HL7 FHIR JP Core ImplementationGuide
1.1.1 - ci-build Japan flag

HL7 FHIR JP Core ImplementationGuide - Local Development build (v1.1.1). See the Directory of published versions

Resource Profile: JP_MedicationDispense_Injection - Detailed Descriptions

Active as of 2022-10-24

Definitions for the jp-medicationdispense-injection resource profile.

1. MedicationDispense
Definition

指定された患者・個人へ注射薬剤が払い出されたか払い出される予定のものを示す。これには(供給される)提供される製品についての説明や注射薬剤の服用に関する指示も含まれる。薬剤払い出しは注射オーダに対して薬局システムが対応した結果となる。

指定された患者・個人へ薬剤が払い出されたか払い出される予定のものを示す。これには(供給される)提供される製品についての説明や薬剤の服用に関する指示も含まれる。薬剤払い出しは薬剤オーダに対して薬局システムが対応した結果となる。

2. MedicationDispense.medication[x]
TypeChoice of: (Medication)), CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
3. MedicationDispense.medicationReference
Control1..1
TypeReference(JP_Medication))
4. MedicationDispense.authorizingPrescription
TypeReference(JP_MedicationRequest_Injection|MedicationRequest))
5. MedicationDispense.dosageInstruction
TypeDosage(JP_MedicationDosage_Injection, JP_MedicationDosageBase)
1. MedicationDispense
Definition

指定された患者・個人へ注射薬剤が払い出されたか払い出される予定のものを示す。これには(供給される)提供される製品についての説明や注射薬剤の服用に関する指示も含まれる。薬剤払い出しは注射オーダに対して薬局システムが対応した結果となる。

Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

Control0..*
InvariantsDefined on this element
dom-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 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(canonical) = '#').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())
mdd-1: whenHandedOver cannot be before whenPrepared (: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.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.

Control0..1
Typeuri
Is Modifiertrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. MedicationDispense.extension:preparation
SliceNamepreparation
Definition

薬剤単位の調剤結果

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationDispense_Preparation) (Extension Type: Choice of: string, CodeableConcept)
InvariantsDefined on this element
ele-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. MedicationDispense.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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
ele-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())
5. MedicationDispense.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。処方箋全体としてのIDとしては使用しない。 処方箋内で同一の用法をまとめて表記されるRp番号はこのIdentifier elementの別スライスで表現する。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 Dispense 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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationDispense.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
6. MedicationDispense.identifier:rpNumber
SliceNamerpNumber
Definition

処方箋内で同一用法の薬剤を慣用的にまとめて、Rpに番号をつけて剤グループとして一括指定されることがある。このスライスでは剤グループに対して割り振られたRp番号を記録する。

Identifiers associated with this Medication Dispense 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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..1*
TypeIdentifier
Comments

剤グループに複数の薬剤が含まれる場合、このグループ内の薬剤には同じRp番号が割り振られる。

This is a business identifier, not a resource identifier.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. MedicationDispense.identifier:rpNumber.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
8. MedicationDispense.identifier:rpNumber.system
Definition

ここで付番されたIDがRp番号であることを明示するためにOIDとして定義された。urn:oid:1.2.392.100495.20.3.81で固定される。

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control10..1
Typeuri
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Fixed Valueurn:oid:1.2.392.100495.20.3.81
Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. MedicationDispense.identifier:rpNumber.value
Definition

Rp番号(剤グループ番号)。"1"など。

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control10..1
Typestring
Comments

value は string型であり、数値はゼロサプレス、つまり、'01'でなく'1'と指定すること。

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
10. MedicationDispense.identifier:requestIdentifier
SliceNamerequestIdentifier
Definition

薬剤をオーダする単位としての処方箋に対するID。原則として調剤の基となったMedicationRequestのIDを設定する。

Identifiers associated with this Medication Dispense 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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Comments

This is a business identifier, not a resource identifier.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. MedicationDispense.identifier:requestIdentifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. MedicationDispense.identifier:requestIdentifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control10..1
Typeuri
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Fixed Valuehttp://jpfhir.jp/fhir/core/IdSystem/resourceInstance-identifier
Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. MedicationDispense.identifier:requestIdentifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control10..1
Typestring
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. MedicationDispense.status
Definition

A code specifying the state of the set of dispense events.

