HL7 FHIR JP Core ImplementationGuide
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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

Data Type Profile: JP_MedicationDosage - Detailed Descriptions

Active as of 2023-10-31

Definitions for the jp-medicationdosage data type profile.

Guidance on how to interpret the contents of this table can be found here

0. Dosage
Definition

薬の服用方法・服用した方法、または服用すべき方法


Indicates how the medication is/was taken or should be taken by the patient.

Short薬の服用方法・服用した方法、または服用すべき方法How the medication is/was taken or should be taken
Control0..*
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
2. Dosage.extension:periodOfUse
Slice NameperiodOfUse
Definition

MedicationRequestの投与期間の開始日を明示するための拡張

Short投与期間の開始日を明示するための拡張
Control0..1
TypeExtension(JP Core Medication Dosage PeriodOfUse Extension) (Extension Type: Period)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
4. Dosage.extension:usageDuration
Slice NameusageDuration
Definition

隔日投与などで実投与日数と処方期間が異なる場合に用いられる。

Short実投与日数
Control0..1
TypeExtension(JP Core Medication Dosage UsageDuration Extension) (Extension Type: Duration)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Dosage.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

Guidance on how to interpret the contents of this table can be found here

0. Dosage
2. Dosage.extension:periodOfUse
Slice NameperiodOfUse
Control0..1
TypeExtension(JP Core Medication Dosage PeriodOfUse Extension) (Extension Type: Period)
4. Dosage.extension:usageDuration
Slice NameusageDuration
Control0..1
TypeExtension(JP Core Medication Dosage UsageDuration Extension) (Extension Type: Duration)
6. Dosage.timing
8. Dosage.timing.repeat
10. Dosage.timing.repeat.bounds[x]
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
SlicingThis element introduces a set of slices on Dosage.timing.repeat.bounds[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 12. Dosage.timing.repeat.bounds[x]:boundsDuration
    Slice NameboundsDuration
    Control0..1
    TypeDuration
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    14. Dosage.timing.repeat.bounds[x]:boundsDuration.value
    Definition

    投薬日数

    Short投薬日数
    16. Dosage.timing.repeat.bounds[x]:boundsDuration.unit
    Definition

    投薬日数の単位文字列。日で固定される

    Short投薬日数の単位
    Fixed Value
    18. Dosage.timing.repeat.bounds[x]:boundsDuration.system
    Definition

    単位コード UCUMを識別するURI。固定値。

    ShortUCUM
    Fixed Valuehttp://unitsofmeasure.org
    20. Dosage.timing.repeat.bounds[x]:boundsDuration.code
    Definition

    単位コードUCUMにおける投与日数の単位。dで固定される。

    Short投与日数の単位
    Fixed Valued
    22. Dosage.timing.code
    Comments

    BIDなどは「施設特有の時間」として定義される。たとえば、施設がBIDを「つねに朝7時と夕方6時」であると指定することがある。この指定が不適切であれば、BIDというコードは使うべきではない。その代わり、HL7が定義したBIDのコードではなく、その施設特有のコードで明示的に示すべきであり、構造化された表現を使うべきである(この場合、2回のイベントの時刻を指定する必要がある)。
    【JP Core仕様】JAMI標準用法コード(16桁)を使用することが望ましいが、ローカルコードも使用可能。

    BindingThe codes SHOULD be taken from JP Core Medication JAMI Usage ValueSet
    (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationUsageJAMI_VS)
    24. Dosage.doseAndRate
    26. Dosage.doseAndRate.dose[x]
    Definition

    1回投与量

    Short1回投与量
    Comments

    この量は指定された薬剤の量を指定するものであって、各有効成分の量を指定するものではない。各成分の量はMedication resourceで伝えることができる。たとえば、有効成分が375mgである錠剤を1錠投与することを伝えたい場合、Medication resourceを利用して、XYZ成分が375mg含有しているという錠剤であることを文書化することができる。あるいは1回投与量が375mgであることを伝えるのであれば、Medication resourceをつかって単にそれが錠剤であることを示せばよい。もし、ドーパミンの静注を例に挙げて、400mgのドーパミンを500mlの注射溶液に混ぜて使うことを伝えたいのであれば、それをすべてMedication resourceで伝えることができる。もし、投与について即時に伝達することを意図していない(たとえば投与速度が示されていたり、投与時期に範囲があるような場合)のであれば、たとえば1回500mlを4時間以上かけて投与する予定を伝える場合にもMedication resourceで伝えることができる。
    【JP Core仕様】1回の投与量を指定する。単位は医薬品単位略号を使用することが望ましい。

