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 Condition Diagnosis Profile

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

JP_Condition_Diagnosis
Title

JP Core Condition Diagnosis Profile
Status Active ( 2023-08-05 )
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Conditionリソースに対して、患者の診断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、診療情報提供書や退院時サマリーなどで患者の診断に関する情報を表現するJP_Condition_Diagnosis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_Condition_Diagnosisリソースは、診療情報提供書や退院時サマリーの傷病名、現病歴、既往歴に記述する、医療者が専門的な知識に基づき診断した結果などの情報を表現する。
  • JP_Condition_Diagnosisリソースは、レセプト病名やDPC病名、プロブレムとして記述される症状、所見なども対象とするが、それらの記述に必要な固有の属性（主傷病かどうか、医療資源を最も投入した傷病名かどうか、など）は含まれない。
  • JP_Condition_Diagnosisリソースは、歯科で用いられる病名（歯科病名）は対象としない。

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。

  • 診療情報提供書や退院時サマリにおいて傷病名を記述する
  • 電子カルテで医師が登録した病名情報を検索する
  • 地域連携システムにおいて患者の病名情報を電子的に情報交換する
  • 各種検査オーダーにおいて対象となる病名情報（依頼病名）を記述する
  • SS-MIX2やJAHIS病名情報データ交換規約に準拠した病名オーダメッセージをJSONに変換する

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.

This structure is derived from JP_Condition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..* JP_Condition Detailed information about disease. 患者の診断に関する詳細な情報
... extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... clinicalStatus 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）【詳細参照】
.... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:hl70241 0..1 Coding HL7表0241。【詳細参照】
Binding: JP Core Condition Disease Outcome HL70241 ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/HL70241
...... code 1..1 code Symbol in syntax defined by the system
..... coding:jhsd0006 0..1 Coding JHSD表0006。【詳細参照】
Binding: JP Core Condition Disease Outcome JHSD0006 ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006
...... code 1..1 code Symbol in syntax defined by the system
..... coding:receipt 0..1 Coding レセプト電算システム転帰区分コード。【詳細参照】
Binding: JP Core Condition Disease Outcome Receipt System ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS
...... code 1..1 code Symbol in syntax defined by the system
... verificationStatus 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）。【詳細参照】
... code S 0..1 CodeableConcept 病名の識別コード。【詳細参照】
.... Slices for extension Content/Rules for all slices
..... extension:diseasePrefixModifier 0..* CodeableConcept 前置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePrefixModifier
..... extension:diseasePostfixModifier 0..* CodeableConcept 後置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier
.... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:medisExchange 0..1 Coding MEDIS ICD10対応標準病名マスター(交換用コード)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS Exchange ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.6
...... code 1..1 code Symbol in syntax defined by the system
..... coding:medisRecordNo 0..1 Coding MEDIS ICD10対応標準病名マスター(管理番号)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS RecordNo ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.2
...... code 1..1 code Symbol in syntax defined by the system
..... coding:receipt 0..1 Coding レセプト電算用傷病名マスター。【詳細参照】
Binding: JP Core Condition Disease Code Receipt System ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeReceipt_CS
...... code 1..1 code Symbol in syntax defined by the system
..... coding:icd10 0..1 Coding ICD-10コード。【詳細参照】
Binding: JP Core Condition Disease Code ICD-10 ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeICD10_CS
...... code 1..1 code Symbol in syntax defined by the system
.... text 0..1 string 病名や所見、症状のフルテキスト【詳細参照】
... onset[x] 0..1 dateTime, Age, Period, Range, string 発症日（病名開始日）。診断された疾患や症状が開始された、推定もしくは実際の日付、日時、年齢。【詳細参照】
... abatement[x] 0..1 dateTime, Age, Period, Range, string 転帰日（病名終了日）。診断された疾患や症状がいつ治癒／寛解／軽快したか。【詳細参照】

