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

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

Data Type Profile: JP_MedicationDosage_Injection - Detailed Descriptions

Active as of 2023-10-31

Definitions for the jp-medicationdosage-injection 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:dosageComment
Slice NamedosageComment
Definition

用法コメントを格納するための拡張

Short用法コメント
Control0..*
TypeExtension(JP Core Medication Dosage DosageComment Extension) (Extension Type: Choice of: string, CodeableConcept)
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:device
Slice Namedevice
Definition

投与装置を格納する拡張

Short投与装置
Control0..*
TypeExtension(JP Core Medication Dosage Device Extension) (Extension Type: Reference(Device))
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.extension:line
Slice Nameline
Definition

指示ラインを格納する拡張

Short指示ライン
Control0..*
TypeExtension(JP Core Medication Dosage Line Extension) (Extension Type: CodeableConcept)
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:lineComment
Slice NamelineComment
Definition

ラインコメントを格納するための拡張

Shortラインコメント
Control0..*
TypeExtension(JP Core Medication Dosage LineComment Extension) (Extension Type: Choice of: string, CodeableConcept)
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.timing
Definition

投与タイミングを記録する。


When medication should be administered.

Short投与タイミングWhen 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()))
14. 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())
16. 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。


A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

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】頓用指示時にはJAMI処方・注射オーダ標準用法規格の表6 イベント区分、イベント詳細区分(“http://jpfhir.jp/fhir/core/CodeSystem/JP_MedicationAsNeededConditionJAMI_CS”)を推奨するが、MERIT-9 処方オーダ 表5 頓用指示(“http://jpfhir.jp/fhir/core/CodeSystem/JP_MedicationAsNeededConditionMERIT9_CS”) を使用してもよい。


BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

Control0..1
BindingThe codes SHOULD be taken from JP Core MedicationReuqest Injection Usage ValueSethttp://hl7.org/fhir/ValueSet/timing-abbreviation
(preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationUsageInjection_VS)
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. Dosage
2. Dosage.extension:dosageComment
Slice NamedosageComment
Control0..*
TypeExtension(JP Core Medication Dosage DosageComment Extension) (Extension Type: Choice of: string, CodeableConcept)
4. Dosage.extension:device
Slice Namedevice
Control0..*
TypeExtension(JP Core Medication Dosage Device Extension) (Extension Type: Reference(Device))
6. Dosage.extension:line
Slice Nameline
Control0..*
TypeExtension(JP Core Medication Dosage Line Extension) (Extension Type: CodeableConcept)
8. Dosage.extension:lineComment
Slice NamelineComment
Control0..*
TypeExtension(JP Core Medication Dosage LineComment Extension) (Extension Type: Choice of: string, CodeableConcept)
10. Dosage.timing
Definition

投与タイミングを記録する。

Short投与タイミング
12. 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】頓用指示時にはJAMI処方・注射オーダ標準用法規格の表6 イベント区分、イベント詳細区分(“http://jpfhir.jp/fhir/core/CodeSystem/JP_MedicationAsNeededConditionJAMI_CS”)を推奨するが、MERIT-9 処方オーダ 表5 頓用指示(“http://jpfhir.jp/fhir/core/CodeSystem/JP_MedicationAsNeededConditionMERIT9_CS”) を使用してもよい。

BindingThe codes SHOULD be taken from JP Core MedicationReuqest Injection Usage ValueSet
(preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationUsageInjection_VS)
14. Dosage.site
16. Dosage.site.extension:siteComment
Slice NamesiteComment
Control0..*
TypeExtension(JP Core Medication Dosage SiteComment Extension) (Extension Type: Choice of: string, CodeableConcept)
18. Dosage.site.extension:bodySite
Slice NamebodySite
Definition

身体部位の位置に関する詳細情報。site概念がユースケースに必要な詳細を提供しない場合に使用される。

Short身体部位の位置に関する詳細
Control0..*
TypeExtension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
20. Dosage.route
22. Dosage.route.extension:routeComment
Slice NamerouteComment
Control0..*
TypeExtension(JP Core Medication Dosage RouteComment Extension) (Extension Type: Choice of: string, CodeableConcept)
24. Dosage.method
26. Dosage.method.extension:methodComment
Slice NamemethodComment
Control0..*
TypeExtension(JP Core Medication Dosage MethodComment Extension) (Extension Type: Choice of: string, CodeableConcept)
28. Dosage.doseAndRate
30. Dosage.doseAndRate.extension:rateComment
Slice NamerateComment
Control0..*
TypeExtension(JP Core Medication Dosage RateComment Extension) (Extension Type: Choice of: string, CodeableConcept)
32. Dosage.doseAndRate.dose[x]
Definition

1回投与量(体積)

Short1回投与量(体積)
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(体積)を指定する。単位はUCUMを使用する。

TypeQuantity(JP Core Medication Quantity DataType)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
34. 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
  • 36. Dosage.doseAndRate.rate[x]:rateRatio
    Slice NamerateRatio
    Control0..1
    TypeRatio(JP Core Medication Rate Ratio DataType)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    38. 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]
    40. Dosage.doseAndRate.rate[x]:rateQuantity
    Slice NamerateQuantity
    Definition

    投与速度(流量)を指定する単位は流量を表す単位(e.g. 量/時間)を指定する

    Short投与速度(流量)を指定する単位は流量を表す単位(e.g. 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:dosageComment
      Slice NamedosageComment
      Definition

