HL7 FHIR JP Core ImplementationGuide
2.0.0-dev - ci-build
HL7 FHIR JP Core ImplementationGuide
2.0.0-dev - ci-build
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
| 項目 | 内容 |
| 定義URL | http://jpfhir.jp/fhir/core/StructureDefinition/JP_MedicationAdministration |
| Version | 2.0.0-dev |
| Name | JP_MedicationAdministration |
| Title | JP Core MedicationAdministration Profile |
| Status | Active ( 2023-10-31 ) |
| 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MedicationAdministrationリソースに対して、内服・外用薬剤処方投与実施情報のデータを送受信するための基礎となる制約と拡張を定めたものである。
このResource/Profileは内服、外用の薬剤処方の投与実施情報を表現する。薬剤処方は指示する項目、使用する用語集、プロセスなどにおいて諸外国と日本では異なっており、日本国内で規格を運用するためにExtensionの追加や用語集の追加・変更を行った。現在、日本での処方関連規格として利用されているJAHIS 処方データ交換規約 Ver 3.0C を参考にした。
薬剤処方のFHIR仕様に関しては、先行事例として「処方情報 HL7FHIR 記述仕様」があるが、利用できる仕様については可能な限り取り入れるようにした。ただし、拡張のURLは新たにJP Coreの命名規則に基づいて命名している。
本プロファイルは、以下のようなユースケースを想定している。
このProfileの対象は内服、外用の一般的な薬剤処方の投与実施情報を電子的に連携するためのメッセージを記述することである。
このProfileは内服、外用の薬剤に関するものであり、注射薬剤については対象としない。注射薬剤は、指示の仕方や指示する項目が内服、外用とは大きく異なるため、別のProfileとして記述することとする。
また、このリソースは薬剤の投与実施に関するものであり、指示（オーダ）、調剤や払い出しは対象としない。それぞれ、MedicationRequest、MedicationDispense が対応するリソースである。
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from JP_MedicationAdministrationBase
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  MedicationAdministration |
0..* | JP_MedicationAdministrationBase | 患者への薬剤投与記録 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 |
 Slices for extension |
Content/Rules for all slices | |||
   extension:requestDepartment |
0..1 | CodeableConcept | 依頼科 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestDepartment Binding: JP Core Department SS-MIX ValueSet (preferred) ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both | |
| extension:requestAuthoredOn |
0..1 | dateTime | 依頼日時 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestAuthoredOn ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both | |
| extension:location |
0..1 | Reference(JP Core Location Profile) | 実施場所 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Location ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both | |
 extension:requester |
0..* | Reference(JP Core Practitioner Profile) | 依頼医 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Requester ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource 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 |
| Slices for identifier |
2..* | Identifier | 外部から参照されるID Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children | |
| identifier:rpNumber |
1..1 | Identifier | 処方箋内部の剤グループとしてのRp番号 ele-1: All FHIR elements must have a @value or children | |
  use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
| system |
Σ | 1..1 | uri | Rp番号(剤グループ番号)についてのsystem値 ele-1: All FHIR elements must have a @value or children Fixed Value: urn:oid:1.2.392.100495.20.3.81 |
 value |
Σ | 1..1 | string | Rp番号(剤グループ番号) ele-1: All FHIR elements must have a @value or children Example General: 123456 |
| identifier:requestIdentifier |
0..* | Identifier | 処方オーダに対するID(MedicationRequestからの継承) ele-1: All FHIR elements must have a @value or children | |
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
| system |
Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: http://jpfhir.jp/fhir/core/IdSystem/resourceInstance-identifier |
| value |
Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
| identifier:orderInRp |
1..1 | Identifier | 同一RP番号（剤グループ）での薬剤の表記順 ele-1: All FHIR elements must have a @value or children | |
 use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
| system |
Σ | 1..1 | uri | RP番号内（剤グループ内）の連番を示すsystem値 ele-1: All FHIR elements must have a @value or children Fixed Value: urn:oid:1.2.392.100495.20.3.82 |
| value |
Σ | 1..1 | string | RP番号内（剤グループ内）の連番 ele-1: All FHIR elements must have a @value or children Example General: 123456 |
| status |
?!Σ | 1..1 | code | completed | stopped Binding: MedicationAdministration Status Codes (required): 患者への投与状況 ele-1: All FHIR elements must have a @value or children |
 medication[x] |
Σ | 1..1 | CodeableConcept | 医薬品 Binding: JP Core MedicationCode ValueSet (preferred): 処方する製剤を表すコード。 ele-1: All FHIR elements must have a @value or children |
 subject |
Σ | 1..1 | Reference(JP Core Patient Profile) | 投与対象患者 ele-1: All FHIR elements must have a @value or children |
| context |
0..1 | Reference(JP Core Encounter Profile | EpisodeOfCare) | Encounter、または一部として実施されるケアエピソード ele-1: All FHIR elements must have a @value or children | |
| supportingInformation |
0..* | Reference(Resource) | 投与をサポートする追加情報 ele-1: All FHIR elements must have a @value or children | |
 effective[x] |
Σ | 1..1 | 開始時間と終了時間 ele-1: All FHIR elements must have a @value or children | |
| effectiveDateTime |
dateTime | |||
 effectivePeriod |
Period | |||
| performer |
Σ | 0..* | BackboneElement | 投薬を実施した人 ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| actor |
Σ | 1..1 | Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson | Device) | Who performed the medication administration ele-1: All FHIR elements must have a @value or children |
| reasonCode |
0..* | CodeableConcept | 投薬が実施された理由 Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made. ele-1: All FHIR elements must have a @value or children | |
