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

Resource Profile: JP_MedicationStatement_Injection - Detailed Descriptions

Draft as of 2022-07-04

Definitions for the jp-medicationstatement-injection resource profile.

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

0. MedicationStatement
Definition

患者が薬剤を服用している状況についての情報である。


A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.

Short服薬情報Record of medication being taken by a patient
Comments

When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationStatement.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationStatement.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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
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 resource that contains them
Must Supportfalse
Summaryfalse
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
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. MedicationStatement.identifier
Definition

このインスタンスが外部から参照されるために使われるIDである。それ以外に任意のIDを付与してもよい。 このIDは業務手順によって定められた処方オーダーに対して、直接的なURL参照が適切でない場合も含めて関連付けるために使われる。この業務手順のIDは実施者によって割り当てられたものであり、リソースが更新されたりサーバからサーバに転送されたとしても固定のものとして存続する。


Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

Short外部から参照されるIDExternal identifier
Comments

これは業務IDであって、リソースに対するIDではない。


This is a business identifier, not a resource identifier.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationStatement.status
Definition

服薬状況のを示す。コード表: http://hl7.org/fhir/CodeSystem/medication-statement-status active | completed | entered-in-error |intended | stopped | on-hold | unknown | not-take


A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.

Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Comments

このエレメントはmodifierとされている。StatusとはこのResourceが現在妥当な状態ではないことも示すからである。


MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from MedicationStatement Status Codeshttp://hl7.org/fhir/ValueSet/medication-statement-status|4.3.0
(required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.3.0)

A coded concept indicating the current status of a MedicationStatement.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationStatement.statusReason
Definition

現在の服薬状況を示す上記のstatusとなった理由


Captures the reason for the current state of the MedicationStatement.

Short服薬状況の理由Reason for current status
Comments

コード化せずにtextのみで表現する。


This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

Control0..*
BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodeshttp://hl7.org/fhir/ValueSet/reason-medication-status-codes
(example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes)

A coded concept indicating the reason for the status of the statement.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. MedicationStatement.category
Definition

薬剤が服用されると想定されている場所。日本では「院外」「院内」「入院」「外来」などの区分を想定する。 一般的には、外来や入院などどこでこの薬剤が投与、内服されるかを想定した区分である。 処方病棟や処方した診療科をOrganization resourceで表現することが冗長である場合にはこの区分が用いられることもある。 HL7 FHIRではvalue setとして http://terminology.hl7.org/CodeSystem/medicationrequest-category がデフォルトで用いられるが、日本での使用の場合持参薬をカバーする必要があり、JAHIS処方データ規約V3.0Cに記載されているMERIT-9処方オーダ表7とJHSP0007表を組み合わせて持ちいることとする


Indicates where the medication is expected to be consumed or administered.

Short薬剤使用区分Type of medication usage
Control0..1
BindingThe codes SHOULD be taken from Medication usage category codeshttp://hl7.org/fhir/ValueSet/medication-statement-category
(preferred to http://hl7.org/fhir/ValueSet/medication-statement-category)

A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. MedicationStatement.medication[x]
Definition

Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

投与された薬剤を識別する。既知の薬のリストから薬を識別するコード情報を設定する。


Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

ShortWhat medication was supplied 医薬品What medication was taken
Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

ひとつのtext要素と、複数のcoding 要素を記述できる。処方オーダ時に選択または入力し、実際に処方箋に印字される文字列を必ずtext要素に格納した上で、それをコード化した情報を1個以上のcoding 要素に記述する。

厚生労働省標準であるHOT9コード(販社指定が不要な場合にはHOT7コード)または広く流通しているYJコードを用いるか、一般名処方の場合には厚生労働省保険局一般名処方マスタのコードを使用して、Coding要素(コードsystemを識別するURI、医薬品のコード、そのコード表における医薬品の名称の3つからなる)で記述する。