    TypeQuantity(JP Core Medication Quantity DataType)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    28. Dosage.doseAndRate.rate[x]
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on Dosage.doseAndRate.rate[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 30. Dosage.doseAndRate.rate[x]:rateRatio
      Slice NamerateRatio
      Control0..1
      TypeRatio(JP Core Medication Rate Ratio DosePerDay DataType)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      32. Dosage.doseAndRate.rate[x]:rateRange
      Slice NamerateRange
      Control0..1
      TypeRange(JP Core Medication Range DataType)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      34. Dosage.doseAndRate.rate[x]:rateQuantity
      Slice NamerateQuantity
      Definition

      投与速度(量/時間)を指定する

      Short投与速度(量/時間)を指定する
      Control0..1
      TypeQuantity(SimpleQuantity)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]

      Guidance on how to interpret the contents of this table can be found here

      0. Dosage
      Definition

      薬の服用方法・服用した方法、または服用すべき方法

      Short薬の服用方法・服用した方法、または服用すべき方法
      Control0..*
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      2. Dosage.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      4. Dosage.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Dosage.extension:periodOfUse
        Slice NameperiodOfUse
        Definition

        MedicationRequestの投与期間の開始日を明示するための拡張

        Short投与期間の開始日を明示するための拡張
        Control0..1
        TypeExtension(JP Core Medication Dosage PeriodOfUse Extension) (Extension Type: Period)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. Dosage.extension:usageDuration
        Slice NameusageDuration
        Definition

        隔日投与などで実投与日数と処方期間が異なる場合に用いられる。

        Short実投与日数
        Control0..1
        TypeExtension(JP Core Medication Dosage UsageDuration Extension) (Extension Type: Duration)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. Dosage.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. Dosage.sequence
        Definition

        どの服用指示を適応するか判断するかについての順序を示したもの

        Short服用指示の順番
        Comments

        32 bitの数値。これ以上の値であれば10進数を使うこと。

        Control0..1
        Typeinteger
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        もし、複数の服用法(Dosage)でsequenceの数値が同じであれば、その指示が同時に扱われることを示している。sequenceの数値が異なれば、服用指示(Dosage)の順番を意図している。

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. Dosage.text
        Definition

        投与⽅法のテキスト表現。コードで指定できない場合、本要素で文字列として指定してもよい。

        Short投与⽅法のテキスト表現
        Comments

        textエレメントはcodingのdisplayNameエレメントと一致することがよくある。

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        ターミノロジ由来のコードは必ずしも人間が使う言葉の全てのニュアンスを含めた正確な意味を捉えているわけではなく、適切なコードが見つからない場合もある。そのような場合でもtextエレメントは元々の意味のすべてを捉えるために使うことができる。

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Dosage.additionalInstruction
        Definition

        どのように薬剤を内服するかについての患者への補足指示(たとえば、「食事と一緒に」や「30分から1時間前に内服」)や薬剤についての注意書き(たとえば、「眠くなることがある」や「日光や紫外線が皮膚にあたららないようにすること」)

        Short患者に対する補足指示や注意。たとえば、「食事と一緒に」「眠くなることがある」
        Comments

        薬剤投与や調剤についての情報(たとえば、「腹膜内ポートに可能な限り迅速に注入」や「薬剤Xの直後に」)であり、dosage.textにも複製されるべきである。

        Control0..*
        BindingThe codes SHOULD be taken from JP Core Medication JAMI Additional Usage ValueSet
        (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationUsageJAMIAdditional_VS)
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        補足指示はコード化されるように意図されているが、コードがない場合はエレメントはテキストだけで表現することができる。たとえば、「大量の水で服用する」という指示はコード化されていることもあれば、されていないことおある。

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Dosage.patientInstruction
        Definition

        患者あるいは消費者に理解してもらうための指示。

        Short患者あるいは消費者向けの指示
        Comments

        FHIRの文字列は1MB以上の大きさとなってなはらない(SHALL NOT)。

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Dosage.timing
        Definition

        When medication should be administered.