| reasonReference |
0..* | Reference(JP Core Condition Profile | JP Core Observation Common Profile | JP Core DiagnosticReport Common Profile) | 薬が投与された理由を裏付ける状態または観察 ele-1: All FHIR elements must have a @value or children | |
| request |
0..1 | Reference(MedicationRequest) | 実施された元の投与依頼情報 ele-1: All FHIR elements must have a @value or children | |
| device |
0..* | Reference(Device) | 投与に使用されるデバイス ele-1: All FHIR elements must have a @value or children | |
| note |
0..* | Annotation | 投与に関する備考情報 ele-1: All FHIR elements must have a @value or children | |
| dosage |
C | 0..1 | BackboneElement | 薬の服用方法の詳細 ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| text |
0..1 | string | フリーテキストの投与方法の説明 SIG:用法 ele-1: All FHIR elements must have a @value or children | |
| site |
0..1 | CodeableConcept | 投与部位 Binding: JP Core Medication JAMI External Body Site ValueSet (preferred) ele-1: All FHIR elements must have a @value or children | |
| method |
0..1 | CodeableConcept | 投与方法 Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. 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:unitDigit1 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法１桁コード Binding: JP Core Medication JAMI Basic Usage Type ValueSet (preferred) 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:1.2.392.200250.2.2.20.30 |
| coding:unitDigit2 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法2桁コード Binding: JP Core Medication JAMI Detail Usage ValueSet (preferred) 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:1.2.392.200250.2.2.20.40 |
| text |
Σ | 0..1 | string | 投与⽅法のテキスト表現 ele-1: All FHIR elements must have a @value or children |
| dose |
0..1 | JP_MedicationSimpleQuantity | 用量あたりの投薬量 ele-1: All FHIR elements must have a @value or children | |
| Slices for rate[x] |
0..1 | 単位時間あたりの用量 Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children | ||
| rateRatio |
Ratio | |||
| rateQuantity |
Quantity(SimpleQuantity) | |||
| rate[x]:rateRatio |
0..1 | JP_MedicationRatio_DosePerPeriod | Dose quantity per unit of time ele-1: All FHIR elements must have a @value or children | |
| eventHistory |
0..* | Reference(Provenance) | ライフサイクルで関心のあるイベントのリスト ele-1: All FHIR elements must have a @value or children | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationAdministration |
0..* | JP_MedicationAdministrationBase | 患者への薬剤投与記録 | |||||
| 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
| |||||
| 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 | |||||
 Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:requestDepartment |
0..1 | CodeableConcept | 依頼科 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestDepartment Binding: JP Core Department SS-MIX ValueSet (preferred) | |||||
| extension:requestAuthoredOn |
0..1 | dateTime | 依頼日時 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestAuthoredOn | |||||
| extension:location |
0..1 | Reference(JP Core Location Profile) | 実施場所 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Location | |||||
| extension:requester |
0..* | Reference(JP Core Practitioner Profile) | 依頼医 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Requester | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| Slices for identifier |
2..* | Identifier | 外部から参照されるID Slice: Unordered, Open by value:system | |||||
| identifier:rpNumber |
1..1 | Identifier | 処方箋内部の剤グループとしてのRp番号 | |||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
| type |
Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible) | ||||
| system |
Σ | 1..1 | uri | Rp番号(剤グループ番号)についてのsystem値 Fixed Value: urn:oid:1.2.392.100495.20.3.81 | ||||
| value |
Σ | 1..1 | string | Rp番号(剤グループ番号) Example General: 123456 | ||||
| period |
Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner |
Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| identifier:requestIdentifier |
0..* | Identifier | 処方オーダに対するID(MedicationRequestからの継承) | |||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
| type |
Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible) | ||||
| system |
Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://jpfhir.jp/fhir/core/IdSystem/resourceInstance-identifier | ||||
| value |
Σ | 1..1 | string | The value that is unique Example General: 123456 | ||||
| period |
Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner |
Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| identifier:orderInRp |
1..1 | Identifier | 同一RP番号（剤グループ）での薬剤の表記順 | |||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
| type |
Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible) | ||||
| system |
Σ | 1..1 | uri | RP番号内（剤グループ内）の連番を示すsystem値 Fixed Value: urn:oid:1.2.392.100495.20.3.82 | ||||
| value |
Σ | 1..1 | string | RP番号内（剤グループ内）の連番 Example General: 123456 | ||||
| period |
Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner |
Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| instantiates |
Σ | 0..* | uri | プロトコルや定義のインスタンス化 | ||||
| partOf |
Σ | 0..* | Reference(MedicationAdministration | Procedure) | 親イベントへの参照 | ||||
| status |
?!Σ | 1..1 | code | completed | stopped Binding: MedicationAdministration Status Codes (required): 患者への投与状況 | ||||