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* JP_Condition Detailed information about disease. 患者の診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
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
... extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... 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
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）【詳細参照】
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
ele-1: All FHIR elements must have a @value or children
..... coding:hl70241 Σ 0..1 Coding HL7表0241。【詳細参照】
Binding: JP Core Condition Disease Outcome HL70241 ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/HL70241
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:jhsd0006 Σ 0..1 Coding JHSD表0006。【詳細参照】
Binding: JP Core Condition Disease Outcome JHSD0006 ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:receipt Σ 0..1 Coding レセプト電算システム転帰区分コード。【詳細参照】
Binding: JP Core Condition Disease Outcome Receipt System ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）。【詳細参照】
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... code SΣ 0..1 CodeableConcept 病名の識別コード。【詳細参照】
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
.... Slices for extension Content/Rules for all slices
..... extension:diseasePrefixModifier 0..* CodeableConcept 前置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePrefixModifier
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... extension:diseasePostfixModifier 0..* CodeableConcept 後置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
ele-1: All FHIR elements must have a @value or children
..... coding:medisExchange Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(交換用コード)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS Exchange ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: urn:oid:1.2.392.200119.4.101.6
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:medisRecordNo Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(管理番号)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS RecordNo ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: urn:oid:1.2.392.200119.4.101.2
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:receipt Σ 0..1 Coding レセプト電算用傷病名マスター。【詳細参照】
Binding: JP Core Condition Disease Code Receipt System ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeReceipt_CS
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:icd10 Σ 0..1 Coding ICD-10コード。【詳細参照】
Binding: JP Core Condition Disease Code ICD-10 ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeICD10_CS
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
.... text Σ 0..1 string 病名や所見、症状のフルテキスト【詳細参照】
ele-1: All FHIR elements must have a @value or children
... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
ele-1: All FHIR elements must have a @value or children
... onset[x] Σ 0..1 発症日（病名開始日）。診断された疾患や症状が開始された、推定もしくは実際の日付、日時、年齢。【詳細参照】
ele-1: All FHIR elements must have a @value or children
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 転帰日（病名終了日）。診断された疾患や症状がいつ治癒／寛解／軽快したか。【詳細参照】
ele-1: All FHIR elements must have a @value or children
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* JP_Condition Detailed information about disease. 患者の診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... 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. このリソースを人間が解釈するためのテキスト要約
... 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 Extension
Slice: Unordered, Open by value:url
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this condition
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）【詳細参照】
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:hl70241 Σ 0..1 Coding HL7表0241。【詳細参照】
Binding: JP Core Condition Disease Outcome HL70241 ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/HL70241
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:jhsd0006 Σ 0..1 Coding JHSD表0006。【詳細参照】
Binding: JP Core Condition Disease Outcome JHSD0006 ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:receipt Σ 0..1 Coding レセプト電算システム転帰区分コード。【詳細参照】
Binding: JP Core Condition Disease Outcome Receipt System ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）。【詳細参照】
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
... code SΣ 0..1 CodeableConcept 病名の識別コード。【詳細参照】
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.

.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:diseasePrefixModifier 0..* CodeableConcept 前置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePrefixModifier
..... extension:diseasePostfixModifier 0..* CodeableConcept 後置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:medisExchange Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(交換用コード)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS Exchange ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.6
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:medisRecordNo Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(管理番号)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS RecordNo ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.2
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:receipt Σ 0..1 Coding レセプト電算用傷病名マスター。【詳細参照】
Binding: JP Core Condition Disease Code Receipt System ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeReceipt_CS
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10 Σ 0..1 Coding ICD-10コード。【詳細参照】
Binding: JP Core Condition Disease Code ICD-10 ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeICD10_CS
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string 病名や所見、症状のフルテキスト【詳細参照】
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts


... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
... encounter Σ 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
... onset[x] Σ 0..1 発症日（病名開始日）。診断された疾患や症状が開始された、推定もしくは実際の日付、日時、年齢。【詳細参照】
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 転帰日（病名終了日）。診断された疾患や症状がいつ治癒／寛解／軽快したか。【詳細参照】
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
... recorder Σ 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
... asserter Σ 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
... stage C 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
con-1: Stage SHALL have summary or assessment
.... 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
.... summary C 0..1 CodeableConcept Simple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment C 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
.... type 0..1 CodeableConcept Kind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence C 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
con-2: evidence SHALL have code or details
.... 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
.... code ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.3.0
from the FHIR Standard
Condition.clinicalStatus.coding:hl70241requiredJP_ConditionDiseaseOutcomeHL70241_VS (a valid code from JP Core Condition Disease Outcome HL7 Table 0241 - Patient Outcome CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseOutcomeHL70241_VS
from this IG
Condition.clinicalStatus.coding:jhsd0006requiredJP_ConditionDiseaseOutcomeJHSD0006_VS (a valid code from JP Core Condition Disease Outcome JHSD0006 CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseOutcomeJHSD0006_VS
from this IG
Condition.clinicalStatus.coding:receiptrequiredJP_ConditionDiseaseOutcomeReceipt_VS (a valid code from JP Core Condition Disease Outcome Receipt CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseOutcomeReceipt_VS
from this IG
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.3.0
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.severitypreferredJP_ConditionSeverity_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionSeverity_VS
from this IG
Condition.codeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
Condition.code.coding:medisExchangerequiredJP_ConditionDiseaseCodeMEDISExchange_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeMEDISExchange_VS
from this IG
Condition.code.coding:medisRecordNorequiredJP_ConditionDiseaseCodeMEDISRecordNo_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeMEDISRecordNo_VS
from this IG
Condition.code.coding:receiptrequiredJP_ConditionDiseaseCodeReceipt_VS (a valid code from JP Core Condition Disease Code Receipt System CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeReceipt_VS
from this IG
Condition.code.coding:icd10requiredJP_ConditionDiseaseCodeICD10_VS (a valid code from JP Core Condition Disease Code ICD-10 CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeICD10_VS
from this IG
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codeexampleManifestationAndSymptomCodes
http://hl7.org/fhir/ValueSet/manifestation-or-symptom
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
: verificationStatus.empty().not() and verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').exists().not() and category.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-category' and code='problem-list-item').exists() implies clinicalStatus.empty().not()
con-4errorConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5errorConditionCondition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf 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-4errorConditionIf 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-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
dom-r4bwarningCondition.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()

This structure is derived from JP_Condition

Summary

Mandatory: 0 element(14 nested mandatory elements)
Must-Support: 1 element
Fixed: 7 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the values of Condition.clinicalStatus.coding
  • The element 1 is sliced based on the values of Condition.code.coding

Differential View

This structure is derived from JP_Condition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..* JP_Condition Detailed information about disease. 患者の診断に関する詳細な情報
... extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... clinicalStatus 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）【詳細参照】
.... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:hl70241 0..1 Coding HL7表0241。【詳細参照】
Binding: JP Core Condition Disease Outcome HL70241 ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/HL70241
...... code 1..1 code Symbol in syntax defined by the system
..... coding:jhsd0006 0..1 Coding JHSD表0006。【詳細参照】
Binding: JP Core Condition Disease Outcome JHSD0006 ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006
...... code 1..1 code Symbol in syntax defined by the system
..... coding:receipt 0..1 Coding レセプト電算システム転帰区分コード。【詳細参照】
Binding: JP Core Condition Disease Outcome Receipt System ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS
...... code 1..1 code Symbol in syntax defined by the system
... verificationStatus 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）。【詳細参照】
... code S 0..1 CodeableConcept 病名の識別コード。【詳細参照】
.... Slices for extension Content/Rules for all slices
..... extension:diseasePrefixModifier 0..* CodeableConcept 前置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePrefixModifier
..... extension:diseasePostfixModifier 0..* CodeableConcept 後置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier
.... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:medisExchange 0..1 Coding MEDIS ICD10対応標準病名マスター(交換用コード)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS Exchange ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.6
...... code 1..1 code Symbol in syntax defined by the system
..... coding:medisRecordNo 0..1 Coding MEDIS ICD10対応標準病名マスター(管理番号)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS RecordNo ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.2
...... code 1..1 code Symbol in syntax defined by the system
..... coding:receipt 0..1 Coding レセプト電算用傷病名マスター。【詳細参照】
Binding: JP Core Condition Disease Code Receipt System ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeReceipt_CS
...... code 1..1 code Symbol in syntax defined by the system
..... coding:icd10 0..1 Coding ICD-10コード。【詳細参照】
Binding: JP Core Condition Disease Code ICD-10 ValueSet (required)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeICD10_CS
...... code 1..1 code Symbol in syntax defined by the system
.... text 0..1 string 病名や所見、症状のフルテキスト【詳細参照】
... onset[x] 0..1 dateTime, Age, Period, Range, string 発症日（病名開始日）。診断された疾患や症状が開始された、推定もしくは実際の日付、日時、年齢。【詳細参照】
... abatement[x] 0..1 dateTime, Age, Period, Range, string 転帰日（病名終了日）。診断された疾患や症状がいつ治癒／寛解／軽快したか。【詳細参照】

