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_MedicationDosageBase - Detailed Descriptions

Active as of 2023-10-31

Definitions for the jp-medicationdosagebase 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.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())
4. 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


Indicates the order in which the dosage instructions should be applied or interpreted.

Short服用指示の順番The order of the dosage instructions
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。


If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. 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。


Free text dosage instructions e.g. SIG.

Short投与⽅法のテキスト表現Free text dosage instructions e.g. SIG
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。


Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. 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」)


Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

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」Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
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。


Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Control0..*
BindingThe codes SHOULD be taken from For example codes, see JP Core Medication JAMI Additional Usage ValueSethttp://hl7.org/fhir/ValueSet/additional-instruction-codes
(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。


Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. 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。


Instructions in terms that are understood by the patient or consumer.

Short患者あるいは消費者向けの指示Patient or consumer oriented instructions
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()))
12. Dosage.timing
Definition

When medication should be administered.

ShortWhen medication should be administered
Comments

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

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

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

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


Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

Short「頓用」指示Take "as needed" (for x)
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, CodeableConcept
[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()))
16. 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。


Body site to administer to.

Short投与される身体部位Body site to administer to
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。


If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Control0..1
BindingThe codes SHOULD be taken from For example codes, see JP Core Medication JAMI External Body Site ValueSethttp://hl7.org/fhir/ValueSet/approach-site-codes
(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()))
18. Dosage.route
Definition

投与経路


How drug should enter body.

Short投与経路How drug should enter body
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 For example codes, see JP Core Medication HL70162-based Route ValueSethttp://hl7.org/fhir/ValueSet/route-codes
(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()))
20. Dosage.method
Definition

投与方法


Technique for administering medication.

Short投与方法Technique for administering medication
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。


Terminologies used often pre-coordinate this term with the route and or form of administration.

Control0..1
BindingFor example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes
(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。


A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. 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
  • 24. 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。


    A reference to a code defined by a terminology system.

    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Code defined by a terminology system
    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。


    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..1*
    BindingThe codes SHOULD be taken from For codes, see 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。


    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()))
    26. 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.

    Control10..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()))
    28. 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


    A reference to a code defined by a terminology system.

    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Code defined by a terminology system
    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。


    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..1*
    BindingThe codes SHOULD be taken from For codes, see 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。


    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()))
    30. 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.

    Control10..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()))
    32. 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。


    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.

    Short投与⽅法のテキスト表現Plain text representation of the concept
    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。


    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

    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。


    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()))
    34. Dosage.doseAndRate
    Definition

    薬剤が投与される量


    The amount of medication administered.

    Short薬剤の投与量Amount of medication administered
    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)
    36. Dosage.doseAndRate.type
    Definition

    力価区分


    The kind of dose or rate specified, for example, ordered or calculated.

    Short力価区分The kind of dose or rate specified
    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 For example codes, see JP Core Medication IngredientStrength StrengthType ValueSethttp://hl7.org/fhir/ValueSet/dose-rate-type
    (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。


    If the type is not populated, assume to be "ordered".

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

    Amount of medication per dose.

    ShortAmount of medication per dose
    Comments

    Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

    Control0..1
    TypeQuantity(SimpleQuantity), Range
    [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()))
    40. Dosage.doseAndRate.rate[x]
    Definition

    薬剤が投与される量の速度


    Amount of medication per unit of time.

    Short薬剤の投与量速度Amount of medication per unit of time
    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()))
    42. Dosage.maxDosePerPeriod
    Definition

    単位時間当たりの投薬量の上限


    Upper limit on medication per unit of time.

    Short単位時間当たりの投薬量の上限Upper limit on medication per unit of time
    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()))
    44. Dosage.maxDosePerAdministration
    Definition

    1回あたりの投薬量の上限


    Upper limit on medication per administration.

    Short1回あたりの投薬量の上限Upper limit on medication per administration
    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, SimpleQuantity)
    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()))
    46. Dosage.maxDosePerLifetime
    Definition

    生涯の投薬量の上限


    Upper limit on medication per lifetime of the patient.

    Short生涯の投薬量の上限Upper limit on medication per lifetime of the patient
    Control0..1
    TypeQuantity(JP Core Medication Quantity DataType, SimpleQuantity)
    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()))

    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
    2. 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。

    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。

    4. 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。

    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。

    6. 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。

    BindingThe codes SHOULD be taken from JP Core Medication JAMI Additional Usage ValueSet
    (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationUsageJAMIAdditional_VS)
    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。

    8. 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)。

    10. Dosage.timing
    TypeTiming(JP Core Medication Timing DataType)
    12. 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
    Typeboolean, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    14. 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。

    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)
    16. 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。

    BindingThe codes SHOULD be taken from JP Core Medication HL70162-based Route ValueSet
    (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationRouteHL70162_VS)
    18. 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。

    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。

    20. Dosage.method.coding
    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
    • 22. 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)
      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。

      24. Dosage.method.coding:unitDigit1.system
      Control1..?
      Fixed Valueurn:oid:1.2.392.200250.2.2.20.30
      26. 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)
      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。

      28. Dosage.method.coding:unitDigit2.system
      Control1..?
      Fixed Valueurn:oid:1.2.392.200250.2.2.20.40
      30. 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。

      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。

      32. Dosage.doseAndRate
      Definition

      薬剤が投与される量

      Short薬剤の投与量
      34. 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。

      BindingThe codes SHOULD be taken from JP Core Medication IngredientStrength StrengthType ValueSet
      (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_MedicationIngredientStrengthStrengthType_VS)
      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。

      36. Dosage.doseAndRate.dose[x]
      TypeQuantity(SimpleQuantity), Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      38. 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
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      40. 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
      TypeRatio(JP Core Medication Rate Ratio DataType)
      42. 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
      TypeQuantity(JP Core Medication Quantity DataType)
      44. Dosage.maxDosePerLifetime
      Definition

      生涯の投薬量の上限

      Short生涯の投薬量の上限
      TypeQuantity(JP Core Medication Quantity DataType)

      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.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())
        8. 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()))
        10. 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()))
        12. 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()))
        14. 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()))
        16. Dosage.timing
        Definition

        When medication should be administered.

        ShortWhen medication should be administered
        Comments

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

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

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. 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()))
        20. 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()))
        22. 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()))
        24. 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()))
        26. 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
        28. 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
        • 30. 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
          • 32. 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()))
            34. 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
            36. 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
            • 38. 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()))
              40. 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()))
              42. 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()))
              44. 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()))
              46. 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()))
              48. 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()))
              50. 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
              52. 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
              • 54. 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()))
                56. 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()))
                58. 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()))
                60. 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()))
                62. 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()))
                64. 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()))
                66. 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)
                68. 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
                70. 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
                • 72. 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()))
                  74. Dosage.doseAndRate.dose[x]
                  Definition

                  Amount of medication per dose.

                  ShortAmount of medication per dose
                  Comments

                  Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  [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()))
                  76. 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()))
                  78. 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()))
                  80. 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()))
                  82. 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。