| statusReason |
0..* | CodeableConcept | 実施されていない理由 Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated. | |||||
| category |
0..1 | CodeableConcept | 薬が使用される区分 Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur. | |||||
| medication[x] |
Σ | 1..1 | CodeableConcept | 医薬品 Binding: JP Core MedicationCode ValueSet (preferred): 処方する製剤を表すコード。 | ||||
| subject |
Σ | 1..1 | Reference(JP Core Patient Profile) | 投与対象患者 | ||||
| context |
0..1 | Reference(JP Core Encounter Profile | EpisodeOfCare) | Encounter、または一部として実施されるケアエピソード | |||||
| supportingInformation |
0..* | Reference(Resource) | 投与をサポートする追加情報 | |||||
| effective[x] |
Σ | 1..1 | 開始時間と終了時間 | |||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| performer |
Σ | 0..* | BackboneElement | 投薬を実施した人 | ||||
| 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 | ||||
| function |
0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication. | |||||
| actor |
Σ | 1..1 | Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson | Device) | Who performed the medication administration | ||||
| reasonCode |
0..* | CodeableConcept | 投薬が実施された理由 Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made. | |||||
| reasonReference |
0..* | Reference(JP Core Condition Profile | JP Core Observation Common Profile | JP Core DiagnosticReport Common Profile) | 薬が投与された理由を裏付ける状態または観察 | |||||
| request |
0..1 | Reference(MedicationRequest) | 実施された元の投与依頼情報 | |||||
| device |
0..* | Reference(Device) | 投与に使用されるデバイス | |||||
| note |
0..* | Annotation | 投与に関する備考情報 | |||||
| dosage |
C | 0..1 | BackboneElement | 薬の服用方法の詳細 mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] | ||||
| 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 | ||||
| text |
0..1 | string | フリーテキストの投与方法の説明 SIG:用法 | |||||
| site |
0..1 | CodeableConcept | 投与部位 Binding: JP Core Medication JAMI External Body Site ValueSet (preferred) | |||||
| route |
0..1 | CodeableConcept | Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | |||||
| method |
0..1 | CodeableConcept | 投与方法 Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | |||||
| 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:unitDigit1 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法１桁コード Binding: JP Core Medication JAMI Basic Usage Type ValueSet (preferred) | ||||
| 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:1.2.392.200250.2.2.20.30 | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..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:unitDigit2 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法2桁コード Binding: JP Core Medication JAMI Detail Usage ValueSet (preferred) | ||||
| 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:1.2.392.200250.2.2.20.40 | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..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 | 投与⽅法のテキスト表現 | ||||
| dose |
0..1 | JP_MedicationSimpleQuantity | 用量あたりの投薬量 | |||||
| Slices for rate[x] |
0..1 | 単位時間あたりの用量 Slice: Unordered, Open by type:$this | ||||||
| rateRatio |
Ratio | |||||||
| rateQuantity |
Quantity(SimpleQuantity) | |||||||
| rate[x]:rateRatio |
0..1 | JP_MedicationRatio_DosePerPeriod | Dose quantity per unit of time | |||||
| eventHistory |
0..* | Reference(Provenance) | ライフサイクルで関心のあるイベントのリスト | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Conformance | ValueSet | URI | |||
| MedicationAdministration.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| MedicationAdministration.identifier:rpNumber.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.identifier:rpNumber.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-typefrom the FHIR Standard | ||||
| MedicationAdministration.identifier:requestIdentifier.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.identifier:requestIdentifier.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-typefrom the FHIR Standard | ||||
| MedicationAdministration.identifier:orderInRp.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.identifier:orderInRp.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-typefrom the FHIR Standard | ||||
| MedicationAdministration.status | required | MedicationAdministration Status Codeshttp://hl7.org/fhir/ValueSet/medication-admin-status|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.statusReason | example | SNOMEDCTReasonMedicationNotGivenCodeshttp://hl7.org/fhir/ValueSet/reason-medication-not-given-codesfrom the FHIR Standard | ||||
| MedicationAdministration.category | preferred | MedicationAdministration Category Codeshttp://hl7.org/fhir/ValueSet/medication-admin-categoryfrom the FHIR Standard | ||||
| MedicationAdministration.medication[x] | preferred | JP_MedicationCode_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationCode_VS | ||||
| MedicationAdministration.performer.function | example | MedicationAdministration Performer Function Codeshttp://hl7.org/fhir/ValueSet/med-admin-perform-functionfrom the FHIR Standard | ||||
| MedicationAdministration.reasonCode | example | ReasonMedicationGivenCodeshttp://hl7.org/fhir/ValueSet/reason-medication-given-codesfrom the FHIR Standard | ||||