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* JP_Condition Detailed information about disease. 患者の診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
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
... extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... 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
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）【詳細参照】
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
ele-1: All FHIR elements must have a @value or children
..... coding:hl70241 Σ 0..1 Coding HL7表0241。【詳細参照】
Binding: JP Core Condition Disease Outcome HL70241 ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/HL70241
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:jhsd0006 Σ 0..1 Coding JHSD表0006。【詳細参照】
Binding: JP Core Condition Disease Outcome JHSD0006 ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:receipt Σ 0..1 Coding レセプト電算システム転帰区分コード。【詳細参照】
Binding: JP Core Condition Disease Outcome Receipt System ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）。【詳細参照】
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... code SΣ 0..1 CodeableConcept 病名の識別コード。【詳細参照】
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
.... Slices for extension Content/Rules for all slices
..... extension:diseasePrefixModifier 0..* CodeableConcept 前置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePrefixModifier
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... extension:diseasePostfixModifier 0..* CodeableConcept 後置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
ele-1: All FHIR elements must have a @value or children
..... coding:medisExchange Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(交換用コード)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS Exchange ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: urn:oid:1.2.392.200119.4.101.6
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:medisRecordNo Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(管理番号)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS RecordNo ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: urn:oid:1.2.392.200119.4.101.2
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:receipt Σ 0..1 Coding レセプト電算用傷病名マスター。【詳細参照】
Binding: JP Core Condition Disease Code Receipt System ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeReceipt_CS
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
..... coding:icd10 Σ 0..1 Coding ICD-10コード。【詳細参照】
Binding: JP Core Condition Disease Code ICD-10 ValueSet (required)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeICD10_CS
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
.... text Σ 0..1 string 病名や所見、症状のフルテキスト【詳細参照】
ele-1: All FHIR elements must have a @value or children
... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
ele-1: All FHIR elements must have a @value or children
... onset[x] Σ 0..1 発症日（病名開始日）。診断された疾患や症状が開始された、推定もしくは実際の日付、日時、年齢。【詳細参照】
ele-1: All FHIR elements must have a @value or children
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 転帰日（病名終了日）。診断された疾患や症状がいつ治癒／寛解／軽快したか。【詳細参照】
ele-1: All FHIR elements must have a @value or children
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* JP_Condition Detailed information about disease. 患者の診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... 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. このリソースを人間が解釈するためのテキスト要約
... 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 Extension
Slice: Unordered, Open by value:url
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this condition
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）【詳細参照】
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:hl70241 Σ 0..1 Coding HL7表0241。【詳細参照】
Binding: JP Core Condition Disease Outcome HL70241 ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/HL70241
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:jhsd0006 Σ 0..1 Coding JHSD表0006。【詳細参照】
Binding: JP Core Condition Disease Outcome JHSD0006 ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:receipt Σ 0..1 Coding レセプト電算システム転帰区分コード。【詳細参照】
Binding: JP Core Condition Disease Outcome Receipt System ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）。【詳細参照】
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
... code SΣ 0..1 CodeableConcept 病名の識別コード。【詳細参照】
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.

.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:diseasePrefixModifier 0..* CodeableConcept 前置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePrefixModifier
..... extension:diseasePostfixModifier 0..* CodeableConcept 後置修飾語
URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:medisExchange Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(交換用コード)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS Exchange ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.6
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:medisRecordNo Σ 0..1 Coding MEDIS ICD10対応標準病名マスター(管理番号)。【詳細参照】
Binding: JP Core Condition Disease Code MEDIS RecordNo ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: urn:oid:1.2.392.200119.4.101.2
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:receipt Σ 0..1 Coding レセプト電算用傷病名マスター。【詳細参照】
Binding: JP Core Condition Disease Code Receipt System ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeReceipt_CS
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:icd10 Σ 0..1 Coding ICD-10コード。【詳細参照】
Binding: JP Core Condition Disease Code ICD-10 ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseCodeICD10_CS
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string 病名や所見、症状のフルテキスト【詳細参照】
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts


... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
... encounter Σ 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
... onset[x] Σ 0..1 発症日（病名開始日）。診断された疾患や症状が開始された、推定もしくは実際の日付、日時、年齢。【詳細参照】
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 転帰日（病名終了日）。診断された疾患や症状がいつ治癒／寛解／軽快したか。【詳細参照】
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
... recorder Σ 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
... asserter Σ 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
... stage C 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
con-1: Stage SHALL have summary or assessment
.... 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
.... summary C 0..1 CodeableConcept Simple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment C 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
.... type 0..1 CodeableConcept Kind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence C 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
con-2: evidence SHALL have code or details
.... 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
.... code ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.3.0
from the FHIR Standard
Condition.clinicalStatus.coding:hl70241requiredJP_ConditionDiseaseOutcomeHL70241_VS (a valid code from JP Core Condition Disease Outcome HL7 Table 0241 - Patient Outcome CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseOutcomeHL70241_VS
from this IG
Condition.clinicalStatus.coding:jhsd0006requiredJP_ConditionDiseaseOutcomeJHSD0006_VS (a valid code from JP Core Condition Disease Outcome JHSD0006 CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseOutcomeJHSD0006_VS
from this IG
Condition.clinicalStatus.coding:receiptrequiredJP_ConditionDiseaseOutcomeReceipt_VS (a valid code from JP Core Condition Disease Outcome Receipt CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseOutcomeReceipt_VS
from this IG
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.3.0
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.severitypreferredJP_ConditionSeverity_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionSeverity_VS
from this IG
Condition.codeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
Condition.code.coding:medisExchangerequiredJP_ConditionDiseaseCodeMEDISExchange_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeMEDISExchange_VS
from this IG
Condition.code.coding:medisRecordNorequiredJP_ConditionDiseaseCodeMEDISRecordNo_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeMEDISRecordNo_VS
from this IG
Condition.code.coding:receiptrequiredJP_ConditionDiseaseCodeReceipt_VS (a valid code from JP Core Condition Disease Code Receipt System CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeReceipt_VS
from this IG
Condition.code.coding:icd10requiredJP_ConditionDiseaseCodeICD10_VS (a valid code from JP Core Condition Disease Code ICD-10 CodeSystem)
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionDiseaseCodeICD10_VS
from this IG
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codeexampleManifestationAndSymptomCodes
http://hl7.org/fhir/ValueSet/manifestation-or-symptom
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
: verificationStatus.empty().not() and verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').exists().not() and category.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-category' and code='problem-list-item').exists() implies clinicalStatus.empty().not()
con-4errorConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5errorConditionCondition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf 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-4errorConditionIf 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-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
dom-r4bwarningCondition.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()

This structure is derived from JP_Condition

Summary

Mandatory: 0 element(14 nested mandatory elements)
Must-Support: 1 element
Fixed: 7 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the values of Condition.clinicalStatus.coding
  • The element 1 is sliced based on the values of Condition.code.coding

 

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。

  • subject : 本リソースを所有する患者

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
病名修飾語 病名の前置修飾語を格納する拡張
《code配下》		 JP_Condition_DiseasePrefixModifier CodeableConcept
病名修飾語 病名の後置修飾語を格納する拡張
《code配下》		 JP_Condition_DiseasePostfixModifier CodeableConcept

用語定義

HL7 FHIRの基底規格では、病名コードなどでSNOMED CTが使われているが、日本ではライセンスの問題もあり普及していない。代替としてJAHIS病名情報データ交換規約やSS-MIX2で使われている用語集を採用した。（★他に参照すべき標準規格はあるか★）

HL7 V2系では用語集を識別するコーディングシステム名（以下、「CS名」）は文字列であったが、FHIRではURIを指定する必要があるため、それぞれにURIを割り当てた。以下に使用する用語集のCS名とURI表記を列記する。

