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_Patient - Detailed Descriptions

Active as of 2022-10-24

Definitions for the jp-patient resource profile.

1. Patient
Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

ケアまたはその他の健康関連サービスを受けている個人または動物に関する人口統計およびその他の管理情報。

2. Patient.extension
SlicingThis element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
3. Patient.extension:religion
SliceNamereligion
Definition

The patient's professed religious affiliations. 患者の公言された宗教的所属。

Control0..*
TypeExtension(religion) (Extension Type: CodeableConcept)
Comments

患者の宗教をValueSet(v3.ReligiousAffiliation)より選択する。輸血や食事で考慮が必要な場合がある。

  • 1013 キリスト教
  • 1020 ヒンドゥー教
  • 1023 イスラム教

など

4. Patient.extension:birthPlace
SliceNamebirthPlace
Definition

The registered place of birth of the patient. A system may use the address.text if they don't store the birthPlace address in discrete elements. 患者の登録された出生地。システムは、birthPlaceアドレスを個別の要素に格納しない場合、address.textを使用してよい。

Control0..1
TypeExtension(birthPlace) (Extension Type: Address)
Comments

患者の生誕地をAddress型で表現する

5. Patient.extension:race
SliceNamerace
Definition

Optional Extension Element - found in all resources. オプションの拡張要素-すべてのリソースで使用できる。

Control0..*
TypeExtension(JP_Patient_Race) (Extension Type: CodeableConcept)
Comments

患者の人種をValueSet(Race)より選択する。

  • 2034-7 中国人
  • 2039-6 日本人
  • 2040-4 韓国人
  • 2108-9 ヨーロッパ人
  • 2110-5 英国人
  • 2111-3 フランス人
  • 2112-1 ドイツ人

など

6. Patient.identifier
Definition

An identifier for this patient.

この患者の識別子。

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

Patients are almost always assigned specific numerical identifiers.

ほとんどの場合、患者には特定の数値識別子が割り当てられる。

Comments

IDの名前空間を表す Patient.identifier.system と ID値そのものを表す Patient.identifier.value の組み合わせとして表現する。
Patient.identifier.system には、urn:oid:1.2.392.100495.20.3.51.医療機関識別OID番号を使用する。
医療機関識別OID番号は患者IDの発行者である機関の医療機関コード(10桁)の先頭に1をつけた11桁とする。医療機関コード(10桁)の詳細はこちらのリンクを参照すること。

例:医療機関コード「1312345670」の場合「urn:oid:1.2.392.100495.20.3.51.11312345670」

なお、urn:oid:1.2.392.100495.20.3.51の部分は、「処方情報 HL7FHIR 記述仕様」表19 識別子名前空間一覧において医療機関等の患者IDとして割り当てられたOIDのURL型である。地域医療連携ネットワークの地域患者IDを指定する場合も同様に、地域患者IDを識別する名前空間(IHE ITI PIX等で使用されるOID等)をsystemに使用することができる。

7. Patient.identifier.use
Control0..?
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
IDの種別をValueSet(IdentifierUse)より選択する。

  • usual : 一般
  • official : 公式(マイナンバーなど、最も信頼できると見なされる場合に使用)
  • temp : 一時的
  • secondary : 二次利用
  • old : 過去の識別子
8. Patient.identifier.type
Control0..?
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.
IDの種別をValueSet(Identifier Type Codes)より選択する。

  • DL : 運転免許証番号
  • PPN : パスポート番号
  • BRN : 血統登録番号
  • MR : カルテ番号

など

9. Patient.identifier.system
Control0..?
Comments

Identifier.system is always case sensitive.
Patient.identifier.system には、urn:oid:1.2.392.100495.20.3.51.医療機関識別OID番号を使用する。
医療機関識別OID番号は患者IDの発行者である機関の医療機関コード(10桁)の先頭に1をつけた11桁とする。医療機関コード(10桁)の詳細はこちらのリンクを参照すること。

例:医療機関コード「1312345670」の場合「urn:oid:1.2.392.100495.20.3.51.11312345670」

なお、urn:oid:1.2.392.100495.20.3.51の部分は、「処方情報 HL7FHIR 記述仕様」表19 識別子名前空間一覧において医療機関等の患者IDとして割り当てられたOIDのURL型である。地域医療連携ネットワークの地域患者IDを指定する場合も同様に、地域患者IDを識別する名前空間(IHE ITI PIX等で使用されるOID等)をsystemに使用することができる。

10. Patient.identifier.value
Control1..?
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 processor to be confident that non-case-sensitive processing is safe.

患者を一意的に識別するID(例えば、患者IDやカルテ番号など)を設定。

11. Patient.identifier.period
Control0..?
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.

IDが使われていた/使われている期間。

12. Patient.identifier.assigner
Control0..?
TypeReference(JP_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.

IDを発行した組織(テキストのみでも可)

13. Patient.active
Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
この患者記録がアクティブに使用されているかどうか。多くのシステムは、このプロパティを使用して、組織のビジネスルールに基づいて一定期間見られなかった患者など、非現在の患者としてマークする。
非アクティブな患者を除外するために患者リストをフィルタリングするためによく使用される。
死亡した患者は、同じ理由で不活性とマークされる場合があるが、死後しばらくは活性である場合がある。

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Requirements

Need to be able to mark a patient record as not to be used because it was created in error.
患者レコードが誤って作成された場合のため、使用されないレコードとしてマークできる必要がある。

Need to be able to mark a patient record as not to be used because it was created in error.

Comments

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
この患者の記録が有効かどうか
誤って患者を登録して削除したい場合などにfalseにする

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element アクティブな要素に値が指定されていない場合、このリソースは通常アクティブであると想定される
14. Patient.name
Definition

A name associated with the individual.

