HL7 FHIR JP Core ImplementationGuide
2.0.0-dev - ci-build Japan flag

HL7 FHIR JP Core ImplementationGuide - Local Development build (v2.0.0-dev) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: JP Core ActivityDefinition ChemotherapyRegimen Injection Profile

項目内容
定義URL http://jpfhir.jp/fhir/core/StructureDefinition/JP_ActivityDefinition_ChemotherapyRegimen_Injection
Version 2.0.0-dev
Name

JP_ActivityDefinition_ChemotherapyRegimen_Injection
Title

JP Core ActivityDefinition ChemotherapyRegimen Injection Profile
Status Draft ( 2023-11-30 )
Copyright

Copyright FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI) 一般社団法人日本医療情報学会NeXEHRS課題研究会FHIR日本実装検討WG

このプロファイルはActivityDefinitionリソースに対して、化学療法レジメンの定義に関する情報を送受信するための共通の制約と拡張を定めたものである。

本プロファイルは、化学療法レジメンの注射薬剤情報を表現するJP_ActivityDefinition_ChemotherapyRegimen_Injectionリソースの記録・更新・検索を行う上で、準拠するべき必須となる要素や、サポートすべき拡張、用語、検索パラメータを定義する。

スコープ

  • JP_ActivityDefinition_ChemotherapyRegimen_Injectionリソースは、化学療法における抗がん剤（注射薬）、輸液、支持療法（制吐剤など）、投与量（標準投与量）、手技、投与ルート、投与速度などの情報を記述する。
  • 当リソースは、化学療法レジメンの定義情報であるJP_PlanDefinition_ChemotherapyRegimenのcontained要素に内包される。

想定シナリオ

本プロファイルは、以下のようなユースケースを想定する。

  • 電子カルテに登録されている化学療法レジメンマスタを他施設に共有する。
  • any more

プロファイル定義

Usage:

プロファイル詳細

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraintsdoco
.. ActivityDefinition C 0..* ActivityDefinition TBD
cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


ele-1: All FHIR elements must have a @value or children
... doNotPerform ?!Σ 0..1 boolean True if the activity should not be performed
ele-1: All FHIR elements must have a @value or children
... product[x] 0..1 Reference(JP Core Medication Profile) 医薬品
ele-1: All FHIR elements must have a @value or children
... dosage 0..* JP_MedicationDosage_Injection 医薬品の服用方法等
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. ActivityDefinition C 0..* ActivityDefinition TBD
cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): IETF language tag

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... url Σ 0..1 uri Canonical identifier for this activity definition, represented as a URI (globally unique)
... identifier Σ 0..* Identifier Additional identifier for the activity definition
... version Σ 0..1 string Business version of the activity definition
... name ΣC 0..1 string Name for this activity definition (computer friendly)
... title Σ 0..1 string Name for this activity definition (human friendly)
... subtitle 0..1 string Subordinate title of the activity definition
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... experimental Σ 0..1 boolean For testing purposes, not real usage
... subject[x] 0..1 Type of individual the activity definition is intended for
Binding: SubjectType (extensible): The possible types of subjects for an activity (E.g. Patient, Practitioner, Organization, Location, etc.).

.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
.... subjectCanonical canonical(Any)
... date Σ 0..1 dateTime Date last changed
... publisher Σ 0..1 string Name of the publisher (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher
... description Σ 0..1 markdown Natural language description of the activity definition
... useContext Σ 0..* UsageContext The context that the content is intended to support
... jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for activity definition (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose 0..1 markdown Why this activity definition is defined
... usage 0..1 string Describes the clinical usage of the activity definition
... copyright 0..1 markdown Use and/or publishing restrictions
... approvalDate 0..1 date When the activity definition was approved by publisher
... lastReviewDate 0..1 date When the activity definition was last reviewed
... effectivePeriod Σ 0..1 Period When the activity definition is expected to be used
... topic 0..* CodeableConcept E.g. Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author 0..* ContactDetail Who authored the content
... editor 0..* ContactDetail Who edited the content
... reviewer 0..* ContactDetail Who reviewed the content
... endorser 0..* ContactDetail Who endorsed the content
... relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc.
... library 0..* canonical(Library) Logic used by the activity definition
... kind Σ 0..1 code Kind of resource
Binding: RequestResourceType (required): The kind of activity the definition is describing.