分類 用語集 CS名 URI
病名 MEDIS ICD10対応標準病名マスター(管理番号) MDCDX2 urn:oid:1.2.392.200119.4.101.2
病名 MEDIS ICD10対応標準病名マスター(交換用コード) MDCDX2 urn:oid:1.2.392.200119.4.101.6
病名 ICD-10 ICD10 http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDisaseCodeICD10_CS
病名 ICD-11 ICD11 http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDisaseCodeICD11_CS
病名 レセプト電算用傷病名マスター (なし) http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDisaseCodeReceipt_CS
病名修飾語 MEDIS ICD10対応標準病名マスター(修飾語管理番号) MDCDX2 urn:oid:1.2.392.200119.4.201.2
病名修飾語 MEDIS ICD10対応標準病名マスター(修飾語交換用コード) MDCDX2 urn:oid:1.2.392.200119.4.201.5
病名修飾語 レセプト電算用修飾語マスター (なし) http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseModifierReceipt_CS
転帰区分 HL7表0241 HL70241 hhttp://jpfhir.jp/fhir/core/CodeSystem/HL70241
転帰区分 JHSD表0006 JHSD0006 http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006
転帰区分 レセプト電算システム転帰区分コード (なし) http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS

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。

  • 転帰区分（clinicalStatusを使用）
  • 発症日（病名開始日）(onset[x]を使用)
  • 転帰日（病名終了日）(abatement[x]を使用)
  • 病名修飾語（拡張「DiseasePrefixModifier」「DiseasePostfixModifier」を使用）

利用方法

OperationおよびSearch Parameter 一覧

Search Parameter一覧

コンフォーマンス パラメータ 型 例
SHALL identifier token GET [base]/Condition?identifier=http://myhospital.com/fhir/condition|123
SHOULD patient reference GET [base]/Condition?patient=Patient/123
MAY patient,onset-date reference,date GET [base]/Condition?patient=Patient/123&onset-date=ge2021-08-24
MAY patient,clinical-status reference,code GET [base]/Condition?patient=Patient/123&clinical-status=active
MAY patient,verification-status reference,code GET [base]/Condition?patient=Patient/123&verification-status=confirmed
MAY patient,category reference,code GET [base]/Condition??patient=Patient/123&category=problem-list-item
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Conditionを検索

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

    例：

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

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

推奨検索パラメータ

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することが推奨される（SHOULD）

  1. 検索パラメータpatientを指定し、該当するすべてのConditionを検索

    GET [base]/Condition?patient={reference}

    例：

    GET [base]/Condition?patient=Patient/123

    指定された患者のすべてのConditionリソースを含むBundleを検索する。

追加検索パラメータ

オプションとして次の検索パラメータをサポートすることができる（MAY）

  1. 検索パラメータpatientとonset-dateを指定し、該当するすべてのConditionを検索

    • dateに対する次の比較演算子のサポートを含む: gt,lt,ge,le
    • AND検索のオプションのサポートを含む (例えば.onset-date=[date]&onset-date=[date]]&…)
       GET [base]/Condition?patient={reference}&onset-date={gt|lt|ge|le}[date]{&onset-&date={gt|lt|ge|le}[date]&...}

    例：

       GET [base]/Condition?patient=Patient/123&onset-date=ge2021-08-24

    指定された患者および発症日のすべてのConditionを含むBundleを検索する。

  2. 検索パラメータpatientとclinical-statusを指定し、該当するすべてのConditionを検索

    • OR検索のサポートを含む(例えば clinical-status={system|}[code],{system|}[code],…)
       GET [base]/Condition?patient={reference}&clinical-status={system|}[code]{,{system|}[code],...}

    例：

       GET [base]/Condition?patient=Patient/123&clinical-status=active

       GET [base]/Condition?patient=Patient/123&clinical-status=http://hl7.org/fhir/ValueSet/condition-clinical|active

    指定された患者およびステータスのすべてのConditionを含むBundleを検索する。

  3. 検索パラメータpatientとverification-statusを指定し、該当するすべてのConditionを検索

       GET [base]/Condition?patient={reference}&verification-status={system|}[code]