個人に関連付けられた名前。

TypeHumanName(JP_HumanName)
Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

複数の名前で患者を追跡できる必要がある。例としては、正式名とパートナー名がある。

Comments

Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
患者は、用途や適用期間が異なる複数の名前を持つ場合がある。動物の場合、名前は人間によって割り当てられて使用され、同じパターンを持つという意味で「HumanName」を使用する。
FHIRデータ型仕様に従って、以下の内容を採用する。

  • 姓名分割できる場合は、名前パート HumanName.familyとHumanName.givenに指定する
  • ミドルネームがある場合は、given に指定する(givenは繰り返し可能)
  • 姓名に分割できない場合は、HumanName.text にフルネームを指定する
  • 各名前パートとtext は、両方存在してもよい
  • 漢字氏名、カナ氏名の区別は、iso21090-EN-representation を使用する

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

15. Patient.telecom
Definition

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

個人に連絡するための連絡先の詳細(電話番号や電子メールアドレスなど)。

Requirements

People have (primary) ways to contact them in some way such as phone, email.

人々は、電話、電子メールなどの何らかの方法で彼らに連絡する(プライマリ)方法を持っている。

Comments

A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

患者は、さまざまな用途または適用期間違いで連絡先を複数の方法を持っている場合がある。緊急時連絡先として、また身元確認を支援するためのオプションが必要になる場合がある。患者当人に直接連絡できない場合があるが、患者を代理できる別の関係者(自宅の電話、またはペットの所有者の電話)を設定する場合もある。

16. Patient.telecom.system
Control0..?
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size
患者の連絡先の種別をValueSet(ContactPointSystem)より選択する。

  • phone : 電話
  • fax : Fax
  • email : 電子メール
  • pager : ポケットベル
  • url : 電話、ファックス、ポケットベル、または電子メールアドレスではなく、URLとして表される連絡先
    これはWebサイト、ブログ、Skype、Twitter、Facebookなどのさまざまな機関または個人の連絡先を対象としている。電子メールアドレスには使用しないこと。
  • sms : SMSメッセージの送信に使用できる連絡先(携帯電話、一部の固定電話など)
  • other : 電話、Fax、ポケットベル、または電子メールアドレスではなく、URLとして表現できない連絡先
    例:内部メールアドレス。これは、URLとして表現できる連絡先(Skype、Twitter、Facebookなど)には使用しないこと。
17. Patient.telecom.value
Control0..?
Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

連絡先の番号やメールアドレス

18. Patient.telecom.use
Control0..?
Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
患者の連絡先の種別をValueSet(ContactPointUse)より選択する。

  • home : 自宅
  • work : 職場
  • temp : 一時的
  • old : 以前の
  • mobile : モバイル機器
19. Patient.telecom.rank
Control0..?
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

連絡先の使用順序(1 = 最高)

20. Patient.telecom.period
Control0..?
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.
連絡先が使用されていた/されている期間

21. Patient.gender
Definition

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. 管理上の性別-患者が管理および記録管理の目的で持つと見なされる性別。

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

患者の性別をValueSet(AdministrativeGender)より選択する。 male 男性 female 女性 other その他 unknown 不明

22. Patient.birthDate
Definition

The date of birth for the individual. 個人の生年月日

The date of birth for the individual.

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
実際の生年月日が不明な場合は、少なくとも推定年を推測として提供する必要があり、時間が必要な場合(出産/乳児ケアシステムなど)に使用できる標準の拡張extension「patient-birthTime」がある。
患者の生年月日をYYYY-MM-DD形式で入れる。
例:1945-08-23

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

23. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not. 個人が死亡しているかどうかを示す。

Indicates if the individual is deceased or not.

[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
値がない場合は、個人が死亡したかどうかについてのステートメントがないことを意味し、ほとんどのシステムは、値がないことを人が生きていることの兆候として解釈する。
患者が死亡しているかどうかを示す
deceasedBooleanまたはdeceasedDateTimeのどちらかに値が入る

  • deceasedBoolean : true(死亡) / false(生存)
  • deceasedDateTime : 患者の死亡日時

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

24. Patient.address
Definition

An address for the individual. 個人の住所。

An address for the individual.

Comments

Patient may have multiple addresses with different uses or applicable periods. 患者は、異なる用途または適用可能な期間で複数の住所を持っている可能性がある。

【JP Core仕様】FHIRデータ型仕様に従って、以下の案とした。

  • 住所が構造化されている場合、住所パート Address.country、Address.postalcode、Address.state、Address.city、Address.line に分割して記載する
  • 住所が構造化されていない場合は、Address.text に記述する
  • 各住所パートとtext は、両方存在してもよい

※診療文書構造化記述規約等では、streetAddressLine (FHIRではlineに対応) に指定するとなっていた。

Patient may have multiple addresses with different uses or applicable periods.

25. Patient.address.use
Definition

The purpose of this address. 住所の用途

Control0..?
Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

住所の用途をValueSet(AddressUse)より選択する。

  • home : 自宅
  • work : 職場
  • temp : 一時的
  • old : 以前の
  • billing : 請求書、インボイス、領収書などの送付用
26. Patient.address.type
Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

住所(訪問できる住所)と郵送先住所(私書箱や気付住所など)を区別する。ほとんどのアドレスは両方。

Control0..?
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).
住所の種類をValueSet(AddressType)より選択する。

  • postal : 郵送先 - 私書箱、気付の住所
  • physical : 訪れることのできる物理的な住所
  • both : postalとphysicalの両方
27. Patient.address.text
Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
表示するアドレス全体を指定する
例:郵便ラベル。これは、特定の部品の代わりに、または特定の部品と同様に提供される場合がある。

Control0..?
Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
テキスト表現とパーツの両方を提供できる。アドレスを更新するアプリケーションは、テキストとパーツの両方が存在する場合、パーツにないコンテンツはテキストに含まれないようにする必要がある。