        ShortWhen medication should be administered
        Comments

        This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

        Control0..1
        TypeTiming(JP Core Medication Timing DataType)
        Is Modifierfalse
        Summarytrue
        Requirements

        The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Dosage.timing.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typeid
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        24. Dosage.timing.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Dosage.timing.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 26. Dosage.timing.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          28. Dosage.timing.event
          Definition

          服用タイミングを具体的な日時で指定する場合に使用する

          Short服用もしくは注射を行なうタイミングを示す時刻
          Control0..*
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Dosage.timing.repeat
          Definition

          イベントがスケジュールされたルールについての記述。

          Shortイベントが発生する時刻
          Control0..1
          TypeElement
          Is Modifierfalse
          Summarytrue
          Requirements

          スケジュールされたタイミングの多くは規則的な繰り返しで決定されている。

          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
          tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
          tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
          tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
          tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
          tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
          tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
          tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
          tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
          32. Dosage.timing.repeat.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          34. Dosage.timing.repeat.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Dosage.timing.repeat.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 36. Dosage.timing.repeat.bounds[x]
            Definition

            服用・注射開始日から服用・注射終了日までの全日数。実投与日数ではないことに注意する。

            Short服用・注射開始日から服用・注射終了日までの全日数
            Control0..1
            TypeChoice of: Duration, Range, Period
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Dosage.timing.repeat.bounds[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 38. Dosage.timing.repeat.bounds[x]:boundsDuration
              Slice NameboundsDuration
              Definition

              服用・注射開始日から服用・注射終了日までの全日数。実投与日数ではないことに注意する。

              Short服用・注射開始日から服用・注射終了日までの全日数
              Control0..1
              TypeDuration
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. Dosage.timing.repeat.bounds[x]:boundsDuration.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              42. Dosage.timing.repeat.bounds[x]:boundsDuration.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Dosage.timing.repeat.bounds[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 44. Dosage.timing.repeat.bounds[x]:boundsDuration.value
                Definition

                投薬日数

                Short投薬日数
                Comments

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

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Precision is handled implicitly in almost all cases of measurement.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. Dosage.timing.repeat.bounds[x]:boundsDuration.comparator
                Definition

                How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                Short< | <= | >= | > - how to understand the value
                Control0..1
                BindingThe codes SHALL be taken from QuantityComparator
                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.3.0)
                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                Meaning if MissingIf there is no comparator, then there is no modification of the value
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                48. Dosage.timing.repeat.bounds[x]:boundsDuration.unit
                Definition

                投薬日数の単位文字列。日で固定される

                Short投薬日数の単位
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

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

                Fixed Value
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                50. Dosage.timing.repeat.bounds[x]:boundsDuration.system
                Definition

                単位コード UCUMを識別するURI。固定値。

                ShortUCUM
                Control0..1
                This element is affected by the following invariants: qty-3
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

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

                Fixed Valuehttp://unitsofmeasure.org
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                52. Dosage.timing.repeat.bounds[x]:boundsDuration.code
                Definition

                単位コードUCUMにおける投与日数の単位。dで固定される。

                Short投与日数の単位
                Comments

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

                Control0..1
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

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

                Fixed Valued
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                54. Dosage.timing.repeat.count
                Definition

                Timing仕様の全てにおいて、特定の期間に繰り返されるように指定された総回数。もし、countMaxが設定されていれば、このエレメントは許容される最低限度の回数を示す。

                Short繰り返し服用もしくは注射回数
                Comments

                回数に上限、下限の範囲がある場合は、このcountで示される回数が起きるまでは、エレメントは範囲の中にあると解釈されるべきである。

                Control0..1
                TypepositiveInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Repetitions may be limited by end time or total occurrences.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. Dosage.timing.repeat.countMax
                Definition