    例：

       GET [base]/Condition?patient=Patient/123&verification-status=confirmed

       GET [base]/Condition?patient=Patient/123&verification-status=http://hl7.org/fhir/ValueSet/condition-ver-status|confirmed

    指定された患者および確認状態のすべてのConditionを含むBundleを検索する。

  4. 検索パラメータpatientとcategoryを指定し、該当するすべてのConditionを検索

       GET [base]/Condition?patient={reference}&category={system|}[code]

    例：

       GET [base]/Condition?patient=Patient/123&category=claim-diagnosis

       GET [base]/Condition?patient=Patient/123&category=http://hl7.org/fhir/ValueSet/condition-category|problem-list-item

    指定された患者およびカテゴリーのすべてのConditionを含むBundleを検索する。

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

注意事項

病名の識別コードと名称について

病名を識別するコードと名称は、Condition.code要素に、CodeableConcept型を使用して記録する。標準コードとしては、MEDIS ICD10対応標準病名マスターの交換用コード（"urn:oid:1.2.392.200119.4.101.6"）、ICD-10（"http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDisaseCodeICD10_CS"）、レセプト電算用傷病名マスター（"http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionReceiptCode_CS"）を推奨する。CodeableConcept型はcoding要素を繰り返すことが可能なので、１つの病名の識別情報を複数のコードシステムで記述してもよい。 また、Condition.code.text には修飾情報を含めた病名のフルテキストを記述する。

「急性化膿性虫垂炎の疑い」の場合のインスタンス例を示す。

"code": {
  "coding": [ { 
    "system": "http://terminology.sample.com/CodeSystem/disease/1311234567", 
    "code": "MD03981", 
    "display": "急性化膿性虫垂炎" 
  }, { 
    "system": "urn:oid:1.2.392.200119.4.101.6", 
    "code": "HR19", 
    "display": "急性化膿性虫垂炎" 
  }, { 
    "system": "http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDisaseCodeICD10_CS", 
    "code": "K358", 
    "display": "急性化膿性虫垂炎" 
  }, { 
    "system": "http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionReceiptCode_CS", 
    "code": "5409004", 
    "display": "急性化膿性虫垂炎" 
  } ], 
  "text": "急性化膿性虫垂炎の疑い" 
},

病名修飾語について

病名修飾語は「急性」「過敏性」「症候群」などの修飾を病名に付加するためのものであり、Condition.code要素に対して定義した拡張「JP_Condition_DiseasePrefixModifier」「JP_Condition_DiseasePostfixModifier」を使用し、CodeableConcept型を使用して記録する。標準コードとしては、MEDIS ICD10対応標準病名マスターの修飾語交換用コード（"urn:oid:1.2.392.200119.4.102.5"）ないしレセプト電算資システム用修飾語コード("http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseModifierReceipt_CS")を推奨する。この拡張を繰り返すことにより、複数の修飾語を記述することができる。

「過敏性大腸炎の初期疾患」の場合のインスタンス例を示す。（★適用順序が分からないがよいか？★）

"code": {
  "extension": [ {
    "url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePrefixModifier",
    "valueCodeableConcept": {
      "coding": [ { 
        "system": "urn:oid:1.2.392.200119.4.102.5", 
        "code": "3216", 
        "display": "過敏性" 
      } ],
      "text": "過敏性"
    }
  }, {
    "url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier",
    "valueCodeableConcept": {
      "coding": [ { 
        "system": "urn:oid:1.2.392.200119.4.102.5", 
        "code": "1111", 
        "display": "の初期" 
      } ],
      "text": "の初期"
    }
  }, {
    "url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Condition_DiseasePostfixModifier",
    "valueCodeableConcept": {
      "coding": [ { 
        "system": "urn:oid:1.2.392.200119.4.102.5", 
        "code": "08MV", 
        "display": "疾患" 
      } ],
      "text": "疾患"
    }
  } ],
  "coding": [ { 
    "system": "http://terminology.sample.com/CodeSystem/disease/1311234567", 
    "code": "MD13062", 
    "display": "大腸炎" 
  }, { 
    "system": "urn:oid:1.2.392.200119.4.101.6", 
    "code": "VSES", 
    "display": "大腸炎" 
  } ], 
  "text": "過敏性大腸炎の初期疾患" 
},