... profile 0..1 canonical(StructureDefinition) What profile the resource needs to conform to
... code Σ 0..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed type of the activity; e.g. CBC.

... intent 0..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a request.

... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if the activity should not be performed
... timing[x] 0..1 When activity is to occur
.... timingTiming Timing
.... timingDateTime dateTime
.... timingAge Age
.... timingPeriod Period
.... timingRange Range
.... timingDuration Duration
... location 0..1 Reference(Location) Where it should happen
... participant 0..* BackboneElement Who should participate in the action
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 code patient | practitioner | related-person | device
Binding: ActionParticipantType (required): The type of participant in the activity.

.... role 0..1 CodeableConcept E.g. Nurse, Surgeon, Parent, etc.
Binding: Action Participant Role (example): Defines roles played by participants for the action.

... product[x] 0..1 Reference(JP Core Medication Profile) 医薬品
... quantity 0..1 SimpleQuantity How much is administered/consumed/supplied
... dosage 0..* JP_MedicationDosage_Injection 医薬品の服用方法等
... bodySite 0..* CodeableConcept What part of body to perform on
Binding: SNOMEDCTBodyStructures (example): A code that identifies the anatomical location.


... specimenRequirement 0..* Reference(SpecimenDefinition) What specimens are required to perform this action
... observationRequirement 0..* Reference(ObservationDefinition) What observations are required to perform this action
... observationResultRequirement 0..* Reference(ObservationDefinition) What observations must be produced by this action
... transform 0..1 canonical(StructureMap) Transform to apply the template
... dynamicValue 0..* BackboneElement Dynamic aspects of the definition
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... path 1..1 string The path to the element to be set dynamically
.... expression 1..1 Expression An expression that provides the dynamic value for the customization

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
ActivityDefinition.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
ActivityDefinition.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.3.0
from the FHIR Standard
ActivityDefinition.subject[x]extensibleSubjectType
http://hl7.org/fhir/ValueSet/subject-type
from the FHIR Standard
ActivityDefinition.jurisdictionextensibleJurisdiction ValueSet
http://hl7.org/fhir/ValueSet/jurisdiction
from the FHIR Standard
ActivityDefinition.topicexampleDefinitionTopic
http://hl7.org/fhir/ValueSet/definition-topic
from the FHIR Standard
ActivityDefinition.kindrequiredRequestResourceType
http://hl7.org/fhir/ValueSet/request-resource-types|4.3.0
from the FHIR Standard
ActivityDefinition.codeexampleProcedureCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-code
from the FHIR Standard
ActivityDefinition.intentrequiredRequestIntent
http://hl7.org/fhir/ValueSet/request-intent|4.3.0
from the FHIR Standard
ActivityDefinition.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.3.0
from the FHIR Standard
ActivityDefinition.participant.typerequiredActionParticipantType
http://hl7.org/fhir/ValueSet/action-participant-type|4.3.0
from the FHIR Standard
ActivityDefinition.participant.roleexampleActionParticipantRole
http://terminology.hl7.org/ValueSet/action-participant-role
ActivityDefinition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cnl-0warningActivityDefinitionName should be usable as an identifier for the module by machine processing applications such as code generation
: name.exists() implies name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
dom-2errorActivityDefinitionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorActivityDefinitionIf 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorActivityDefinitionIf 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-5errorActivityDefinitionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceActivityDefinitionA resource should have narrative for robust management
: text.`div`.exists()
dom-r4bwarningActivityDefinition.containedContaining new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ActivityDefinition C 0..* ActivityDefinition TBD
cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.


ele-1: All FHIR elements must have a @value or children
... doNotPerform ?!Σ 0..1 boolean True if the activity should not be performed
ele-1: All FHIR elements must have a @value or children
... product[x] 0..1 Reference(JP Core Medication Profile) 医薬品
ele-1: All FHIR elements must have a @value or children
... dosage 0..* JP_MedicationDosage_Injection 医薬品の服用方法等
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ActivityDefinition C 0..* ActivityDefinition TBD
cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): IETF language tag

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... url Σ 0..1 uri Canonical identifier for this activity definition, represented as a URI (globally unique)
... identifier Σ 0..* Identifier Additional identifier for the activity definition
... version Σ 0..1 string Business version of the activity definition
... name ΣC 0..1 string Name for this activity definition (computer friendly)
... title Σ 0..1 string Name for this activity definition (human friendly)
... subtitle 0..1 string Subordinate title of the activity definition
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... experimental Σ 0..1 boolean For testing purposes, not real usage
... subject[x] 0..1 Type of individual the activity definition is intended for
Binding: SubjectType (extensible): The possible types of subjects for an activity (E.g. Patient, Practitioner, Organization, Location, etc.).