| MedicationAdministration.dosage.site | preferred | JP_MedicationBodySiteJAMIExternal_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationBodySiteJAMIExternal_VS | ||||
| MedicationAdministration.dosage.route | example | SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codesfrom the FHIR Standard | ||||
| MedicationAdministration.dosage.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesfrom the FHIR Standard | ||||
| MedicationAdministration.dosage.method.coding:unitDigit1 | preferred | JP_MedicationMethodJAMIBasicUsage_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationMethodJAMIBasicUsage_VS | ||||
| MedicationAdministration.dosage.method.coding:unitDigit2 | preferred | JP_MedicationMethodJAMIDetailUsage_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationMethodJAMIDetailUsage_VS |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where(((id.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-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management : text.`div`.exists() | |
| dom-r4b | warning | MedicationAdministration.contained | Containing 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-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] : dose.exists() or rate.exists() |
This structure is derived from JP_MedicationAdministrationBase
Summary
Mandatory: 3 elements(2 nested mandatory elements)
Fixed: 3 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from JP_MedicationAdministrationBase
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationAdministration |
0..* | JP_MedicationAdministrationBase | 患者への薬剤投与記録 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 |
| Slices for extension |
Content/Rules for all slices | |||
| extension:requestDepartment |
0..1 | CodeableConcept | 依頼科 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestDepartment Binding: JP Core Department SS-MIX ValueSet (preferred) ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both | |
| extension:requestAuthoredOn |
0..1 | dateTime | 依頼日時 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestAuthoredOn ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both | |
| extension:location |
0..1 | Reference(JP Core Location Profile) | 実施場所 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Location ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both | |
| extension:requester |
0..* | Reference(JP Core Practitioner Profile) | 依頼医 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Requester ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource 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 |
| Slices for identifier |
2..* | Identifier | 外部から参照されるID Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children | |
| identifier:rpNumber |
1..1 | Identifier | 処方箋内部の剤グループとしてのRp番号 ele-1: All FHIR elements must have a @value or children | |
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
| system |
Σ | 1..1 | uri | Rp番号(剤グループ番号)についてのsystem値 ele-1: All FHIR elements must have a @value or children Fixed Value: urn:oid:1.2.392.100495.20.3.81 |
| value |
Σ | 1..1 | string | Rp番号(剤グループ番号) ele-1: All FHIR elements must have a @value or children Example General: 123456 |
| identifier:requestIdentifier |
0..* | Identifier | 処方オーダに対するID(MedicationRequestからの継承) ele-1: All FHIR elements must have a @value or children | |
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
| system |
Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: http://jpfhir.jp/fhir/core/IdSystem/resourceInstance-identifier |
| value |
Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
| identifier:orderInRp |
1..1 | Identifier | 同一RP番号（剤グループ）での薬剤の表記順 ele-1: All FHIR elements must have a @value or children | |
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
| system |
Σ | 1..1 | uri | RP番号内（剤グループ内）の連番を示すsystem値 ele-1: All FHIR elements must have a @value or children Fixed Value: urn:oid:1.2.392.100495.20.3.82 |
| value |
Σ | 1..1 | string | RP番号内（剤グループ内）の連番 ele-1: All FHIR elements must have a @value or children Example General: 123456 |
| status |
?!Σ | 1..1 | code | completed | stopped Binding: MedicationAdministration Status Codes (required): 患者への投与状況 ele-1: All FHIR elements must have a @value or children |
| medication[x] |
Σ | 1..1 | CodeableConcept | 医薬品 Binding: JP Core MedicationCode ValueSet (preferred): 処方する製剤を表すコード。 ele-1: All FHIR elements must have a @value or children |
| subject |
Σ | 1..1 | Reference(JP Core Patient Profile) | 投与対象患者 ele-1: All FHIR elements must have a @value or children |
| context |
0..1 | Reference(JP Core Encounter Profile | EpisodeOfCare) | Encounter、または一部として実施されるケアエピソード ele-1: All FHIR elements must have a @value or children | |
| supportingInformation |
0..* | Reference(Resource) | 投与をサポートする追加情報 ele-1: All FHIR elements must have a @value or children | |
| effective[x] |
Σ | 1..1 | 開始時間と終了時間 ele-1: All FHIR elements must have a @value or children | |
| effectiveDateTime |
dateTime | |||
| effectivePeriod |
Period | |||
| performer |
Σ | 0..* | BackboneElement | 投薬を実施した人 ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| actor |
Σ | 1..1 | Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson | Device) | Who performed the medication administration ele-1: All FHIR elements must have a @value or children |