                このエレメントが設定されている場合は、回数に範囲があることを示している。したがって、[count]から[countmax]までの回数で繰り返される。

                Short繰り返しの最大回数
                Comments

                32bit整数。もし、値がこれを超える場合はdecimalで記録される。

                Control0..1
                TypepositiveInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                58. Dosage.timing.repeat.duration
                Definition

                投与されるタイミングが発生している時間。もし、durationMaxが設定されていれば、このエレメントは許容される継続時間の下限を示す。

                Short継続時間
                Comments

                継続時間はイベントの定義の一部(たとえば、静脈注射(IV)では特定の量と速度が明示される)として示されることがある。その他、Timing仕様の一部(たとえば、運動)として示されることもある。

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                アクティビティによっては即時的なものではなく、その期間において維持される必要がある。

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. Dosage.timing.repeat.durationMax
                Definition

                もし、このエレメントに値が設定されていれば、durationには範囲があることを示している。したがって、[duration]から[durationMax]までの継続時間の範囲で投与される。

                Short継続時間(最大値)
                Comments

                継続時間はイベントの定義の一部(たとえば、静脈注射(IV)では特定の量と速度が明示される)として示されることがある。その他、Timing仕様の一部(たとえば、運動)として示されることもある。

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                アクティビティによっては即時的なものではなく、その期間において維持される必要がある。

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. Dosage.timing.repeat.durationUnit
                Definition

                UCUM単位で表される継続時間についての単位。

                Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                Comments

                FHIRの文字列は1MB以上の大きさとなってなはらない(SHALL NOT)。

                Control0..1
                BindingThe codes SHALL be taken from UnitsOfTime
                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.3.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. Dosage.timing.repeat.frequency
                Definition

                特定の期間に繰り返して発生した行為の回数。もし、frequencyMaxが設定されていれば、このエレメントはfrequencyとして認められた下限を示す。

                Short期間内にイベントが発生する回数、頻度
                Comments

                32ビットの数値。もし、値がそれを上回るようであればdecimalを使用する。

                Control0..1
                TypepositiveInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. Dosage.timing.repeat.frequencyMax
                Definition

                このエレメントに値が設定されていれば、frequencyには範囲が指定されている。つまり、期間あるいは期間の範囲内に[frequency]から[frequencyMax]回繰り返されることを示している。

                Short期間内にイベントが発生する最大回数、最大頻度
                Comments

                32ビットの数値。もし、値がそれを上回るようであればdecimalを使用する。

                Control0..1
                TypepositiveInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. Dosage.timing.repeat.period
                Definition

                繰り返し投与が行われる期間を示す。たとえば、「1日3回」であれば、3は繰り返しの頻度(frequency)であり、「1日」が期間(period)である。もし、periodMaxに値が設定されていれば、このエレメントは期間として認められた範囲の下限を示す。

                Shortイベントが発生する頻度に対応する期間
                Comments

                IEEEの浮動小数点型を使わずに、小数点も含むdecimal型のようなものを利用すること(たとえばJavaのBigInteger)。

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                70. Dosage.timing.repeat.periodMax
                Definition

                もし、この値が設定されていれば、期間は[period]から[periodMax]までであることを示し、「3-5日に1回投与」のような表現が認められる。

                Short期間の上限(3-4時間)
                Comments

                IEEEの浮動小数点型を使わずに、小数点の制度も示すdecimal型のようなものを利用すること(たとえばJavaのBigInteger)。

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. Dosage.timing.repeat.periodUnit
                Definition

                期間を表すUCUM単位。

                Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                Comments

                FHIRの文字列は1MB以上の大きさとなってなはらない(SHALL NOT)。

                Control0..1
                BindingThe codes SHALL be taken from UnitsOfTime
                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.3.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. Dosage.timing.repeat.dayOfWeek
                Definition

                期間として1週間以上が指定されていれば、指定された曜日のみで投与が行われる。

                Shortmon | tue | wed | thu | fri | sat | sun
                Comments

                曜日が指定されていなければ、他に指定された日には毎日投与されると想定される。frequencyとperiodエレメントはdayOfWeekと同じように使うことはできない。