.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
.... subjectCanonical canonical(Any)
... date Σ 0..1 dateTime Date last changed
... publisher Σ 0..1 string Name of the publisher (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher
... description Σ 0..1 markdown Natural language description of the activity definition
... useContext Σ 0..* UsageContext The context that the content is intended to support
... jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for activity definition (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose 0..1 markdown Why this activity definition is defined
... usage 0..1 string Describes the clinical usage of the activity definition
... copyright 0..1 markdown Use and/or publishing restrictions
... approvalDate 0..1 date When the activity definition was approved by publisher
... lastReviewDate 0..1 date When the activity definition was last reviewed
... effectivePeriod Σ 0..1 Period When the activity definition is expected to be used
... topic 0..* CodeableConcept E.g. Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author 0..* ContactDetail Who authored the content
... editor 0..* ContactDetail Who edited the content
... reviewer 0..* ContactDetail Who reviewed the content
... endorser 0..* ContactDetail Who endorsed the content
... relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc.
... library 0..* canonical(Library) Logic used by the activity definition
... kind Σ 0..1 code Kind of resource
Binding: RequestResourceType (required): The kind of activity the definition is describing.

... profile 0..1 canonical(StructureDefinition) What profile the resource needs to conform to
... code Σ 0..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed type of the activity; e.g. CBC.

... intent 0..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a request.

... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ 0..1 boolean True if the activity should not be performed
... timing[x] 0..1 When activity is to occur
.... timingTiming Timing
.... timingDateTime dateTime
.... timingAge Age
.... timingPeriod Period
.... timingRange Range
.... timingDuration Duration
... location 0..1 Reference(Location) Where it should happen
... participant 0..* BackboneElement Who should participate in the action
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 code patient | practitioner | related-person | device
Binding: ActionParticipantType (required): The type of participant in the activity.

.... role 0..1 CodeableConcept E.g. Nurse, Surgeon, Parent, etc.
Binding: Action Participant Role (example): Defines roles played by participants for the action.

... product[x] 0..1 Reference(JP Core Medication Profile) 医薬品
... quantity 0..1 SimpleQuantity How much is administered/consumed/supplied
... dosage 0..* JP_MedicationDosage_Injection 医薬品の服用方法等
... bodySite 0..* CodeableConcept What part of body to perform on
Binding: SNOMEDCTBodyStructures (example): A code that identifies the anatomical location.


... specimenRequirement 0..* Reference(SpecimenDefinition) What specimens are required to perform this action
... observationRequirement 0..* Reference(ObservationDefinition) What observations are required to perform this action
... observationResultRequirement 0..* Reference(ObservationDefinition) What observations must be produced by this action
... transform 0..1 canonical(StructureMap) Transform to apply the template
... dynamicValue 0..* BackboneElement Dynamic aspects of the definition
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... path 1..1 string The path to the element to be set dynamically
.... expression 1..1 Expression An expression that provides the dynamic value for the customization