  • 住所を(都道府県や市町村などに)分離して管理していない場合は、textに入れる。
  • 住所を(都道府県や市町村などに)分離して管理している場合でも、まとめてtextに入れること。
  • 郵便番号は含めない。

例:東京都文京区本郷7-3-1

28. Patient.address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. このコンポーネントには、家番号、アパート番号、通りの名前、通りの方向、P.O。が含まれる。ボックス番号、配達のヒント、および同様の住所情報など。

Control0..?
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
【JP Core仕様】state要素とcity要素で表現しなかったそのあとの住所部分を番地以降の部分も含めてすべていれる。
英数字は半角でも全角でもよい。文字列の前後および途中に空白文字を含めないこと。
繰り返し要素が許されているので、区切りを表現したい場合には、複数要素に分けて格納してもよい。

例:本郷7-3-1
例:大字石神976
例:藤崎町大字藤崎字西村1-2 春山荘201号室

29. Patient.address.city
Definition

The name of the city, town, suburb, village or other community or delivery center. 市、町、郊外、村、その他のコミュニティまたは配達センターの名前。

Control0..?
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
【JP Core仕様】郡市区町村部分だけを「郡」「市」「区」「町」「村」などの文字を含めて設定する。 例:文京区

30. Patient.address.district
Control0..?
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. 【JP Core仕様】日本の住所では使用しない。

31. Patient.address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). 国の主権が制限されている国のサブユニット。日本の場合、都道府県名。

Control0..?
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
都道府県名。「都」「道」「府」「県」のそれぞれの文字を含める。 例:東京都

32. Patient.address.postalCode
Control0..?
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
郵便番号。日本の郵便番号の場合には3桁数字とハイフン1文字と4桁数字からなる半角8文字、または最初の3桁だけの3文字のいずれかとする。 例:113-8655

33. Patient.address.country
Definition

Country - a nation as commonly understood or generally accepted. 国-一般的に理解されている、または一般的に受け入れられている国の国名かコード。

Control0..?
Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.
ISO 3166 3文字コードは、人間が読める国名の代わりに使用する。
ISO 3166の2文字または3文字のコード
日本であれば、jpまたはjpn

34. Patient.address.period
Definition

Time period when address was/is in use. 住所が使用されていた(いる)期間

Control0..?
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
住所が使用されていた/されている期間。
期間は時間の範囲を指定する。使用状況はその期間全体に適用されるか、範囲から1つの値が適用される。
期間は、時間間隔(経過時間の測定値)には使用されない。

35. Patient.maritalStatus
Definition

This field contains a patient's most recent marital (civil) status. このフィールドは患者の最新の婚姻(市民)状態が含む。

This field contains a patient's most recent marital (civil) status.

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.
患者の婚姻関係をValueSet(Marital Status Codes)より選択する。

  • A : 婚姻取消・無効
  • D : 離婚
  • I : 暫定法令
  • L : 法的別居中
  • M : 既婚
  • P : 一夫多妻制
  • S : 生涯独身・非婚
  • T : 同棲
  • U : 未婚
  • W : 未亡人
  • UNK : 不明
36. Patient.multipleBirth[x]
Definition

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). 患者が多胎児の一人であるか(boolean)、実際の出生順位(integer)であるかを示す。

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. 多産児の曖昧性解消、特にラボなど、医療提供者が患者に会わない場合に関連する。

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).
multipleBirthBooleanまたはmultipleBirthIntegerのどちらかに値が入る

  • multipleBirthBoolean : 多胎出産時かどうか
    3つ子の例にbooleanが指定された場合、3つの患者レコードすべてがvalueBoolean = trueになる(順序は示されない)
  • multipleBirthInteger : 多胎出産時の出生順位
    たとえば、3つ子の2番目の生まれはvalueInteger = 2で、3番目の生まれはvalueInteger = 3になる

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

37. Patient.photo
Definition

Image of the patient. 患者の画像。

Image of the patient.

Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

多くのEHRシステムには、患者の画像をキャプチャする機能がある。より新しいソーシャルメディアの使用にも適合する。

Comments

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates

ガイドライン:

  • 臨床写真ではなく、身分証明写真を使用すること
  • 寸法をサムネイルに制限する
  • リソースの更新を容易にするため、バイト数を少なくすること

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates.
38. Patient.contact
Definition

A contact party (e.g. guardian, partner, friend) for the patient.

患者の連絡先者(例:保護者、パートナー、友人)。

Requirements

Need to track people you can contact about the patient.

患者について連絡できる人を確認する必要がある。

Comments

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

連絡先には、家族、取引先、保護者、介護者など、あらゆる種類の連絡先が含まれる。連絡先として使用しない親戚や家族を登録するためには適用されない。

39. Patient.contact.relationship
Definition

The nature of the relationship between the patient and the contact person.

患者と連絡先の関係性。

Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

状況に応じて、アプローチするのに最適な関係者を決定するために使用される。

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.
患者との関係性をValueSet(PatientContactRelationship)より選択する。

  • C : 緊急連絡先
  • E : 雇用者
  • F : 連邦政府機関
  • I : 保険会社
  • N : 近親者
  • S : 州政府機関
  • U : 不明
40. Patient.contact.name
Definition

A name associated with the contact person.

連絡先に登録された名前。

Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

連絡先は名前で識別する必要があるが、その連絡先に複数の名前が必要になることはまれである。

41. Patient.contact.telecom
Definition

A contact detail for the person, e.g. a telephone number or an email address.

連絡先に登録された連絡方法(電話番号やメールアドレスなど)。

Requirements

People have (primary) ways to contact them in some way such as phone, email.

電話、電子メールなどの(優先する)連絡方法を確認する必要がある。

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

連絡先には、さまざまな用途または適用期間で連絡を取るための複数の方法がある。その人に緊急に連絡する際の連絡先を確認する必要がある。

42. Patient.contact.address
Definition

Address for the contact person. 連絡先の住所。

Address for the contact person.

