
Data Type unsignedInt Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
code | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code Short description BID | TID | QID | AM | PM | QD | QOD | + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).
Comments BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).
Data Type CodeableConcept Binding Code for a known / defined timing pattern. TimingAbbreviation (preferred)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim:QSC.code
|
coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system.
Requirements Allows for alternative encodings within a code system, and translations to other code systems.
Comments 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.
Data Type Coding Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
- rim:CV
- orim:fhir:Coding rdfs:subClassOf dt:CDCoding
- v2:C*E.1-8, C*E.10-22
- rim:union(., ./translation)
- orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code.
Requirements Need to be unambiguous about the source of the definition of the symbol.
Comments 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.
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.3
- rim:./codeSystem
- orim:fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.version Short description Version of the system - if relevant Definition 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.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.7
- rim:./codeSystemVersion
- orim:fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
code | Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.code Short description Symbol in syntax defined by the system Definition 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).
Requirements Need to refer to a particular code in the system.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type code Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.1
- rim:./code
- orim:fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system.
Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Comments Note that FHIR strings SHALL NOT exceed 1MB in size
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.2 - but note this is not well followed
- rim:CV.displayName
- orim:fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Requirements 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.
Comments 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.
Data Type boolean Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:Sometimes implied by being first
- rim:CD.codingRationale
- orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.text Short description Plain text representation of the concept Definition 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.
Requirements 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.
Comments Very often the text is the same as a displayName of one of the codings.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:C*E.9. But note many systems use C*E.2 for this
- rim:./originalText[mediaType/code="text/plain"]/data
- orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
|
asNeeded[x] | Σ | 0..1 | | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.asNeeded[x] Short description Take "as needed" (for x) 「必要に応じて」(xの場合) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
特定の投薬スケジュール内で必要な場合にのみ薬を服用するか(ブールオプション)、または薬を服用するための前提条件(CodeableConcept)を示す。
Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
ブール値= Trueを設定することにより、理由なしに「必要に応じて」表現できる。この場合、CodeableConceptは設定されないか、またはCodeableConceptを含めることで、理由を付けて「必要に応じて」表現することもできる。この場合、ブール値はTrueであると見なされます。
ブール値をFalseに設定すると、投与量はスケジュールに従って与えられ、「prn」( =as needed/as requiredの略記号)または「必要に応じて」ではありません。
Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:TQ1-9
- rim:.outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
|
asNeededBoolean | | | boolean | There are no (further) constraints on this element Data Type boolean |
asNeededCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data Type CodeableConcept |
site | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site Short description Body site to administer to 投与部位 Definition Body site to administer to.
投与部位(人体の部位)
Requirements A coded specification of the anatomic site where the medication first enters the body.
Comments 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。
Data Type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:RXR-2
- rim:.approachSiteCode
|
route | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route Short description How drug should enter body 薬が身体に入る経路 Definition How drug should enter body.
薬が身体に入る経路
【JP-CORE】
HL7 V2(HL7表0162)
Requirements 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。
Comments 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。
Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:RXR-1
- rim:.routeCode
|
method | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method Short description Technique for administering medication 投与手技 Definition 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)。
Requirements 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.
Comments Terminologies used often pre-coordinate this term with the route and or form of administration.
Data Type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:RXR-4
- rim:.doseQuantity
|
doseAndRate | Σ | 0..* | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate Short description Amount of medication administered Definition The amount of medication administered.
Data Type Element Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated.
Requirements If the type is not populated, assume to be "ordered".
Comments 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.
Data Type CodeableConcept Binding The kind of dose or rate specified. DoseAndRateType (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:RXO-21; RXE-23
|
dose[x] | Σ | 0..1 | | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.dose[x] Short description Amount of medication per dose Definition Amount of medication per dose.
Requirements The amount of therapeutic or other substance given at one administration event.
Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.
Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:RXO-2, RXE-3
- rim:.doseQuantity
|
doseRange | | | Range | There are no (further) constraints on this element Data Type Range |
doseQuantity | | | SimpleQuantity | There are no (further) constraints on this element Data Type SimpleQuantity |
rate[x] | Σ | 0..1 | | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.rate[x] Short description Amount of medication per unit of time Definition Amount of medication per unit of time.
Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.
It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:RXE22, RXE23, RXE-24
- rim:.rateQuantity
|
rateRatio | | | Ratio | There are no (further) constraints on this element Data Type Ratio |
rateRange | | | Range | There are no (further) constraints on this element Data Type Range |
rateQuantity | | | SimpleQuantity | There are no (further) constraints on this element Data Type SimpleQuantity |
maxDosePerPeriod | Σ I | 0..1 | Ratio | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod Short description Upper limit on medication per unit of time Definition Upper limit on medication per unit of time.
Requirements 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.
Comments 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".
Data Type Ratio Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - rat-1:Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
Mappings- rim:n/a
- v2:N/A
- rim:RTO
- v2:RXO-23, RXE-19
- rim:.maxDoseQuantity
|
maxDosePerAdministration | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration.
Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.
Comments 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.
Data Type SimpleQuantity Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()
Mappings- rim:n/a
- v2:SN (see also Range) or CQ
- rim:PQ, IVL<PQ>, MO, CO, depending on the values
- rim:not supported
|
maxDosePerLifetime | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient.
Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
Comments 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.
Data Type SimpleQuantity Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - qty-3:If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists() - sqty-1:The comparator is not used on a SimpleQuantity
comparator.empty()
Mappings- rim:n/a
- v2:SN (see also Range) or CQ
- rim:PQ, IVL<PQ>, MO, CO, depending on the values
- rim:not supported
|
substitution | | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.substitution Short description Whether a substitution was performed on the dispense 調剤で置換が実行されたかどうか。 Definition Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.
調剤の一部として置換が行われたかどうかを示す。場合によっては、置換が期待されるが発生しない場合もあれば、置換が予期されないが発生する場合もある。このブロックは、置換が行われたか行われなかったか、およびその理由を説明する。何も指定されていない場合、置換は行われていない。
Data Type BackboneElement Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:.outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
- rx-dispense-rmim:CombinedMedicationDispense.substitutionMade
|
wasSubstituted | | 1..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.substitution.wasSubstituted Short description Whether a substitution was or was not performed on the dispense 調剤で置換が実行されたか、あるいはされていないかを'true'または'false'で表す。 Definition 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。
Data Type boolean Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:.actionNegationInd
|
type | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.type Short description 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 Definition 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。
Comments 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.
Data Type CodeableConcept Binding A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. v3.ActSubstanceAdminSubstitutionCode (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:RXO-9-Allow Substitutions / RXE-9-Substitution Status
- rim:.code
- rx-dispense-rmim:CombinedMedicationDispense.substitutionMade.code
|
reason | | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.reason Short description Why was substitution made 置換が実施された理由 Definition 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
Comments 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。
Data Type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim:.reasonCode
- rx-dispense-rmim:CombinedMedicationDispense.substitutionMade.reasonCode
|
responsibleParty | I | 0..* | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdMedicationDispense.substitution.responsibleParty Short description Who is responsible for the substitution 置換責任者 Definition 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。
Comments 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。
Data Type Reference(Practitioner | PractitionerRole) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim:.participation[typeCode=PFM].role[classCode=ASSIGN]
- rx-dispense-rmim:CombinedMedicationDispense.substitutionMade.ResponsibleParty
|
detectedIssue | I | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element IdMedicationDispense.detectedIssue Short description Clinical issue with action アクションを伴う臨床的問題 Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition 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。
Comments 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.
Data Type Reference(DetectedIssue) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim:.inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
|
eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdMedicationDispense.eventHistory Short description A list of relevant lifecycle events 関連するライフサイクルイベントのリスト Definition 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。
Comments 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.).
Data Type Reference(Provenance) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim:.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
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