なお、上記のいずれの標準的コードも付番されていない医薬品や医療材料の場合には、薬機法の下で使用されているGS1標準の識別コードであるGTIN(Global Trade Item Number)の調剤包装単位(最少包装単位、個別包装単位)14桁を使用する。

ひとつの処方薬、医療材料を複数のコード体系のコードで記述してもよく、その場合にcoding 要素を繰り返して記述する。 ただし、ひとつの処方薬を複数のコードで繰り返し記述する場合には、それらのコードが指し示す処方薬、医療材料は当然同一でなければならない。 また、処方を発行した医療機関内でのデータ利用のために、医療機関固有コード体系によるコード(ハウスコード、ローカルコード)の記述を含めてもよいが、その場合でも上述したいずれかの標準コードを同時に記述することが必要である。


If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

Control1..1
TypeReference(JP Core Medication Profile, Medication), CodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. MedicationStatement.subject
Definition

JP Coreでは患者を表すPatientリソースへの参照。 一般には薬剤が投与される対象となる患者を表現するPatient Resourceに対するリンク。


The person, animal or group who is/was taking the medication.

Short処方箋が発行された患者に対する参照Who is/was taking the medication
Comments

処方オーダーの対象は必須項目である。 二次利用のためにどこに実際の対象がいるのかについての情報は提供されない。特定の対象に対して匿名化することも必要である。

Control1..1
TypeReference(JP Core Patient Profile, Patient, Group)
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. MedicationStatement.effective[x]
Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

ShortThe date/time or interval when the medication is/was/will be taken
Comments

This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

Control0..1
TypeChoice of: dateTime, Period
[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
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 20. MedicationStatement.effective[x]:effectivePeriod
    Slice NameeffectivePeriod
    Definition

    薬が服用される期間


    The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

    Short服薬期間The date/time or interval when the medication is/was/will be taken
    Comments

    This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

    Control0..1
    TypePeriod, dateTime
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. MedicationStatement.effective[x]:effectivePeriod.start
    Definition

    薬の服用を開始した日


    The start of the period. The boundary is inclusive.

    Short開始日Starting time with inclusive boundary
    Comments

    If the low element is missing, the meaning is that the low boundary is not known.

    Control0..1
    This element is affected by the following invariants: per-1
    TypedateTime
    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. MedicationStatement.effective[x]:effectivePeriod.end
    Definition

    薬の服用を終了する日


    The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

    Short終了日End time with inclusive boundary, if not ongoing
    Comments

    この値は必ず境界日を含む。2012-02-03T10:00:00は2012-02-03を終了時刻(end)の値とする期間を示す。


    The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

    Control0..1
    This element is affected by the following invariants: per-1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. MedicationStatement.dateAsserted
    Definition

    情報源となったインスタンスでこのステートメントが言明された日


    The date when the medication statement was asserted by the information source.

    Shortこのステートメントが言明された日When the statement was asserted?
    Control0..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. MedicationStatement.informationSource
    Definition

    この服用状況についての情報を提供した人物あるいは組織についての参照


    The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.

    Shortこの服用状況についての情報を提供した人物あるいは組織についての参照Person or organization that provided the information about the taking of this medication
    Control0..1
    TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. MedicationStatement.derivedFrom
    Definition

    MedicationStatementリソースと関連するMedicationRequestやその他の支持情報を表すリソースと関連付けられるようにする。


    Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

    Shortその他の支持情報Additional supporting information
    Comments

    Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

    Control0..*
    TypeReference(Resource)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. MedicationStatement.reasonCode
    Definition

    この薬剤た投与された理由


    A reason for why the medication is being/was taken.

    Shortこの投薬の理由。対象疾患Reason for why the medication is being/was taken
    Comments

    このコードは疾患分類であっても良い。JP Coreでは傷病名マスターの使用を前提とする。


    This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

    Control0..*
    BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
    (example to http://hl7.org/fhir/ValueSet/condition-code)

    A coded concept identifying why the medication is being taken.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. MedicationStatement.reasonCode.coding
    Definition

    A reference to a code defined by a terminology system.