Requirements

Need to keep track where the contact person can be contacted per postal mail or visited. 郵送ないし訪問により連絡を取ることができるよう注意する必要があるため。

Need to keep track where the contact person can be contacted per postal mail or visited.

43. Patient.contact.gender
Definition

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. 管理上の性別-連絡先担当者が管理および記録管理のために持っていると考えられる性別。

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

Requirements

Needed to address the person correctly. その人に正しく話しかけるために必要である。

Needed to address the person correctly.

44. Patient.contact.organization
Definition

Organization on behalf of which the contact is acting or for which the contact is working. 連絡先が主として活動する、または勤務している組織。

Organization on behalf of which the contact is acting or for which the contact is working.

TypeReference(JP_Organization|Organization))
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.

連絡先に関連する組織

45. Patient.contact.period
Definition

The period during which this contact person or organization is valid to be contacted relating to this patient. この患者に関連して、この連絡担当者または組織に連絡することが有効な期間。

The period during which this contact person or organization is valid to be contacted relating to this patient.

46. Patient.communication
Definition

A language which may be used to communicate with the patient about his or her health. 彼または彼女の健康について患者と会話する際に使用する言語。

A language which may be used to communicate with the patient about his or her health.

Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
患者が現地の言語を話さない場合、通訳が必要になる場合があるため、話せる言語と習熟度は、患者と関心のある他の人の両方にとって注意すべき重要な事項である。

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
言語が指定されていない場合、デフォルトのローカル言語が話されていることを意味する。複数のモードの習熟度を伝える必要がある場合は、複数のPatient.Communicationアソシエーションが必要である。動物の場合、言語は関連するフィールドではないため、インスタンスから除外する必要がある。患者がデフォルトの現地言語を話さない場合、通訳者が必要であることを明示的に宣言するために、通訳者必須基準を使用できる。

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

47. Patient.communication.language
Definition

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
ISO-639-1 alpha 2コード小文字で言語を、またオプションとしてハイフンとISO-3166-1 alpha 2コード大文字を続けて地域を表す。たとえば、英語の場合は「en」、アメリカ英語の場合は「en-US」、イギリス英語の場合は「en-EN」である。

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. 多言語の国のほとんどのシステムは、言語を伝えたいと考えられる。 すべてのシステムが実際に地域の方言を必要とするわけではない。

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

患者とコミュニケーションするときに使用できる言語をValueSet(CommonLanguages)より選択する。

  • de : ドイツ語
  • en : 英語
  • fr : フランス語
  • ja : 日本語
  • ko : 韓国語
    など
48. Patient.communication.preferred
Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

患者がこの言語を優先するかどうかを示す(他の言語よりも特定レベルまで習得している)。

Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

特定のレベルまで複数の言語を習得している人は、複数の言語を選択する可能性がある。つまり、特定の言語でのコミュニケーションに自信を持ち、他の言語を一種の備えとしている。

Comments

This language is specifically identified for communicating healthcare information.

この言語は、医療情報を伝えるために特に識別される。 患者がこの言語を習得している場合はtrue、そうでなければfalseを設定する。

49. Patient.generalPractitioner
Definition

Patient's nominated care provider. 患者が指名するケア提供者

Patient's nominated care provider.

TypeReference(JP_Organization|JP_Practitioner|JP_PractitionerRole|Organization|Practitioner|PractitionerRole))
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.
Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
これはプライマリケア提供者(GPを含む)である場合もあれば、コミュニティ/障害を持つ患者指定のケアマネージャーである場合もある。ケアチームの記録には使用されない。これらはケアプランまたはEpisodeOfCareリソースにリンクされるCareTeamリソースに含まれている必要がある。複数のGPは、学期中の大学GPと共にリストされた家庭GPなどの学生や、「フライイン/フライアウト」労働者など、さまざまな理由で患者に対して記録される場合がある。また、医学的問題を認識し続けるために家庭GPに含まれる。
管轄区域は、必要に応じてこれを1、またはタイプごとに1にプロファイルできると決定する場合がある。

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

50. Patient.managingOrganization
Definition

Organization that is the custodian of the patient record. 患者記録の管理者である組織。

Organization that is the custodian of the patient record.

TypeReference(JP_Organization|Organization))
Requirements

Need to know who recognizes this patient record, manages and updates it.

この患者記録を誰が認識し、管理し、更新するかを知る必要がある。

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

特定の患者記録を管理する組織は1つだけである。他の組織には独自の患者レコードがあり、Linkプロパティを使用してレコードを結合する場合がある(または、関連付けの信頼性評価を含めることができる個人リソース)

51. Patient.link
Definition

Link to another patient resource that concerns the same actual patient.

事実上の同一患者をリンクする別のPatientリソース。

Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers

複数のユースケースがある。

  • 事務的なエラーのため一貫して人間を特定することが困難であり患者の記録が重複している
  • 複数のサーバにわたり患者情報が配布されている

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers.
Comments

There is no assumption that linked patient records have mutual links.

リンクされた患者記録に相互リンクがあるという仮定はない。

52. Patient.link.other
Definition

The other patient resource that the link refers to.

リンクが参照する他の患者リソース。

TypeReference(JP_Patient|RelatedPerson|Patient))
Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

ここでRelatedPersonを参照すると、Personレコードを使用して患者とRelatedPersonを同じ個人として関連付ける必要がなくなる。

53. Patient.link.type
Definition

The type of link between this patient resource and another patient resource.