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
ActivityDefinition.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
ActivityDefinition.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.3.0
from the FHIR Standard
ActivityDefinition.subject[x]extensibleSubjectType
http://hl7.org/fhir/ValueSet/subject-type
from the FHIR Standard
ActivityDefinition.jurisdictionextensibleJurisdiction ValueSet
http://hl7.org/fhir/ValueSet/jurisdiction
from the FHIR Standard
ActivityDefinition.topicexampleDefinitionTopic
http://hl7.org/fhir/ValueSet/definition-topic
from the FHIR Standard
ActivityDefinition.kindrequiredRequestResourceType
http://hl7.org/fhir/ValueSet/request-resource-types|4.3.0
from the FHIR Standard
ActivityDefinition.codeexampleProcedureCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-code
from the FHIR Standard
ActivityDefinition.intentrequiredRequestIntent
http://hl7.org/fhir/ValueSet/request-intent|4.3.0
from the FHIR Standard
ActivityDefinition.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.3.0
from the FHIR Standard
ActivityDefinition.participant.typerequiredActionParticipantType
http://hl7.org/fhir/ValueSet/action-participant-type|4.3.0
from the FHIR Standard
ActivityDefinition.participant.roleexampleActionParticipantRole
http://terminology.hl7.org/ValueSet/action-participant-role
ActivityDefinition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cnl-0warningActivityDefinitionName should be usable as an identifier for the module by machine processing applications such as code generation
: name.exists() implies name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
dom-2errorActivityDefinitionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorActivityDefinitionIf 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorActivityDefinitionIf 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-5errorActivityDefinitionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceActivityDefinitionA resource should have narrative for robust management
: text.`div`.exists()
dom-r4bwarningActivityDefinition.containedContaining new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron

必須要素

本プロファイルに準拠するためには、次の項目の値が存在しなければならない。

  • status : 本リソースのステータス (draft active retired unknown)

Extensions定義

本プロファイルで定義された拡張は次の通りである。

|拡張|説明|定義|値型| |:—-|:—-|:—-|:—-|

用語定義

TBD

制約一覧

本プロファイルで追加定義された制約はない。

項目の追加

本プロファイルで追加された項目は以下の通りである。

利用方法

OperationおよびSearch Parameter 一覧

Search Parameter一覧

必須検索パラメータ

本プロファイルに準拠するためには、以下の検索パラメータをサポートしなければならない（SHALL）

  1. 検索パラメータidentifierを指定し、レコードIDなどの識別子によりActivityDefinitionを検索

    GET [base]/ActivityDefinition?identifier={system|}[code]

    例：

    GET [base]/ActivityDefinition?identifier=http://myhospital.com/fhir/ActivityDefinition|123

    指定された識別子に一致するActivityDefinitionリソースを含むBundleを検索する。

推奨検索パラメータ

TBD

オプション検索パラメータ

本プロファイルで追加定義されたオプション検索パラメータはない。

サンプル

TBD

注意事項

記述の単位について

JP_MedicationRequest_Injectionプロファイルと同等の粒度になるようにするため、複数の薬剤をまとめたMedicationリソースのインスタンスをcontained属性に内包した上で参照する。

投与薬剤、投与量(基準投与量)の記述方法

1回の投与薬剤と投与量(基準投与量)は、RP内の薬剤が単独薬剤の場合も、複数の薬剤を混注する場合も、すべての薬剤を記述したMedicationリソースをActivityDefinition.contained属性に内包し、そのActivityDefinitionリソースを一意に識別可能なidをPlanDefinition.action.definitionCanonicalに記録する。Medicationリソースのingredient.itemCodeableConcept要素にCodeableConcept型で各薬剤の識別情報を記述し、ingredient.strength.numerator要素に1回あたりの含有量を記述する。薬剤を識別するコードについては、医療機関の具体的な採用薬を用いて記述する場合はHOT7、HOT9、YJコードを推奨し、成分名のみを用いて記述する場合はATCコードを推奨する。

「オキサリプラチン」と「５％ブドウ糖液」を混注する場合のサンプルインスタンスを示す。

TODO
- MERIT-9の単位の中に「mg/㎡」や「mg/body」などがない（UCUMに「mg/m2」は存在する）
- 案1: numeratorに「mg」、denominator「㎡」を記述する（MERIT-9に「㎡」が定義されていない）
- 案2: numeratorにUCUM「mg/m2」を記述する（denominatorには何を記述するか）
 