    Short投与理由,対象疾患についてのコードCode 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()))
    36. MedicationStatement.reasonReference
    Definition

    Condition or observation that supports why the medication is being/was taken.

    Short服薬理由を支持するObservation, Condition, DiagnosticReportについての参照。Condition or observation that supports why the medication is being/was taken
    Comments

    This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

    Control0..*
    TypeReference(Condition, Observation, DiagnosticReport)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. MedicationStatement.note
    Definition

    他の属性には記載できないこのstatementについての備考情報


    Provides extra information about the medication statement that is not conveyed by the other attributes.

    Short他のフィールドには記述できないこのstatementについての追加情報Further information about the statement
    Control0..*
    TypeAnnotation
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. MedicationStatement.dosage
    Definition

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

    ShortDetails of how medication is/was taken or should be taken
    Comments

    The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

    Control0..*
    TypeDosage(JP Core MedicationDosage Injection DataType)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    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. MedicationStatement
    Definition

    患者が薬剤を服用している状況についての情報である。

    Short服薬情報
    2. MedicationStatement.identifier
    Definition

    このインスタンスが外部から参照されるために使われるIDである。それ以外に任意のIDを付与してもよい。 このIDは業務手順によって定められた処方オーダーに対して、直接的なURL参照が適切でない場合も含めて関連付けるために使われる。この業務手順のIDは実施者によって割り当てられたものであり、リソースが更新されたりサーバからサーバに転送されたとしても固定のものとして存続する。

    Short外部から参照されるID
    Comments

    これは業務IDであって、リソースに対するIDではない。

    NoteThis is a business identifier, not a resource identifier (see discussion)
    4. MedicationStatement.status
    Definition

    服薬状況のを示す。コード表: http://hl7.org/fhir/CodeSystem/medication-statement-status active | completed | entered-in-error |intended | stopped | on-hold | unknown | not-take

    Comments

    このエレメントはmodifierとされている。StatusとはこのResourceが現在妥当な状態ではないことも示すからである。

    6. MedicationStatement.statusReason
    Definition

    現在の服薬状況を示す上記のstatusとなった理由

    Short服薬状況の理由
    Comments

    コード化せずにtextのみで表現する。

    8. MedicationStatement.category
    Definition

    薬剤が服用されると想定されている場所。日本では「院外」「院内」「入院」「外来」などの区分を想定する。 一般的には、外来や入院などどこでこの薬剤が投与、内服されるかを想定した区分である。 処方病棟や処方した診療科をOrganization resourceで表現することが冗長である場合にはこの区分が用いられることもある。 HL7 FHIRではvalue setとして http://terminology.hl7.org/CodeSystem/medicationrequest-category がデフォルトで用いられるが、日本での使用の場合持参薬をカバーする必要があり、JAHIS処方データ規約V3.0Cに記載されているMERIT-9処方オーダ表7とJHSP0007表を組み合わせて持ちいることとする

    Short薬剤使用区分
    10. MedicationStatement.medication[x]
    Definition

    Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

    投与された薬剤を識別する。既知の薬のリストから薬を識別するコード情報を設定する。

    ShortWhat medication was supplied 医薬品
    Comments

    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

    ひとつのtext要素と、複数のcoding 要素を記述できる。処方オーダ時に選択または入力し、実際に処方箋に印字される文字列を必ずtext要素に格納した上で、それをコード化した情報を1個以上のcoding 要素に記述する。

    厚生労働省標準であるHOT9コード(販社指定が不要な場合にはHOT7コード)または広く流通しているYJコードを用いるか、一般名処方の場合には厚生労働省保険局一般名処方マスタのコードを使用して、Coding要素(コードsystemを識別するURI、医薬品のコード、そのコード表における医薬品の名称の3つからなる)で記述する。

    なお、上記のいずれの標準的コードも付番されていない医薬品や医療材料の場合には、薬機法の下で使用されているGS1標準の識別コードであるGTIN(Global Trade Item Number)の調剤包装単位(最少包装単位、個別包装単位)14桁を使用する。