一連の調剤イベントの状態を指定するコード。

Control1..1
BindingThe codes SHALL be taken from MedicationDispense Status Codes

A coded concept specifying the state of the dispense event.

Typecode
Is Modifiertrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. MedicationDispense.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.

Control1..1
TypeChoice of: Reference(Medication)), CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
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。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
16. MedicationDispense.medication[x]:medicationReference
SliceNamemedicationReference
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.

Control1..1
TypeChoice of: Reference(JP_Medication|Medication)), CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
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。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. MedicationDispense.subject
Definition

The person or animal or group receiving the medication.

投与を受ける患者

A link to a resource representing the person or the group to whom the medication will be given.

Control10..1
TypeReference(JP_Patient|Patient|Group))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

SubstanceAdministration->subject->Patient.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. MedicationDispense.authorizingPrescription
Definition

Indicates the medication order that is being dispensed against. 調剤の元になった処方オーダを表すMedicationRequestリソースへの参照。

Indicates the medication order that is being dispensed against.

Control0..*
TypeReference(JP_MedicationRequest_Injection|MedicationRequest))
Comments

Maps to basedOn in Event logical model.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. MedicationDispense.quantity
Definition

調剤総量。 JP Coreでは必須 払い出される薬剤の量。計測単位を含む。

The amount of medication that has been dispensed. Includes unit of measure.

Control10..1 This element is affected by the following invariants: ele-1
TypeQuantity(JP_MedicationSimpleQuantity, SimpleQuantity)
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

使用状況によって、これがどのような量であるか、したがってどのような単位を使用できるかが定義される場合がかなりある。使用状況によっては、比較演算子の値も制限される場合がある。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
qty-3: If a code for the unit is present, the system SHALL also be present (: code.empty() or system.exists())
sqty-1: The comparator is not used on a SimpleQuantity (: comparator.empty())
20. MedicationDispense.whenHandedOver
Definition

The time the dispensed product was provided to the patient or their representative.

必須。 患者あるいはその代理人に払い出される薬剤が提供された日時。

Control10..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. MedicationDispense.dosageInstruction
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 to be used by the patient.

Control0..*
TypeDosage(JP_MedicationDosage_Injection)
Comments

When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
1. MedicationDispense
Definition

指定された患者・個人へ注射薬剤が払い出されたか払い出される予定のものを示す。これには(供給される)提供される製品についての説明や注射薬剤の服用に関する指示も含まれる。薬剤払い出しは注射オーダに対して薬局システムが対応した結果となる。

Control0..*
2. MedicationDispense.id
Definition

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

Control0..1
Typeid
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.

3. MedicationDispense.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.

Control0..1
TypeMeta
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. MedicationDispense.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.

Control0..1
Typeuri
Is Modifiertrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. MedicationDispense.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages A human language
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. MedicationDispense.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.

Control0..1
TypeNarrative
Alternate Namesnarrativehtmlxhtmldisplay
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. MedicationDispense.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.

Control0..*
TypeResource
Alternate Namesinline resourcesanonymous resourcescontained 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.

8. MedicationDispense.extension
Definition

An Extension

Control0..*
TypeExtension
InvariantsDefined on this element
ele-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 MedicationDispense.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. MedicationDispense.extension:preparation
SliceNamepreparation
Definition

薬剤単位の調剤結果

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationDispense_Preparation) (Extension Type: Choice of: string, CodeableConcept)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. MedicationDispense.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).

Control0..*
TypeExtension
Is Modifiertrue
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 Namesextensionsuser content
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.

InvariantsDefined on this element
ele-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())
11. MedicationDispense.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。処方箋全体としてのIDとしては使用しない。 処方箋内で同一の用法をまとめて表記されるRp番号はこのIdentifier elementの別スライスで表現する。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。

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier
Comments

これは業務IDであって、リソースに対するIDではない。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationDispense.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
12. MedicationDispense.identifier:rpNumber
SliceNamerpNumber
Definition

処方箋内で同一用法の薬剤を慣用的にまとめて、Rpに番号をつけて剤グループとして一括指定されることがある。このスライスでは剤グループに対して割り振られたRp番号を記録する。