発症日（病名開始日）、転帰日（病名終了日）の記述方法

病名や症状などの発症日（病名や症状が始まった日）および転帰日（病名や症状が治まった日）は、それぞれCondition.onset[x]要素およびCondition.abatement[x]要素を使用して記述する。発症日や転帰日が不明の場合、代わりに病名開始日（当該病名の診療を開始した日）や病名終了日（当該病名の診療を終了した日）を記載してもよい。 dateTime, Age, Period, Range, string の５種類のデータ型を選択でき、情報の精度に応じて様々な記述方法が可能である。 abatement[x]要素はCondition.clinicalStatus要素の値が"resolved","remission","inactive"の場合のみ記述できることに注意すること。

「2023-09-01」に発症し、「2023-09-23」に転帰した場合のインスタンス例を示す。

"onsetDateTime": "2023-09-01",
"abatementDateTime": "2023-09-23",

「2023年6月から7月」に発症した場合のインスタンス例を示す。

"onsetPeriod": {
  "start": "2023-06",
  "end": "2023-07"
},

「15歳」の時に発症した場合のインスタンス例を示す。

"onsetAge": {
  "value": 15,
  "unit": "years",
  "system": "http://unitsofmeasure.org",
  "code": "a"
},

転帰区分の記述方法

転帰区分は、Condition.clinicalStatus要素を使用し、CodeableConcept型で記載する。使用するコードは、Requiredレベルでバインディングされている値セット ("http://terminology.hl7.org/ValueSet/condition-clinical") の他、HL7V2.ｘで定義されているHL7表0241 ("http://jpfhir.jp/fhir/core/CodeSystem/HL70241") およびJAHIS病名情報データ交換規約Ver.3.1Cで定義されているJHSD表0006 ("http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006")の併用ないしレセプト電算用転帰区分コード（"http://jpfhir.jp/fhir/core/CodeSystem/JP_ConditionDiseaseOutcomeReceipt_CS"）が標準コードとして使用できる。 なお、記述する転帰区分は、abatement[x]に記述した時点、ないしabatement[x]がない場合は出力時点での情報とする。

「寛解」の場合のインスタンス例を示す。

"clinicalStatus": {
  "coding": [ { 
    "system": "http://terminology.hl7.org/CodeSystem/condition-clinical", 
    "code": "remission", 
    "display": "Remission" 
  }, { 
    "system": "http://jpfhir.jp/fhir/core/CodeSystem/JHSD0006", 
    "code": "M", 
    "display": "寛解" 
  }, { 
    "system": "http://terminology.sample.com/CodeSystem/disease-outcome", 
    "code": "2", 
    "display": "寛解" 
  } ], 
  "text": "寛解" 
},

疑い病名の記述方法

疑い病名かどうかは、Condition.verificationStatus要素に、CodeableConcept型を使用して記録する。コードは、Requiredレベルでバインディングされている値セット（"http://hl7.org/fhir/ValueSet/condition-ver-status"）を使用し、確定病名の場合は"confirmed"、疑い病名の場合は"unconfirmed"をセットする。 また、疑い病名の場合はCondition.code.textの末尾を「～の疑い」とする。

「急性化膿性虫垂炎の疑い」の場合のインスタンス例を示す。

"verificationStatus": {
  "coding": [ { 
    "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status", 
    "code": "unconfirmed", 
    "display": "Unconfirmed" 
  } ]
},
...
"code": {
  "coding": [ { 
    "system": "http://terminology.sample.com/CodeSystem/disease/1311234567", 
    "code": "MD03981", 
    "display": "急性化膿性虫垂炎" 
  }, { 
    "system": "urn:oid:1.2.392.200119.4.101.6", 
    "code": "HR19", 
    "display": "急性化膿性虫垂炎" 
  } ], 
  "text": "急性化膿性虫垂炎の疑い" 
},

その他、参考文献・リンク等

  1. JAHIS 病名情報データ交換規約Ver.3.1C https://www.jahis.jp/files/user/04_JAHIS%20standard/18-003_JAHIS病名情報データ交換規約%20Ver.3.1C.pdf
  2. ICD-10 https://terminology.hl7.org/2.1.0/CodeSystem-icd10.html
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