この患者リソースと別の患者リソース間のリンクのタイプ。

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size
この患者リソースと別の患者リソース間のリンクのタイプをValueSet(LinkType)より選択する。

  • replaced-by : このリンクを含む患者リソースは使用しないこと
  • replaces : このリンクを含む患者リソースは、現在アクティブな患者レコードである
  • refer : このリンクを含む患者リソースは使用中であり、有効であるが、患者に関する主な情報源とは見なされていない
  • seealso : このリンクを含む患者リソースは使用中で有効であるが、同じ人物に関するデータが含まれていることがわかっている別の患者リソースを指す
1. Patient
Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

ケアまたはその他の健康関連サービスを受けている個人または動物に関する人口統計およびその他の管理情報。

Control0..*
Alternate NamesSubjectOfCare Client Resident
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())
2. Patient.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. Patient.extension
Definition

An Extension

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.

Control0..*
TypeExtension
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())
SlicingThis element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. Patient.extension:religion
SliceNamereligion
Definition

The patient's professed religious affiliations. 患者の公言された宗教的所属。

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(religion) (Extension Type: CodeableConcept)
Comments

患者の宗教をValueSet(v3.ReligiousAffiliation)より選択する。輸血や食事で考慮が必要な場合がある。

  • 1013 キリスト教
  • 1020 ヒンドゥー教
  • 1023 イスラム教

など

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. Patient.extension:birthPlace
SliceNamebirthPlace
Definition

The registered place of birth of the patient. A system may use the address.text if they don't store the birthPlace address in discrete elements. 患者の登録された出生地。システムは、birthPlaceアドレスを個別の要素に格納しない場合、address.textを使用してよい。

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(birthPlace) (Extension Type: Address)
Comments

患者の生誕地をAddress型で表現する

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())
6. Patient.extension:race
SliceNamerace
Definition

Optional Extension Element - found in all resources. オプションの拡張要素-すべてのリソースで使用できる。

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(JP_Patient_Race) (Extension Type: CodeableConcept)
Comments

患者の人種をValueSet(Race)より選択する。

  • 2034-7 中国人
  • 2039-6 日本人
  • 2040-4 韓国人
  • 2108-9 ヨーロッパ人
  • 2110-5 英国人
  • 2111-3 フランス人
  • 2112-1 ドイツ人

など

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())
7. Patient.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())
8. Patient.identifier
Definition

An identifier for this patient.

この患者の識別子。

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

Patients are almost always assigned specific numerical identifiers.

ほとんどの場合、患者には特定の数値識別子が割り当てられる。

Comments

IDの名前空間を表す Patient.identifier.system と ID値そのものを表す Patient.identifier.value の組み合わせとして表現する。
Patient.identifier.system には、urn:oid:1.2.392.100495.20.3.51.医療機関識別OID番号を使用する。
医療機関識別OID番号は患者IDの発行者である機関の医療機関コード(10桁)の先頭に1をつけた11桁とする。医療機関コード(10桁)の詳細はこちらのリンクを参照すること。

例:医療機関コード「1312345670」の場合「urn:oid:1.2.392.100495.20.3.51.11312345670」

なお、urn:oid:1.2.392.100495.20.3.51の部分は、「処方情報 HL7FHIR 記述仕様」表19 識別子名前空間一覧において医療機関等の患者IDとして割り当てられたOIDのURL型である。地域医療連携ネットワークの地域患者IDを指定する場合も同様に、地域患者IDを識別する名前空間(IHE ITI PIX等で使用されるOID等)をsystemに使用することができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. Patient.identifier.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.
IDの種別をValueSet(IdentifierUse)より選択する。

  • usual : 一般
  • official : 公式(マイナンバーなど、最も信頼できると見なされる場合に使用)
  • temp : 一時的
  • secondary : 二次利用
  • old : 過去の識別子

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()))
10. Patient.identifier.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.
IDの種別をValueSet(Identifier Type Codes)より選択する。

  • DL : 運転免許証番号
  • PPN : パスポート番号
  • BRN : 血統登録番号
  • MR : カルテ番号

など

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()))
11. Patient.identifier.system
Definition

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

Control0..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.
Patient.identifier.system には、urn:oid:1.2.392.100495.20.3.51.医療機関識別OID番号を使用する。
医療機関識別OID番号は患者IDの発行者である機関の医療機関コード(10桁)の先頭に1をつけた11桁とする。医療機関コード(10桁)の詳細はこちらのリンクを参照すること。

例:医療機関コード「1312345670」の場合「urn:oid:1.2.392.100495.20.3.51.11312345670」

なお、urn:oid:1.2.392.100495.20.3.51の部分は、「処方情報 HL7FHIR 記述仕様」表19 識別子名前空間一覧において医療機関等の患者IDとして割り当てられたOIDのURL型である。地域医療連携ネットワークの地域患者IDを指定する場合も同様に、地域患者IDを識別する名前空間(IHE ITI PIX等で使用されるOID等)をsystemに使用することができる。

Identifier.system is always case sensitive.

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()))
12. Patient.identifier.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 processor to be confident that non-case-sensitive processing is safe.

患者を一意的に識別するID(例えば、患者IDやカルテ番号など)を設定。

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()))
13. Patient.identifier.period
Definition

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

Control0..1
TypePeriod
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.

IDが使われていた/使われている期間。

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

Organization that issued/manages the identifier.

Control0..1
TypeReference(JP_Organization|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.

IDを発行した組織(テキストのみでも可)

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

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
この患者記録がアクティブに使用されているかどうか。多くのシステムは、このプロパティを使用して、組織のビジネスルールに基づいて一定期間見られなかった患者など、非現在の患者としてマークする。
非アクティブな患者を除外するために患者リストをフィルタリングするためによく使用される。
死亡した患者は、同じ理由で不活性とマークされる場合があるが、死後しばらくは活性である場合がある。

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Control0..1
Typeboolean
Is Modifiertrue
Requirements

Need to be able to mark a patient record as not to be used because it was created in error.
患者レコードが誤って作成された場合のため、使用されないレコードとしてマークできる必要がある。

Need to be able to mark a patient record as not to be used because it was created in error.

Comments

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
この患者の記録が有効かどうか
誤って患者を登録して削除したい場合などにfalseにする

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Patient.name
Definition

A name associated with the individual.