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
TypeIdentifier
Comments

剤グループに複数の薬剤が含まれる場合、このグループ内の薬剤には同じRp番号が割り振られる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. MedicationDispense.identifier:rpNumber.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
14. MedicationDispense.identifier:rpNumber.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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

InvariantsDefined on this element
ele-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 MedicationDispense.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
15. MedicationDispense.identifier:rpNumber.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known
Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. MedicationDispense.identifier:rpNumber.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose
TypeCodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. MedicationDispense.identifier:rpNumber.system
Definition

ここで付番されたIDがRp番号であることを明示するためにOIDとして定義された。urn:oid:1.2.392.100495.20.3.81で固定される。

Control1..1
Typeuri
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Fixed Valueurn:oid:1.2.392.100495.20.3.81
Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. MedicationDispense.identifier:rpNumber.value
Definition

Rp番号(剤グループ番号)。"1"など。

Control1..1
Typestring
Comments

value は string型であり、数値はゼロサプレス、つまり、'01'でなく'1'と指定すること。

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. MedicationDispense.identifier:rpNumber.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. MedicationDispense.identifier:rpNumber.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization))
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. MedicationDispense.identifier:requestIdentifier
SliceNamerequestIdentifier
Definition

薬剤をオーダする単位としての処方箋に対するID。原則として調剤の基となったMedicationRequestのIDを設定する。

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Comments

This is a business identifier, not a resource identifier.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. MedicationDispense.identifier:requestIdentifier.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
23. MedicationDispense.identifier:requestIdentifier.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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

InvariantsDefined on this element
ele-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 MedicationDispense.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. MedicationDispense.identifier:requestIdentifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known
Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. MedicationDispense.identifier:requestIdentifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose
TypeCodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. MedicationDispense.identifier:requestIdentifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control1..1
Typeuri
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Fixed Valuehttp://jpfhir.jp/fhir/core/IdSystem/resourceInstance-identifier
Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. MedicationDispense.identifier:requestIdentifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. MedicationDispense.identifier:requestIdentifier.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. MedicationDispense.identifier:requestIdentifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization))
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. MedicationDispense.partOf
Definition

The procedure that trigger the dispense.

この調剤の契機となったProcedureリソースへの参照。

Control0..*
TypeReference(JP_Procedure))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. MedicationDispense.status
Definition

A code specifying the state of the set of dispense events.

一連の調剤イベントの状態を指定するコード。

Control1..1
BindingThe codes SHALL be taken from MedicationDispense Status Codes A coded concept specifying the state of the dispense event
Typecode
Is Modifiertrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. MedicationDispense.statusReason[x]
Definition

Indicates the reason why a dispense was not performed.

調剤が実行されなかった理由を示す。

Control0..1
BindingFor example codes, see MedicationDispense Status Reason Codes A code describing why a dispense was not performed
TypeChoice of: CodeableConcept, Reference(DetectedIssue))
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. MedicationDispense.category
Definition

Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

投薬のタイプを示す(たとえば、薬剤が消費または投与されると予想される場所(つまり、入院患者または外来患者))。 入院、外来、退院、自宅など。

Control0..1
BindingThe codes SHOULD be taken from MedicationDispense Category Codes A code describing where the dispensed medication is expected to be consumed or administered
TypeCodeableConcept
Comments

The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. MedicationDispense.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。

Control1..1
TypeReference(Medication))
[x] NoteSee Choice of Data Types for further information about how to use [x]
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。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
35. MedicationDispense.medication[x]:medicationReference
SliceNamemedicationReference
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。

Control1..1
TypeReference(JP_Medication))
[x] NoteSee Choice of Data Types for further information about how to use [x]
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。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. MedicationDispense.subject
Definition

The person or animal or group receiving the medication.

投与を受ける患者

Control1..1
TypeReference(JP_Patient))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. MedicationDispense.context
Definition

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

調剤ベントに関連するEncounterやエピソードへの参照。

Control0..1
TypeReference(JP_EncounterEpisodeOfCare))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. MedicationDispense.supportingInformation
Definition

Additional information that supports the medication being dispensed.

調剤される薬剤をサポートする追加情報への任意のリソースへの参照。

Control0..*
TypeReference(Resource))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. MedicationDispense.performer
Definition

Indicates who or what performed the event. 調剤した人を示す

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. MedicationDispense.performer.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
41. MedicationDispense.performer.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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

InvariantsDefined on this element
ele-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())
42. MedicationDispense.performer.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).