    ひとつの処方薬、医療材料を複数のコード体系のコードで記述してもよく、その場合にcoding 要素を繰り返して記述する。 ただし、ひとつの処方薬を複数のコードで繰り返し記述する場合には、それらのコードが指し示す処方薬、医療材料は当然同一でなければならない。 また、処方を発行した医療機関内でのデータ利用のために、医療機関固有コード体系によるコード(ハウスコード、ローカルコード)の記述を含めてもよいが、その場合でも上述したいずれかの標準コードを同時に記述することが必要である。

    TypeReference(JP Core Medication Profile), CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    12. MedicationStatement.subject
    Definition

    JP Coreでは患者を表すPatientリソースへの参照。 一般には薬剤が投与される対象となる患者を表現するPatient Resourceに対するリンク。

    Short処方箋が発行された患者に対する参照
    Comments

    処方オーダーの対象は必須項目である。 二次利用のためにどこに実際の対象がいるのかについての情報は提供されない。特定の対象に対して匿名化することも必要である。

    TypeReference(JP Core Patient Profile)
    14. MedicationStatement.effective[x]
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 16. MedicationStatement.effective[x]:effectivePeriod
      Slice NameeffectivePeriod
      Definition

      薬が服用される期間

      Short服薬期間
      Control0..1
      TypePeriod
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      18. MedicationStatement.effective[x]:effectivePeriod.start
      Definition

      薬の服用を開始した日

      Short開始日
      20. MedicationStatement.effective[x]:effectivePeriod.end
      Definition

      薬の服用を終了する日

      Short終了日
      Comments

      この値は必ず境界日を含む。2012-02-03T10:00:00は2012-02-03を終了時刻(end)の値とする期間を示す。

      22. MedicationStatement.dateAsserted
      Definition

      情報源となったインスタンスでこのステートメントが言明された日

      Shortこのステートメントが言明された日
      24. MedicationStatement.informationSource
      Definition

      この服用状況についての情報を提供した人物あるいは組織についての参照

      Shortこの服用状況についての情報を提供した人物あるいは組織についての参照
      26. MedicationStatement.derivedFrom
      Definition

      MedicationStatementリソースと関連するMedicationRequestやその他の支持情報を表すリソースと関連付けられるようにする。

      Shortその他の支持情報
      28. MedicationStatement.reasonCode
      Definition

      この薬剤た投与された理由

      Shortこの投薬の理由。対象疾患
      Comments

      このコードは疾患分類であっても良い。JP Coreでは傷病名マスターの使用を前提とする。

      30. MedicationStatement.reasonCode.coding
      Short投与理由,対象疾患についてのコード
      32. MedicationStatement.reasonReference
      Short服薬理由を支持するObservation, Condition, DiagnosticReportについての参照。
      34. MedicationStatement.note
      Definition

      他の属性には記載できないこのstatementについての備考情報

      Short他のフィールドには記述できないこのstatementについての追加情報
      36. MedicationStatement.dosage
      TypeDosage(JP Core MedicationDosage Injection DataType)

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

      0. MedicationStatement
      Definition

      患者が薬剤を服用している状況についての情報である。

      Short服薬情報
      Comments

      When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationStatement.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      4. MedicationStatement.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. MedicationStatement.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. MedicationStatement.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      IETF language tag

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. MedicationStatement.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. MedicationStatement.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      Invariantsdom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
      14. MedicationStatement.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. 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
      Must Supportfalse
      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())
      16. MedicationStatement.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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
      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 resource that contains them
      Must Supportfalse
      Summaryfalse
      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
      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())
      18. MedicationStatement.identifier
      Definition

      このインスタンスが外部から参照されるために使われるIDである。それ以外に任意のIDを付与してもよい。 このIDは業務手順によって定められた処方オーダーに対して、直接的なURL参照が適切でない場合も含めて関連付けるために使われる。この業務手順のIDは実施者によって割り当てられたものであり、リソースが更新されたりサーバからサーバに転送されたとしても固定のものとして存続する。

      Short外部から参照されるID
      Comments

      これは業務IDであって、リソースに対するIDではない。

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. MedicationStatement.basedOn
      Definition

      A plan, proposal or order that is fulfilled in whole or in part by this event.