      用法コメントを格納するための拡張

      Short用法コメント
      Control0..*
      TypeExtension(JP Core Medication Dosage DosageComment Extension) (Extension Type: Choice of: string, CodeableConcept)
      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:device
      Slice Namedevice
      Definition

      投与装置を格納する拡張

      Short投与装置
      Control0..*
      TypeExtension(JP Core Medication Dosage Device Extension) (Extension Type: Reference(Device))
      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.extension:line
      Slice Nameline
      Definition

      指示ラインを格納する拡張

      Short指示ライン
      Control0..*
      TypeExtension(JP Core Medication Dosage Line Extension) (Extension Type: CodeableConcept)
      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())
      12. Dosage.extension:lineComment
      Slice NamelineComment
      Definition

      ラインコメントを格納するための拡張

      Shortラインコメント
      Control0..*
      TypeExtension(JP Core Medication Dosage LineComment Extension) (Extension Type: Choice of: string, CodeableConcept)
      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())
      14. 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())
      16. 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()))
      18. 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()))
      20. 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()))
      22. 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()))
      24. Dosage.timing
      Definition

      投与タイミングを記録する。

      Short投与タイミング
      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()))
      26. 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
      28. 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
      • 30. 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())
        32. 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()))
        34. 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())
        36. 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
        38. 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
        • 40. 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()))
          42. 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()))
          44. 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()))
          46. 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()))
          48. 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()))
          50. 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()))
          52. 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()))
          54. 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()))
          56. 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()))
          58. 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()))
          60. 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()))
          62. 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()))
          64. 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()))
          66. 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()))
          68. 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()))
          70. 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】頓用指示時にはJAMI処方・注射オーダ標準用法規格の表6 イベント区分、イベント詳細区分(“http://jpfhir.jp/fhir/core/CodeSystem/JP_MedicationAsNeededConditionJAMI_CS”)を推奨するが、MERIT-9 処方オーダ 表5 頓用指示(“http://jpfhir.jp/fhir/core/CodeSystem/JP_MedicationAsNeededConditionMERIT9_CS”) を使用してもよい。

          Control0..1
          BindingThe codes SHOULD be taken from JP Core MedicationReuqest Injection Usage ValueSet
          (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationUsageInjection_VS)
          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. 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()))
          74. 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()))
          76. Dosage.site.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
          78. Dosage.site.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.site.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 80. Dosage.site.extension:siteComment
            Slice NamesiteComment
            Definition

            投与部位コメントを格納するための拡張

            Short投与部位コメント
            Control0..*
            TypeExtension(JP Core Medication Dosage SiteComment Extension) (Extension Type: Choice of: string, CodeableConcept)
            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())
            82. Dosage.site.extension:bodySite
            Slice NamebodySite
            Definition

            身体部位の位置に関する詳細情報。site概念がユースケースに必要な詳細を提供しない場合に使用される。

            Short身体部位の位置に関する詳細
            Control0..*
            TypeExtension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
            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())
            84. Dosage.site.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()))
            86. Dosage.site.text
            Definition

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

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

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            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.route.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
            92. Dosage.route.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.route.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 94. Dosage.route.extension:routeComment
              Slice NamerouteComment
              Definition

              投与経路コメントを格納するための拡張

              Short投与経路コメント
              Control0..*
              TypeExtension(JP Core Medication Dosage RouteComment Extension) (Extension Type: Choice of: string, CodeableConcept)
              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())
              96. Dosage.route.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()))
              98. Dosage.route.text
              Definition

              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

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

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              100. 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()))
              102. 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
              104. 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
              • 106. Dosage.method.extension:methodComment
                Slice NamemethodComment
                Definition

                手技コメントを格納するための拡張

                Short手技コメント
                Control0..*
                TypeExtension(JP Core Medication Dosage MethodComment Extension) (Extension Type: Choice of: string, CodeableConcept)
                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())
                108. 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
                • 110. 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()))
                  112. 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
                  114. 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
                  • 116. 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()))
                    118. 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()))
                    120. 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()))
                    122. 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()))
                    124. 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()))
                    126. 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()))
                    128. 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
                    130. 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
                    • 132. 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()))
                      134. 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()))
                      136. 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()))
                      138. 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()))
                      140. 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()))
                      142. 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()))
                      144. 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)
                      146. 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
                      148. 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
                      • 150. Dosage.doseAndRate.extension:rateComment
                        Slice NamerateComment
                        Definition

                        投与速度コメントを格納するための拡張

                        Short投与速度コメント
                        Control0..*
                        TypeExtension(JP Core Medication Dosage RateComment Extension) (Extension Type: Choice of: string, CodeableConcept)
                        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())
                        152. 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()))
                        154. Dosage.doseAndRate.dose[x]
                        Definition

                        1回投与量(体積)

                        Short1回投与量(体積)
                        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(体積)を指定する。単位はUCUMを使用する。

                        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()))
                        156. 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
                        • 158. 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 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()))
                          160. 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()))
                          162. Dosage.doseAndRate.rate[x]:rateQuantity
                          Slice NamerateQuantity
                          Definition

                          投与速度(流量)を指定する単位は流量を表す単位(e.g. 量/時間)を指定する

                          Short投与速度(流量)を指定する単位は流量を表す単位(e.g. 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()))
                          164. 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()))
                          166. 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()))
                          168. 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。