Control0..*
TypeExtension
Is Modifiertrue
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 Namesextensionsuser contentmodifiers
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.

InvariantsDefined on this element
ele-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())
43. MedicationDispense.performer.function
Definition

Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

Control0..1
BindingFor example codes, see MedicationDispense Performer Function Codes A code describing the role an individual played in dispensing a medication
TypeCodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. MedicationDispense.performer.actor
Definition

The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

Control1..1
TypeReference(JP_PractitionerJP_PractitionerRoleJP_OrganizationJP_PatientDeviceRelatedPerson))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. MedicationDispense.location
Definition

The principal physical location where the dispense was performed.

調剤が実施された場所を示すLocationリソースへの参照。

Control0..1
TypeReference(JP_Location))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. MedicationDispense.authorizingPrescription
Definition

Indicates the medication order that is being dispensed against. 調剤の元になった処方オーダを表すMedicationRequestリソースへの参照。

Control0..*
TypeReference(JP_MedicationRequest_Injection))
Comments

Maps to basedOn in Event logical model.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. MedicationDispense.type
Definition

Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. 実行される調剤イベントのタイプを示す。たとえば、トライアルフィル、トライアルの完了、部分フィル、緊急フィル、サンプルなどである。

Control0..1
BindingFor example codes, see ActPharmacySupplyType Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc
TypeCodeableConcept
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

すべてのターミノロジの使用がこの一般的なパターンに適合するわけではない。場合によっては、モデルはCodeableConceptを使用せず、コーディングを直接使用して、テキスト、コーディング、翻訳、および要素間の関係とpre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. MedicationDispense.quantity
Definition

調剤総量。 JP Coreでは必須 払い出される薬剤の量。計測単位を含む。

Control1..1 This element is affected by the following invariants: ele-1
TypeQuantity(JP_MedicationSimpleQuantity)
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

使用状況によって、これがどのような量であるか、したがってどのような単位を使用できるかが定義される場合がかなりある。使用状況によっては、比較演算子の値も制限される場合がある。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
qty-3: If a code for the unit is present, the system SHALL also be present (: code.empty() or system.exists())
sqty-1: The comparator is not used on a SimpleQuantity (: comparator.empty())
49. MedicationDispense.daysSupply
Definition

The amount of medication expressed as a timing amount.

タイミングとして表される投薬量。すなわち、XX日分、XX回分などの数量。

Control0..1 This element is affected by the following invariants: ele-1
TypeQuantity(JP_MedicationSimpleQuantity)
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

使用状況によって、これがどのような量であるか、したがってどのような単位を使用できるかが定義される場合がかなりある。使用状況によっては、比較演算子の値も制限される場合がある。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
qty-3: If a code for the unit is present, the system SHALL also be present (: code.empty() or system.exists())
sqty-1: The comparator is not used on a SimpleQuantity (: comparator.empty())
50. MedicationDispense.whenPrepared
Definition

The time when the dispensed product was packaged and reviewed.

調剤がパッケージ化され、レビューされた日時

Control0..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. MedicationDispense.whenHandedOver
Definition

The time the dispensed product was provided to the patient or their representative.

必須。 患者あるいはその代理人に払い出される薬剤が提供された日時。

Control1..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. MedicationDispense.destination
Definition

Identification of the facility/location where the medication was shipped to, as part of the dispense event.

調剤イベントの一環として、薬剤が出荷された行先先の施設/場所のLocationリソースへの参照。

Control0..1
TypeReference(JP_Location))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. MedicationDispense.receiver
Definition

Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

薬を受け取った人を識別する。これは通常、患者またはその介護者だが、医療専門家になる場合もある。

Control0..*
TypeReference(JP_PatientJP_Practitioner))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. MedicationDispense.note
Definition

Extra information about the dispense that could not be conveyed in the other attributes.