      ShortFulfils plan, proposal or order
      Control0..*
      TypeReference(MedicationRequest, CarePlan, ServiceRequest)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

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

      A larger event of which this particular event is a component or step.

      ShortPart of referenced event
      Control0..*
      TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Observation)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. MedicationStatement.status
      Definition

      服薬状況のを示す。コード表: http://hl7.org/fhir/CodeSystem/medication-statement-status active | completed | entered-in-error |intended | stopped | on-hold | unknown | not-take

      Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
      Comments

      このエレメントはmodifierとされている。StatusとはこのResourceが現在妥当な状態ではないことも示すからである。

      Control1..1
      BindingThe codes SHALL be taken from MedicationStatement Status Codes
      (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.3.0)

      A coded concept indicating the current status of a MedicationStatement.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. MedicationStatement.statusReason
      Definition

      現在の服薬状況を示す上記のstatusとなった理由

      Short服薬状況の理由
      Comments

      コード化せずにtextのみで表現する。

      Control0..*
      BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodes
      (example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes)

      A coded concept indicating the reason for the status of the statement.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. MedicationStatement.category
      Definition

      薬剤が服用されると想定されている場所。日本では「院外」「院内」「入院」「外来」などの区分を想定する。 一般的には、外来や入院などどこでこの薬剤が投与、内服されるかを想定した区分である。 処方病棟や処方した診療科をOrganization resourceで表現することが冗長である場合にはこの区分が用いられることもある。 HL7 FHIRではvalue setとして http://terminology.hl7.org/CodeSystem/medicationrequest-category がデフォルトで用いられるが、日本での使用の場合持参薬をカバーする必要があり、JAHIS処方データ規約V3.0Cに記載されているMERIT-9処方オーダ表7とJHSP0007表を組み合わせて持ちいることとする

      Short薬剤使用区分
      Control0..1
      BindingThe codes SHOULD be taken from Medication usage category codes
      (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category)

      A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. MedicationStatement.medication[x]
      Definition

      Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

      投与された薬剤を識別する。既知の薬のリストから薬を識別するコード情報を設定する。

      ShortWhat medication was supplied 医薬品
      Comments

      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

      ひとつのtext要素と、複数のcoding 要素を記述できる。処方オーダ時に選択または入力し、実際に処方箋に印字される文字列を必ずtext要素に格納した上で、それをコード化した情報を1個以上のcoding 要素に記述する。

      厚生労働省標準であるHOT9コード(販社指定が不要な場合にはHOT7コード)または広く流通しているYJコードを用いるか、一般名処方の場合には厚生労働省保険局一般名処方マスタのコードを使用して、Coding要素(コードsystemを識別するURI、医薬品のコード、そのコード表における医薬品の名称の3つからなる)で記述する。

      なお、上記のいずれの標準的コードも付番されていない医薬品や医療材料の場合には、薬機法の下で使用されているGS1標準の識別コードであるGTIN(Global Trade Item Number)の調剤包装単位(最少包装単位、個別包装単位)14桁を使用する。

      ひとつの処方薬、医療材料を複数のコード体系のコードで記述してもよく、その場合にcoding 要素を繰り返して記述する。 ただし、ひとつの処方薬を複数のコードで繰り返し記述する場合には、それらのコードが指し示す処方薬、医療材料は当然同一でなければならない。 また、処方を発行した医療機関内でのデータ利用のために、医療機関固有コード体系によるコード(ハウスコード、ローカルコード)の記述を含めてもよいが、その場合でも上述したいずれかの標準コードを同時に記述することが必要である。

      Control1..1
      TypeReference(JP Core Medication Profile)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. MedicationStatement.subject
      Definition

      JP Coreでは患者を表すPatientリソースへの参照。 一般には薬剤が投与される対象となる患者を表現するPatient Resourceに対するリンク。

      Short処方箋が発行された患者に対する参照
      Comments

      処方オーダーの対象は必須項目である。 二次利用のためにどこに実際の対象がいるのかについての情報は提供されない。特定の対象に対して匿名化することも必要である。

      Control1..1
      TypeReference(JP Core Patient Profile)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MedicationStatement.context
      Definition

      The encounter or episode of care that establishes the context for this MedicationStatement.