個人に関連付けられた名前。

Control0..* This element is affected by the following invariants: ele-1
TypeHumanName(JP_HumanName)
Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

複数の名前で患者を追跡できる必要がある。例としては、正式名とパートナー名がある。

Comments

Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
患者は、用途や適用期間が異なる複数の名前を持つ場合がある。動物の場合、名前は人間によって割り当てられて使用され、同じパターンを持つという意味で「HumanName」を使用する。
FHIRデータ型仕様に従って、以下の内容を採用する。

  • 姓名分割できる場合は、名前パート HumanName.familyとHumanName.givenに指定する
  • ミドルネームがある場合は、given に指定する(givenは繰り返し可能)
  • 姓名に分割できない場合は、HumanName.text にフルネームを指定する
  • 各名前パートとtext は、両方存在してもよい
  • 漢字氏名、カナ氏名の区別は、iso21090-EN-representation を使用する

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

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

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

個人に連絡するための連絡先の詳細(電話番号や電子メールアドレスなど)。

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

人々は、電話、電子メールなどの何らかの方法で彼らに連絡する(プライマリ)方法を持っている。

Comments

A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

患者は、さまざまな用途または適用期間違いで連絡先を複数の方法を持っている場合がある。緊急時連絡先として、また身元確認を支援するためのオプションが必要になる場合がある。患者当人に直接連絡できない場合があるが、患者を代理できる別の関係者(自宅の電話、またはペットの所有者の電話)を設定する場合もある。

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

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control0..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem

Telecommunications form for contact point.

Typecode
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size
患者の連絡先の種別をValueSet(ContactPointSystem)より選択する。

  • phone : 電話
  • fax : Fax
  • email : 電子メール
  • pager : ポケットベル
  • url : 電話、ファックス、ポケットベル、または電子メールアドレスではなく、URLとして表される連絡先
    これはWebサイト、ブログ、Skype、Twitter、Facebookなどのさまざまな機関または個人の連絡先を対象としている。電子メールアドレスには使用しないこと。
  • sms : SMSメッセージの送信に使用できる連絡先(携帯電話、一部の固定電話など)
  • other : 電話、Fax、ポケットベル、または電子メールアドレスではなく、URLとして表現できない連絡先
    例:内部メールアドレス。これは、URLとして表現できる連絡先(Skype、Twitter、Facebookなど)には使用しないこと。
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Patient.telecom.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control0..1
Typestring
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

連絡先の番号やメールアドレス

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

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse

Use of contact point.

Typecode
Is Modifiertrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
患者の連絡先の種別をValueSet(ContactPointUse)より選択する。

  • home : 自宅
  • work : 職場
  • temp : 一時的
  • old : 以前の
  • mobile : モバイル機器

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

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

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Control0..1
TypepositiveInt
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

連絡先の使用順序(1 = 最高)

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

Time period when the contact point was/is in use.

Control0..1
TypePeriod
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.
連絡先が使用されていた/されている期間

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

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. 管理上の性別-患者が管理および記録管理の目的で持つと見なされる性別。

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

Control0..1
BindingThe codes SHALL be taken from AdministrativeGender

The gender of a person used for administrative purposes.

Typecode
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

患者の性別をValueSet(AdministrativeGender)より選択する。 male 男性 female 女性 other その他 unknown 不明

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

The date of birth for the individual. 個人の生年月日

The date of birth for the individual.

Control0..1
Typedate
Requirements

Age of the individual drives many clinical processes.

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
実際の生年月日が不明な場合は、少なくとも推定年を推測として提供する必要があり、時間が必要な場合(出産/乳児ケアシステムなど)に使用できる標準の拡張extension「patient-birthTime」がある。
患者の生年月日をYYYY-MM-DD形式で入れる。
例:1945-08-23

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
LOINC Code21112-8
25. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not. 個人が死亡しているかどうかを示す。

Indicates if the individual is deceased or not.

Control0..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
値がない場合は、個人が死亡したかどうかについてのステートメントがないことを意味し、ほとんどのシステムは、値がないことを人が生きていることの兆候として解釈する。
患者が死亡しているかどうかを示す
deceasedBooleanまたはdeceasedDateTimeのどちらかに値が入る

  • deceasedBoolean : true(死亡) / false(生存)
  • deceasedDateTime : 患者の死亡日時

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

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

An address for the individual. 個人の住所。

An address for the individual.

Control0..*
TypeAddress
Requirements

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Comments

Patient may have multiple addresses with different uses or applicable periods. 患者は、異なる用途または適用可能な期間で複数の住所を持っている可能性がある。

【JP Core仕様】FHIRデータ型仕様に従って、以下の案とした。

  • 住所が構造化されている場合、住所パート Address.country、Address.postalcode、Address.state、Address.city、Address.line に分割して記載する
  • 住所が構造化されていない場合は、Address.text に記述する
  • 各住所パートとtext は、両方存在してもよい

※診療文書構造化記述規約等では、streetAddressLine (FHIRではlineに対応) に指定するとなっていた。

Patient may have multiple addresses with different uses or applicable periods.

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

The purpose of this address. 住所の用途

The purpose of this address.

Control0..1
BindingThe codes SHALL be taken from AddressUse

The use of an address.

Typecode
Is Modifiertrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

住所の用途をValueSet(AddressUse)より選択する。

  • home : 自宅
  • work : 職場
  • temp : 一時的
  • old : 以前の
  • billing : 請求書、インボイス、領収書などの送付用
Example
General:home
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Patient.address.type
Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

住所(訪問できる住所)と郵送先住所(私書箱や気付住所など)を区別する。ほとんどのアドレスは両方。

Control0..1
BindingThe codes SHALL be taken from AddressType

The type of an address (physical / postal).