他の要素では伝達できなかった調剤に関する追加情報。

Control0..*
TypeAnnotation
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

構造化された注釈(アノテーション)を持たないシステムの場合、作成者や時間なしで単一の注釈を簡単に伝達できる。情報を変更する可能性があるため、この要素をナラティブに含める必要がある場合がある。 注釈は、計算機処理れきる「変更」情報を伝達するために使用されるべきではない。 (ユーザの行動を強制することはほとんど不可能であるため、これはSHOULDとする)。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. MedicationDispense.dosageInstruction
Definition

薬の服用方法・服用した方法、または服用すべき方法

Control0..*
TypeDosage(JP_MedicationDosage_Injection)
Comments

When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. MedicationDispense.substitution
Definition

Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. 調剤の一部として置換が行われたかどうかを示す。場合によっては、置換が期待されるが発生しない場合もあれば、置換が予期されないが発生する場合もある。このブロックは、置換が行われたか行われなかったか、およびその理由を説明する。何も指定されていない場合、置換は行われていない。

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. MedicationDispense.substitution.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
58. MedicationDispense.substitution.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.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

InvariantsDefined on this element
ele-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())
59. MedicationDispense.substitution.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).

Control0..*
TypeExtension
Is Modifiertrue
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 Namesextensionsuser contentmodifiers
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.

InvariantsDefined on this element
ele-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())
60. MedicationDispense.substitution.wasSubstituted
Definition

True if the dispenser dispensed a different drug or product from what was prescribed. 処方されたものとは異なる薬剤または製品を調剤した場合に、'true'を設定する。

Control1..1
Typeboolean
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. MedicationDispense.substitution.type
Definition

A code signifying whether a different drug was dispensed from what was prescribed.

処方されたものとは異なる薬が調剤されたかどうかを示すコード。 HL7 v3 Value Set ActSubstanceAdminSubstitutionCode から以下のコードが使用できる。 E: 別の生物学的同等および治療的に同等の製品で置換が行われたか、許可された。 EC: 代替品が発生したか、次のような別の製品で許可されている:同じ有効成分を含むが異なる塩で処方された代替医薬品、同じ有効成分を持つエステル医薬品同等物、強度、剤形、投与経路. BC: 代替が発生したか、同等のブランド間で許可されてるが、ジェネリックでは許可されない。 G: 代替が発生したか、同等のジェネリック間で許可されているが、ブランド間では許可されない。 TE:同じ治療目的と安全性プロファイルを持つ別の製品で代替が発生したか、許可された。 TB:ジェネリック医薬品ではなく、治療的に同等のブランド間で代替品が発生したか、許可されている TG:治療的に同等のジェネリック間で置換が発生したか、許可されているが、ブランドは許可されない。 F:処方ガイドラインに準拠。 N:置換は発生しなかったか、許可されていない。

Control0..1
BindingFor example codes, see ActSubstanceAdminSubstitutionCode A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription
TypeCodeableConcept
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. MedicationDispense.substitution.reason
Definition

Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

処方されたものからの置換(または置換の欠如)の理由を示す。 HL7 v3 Value Set SubstanceAdminSubstitutionReason では以下のコードが定義されている。 CT:治療継続性確保のため、FP:処方方針、 OS: 在庫欠品、 RR:代替えを義務付けまたは禁止する規制要件に従った

Control0..*
BindingFor example codes, see SubstanceAdminSubstitutionReason A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed
TypeCodeableConcept
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

すべてのターミノロジの使用がこの一般的なパターンに適合するわけではない。場合によっては、モデルはCodeableConceptを使用せず、コーディングを直接使用して、テキスト、コーディング、翻訳、および要素間の関係とpre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. MedicationDispense.substitution.responsibleParty
Definition

The person or organization that has primary responsibility for the substitution.

置換の主な責任を負う個人または組織。Practitioner PractitionerRole リソースへの参照。

Control0..*
TypeReference(JP_PractitionerJP_PractitionerRole))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能(内容に到達可能)である必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. MedicationDispense.detectedIssue
Definition

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

患者に対する1つまたは複数のアクティブまたは提案された臨床アクションを伴う、またはそれらの間の実際のまたは潜在的な臨床問題を示す。例えば薬物間相互作用、重複治療、投与量アラートなど。 DetectedIssue リソースへの参照。

Control0..*
TypeReference(DetectedIssue))
Alternate NamesContraindicationDrug Utilization Review (DUR)Alert
Comments

This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. MedicationDispense.eventHistory
Definition

A summary of the events of interest that have occurred, such as when the dispense was verified.

調剤が確認されたときなど、発生した対象のイベントのサマリー。

Control0..*
TypeReference(Provenance))
Comments

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))