                Control0..*
                BindingThe codes SHALL be taken from DaysOfWeek
                (required to http://hl7.org/fhir/ValueSet/days-of-week|4.3.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. Dosage.timing.repeat.timeOfDay
                Definition

                一日の間で指定された投与される時刻。

                Short一日の間で投与される時刻
                Comments

                もし、このtimeOfDayに値が指定されていれば、毎日(daysOfWeekでフィルタされた曜日の)指定された時刻に投与されると推定される。whenやfrequency, periodエレメントはtimeOfDayとは同様に使うことはできない。

                Control0..*
                Typetime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. Dosage.timing.repeat.when
                Definition

                一日の間のおおよその時間帯で投与すべきタイミングを示す。日常のイベントに関連付けられていることもある。

                Short投薬期間についてのコード
                Comments

                一つ以上のイベントが記載されている場合、そのイベントは特定のイベントの組み合わせと結びついている。

                Control0..*
                BindingThe codes SHALL be taken from EventTiming
                (required to http://hl7.org/fhir/ValueSet/event-timing|4.3.0)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                タイミングはしばしば起床や食事、睡眠などのできごとによってしばしば決定されている。

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                80. Dosage.timing.repeat.offset
                Definition

                イベントからの時間(分)。もし、分で示される時間がイベントのコードが前か後かを示していない場合、offsetはイベントの後であることが想定される。

                Shortイベントからの時間(分、前後)
                Comments

                32ビットの数値。もし、値がそれを上回るようであればdecimalを使用する。

                Control0..1
                TypeunsignedInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                82. Dosage.timing.code
                Definition

                スケジュール上のタイミングを表すコード(あるいはcode.text内のテキスト)。BID(1日2回)のようなコードはどこにでもあるが、多くの医療機関は付加的なコードを定義している。もし、コードが示されていれば、構造化されたタイミングで完全に示されたデータであると解釈され、コードまたはTimingを解釈するためのデータであると解釈される。しかし、例外的に.repeat.bounds(コードは含まれない)はコードを上書きして適用される。

                ShortBID | TID | QID | AM | PM | QD | QOD | +
                Comments

                BIDなどは「施設特有の時間」として定義される。たとえば、施設がBIDを「つねに朝7時と夕方6時」であると指定することがある。この指定が不適切であれば、BIDというコードは使うべきではない。その代わり、HL7が定義したBIDのコードではなく、その施設特有のコードで明示的に示すべきであり、構造化された表現を使うべきである(この場合、2回のイベントの時刻を指定する必要がある)。
                【JP Core仕様】JAMI標準用法コード(16桁)を使用することが望ましいが、ローカルコードも使用可能。

                Control0..1
                BindingThe codes SHOULD be taken from JP Core Medication JAMI Usage ValueSet
                (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationUsageJAMI_VS)
                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. Dosage.asNeeded[x]
                Definition

                【JP Core仕様】頓用型の用法を指定する場合に”true”を指定し、そのコードを指定する場合は用法コードとして指定する。
                Medication(薬剤)が必要なときに指定された量とスケジュールのみで投薬するか(Booleanで選択される)、投薬する前提条件はTiming.Code(CodeableConcept)を示している。

                Short「頓用」指示
                Comments

                Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                Control0..1
                Typeboolean
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. Dosage.site
                Definition

                投与される身体部位。外用薬で部位を指定する場合に使用する。

                Short投与される身体部位
                Comments

                もし、BodySite resourceの属性が必要な場合(たとえば、部位の指定や別々に投与経路を設定する場合)は、bodySiteの標準拡張を使うこと。要約コードや非常に正確な位置の定義へのreferenceを使用することもできる。
                【JP Core仕様】JAMI外用部位3桁コードを使用することが望ましいが、ローカルコードも使用可能。

                Control0..1
                BindingThe codes SHOULD be taken from JP Core Medication JAMI External Body Site ValueSet
                (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationBodySiteJAMIExternal_VS)
                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. Dosage.route
                Definition

                投与経路

                Short投与経路
                Comments

                投与経路の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。
                【JP Core仕様】HL7表0162をベースにした投与経路コードを使用することが望ましいが、ローカルコードも使用可能。