Typecode
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).
住所の種類をValueSet(AddressType)より選択する。

  • postal : 郵送先 - 私書箱、気付の住所
  • physical : 訪れることのできる物理的な住所
  • both : postalとphysicalの両方

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Example
General:both
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Patient.address.text
Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
表示するアドレス全体を指定する
例:郵便ラベル。これは、特定の部品の代わりに、または特定の部品と同様に提供される場合がある。

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
テキスト表現とパーツの両方を提供できる。アドレスを更新するアプリケーションは、テキストとパーツの両方が存在する場合、パーツにないコンテンツはテキストに含まれないようにする必要がある。

  • 住所を(都道府県や市町村などに)分離して管理していない場合は、textに入れる。
  • 住所を(都道府県や市町村などに)分離して管理している場合でも、まとめてtextに入れること。
  • 郵便番号は含めない。

例:東京都文京区本郷7-3-1

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Example
General:137 Nowhere Street, Erewhon 9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Patient.address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. このコンポーネントには、家番号、アパート番号、通りの名前、通りの方向、P.O。が含まれる。ボックス番号、配達のヒント、および同様の住所情報など。

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Control0..*
Typestring
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
【JP Core仕様】state要素とcity要素で表現しなかったそのあとの住所部分を番地以降の部分も含めてすべていれる。
英数字は半角でも全角でもよい。文字列の前後および途中に空白文字を含めないこと。
繰り返し要素が許されているので、区切りを表現したい場合には、複数要素に分けて格納してもよい。

例:本郷7-3-1
例:大字石神976
例:藤崎町大字藤崎字西村1-2 春山荘201号室

Example
General:137 Nowhere Street
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Patient.address.city
Definition

The name of the city, town, suburb, village or other community or delivery center. 市、町、郊外、村、その他のコミュニティまたは配達センターの名前。

The name of the city, town, suburb, village or other community or delivery center.

Control0..1
Typestring
Alternate NamesMunicpality
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
【JP Core仕様】郡市区町村部分だけを「郡」「市」「区」「町」「村」などの文字を含めて設定する。 例:文京区

Example
General:Erewhon
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Patient.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
Alternate NamesCounty
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. 【JP Core仕様】日本の住所では使用しない。

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Example
General:Madison
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. Patient.address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). 国の主権が制限されている国のサブユニット。日本の場合、都道府県名。

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Control0..1
Typestring
Alternate NamesProvince, Territory
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
都道府県名。「都」「道」「府」「県」のそれぞれの文字を含める。 例:東京都

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

A postal code designating a region defined by the postal service.

Control0..1
Typestring
Alternate NamesZip
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
郵便番号。日本の郵便番号の場合には3桁数字とハイフン1文字と4桁数字からなる半角8文字、または最初の3桁だけの3文字のいずれかとする。 例:113-8655

Example
General:9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Patient.address.country
Definition

Country - a nation as commonly understood or generally accepted. 国-一般的に理解されている、または一般的に受け入れられている国の国名かコード。

Country - a nation as commonly understood or generally accepted.

Control0..1
Typestring
Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.
ISO 3166 3文字コードは、人間が読める国名の代わりに使用する。
ISO 3166の2文字または3文字のコード
日本であれば、jpまたはjpn

ISO 3166 3 letter codes can be used in place of a human readable country name.

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

Time period when address was/is in use. 住所が使用されていた(いる)期間

Time period when address was/is in use.

Control0..1
TypePeriod
Requirements

Allows addresses to be placed in historical context.

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
住所が使用されていた/されている期間。
期間は時間の範囲を指定する。使用状況はその期間全体に適用されるか、範囲から1つの値が適用される。
期間は、時間間隔(経過時間の測定値)には使用されない。

Example
General:<valuePeriod xmlns="http://hl7.org/fhir">
  <start value="2010-03-23"/>
  <end value="2010-07-01"/>
</valuePeriod>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Patient.maritalStatus
Definition

This field contains a patient's most recent marital (civil) status. このフィールドは患者の最新の婚姻(市民)状態が含む。

This field contains a patient's most recent marital (civil) status.

Control0..1
BindingThe codes SHALL be taken from Marital Status Codes; other codes may be used where these codes are not suitable

The domestic partnership status of a person.

TypeCodeableConcept
Requirements

Most, if not all systems capture it.

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.
患者の婚姻関係をValueSet(Marital Status Codes)より選択する。

  • A : 婚姻取消・無効
  • D : 離婚
  • I : 暫定法令
  • L : 法的別居中
  • M : 既婚
  • P : 一夫多妻制
  • S : 生涯独身・非婚
  • T : 同棲
  • U : 未婚
  • W : 未亡人
  • UNK : 不明
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Patient.multipleBirth[x]
Definition

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). 患者が多胎児の一人であるか(boolean)、実際の出生順位(integer)であるかを示す。

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

Control0..1
TypeChoice of: boolean, integer
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. 多産児の曖昧性解消、特にラボなど、医療提供者が患者に会わない場合に関連する。

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).
multipleBirthBooleanまたはmultipleBirthIntegerのどちらかに値が入る

  • multipleBirthBoolean : 多胎出産時かどうか
    3つ子の例にbooleanが指定された場合、3つの患者レコードすべてがvalueBoolean = trueになる(順序は示されない)
  • multipleBirthInteger : 多胎出産時の出生順位
    たとえば、3つ子の2番目の生まれはvalueInteger = 2で、3番目の生まれはvalueInteger = 3になる

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

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

Image of the patient. 患者の画像。

Image of the patient.

Control0..*
TypeAttachment
Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

多くのEHRシステムには、患者の画像をキャプチャする機能がある。より新しいソーシャルメディアの使用にも適合する。

Comments

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates

ガイドライン:

  • 臨床写真ではなく、身分証明写真を使用すること
  • 寸法をサムネイルに制限する
  • リソースの更新を容易にするため、バイト数を少なくすること

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates.
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Patient.contact
Definition

A contact party (e.g. guardian, partner, friend) for the patient.