| reasonCode |
0..* | CodeableConcept | 投薬が実施された理由 Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made. ele-1: All FHIR elements must have a @value or children | |
| reasonReference |
0..* | Reference(JP Core Condition Profile | JP Core Observation Common Profile | JP Core DiagnosticReport Common Profile) | 薬が投与された理由を裏付ける状態または観察 ele-1: All FHIR elements must have a @value or children | |
| request |
0..1 | Reference(MedicationRequest) | 実施された元の投与依頼情報 ele-1: All FHIR elements must have a @value or children | |
| device |
0..* | Reference(Device) | 投与に使用されるデバイス ele-1: All FHIR elements must have a @value or children | |
| note |
0..* | Annotation | 投与に関する備考情報 ele-1: All FHIR elements must have a @value or children | |
| dosage |
C | 0..1 | BackboneElement | 薬の服用方法の詳細 ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| text |
0..1 | string | フリーテキストの投与方法の説明 SIG:用法 ele-1: All FHIR elements must have a @value or children | |
| site |
0..1 | CodeableConcept | 投与部位 Binding: JP Core Medication JAMI External Body Site ValueSet (preferred) ele-1: All FHIR elements must have a @value or children | |
| method |
0..1 | CodeableConcept | 投与方法 Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. 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:unitDigit1 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法１桁コード Binding: JP Core Medication JAMI Basic Usage Type ValueSet (preferred) 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:1.2.392.200250.2.2.20.30 |
| coding:unitDigit2 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法2桁コード Binding: JP Core Medication JAMI Detail Usage ValueSet (preferred) 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:1.2.392.200250.2.2.20.40 |
| text |
Σ | 0..1 | string | 投与⽅法のテキスト表現 ele-1: All FHIR elements must have a @value or children |
| dose |
0..1 | JP_MedicationSimpleQuantity | 用量あたりの投薬量 ele-1: All FHIR elements must have a @value or children | |
| Slices for rate[x] |
0..1 | 単位時間あたりの用量 Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children | ||
| rateRatio |
Ratio | |||
| rateQuantity |
Quantity(SimpleQuantity) | |||
| rate[x]:rateRatio |
0..1 | JP_MedicationRatio_DosePerPeriod | Dose quantity per unit of time ele-1: All FHIR elements must have a @value or children | |
| eventHistory |
0..* | Reference(Provenance) | ライフサイクルで関心のあるイベントのリスト ele-1: All FHIR elements must have a @value or children | |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationAdministration |
0..* | JP_MedicationAdministrationBase | 患者への薬剤投与記録 | |||||
| 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
| |||||
| 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 | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:requestDepartment |
0..1 | CodeableConcept | 依頼科 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestDepartment Binding: JP Core Department SS-MIX ValueSet (preferred) | |||||
| extension:requestAuthoredOn |
0..1 | dateTime | 依頼日時 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestAuthoredOn | |||||
| extension:location |
0..1 | Reference(JP Core Location Profile) | 実施場所 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Location | |||||
| extension:requester |
0..* | Reference(JP Core Practitioner Profile) | 依頼医 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_Requester | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| Slices for identifier |
2..* | Identifier | 外部から参照されるID Slice: Unordered, Open by value:system | |||||
| identifier:rpNumber |
1..1 | Identifier | 処方箋内部の剤グループとしてのRp番号 | |||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
| type |
Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible) | ||||
| system |
Σ | 1..1 | uri | Rp番号(剤グループ番号)についてのsystem値 Fixed Value: urn:oid:1.2.392.100495.20.3.81 | ||||
| value |
Σ | 1..1 | string | Rp番号(剤グループ番号) Example General: 123456 | ||||
| period |
Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner |
Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| identifier:requestIdentifier |
0..* | Identifier | 処方オーダに対するID(MedicationRequestからの継承) | |||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
| type |
Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible) | ||||
| system |
Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: http://jpfhir.jp/fhir/core/IdSystem/resourceInstance-identifier | ||||
| value |
Σ | 1..1 | string | The value that is unique Example General: 123456 | ||||
| period |
Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner |
Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| identifier:orderInRp |
1..1 | Identifier | 同一RP番号（剤グループ）での薬剤の表記順 | |||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
| type |
Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible) | ||||
| system |
Σ | 1..1 | uri | RP番号内（剤グループ内）の連番を示すsystem値 Fixed Value: urn:oid:1.2.392.100495.20.3.82 | ||||
| value |
Σ | 1..1 | string | RP番号内（剤グループ内）の連番 Example General: 123456 | ||||
| period |
Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner |
Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| instantiates |
Σ | 0..* | uri | プロトコルや定義のインスタンス化 | ||||
| partOf |