                Control0..1
                BindingThe codes SHOULD be taken from JP Core Medication HL70162-based Route ValueSet
                (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationRouteHL70162_VS)
                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                90. Dosage.method
                Definition

                投与方法

                Short投与方法
                Comments

                ターミノロジは投与する経路あるいは剤型をあらかじめ指定するために用いられる。

                Control0..1
                BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                (example to http://hl7.org/fhir/ValueSet/administration-method-codes)
                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

                コード化された値は体内に薬剤が投与される方法を示している。注射ではよく使われる。たとえば、緩徐に注入、深部に静注など。

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                92. Dosage.method.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                94. Dosage.method.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Dosage.method.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 96. Dosage.method.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Dosage.method.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ system
                  • 98. Dosage.method.coding:unitDigit1
                    Slice NameunitDigit1
                    Definition

                    投与⽅法に対応するJAMI 用法コード表基本用法1桁コードを識別するURI。

                    Short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
                    Comments

                    コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

                    Control0..1
                    BindingThe codes SHOULD be taken from JP Core Medication JAMI Basic Usage Type ValueSet
                    (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationMethodJAMIBasicUsage_VS)
                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    100. Dosage.method.coding:unitDigit1.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    102. Dosage.method.coding:unitDigit1.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Dosage.method.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 104. Dosage.method.coding:unitDigit1.system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Fixed Valueurn:oid:1.2.392.200250.2.2.20.30
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      106. Dosage.method.coding:unitDigit1.version
                      Definition

                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                      ShortVersion of the system - if relevant
                      Comments

                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                      NoteThis is a business version Id, not a resource version Id (see discussion)
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. Dosage.method.coding:unitDigit1.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control0..1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      110. Dosage.method.coding:unitDigit1.display
                      Definition

                      A representation of the meaning of the code in the system, following the rules of the system.

                      ShortRepresentation defined by the system
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      112. Dosage.method.coding:unitDigit1.userSelected
                      Definition

                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                      ShortIf this coding was chosen directly by the user
                      Comments

                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                      Control0..1
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      114. Dosage.method.coding:unitDigit2
                      Slice NameunitDigit2
                      Definition

                      投与⽅法に対応するJAMI 用法コード表基本用法2桁コードを識別するURI。2桁コードurn:oid:1.2.392.200250.2.2.20.40

                      Short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
                      Comments

                      コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

                      Control0..1
                      BindingThe codes SHOULD be taken from JP Core Medication JAMI Detail Usage ValueSet
                      (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationMethodJAMIDetailUsage_VS)
                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      116. Dosage.method.coding:unitDigit2.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typeid
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      118. Dosage.method.coding:unitDigit2.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Dosage.method.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 120. Dosage.method.coding:unitDigit2.system
                        Definition

                        The identification of the code system that defines the meaning of the symbol in the code.

                        ShortIdentity of the terminology system
                        Comments

                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to be unambiguous about the source of the definition of the symbol.

                        Fixed Valueurn:oid:1.2.392.200250.2.2.20.40
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        122. Dosage.method.coding:unitDigit2.version
                        Definition

                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                        ShortVersion of the system - if relevant
                        Comments

                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                        NoteThis is a business version Id, not a resource version Id (see discussion)
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        124. Dosage.method.coding:unitDigit2.code
                        Definition

                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                        ShortSymbol in syntax defined by the system
                        Control0..1
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to refer to a particular code in the system.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        126. Dosage.method.coding:unitDigit2.display
                        Definition

                        A representation of the meaning of the code in the system, following the rules of the system.

                        ShortRepresentation defined by the system
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        128. Dosage.method.coding:unitDigit2.userSelected
                        Definition

                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                        ShortIf this coding was chosen directly by the user
                        Comments

                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                        Control0..1
                        Typeboolean
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        130. Dosage.method.text
                        Definition

                        投与⽅法のテキスト表現。コードで指定できない場合、本要素で文字列として指定してもよい。

                        Short投与⽅法のテキスト表現
                        Comments

                        textエレメントはcodingのdisplayNameエレメントと一致することがよくある。

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        ターミノロジ由来のコードは必ずしも人間が使う言葉の全てのニュアンスを含めた正確な意味を捉えているわけではなく、適切なコードが見つからない場合もある。そのような場合でもtextエレメントは元々の意味のすべてを捉えるために使うことができる。