"contained": [
  {
    "resourceType": "Medication",
    "id": "#medication",
    "ingredient": [
      {
        "itemCodeableConcept": {
          "coding": [
            {
              "code": "TBD",
              "display": "オキサリプラチン",
              "system": "TBD"
            }
          ]
        },
        "strength": {
          "numerator": {
            "value": 85,
            "unit": "mg/m2",
            "system": "http://unitsofmeasure.org",
            "code": "mg/m2"
          },
          "denominator": {
            "value": 1,
            "unit": "回",
            "system": "urn:oid:1.2.392.100495.20.2.101",
            "code": "TIME"
          }
        }
      }, 
      {
        "itemCodeableConcept": {
          "coding": [
            {
              "code": "TBD",
              "display": "５％ブドウ糖液",
              "system": "TBD"
            }
          ]
        },
        "strength": {
          "numerator": {
            "value": 250,
            "unit": "ｍＬ",
            "system": "urn:oid:1.2.392.100495.20.2.101",
            "code": "ML"
          },
          "denominator": {
            "value": 1,
            "unit": "回",
            "system": "urn:oid:1.2.392.100495.20.2.101",
            "code": "TIME"
          }
        }
      }
    ]
  }
]

投与総量(投与基準総量)、投与速度、投与速度コメントの記述方法

投与総量（混注する場合は混注後の総量）をdosage.doseQuantity要素に記述し、投与速度はdosage.doseAndRate.rateRatioに記述する。単位はUCUM(“http://unitsofmeasure.org”)を使用する。 また投与速度を表現するコメントを記述する場合は、dosage.doseAndRate.rateRatioに対して定義した拡張「JP_MedicationDosage_RateComment」を使用し、CodeableConcept型またはString型を使用して記録する。

投与総量「267mL」、投与速度「134mL/h (2時間かけて)」を記述したインスタンス例を示す。

TODO
100mg20mL → 85mg17mL
オキサリプラチン:17mL + ５％ブドウ糖液:250mL = 267mL
2hで投与する場合 = 133.5mL/h (四捨五入: 134mL)
 
"dosage": [
  {
    "doseQuantity": {
      "value": 267,
      "unit": "mL",
      "system": "http://unitsofmeasure.org",
      "code": "mL"
    },
    "doseAndRate": [
      {
        "rateRatio": {
          "extension": [
            {
              "url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationDosage_RateComment",
              "valueString": "２時間で"
            }
          ],
          "numerator": {
            "value": 134,
            "unit": "mL",
            "system": "http://unitsofmeasure.org",
            "code": "mL"
          },
          "denominator": {
            "value": 1,
            "unit": "時間",
            "system": "http://unitsofmeasure.org",
            "code": "h"
          }
        }
      }
    ]
  }
]

投与経路、投与手技の記述方法

「静脈内」「眼内」などの投与経路は、dosageInstruction.route 要素にコードまたは文字列で指定する。使用するコード表はHL7 V2の使用者定義表0162 投薬経路を推奨し、その場合識別するURIとして、”http://jpfhir.jp/fhir/core/CodeSystem/route-codes”を使用する。

「0:静脈注射」、「1:中心静脈注射」などJAMI標準用法コードにて用法詳細区分として表現される区分（注射では「投与手技」とも呼ばれる）は、dosageInstruction.method 要素にコードまたは文字列で指定する。 用法詳細区分を識別するURIとして、”urn:oid:1.2.392.200250.2.2.20.30”を使用する。HL7 V2の使用者定義表0165(“http://terminology.hl7.org/CodeSystem/v2-0165”)やJAHIS注射データ交換規約のJHSI表0003 精密持続点滴(“http://jpfhir.jp/fhir/core/CodeSystem/JHSI0003)を使用してもよい。

"dosage": [
  {
    "route" : {
      "coding" : [
        {
          "system" : "http://jpfhir.jp/fhir/core/CodeSystem/route-codes",
          "code" : "IV",
          "display" : "静脈内"
        }
      ]
    },
    "method" : {
      "coding" : [
        {
          "system" : "urn:oid:1.2.392.200250.2.2.20.40",
          "code" : "30",
          "display" : "静脈注射"
        }
      ]
    }
  }
]

補足指示

補足指示がある場合は、dosage.additionalInstructionに記載する。コード化されていない場合は、text要素にフリーテキストで記載する。

"dosage": [
  {
    "additionalInstruction": [
      {
        "text": "レボホリナートと同時に"
      }
    ]
  }
]

その他、参考文献・リンク等

TBD

本実装ガイドへのご質問・ご指摘については、GitHub IssueおよびGitHub PullRequestにて受け付けております。