Σ | 0..* | Reference(MedicationAdministration | Procedure) | 親イベントへの参照 | ||||
| status |
?!Σ | 1..1 | code | completed | stopped Binding: MedicationAdministration Status Codes (required): 患者への投与状況 | ||||
| statusReason |
0..* | CodeableConcept | 実施されていない理由 Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated. | |||||
| category |
0..1 | CodeableConcept | 薬が使用される区分 Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur. | |||||
| medication[x] |
Σ | 1..1 | CodeableConcept | 医薬品 Binding: JP Core MedicationCode ValueSet (preferred): 処方する製剤を表すコード。 | ||||
| subject |
Σ | 1..1 | Reference(JP Core Patient Profile) | 投与対象患者 | ||||
| context |
0..1 | Reference(JP Core Encounter Profile | EpisodeOfCare) | Encounter、または一部として実施されるケアエピソード | |||||
| supportingInformation |
0..* | Reference(Resource) | 投与をサポートする追加情報 | |||||
| effective[x] |
Σ | 1..1 | 開始時間と終了時間 | |||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| performer |
Σ | 0..* | BackboneElement | 投薬を実施した人 | ||||
| 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 | ||||
| function |
0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication. | |||||
| actor |
Σ | 1..1 | Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson | Device) | Who performed the medication administration | ||||
| reasonCode |
0..* | CodeableConcept | 投薬が実施された理由 Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made. | |||||
| reasonReference |
0..* | Reference(JP Core Condition Profile | JP Core Observation Common Profile | JP Core DiagnosticReport Common Profile) | 薬が投与された理由を裏付ける状態または観察 | |||||
| request |
0..1 | Reference(MedicationRequest) | 実施された元の投与依頼情報 | |||||
| device |
0..* | Reference(Device) | 投与に使用されるデバイス | |||||
| note |
0..* | Annotation | 投与に関する備考情報 | |||||
| dosage |
C | 0..1 | BackboneElement | 薬の服用方法の詳細 mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] | ||||
| 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 | ||||
| text |
0..1 | string | フリーテキストの投与方法の説明 SIG:用法 | |||||
| site |
0..1 | CodeableConcept | 投与部位 Binding: JP Core Medication JAMI External Body Site ValueSet (preferred) | |||||
| route |
0..1 | CodeableConcept | Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | |||||
| method |
0..1 | CodeableConcept | 投与方法 Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | |||||
| 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:unitDigit1 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法１桁コード Binding: JP Core Medication JAMI Basic Usage Type ValueSet (preferred) | ||||
| 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:1.2.392.200250.2.2.20.30 | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..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:unitDigit2 |
Σ | 0..1 | Coding | 投与⽅法に対応するJAMI 用法コード表基本用法2桁コード Binding: JP Core Medication JAMI Detail Usage ValueSet (preferred) | ||||
| 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:1.2.392.200250.2.2.20.40 | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..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 | 投与⽅法のテキスト表現 | ||||
| dose |
0..1 | JP_MedicationSimpleQuantity | 用量あたりの投薬量 | |||||
| Slices for rate[x] |
0..1 | 単位時間あたりの用量 Slice: Unordered, Open by type:$this | ||||||
| rateRatio |
Ratio | |||||||
| rateQuantity |
Quantity(SimpleQuantity) | |||||||
| rate[x]:rateRatio |
0..1 | JP_MedicationRatio_DosePerPeriod | Dose quantity per unit of time | |||||
| eventHistory |
0..* | Reference(Provenance) | ライフサイクルで関心のあるイベントのリスト | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Conformance | ValueSet | URI | |||
| MedicationAdministration.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| MedicationAdministration.identifier:rpNumber.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.identifier:rpNumber.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-typefrom the FHIR Standard | ||||
| MedicationAdministration.identifier:requestIdentifier.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.identifier:requestIdentifier.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-typefrom the FHIR Standard | ||||
| MedicationAdministration.identifier:orderInRp.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.identifier:orderInRp.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-typefrom the FHIR Standard | ||||
| MedicationAdministration.status | required | MedicationAdministration Status Codeshttp://hl7.org/fhir/ValueSet/medication-admin-status|4.3.0from the FHIR Standard | ||||
| MedicationAdministration.statusReason | example | SNOMEDCTReasonMedicationNotGivenCodeshttp://hl7.org/fhir/ValueSet/reason-medication-not-given-codesfrom the FHIR Standard | ||||
| MedicationAdministration.category | preferred | MedicationAdministration Category Codeshttp://hl7.org/fhir/ValueSet/medication-admin-categoryfrom the FHIR Standard | ||||
| MedicationAdministration.medication[x] | preferred | JP_MedicationCode_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationCode_VS | ||||
| MedicationAdministration.performer.function | example | MedicationAdministration Performer Function Codeshttp://hl7.org/fhir/ValueSet/med-admin-perform-functionfrom the FHIR Standard | ||||