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        132. Dosage.doseAndRate
                        Definition

                        薬剤が投与される量

                        Short薬剤の投与量
                        Control0..*
                        TypeElement
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                        134. Dosage.doseAndRate.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        136. Dosage.doseAndRate.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 138. Dosage.doseAndRate.type
                          Definition

                          力価区分

                          Short力価区分
                          Comments

                          投与速度・量の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。

                          Control0..1
                          BindingThe codes SHOULD be taken from JP Core Medication IngredientStrength StrengthType ValueSet
                          (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationIngredientStrengthStrengthType_VS)
                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          このtypeに値が指定されていなければ、"ordered"であることが想定される。

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          140. Dosage.doseAndRate.dose[x]
                          Definition

                          1回投与量

                          Short1回投与量
                          Comments

                          この量は指定された薬剤の量を指定するものであって、各有効成分の量を指定するものではない。各成分の量はMedication resourceで伝えることができる。たとえば、有効成分が375mgである錠剤を1錠投与することを伝えたい場合、Medication resourceを利用して、XYZ成分が375mg含有しているという錠剤であることを文書化することができる。あるいは1回投与量が375mgであることを伝えるのであれば、Medication resourceをつかって単にそれが錠剤であることを示せばよい。もし、ドーパミンの静注を例に挙げて、400mgのドーパミンを500mlの注射溶液に混ぜて使うことを伝えたいのであれば、それをすべてMedication resourceで伝えることができる。もし、投与について即時に伝達することを意図していない(たとえば投与速度が示されていたり、投与時期に範囲があるような場合)のであれば、たとえば1回500mlを4時間以上かけて投与する予定を伝える場合にもMedication resourceで伝えることができる。
                          【JP Core仕様】1回の投与量を指定する。単位は医薬品単位略号を使用することが望ましい。

                          Control0..1
                          TypeQuantity(JP Core Medication Quantity DataType)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          The amount of therapeutic or other substance given at one administration event.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          142. Dosage.doseAndRate.rate[x]
                          Definition

                          薬剤が投与される量の速度

                          Short薬剤の投与量速度
                          Comments

                          It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                          It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                          Control0..1
                          TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Dosage.doseAndRate.rate[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 144. Dosage.doseAndRate.rate[x]:rateRatio
                            Slice NamerateRatio
                            Definition

                            薬剤が投与される量の速度

                            Short薬剤の投与量速度
                            Comments

                            It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                            It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                            Control0..1
                            TypeRatio(JP Core Medication Rate Ratio DosePerDay DataType)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            146. Dosage.doseAndRate.rate[x]:rateRange
                            Slice NamerateRange
                            Definition

                            薬剤が投与される量の速度

                            Short薬剤の投与量速度
                            Comments

                            It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                            It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                            Control0..1
                            TypeRange(JP Core Medication Range DataType)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            148. Dosage.doseAndRate.rate[x]:rateQuantity
                            Slice NamerateQuantity
                            Definition

                            投与速度(量/時間)を指定する

                            Short投与速度(量/時間)を指定する
                            Comments

                            It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                            It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                            Control0..1
                            TypeQuantity(SimpleQuantity)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            150. Dosage.maxDosePerPeriod
                            Definition

                            単位時間当たりの投薬量の上限

                            Short単位時間当たりの投薬量の上限
                            Comments

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

                            Control0..1
                            TypeRatio(JP Core Medication Rate Ratio DataType)
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            152. Dosage.maxDosePerAdministration
                            Definition

                            1回あたりの投薬量の上限

                            Short1回あたりの投薬量の上限
                            Comments

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

                            Control0..1
                            TypeQuantity(JP Core Medication Quantity DataType)
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            154. Dosage.maxDosePerLifetime
                            Definition

                            生涯の投薬量の上限

                            Short生涯の投薬量の上限
                            Control0..1
                            TypeQuantity(JP Core Medication Quantity DataType)
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            本実装ガイドへのご質問・ご指摘については、GitHub IssueおよびGitHub PullRequestにて受け付けております。