      ShortEncounter / Episode associated with MedicationStatement
      Control0..1
      TypeReference(Encounter, EpisodeOfCare)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. MedicationStatement.effective[x]
      Definition

      The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

      ShortThe date/time or interval when the medication is/was/will be taken
      Comments

      This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

      Control0..1
      TypeChoice of: dateTime, Period
      [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
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 38. MedicationStatement.effective[x]:effectivePeriod
        Slice NameeffectivePeriod
        Definition

        薬が服用される期間

        Short服薬期間
        Comments

        This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

        Control0..1
        TypePeriod
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. MedicationStatement.effective[x]:effectivePeriod.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typeid
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        42. MedicationStatement.effective[x]:effectivePeriod.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 MedicationStatement.effective[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 44. MedicationStatement.effective[x]:effectivePeriod.start
          Definition

          薬の服用を開始した日

          Short開始日
          Comments

          If the low element is missing, the meaning is that the low boundary is not known.

          Control0..1
          This element is affected by the following invariants: per-1
          TypedateTime
          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. MedicationStatement.effective[x]:effectivePeriod.end
          Definition

          薬の服用を終了する日

          Short終了日
          Comments

          この値は必ず境界日を含む。2012-02-03T10:00:00は2012-02-03を終了時刻(end)の値とする期間を示す。

          Control0..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. MedicationStatement.dateAsserted
          Definition

          情報源となったインスタンスでこのステートメントが言明された日

          Shortこのステートメントが言明された日
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. MedicationStatement.informationSource
          Definition

          この服用状況についての情報を提供した人物あるいは組織についての参照

          Shortこの服用状況についての情報を提供した人物あるいは組織についての参照
          Control0..1
          TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationStatement.derivedFrom
          Definition

          MedicationStatementリソースと関連するMedicationRequestやその他の支持情報を表すリソースと関連付けられるようにする。

          Shortその他の支持情報
          Comments

          Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

          Control0..*
          TypeReference(Resource)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. MedicationStatement.reasonCode
          Definition

          この薬剤た投与された理由

          Shortこの投薬の理由。対象疾患
          Comments

          このコードは疾患分類であっても良い。JP Coreでは傷病名マスターの使用を前提とする。

          Control0..*
          BindingFor example codes, see Condition/Problem/DiagnosisCodes
          (example to http://hl7.org/fhir/ValueSet/condition-code)

          A coded concept identifying why the medication is being taken.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. MedicationStatement.reasonCode.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
          58. MedicationStatement.reasonCode.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 MedicationStatement.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 60. MedicationStatement.reasonCode.coding
            Definition

            A reference to a code defined by a terminology system.

            Short投与理由,対象疾患についてのコード
            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()))
            62. MedicationStatement.reasonCode.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()))
            64. MedicationStatement.reasonReference
            Definition

            Condition or observation that supports why the medication is being/was taken.

            Short服薬理由を支持するObservation, Condition, DiagnosticReportについての参照。
            Comments

            This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

            Control0..*
            TypeReference(Condition, Observation, DiagnosticReport)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. MedicationStatement.note
            Definition

            他の属性には記載できないこのstatementについての備考情報

            Short他のフィールドには記述できないこのstatementについての追加情報
            Control0..*
            TypeAnnotation
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. MedicationStatement.dosage
            Definition

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

            ShortDetails of how medication is/was taken or should be taken
            Comments

            The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

            Control0..*
            TypeDosage(JP Core MedicationDosage Injection DataType)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
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