| MedicationAdministration.reasonCode | example | ReasonMedicationGivenCodeshttp://hl7.org/fhir/ValueSet/reason-medication-given-codesfrom the FHIR Standard | ||||
| MedicationAdministration.dosage.site | preferred | JP_MedicationBodySiteJAMIExternal_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationBodySiteJAMIExternal_VS | ||||
| MedicationAdministration.dosage.route | example | SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codesfrom the FHIR Standard | ||||
| MedicationAdministration.dosage.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesfrom the FHIR Standard | ||||
| MedicationAdministration.dosage.method.coding:unitDigit1 | preferred | JP_MedicationMethodJAMIBasicUsage_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationMethodJAMIBasicUsage_VS | ||||
| MedicationAdministration.dosage.method.coding:unitDigit2 | preferred | JP_MedicationMethodJAMIDetailUsage_VShttp://jpfhir.jp/fhir/core/ValueSet/JP_MedicationMethodJAMIDetailUsage_VS |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where(((id.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-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management : text.`div`.exists() | |
| dom-r4b | warning | MedicationAdministration.contained | Containing 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-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] : dose.exists() or rate.exists() |
This structure is derived from JP_MedicationAdministrationBase
Summary
Mandatory: 3 elements(2 nested mandatory elements)
Fixed: 3 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron
次のデータ項目は必須（データが存在しなければならない）である。
MedicationAdministration リソースは、次の要素を持たなければならない。
completed or stopped に限定される※投与実施のユースケースにおいては、実施投与量(dose)が必須であることが望ましいが、ワーキンググループでの検討の結果、投与中止のユースケースも考慮して必須としない結論となった。
JP Core MedicationAdministration プロファイルで使用される拡張は次の通りである。
| 依頼科 | 依頼科を格納するための拡張 | JP_MedicationAdministration_RequestDepartment | CodeableConcept |
| 依頼日時 | 依頼日時を格納するための拡張 | JP_MedicationAdministration_RequestAuthoredOn | DateTime |
| 実施場所 | 実施場所を格納するための拡張 | JP_MedicationAdministration_Location | Reference(Location) |
| 依頼医 | 依頼医を格納するための拡張 | JP_MedicationAdministration_Requester | Reference(Practitioner) |
HL7 FHIRの基底規格では、薬剤コードをはじめとして、剤形などでSNOMED CTが使われているが、国としてライセンスを取得していない。代替としてJAHIS処方データ交換規約やSS-MIX2で使われている用語集を採用した。
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 | CS名 | URI |
|---|---|---|
| 医薬品 | HOT7 | urn:oid:1.2.392.200119.4.403.2 |
| 医薬品 | HOT9 | urn:oid:1.2.392.200119.4.403.1 |
| 医薬品 | HOT13 | urn:oid:1.2.392.200119.4.402.1 |
| 医薬品 | YJコード | urn:oid:1.2.392.100495.20.1.73 |
| 医薬品 | ⼀般処⽅名マスター | urn:oid:1.2.392.100495.20.1.81 |
| 薬品単位 | MERIT-9(単位） | urn:oid:1.2.392.100495.20.2.101 |
| 力価区分 | 処方情報 HL7FHIR 記述仕様(力価区分) | urn:oid:1.2.392.100495.20.2.22 |
| 用法 | JAMI処方・注射オーダ標準用法規格(用法コード) | urn:oid:1.2.392.200250.2.2.20 |
| 用法 | JAMI処方・注射オーダ標準用法規格(補足用法コード) | urn:oid:1.2.392.200250.2.2.20.22 |
| 部位 | JAMI処方・注射オーダ標準用法規格(部位コード) | urn:oid:1.2.392.200250.2.2.20.32 |
| 投与方法 | JAMI処方・注射オーダ標準用法規格(基本用法区分) | urn:oid:1.2.392.200250.2.2.20.30 |
| 入外区分 | HL7V2(HL7表0482) | http://terminology.hl7.org/CodeSystem/v2-0482 |
MedicationAdministrationリソースでは、依頼元のMedicationRequestリソースをrequest要素にReferenceで参照できるようになっているが、 依頼元のMedicationRequestリソースが取得できないケースも考慮して、依頼情報を直接記述できるように以下の項目を追加した。
また、投薬実施場所（病棟、病室、ベッド番号など）を記述できるように以下の項目を追加した。
| コンフォーマンス | パラメータ | 型 | 例 |
|---|---|---|---|
| SHALL | identifier | token | GET [base]/MedicationAdministration?identifier=http://myhospital.com/fhir/medication|1234567890 |
| SHOULD | patient | reference | GET [base]/MedicationAdministration?patient=123456 |
| SHOULD | patient,effective-time | reference,date | GET [base]/MedicationAdministration?patient=123456&effective-time=eq2013-01-14 |
| MAY | effective-time,code,performer,request | date,token,reference,reference | GET [base]/MedicationAdministration?code=urn:oid:1.2.392.200119.4.403.1|105271807 |
次の検索パラメータは必須でサポートされなければならない。
identifier 検索パラメータを使用して、オーダIDなどの識別子によるMedicationAdministrationの検索をサポートしなければならない（SHALL）
GET [base]/MedicationAdministration?identifier={system|}[token]
例：
GET [base]/MedicationAdministration?identifier=http://myhospital.com/fhir/medication|1234567890
指定された識別子に一致するMedicationAdministrationリソースを含むBundleを検索する。
次の検索パラメータをサポートすることが望ましい。
patient 検索パラメータを使用して、患者のリファレンス情報によるMedicationAdministrationの検索をサポートすることが望ましい（SHOULD）
GET [base]/MedicationAdministration?patient=[id]
GET [base]/MedicationAdministration?patient=[url]
例：
GET [base]/MedicationAdministration?patient=123456
リソースIDが123456の患者のMedicationAdministrationリソースを含むBundleを検索する。
patient,effective-time 検索パラメータを使用して、患者のリファレンス情報と払い出し日によるMedicationAdministrationの検索をサポートすることが望ましい（SHOULD）
GET [base]/MedicationAdministration?patient=[id]&effective-time=[date]
GET [base]/MedicationAdministration?patient=[url]&effective-time=[date]
例：
GET [base]/MedicationAdministration?patient=123456&effective-time=eq2013-01-14
リソースIDが123456の患者の2013-01-14に投与実施されたMedicationAdministrationリソースを含むBundleを検索する。
追加検索パラメータは定義しない。
JP MedicationAdministration リソースに対して使用される操作は次の通りである。
$everything：[base]/MedicationAdministration/[id]/$everything
この操作は、この操作が呼び出された特定のMedicationAdministrationリソースに関連する全ての情報を返す。応答は "searchset" タイプのBundleリソースである。サーバは、少なくとも、識別されたMedicationAdministrationコンパートメントに含まれる全てのリソースと、それらから参照されるすべてのリソースを返すことが望ましい。
この操作の公式なURLは以下である。
http://hl7.jp/fhir/OperationDefinition/MedicationAdministration-everything
URL: [base]/MedicationAdministration/[id]/$everything
本操作は、べき等な操作である。
| 名前 | 多重度 | 型 | 説明 |
|---|---|---|---|
| start | 0..1 | date | 特定の日付範囲で提供されたケアに関連する全ての記録を意味する。開始日が指定されていない場合、終了日以前のすべてのレコードが対象に含まれる。 |
| end | 0..1 | date | 特定の日付範囲で提供されたケアに関連する全ての記録を意味する。終了日が指定されていない場合、開始日以降のすべてのレコードが対象に含まれる。 |
| _since | 0..1 | instant | 指定された日時以降に更新されたリソースのみが応答に含まれる。 |
| _type | 0..* | code | 応答に含むFHIRリソース型を、カンマ区切りで指定する。指定されない場合は、サーバは全てのリソース型を対象とする。 |
| _count | 0..1 | integer | Bundleの1ページに含まれるリソース件数を指定。 |
| 名前 | 多重度 | 型 | 説明 |
|---|---|---|---|
| return | 1..1 | Bundle | バンドルのタイプは"searchset"である。この操作の結果は、リソースとして直接返される。 |
リクエスト：単一のMedicationAdministrationに関連する全てのリソースを取得する。
GET [base]/MedicationAdministration/1234567890/$everything
[some headers]
レスポンス：指定されたMedicationAdministrationに関連する全てのリソースを返す。
HTTP/1.1 200 OK
[other headers]
{
"resourceType": "Bundle",
"id": "example",
"meta": {
"lastUpdated": "2014-08-18T01:43:33Z"
},
"type": "searchset",
"entry": [
{
"fullUrl": "http://example.org/fhir/MedicationAdministration/1234567890",
"resource": {
"resourceType": "MedicationAdministration",
・・・
},
}
]
}
JAHIS処方データ交換規約 Ver.3.0Cの137ページに記載されている下記の処方実施をFHIRで表現する場合のサンプルを示す。
MedicationAdministrationは薬剤をCodeableConceptとして1つまでしか持つか、Medication Resourceのreferenceをもつことしかできない。 したがって、複数の薬剤を同一のRp番号で表現する場合にはMedicationAdministrationを繰り返すか、複数の薬剤をまとめたMedication Resourceのインスタンスを参照することとなる。 ワーキンググループでの検討の結果、冗長とはなるがidentifierにRp番号と薬剤番号を記録することとし、MedicationAdministrationを繰り返すことで表現する方法を推奨することとした。
基本的にはMedicationRequestに対応したMedicationAdministrationインスタンスを生成する。 ただし、内服薬剤処方のMedicationRequestは複数回、複数日の服薬タイミングをまとめて1つのインスタンスで記述するが、MedicationAdministrationは1回の服薬単位の粒度でインスタンスを生成する必要がある。 例えば、MedicationRequestの用法、投与日数が「１日３回 朝昼夕食後 １４日分」の場合、3 x 14 = 42 (x 薬剤数) の処方実施情報インスタンスが生成される。
投与が実施された場合、status要素に completed を記述する。
"status": "completed"
投与が実施された日時をeffectiveDateTime or effectivePeriod要素にRFC3339形式で記述する。 タイムゾーンはJST(+09:00)を指定する。
開始日時、終了日時が明確である場合はeffectivePeriodに記述する。
"effectivePeriod": {
"start": "2016-07-01T08:05:21+09:00",
"end": "2016-07-01T13:05:43+09:00"
}
開始日時しか存在せず終了日時が明確でない場合、effectivePeriodのstartとendに同じ値を記述するか、effectiveDateTime要素に記述する。
"effectiveDateTime": "2016-08-25T08:30:00+09:00"
投与を実施した医療従事者（自己管理の場合は患者）をperformer要素に記述する。
performer.functionには、FHIR標準のValueSetである http://terminology.hl7.org/CodeSystem/med-admin-perform-function から、実施者を表す performer を固定で記述する。
performer.actorには、医療従事者(Practitioner)、または患者(Patient)リソースの参照を記述する。
"performer": [
{
"function": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/med-admin-perform-function",
"code": "performer",
"display": "Performer"
}
]
},
"actor": {
"reference": "Practitioner/1",
"display": "看護師 夏子"
}
}
]
投与を実施した場所（病棟、病室、ベッド番号など）を、拡張「JP_MedicationAdministrationLocation」を使用して、Reference型でLocationリソースの参照情報を記述する。 (Location Resourceの記述仕様については、当プロファイルのスコープ外とする)
"extension": [
{
"url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministrationLocation",
"valueReference": {
"reference": "Location/1"
}
}
]
「1:内服」、「2:外用」などJAMI標準用法コードにて基本用法区分として表現される区分は、dosage.route 要素にコードまたは文字列で指定する。基本用法区分を識別するURIとして、"urn:oid:1.2.392.200250.2.2.20.30"を使用する。
「A:貼付」、「B:塗布」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は、dosage.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:1.2.392.200250.2.2.20.40"を使用する。
投与量は dosage.dose に、SimpleQuantity型で記録する。単位コードには、医薬品単位略号を使用する。
"dosage": {
"route": {
"coding": [
{
"system": "urn:oid:1.2.392.200250.2.2.20.40",
"code": "10",
"display": "経口"
}
]
},
"method": {
"coding": [
{
"system": "urn:oid:1.2.392.200250.2.2.20.30",
"code": "1",
"display": "内服"
}
]
},
"dose": {
"value": 1,
"unit": "錠",
"system": "urn:oid:1.2.392.100495.20.2.101",
"code": "TAB"
}
}
実施の元となった投薬依頼(MedicationRequest)リソースの参照を記述する。
"request": {
"reference": "MedicationRequest/1"
}
投薬依頼を行なった診療科を、拡張「JP_MedicationAdministration_RequestDepartment」を使用して、CodeableConcept型で記述する。
{
"resourceType": "MedicationAdministration",
"extension": [
{
"url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministration_RequestDepartment",
"valueCodeableConcept": {
"coding": [
{
"system": "urn:oid:1.2.392.200250.2.2.2",
"code": "01",
"display": "内科"
}
]
}
}
]
}
投薬依頼を行なった医師を、拡張「JP_MedicationAdministrationRequester」を使用して、Reference型でPractitionerリソースの参照情報を記述する。 (Practitioner Resourceの記述仕様については、当プロファイルのスコープ外とする)
{
"resourceType": "MedicationAdministration",
"extension": [
{
"url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministrationRequester",
"valueReference": {
"reference": "Practitioner/2"
}
}
]
}
投薬実施の基となった薬剤処方の用法などの情報は、特に記述のない限り JP Core MedicationRequest と同様の記述方法とする。該当する項目としては以下のものがある。
投薬依頼を行なった日時を、拡張「JP_MedicationAdministrationRequestAuthoredOn」を使用して、RFC3339形式で記述する。 タイムゾーンはJST(+09:00)を指定する。
{
"resourceType": "MedicationAdministration",
"extension": [
{
"url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_MedicationAdministrationRequestAuthoredOn",
"valueDateTime": "2016-08-20T09:30:00+09:00"
}
]
}
投与が中止された場合、status要素に stopped を記述する。
"status": "stopped"
投与を実施する予定であった日時をeffectiveDateTime要素にRFC3339形式で記述する。 タイムゾーンはJST(+09:00)を指定する。
"effectiveDateTime": "2016-08-25T08:30:00+09:00"
投与実施と同様