患者の連絡先者(例:保護者、パートナー、友人)。

Control0..*
TypeBackboneElement
Requirements

Need to track people you can contact about the patient.

患者について連絡できる人を確認する必要がある。

Comments

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

連絡先には、家族、取引先、保護者、介護者など、あらゆる種類の連絡先が含まれる。連絡先として使用しない親戚や家族を登録するためには適用されない。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
pat-1: SHALL at least contain a contact's details or a reference to an organization (: name.exists() or telecom.exists() or address.exists() or organization.exists())
41. Patient.contact.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 Namesextensions, user content, modifiers
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. Patient.contact.relationship
Definition

The nature of the relationship between the patient and the contact person.

患者と連絡先の関係性。

Control0..*
BindingThe codes SHALL be taken from PatientContactRelationship; other codes may be used where these codes are not suitable

The nature of the relationship between a patient and a contact person for that patient.

TypeCodeableConcept
Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

状況に応じて、アプローチするのに最適な関係者を決定するために使用される。

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.
患者との関係性をValueSet(PatientContactRelationship)より選択する。

  • C : 緊急連絡先
  • E : 雇用者
  • F : 連邦政府機関
  • I : 保険会社
  • N : 近親者
  • S : 州政府機関
  • U : 不明
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
43. Patient.contact.name
Definition

A name associated with the contact person.

連絡先に登録された名前。

Control0..1
TypeHumanName
Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

連絡先は名前で識別する必要があるが、その連絡先に複数の名前が必要になることはまれである。

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

A contact detail for the person, e.g. a telephone number or an email address.

連絡先に登録された連絡方法(電話番号やメールアドレスなど)。

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

電話、電子メールなどの(優先する)連絡方法を確認する必要がある。

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

連絡先には、さまざまな用途または適用期間で連絡を取るための複数の方法がある。その人に緊急に連絡する際の連絡先を確認する必要がある。

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

Address for the contact person. 連絡先の住所。

Address for the contact person.

Control0..1
TypeAddress
Requirements

Need to keep track where the contact person can be contacted per postal mail or visited. 郵送ないし訪問により連絡を取ることができるよう注意する必要があるため。

Need to keep track where the contact person can be contacted per postal mail or visited.

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

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. 管理上の性別-連絡先担当者が管理および記録管理のために持っていると考えられる性別。

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

Control0..1
BindingThe codes SHALL be taken from AdministrativeGender

The gender of a person used for administrative purposes.

Typecode
Requirements

Needed to address the person correctly. その人に正しく話しかけるために必要である。

Needed to address the person correctly.

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

Organization on behalf of which the contact is acting or for which the contact is working. 連絡先が主として活動する、または勤務している組織。

Organization on behalf of which the contact is acting or for which the contact is working.

Control0..1 This element is affected by the following invariants: pat-1
TypeReference(JP_Organization|Organization))
Requirements

For guardians or business related contacts, the organization is relevant.

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.

連絡先に関連する組織

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

The period during which this contact person or organization is valid to be contacted relating to this patient. この患者に関連して、この連絡担当者または組織に連絡することが有効な期間。

The period during which this contact person or organization is valid to be contacted relating to this patient.

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Patient.communication
Definition

A language which may be used to communicate with the patient about his or her health. 彼または彼女の健康について患者と会話する際に使用する言語。

A language which may be used to communicate with the patient about his or her health.

Control0..*
TypeBackboneElement
Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
患者が現地の言語を話さない場合、通訳が必要になる場合があるため、話せる言語と習熟度は、患者と関心のある他の人の両方にとって注意すべき重要な事項である。

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
言語が指定されていない場合、デフォルトのローカル言語が話されていることを意味する。複数のモードの習熟度を伝える必要がある場合は、複数のPatient.Communicationアソシエーションが必要である。動物の場合、言語は関連するフィールドではないため、インスタンスから除外する必要がある。患者がデフォルトの現地言語を話さない場合、通訳者が必要であることを明示的に宣言するために、通訳者必須基準を使用できる。

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Patient.communication.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 Namesextensions, user content, modifiers
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())
51. Patient.communication.language
Definition

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
ISO-639-1 alpha 2コード小文字で言語を、またオプションとしてハイフンとISO-3166-1 alpha 2コード大文字を続けて地域を表す。たとえば、英語の場合は「en」、アメリカ英語の場合は「en-US」、イギリス英語の場合は「en-EN」である。

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Control1..1
BindingThe codes SHOULD be taken from CommonLanguages

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
TypeCodeableConcept
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. 多言語の国のほとんどのシステムは、言語を伝えたいと考えられる。 すべてのシステムが実際に地域の方言を必要とするわけではない。

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

患者とコミュニケーションするときに使用できる言語をValueSet(CommonLanguages)より選択する。

  • de : ドイツ語
  • en : 英語
  • fr : フランス語
  • ja : 日本語
  • ko : 韓国語
    など
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Patient.communication.preferred
Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

患者がこの言語を優先するかどうかを示す(他の言語よりも特定レベルまで習得している)。

Control0..1
Typeboolean
Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

特定のレベルまで複数の言語を習得している人は、複数の言語を選択する可能性がある。つまり、特定の言語でのコミュニケーションに自信を持ち、他の言語を一種の備えとしている。

Comments

This language is specifically identified for communicating healthcare information.

この言語は、医療情報を伝えるために特に識別される。 患者がこの言語を習得している場合はtrue、そうでなければfalseを設定する。

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

Patient's nominated care provider. 患者が指名するケア提供者

Patient's nominated care provider.

Control0..*
TypeReference(JP_Organization|JP_Practitioner|JP_PractitionerRole|Organization|Practitioner|PractitionerRole))
Alternate NamescareProvider
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.
Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
これはプライマリケア提供者(GPを含む)である場合もあれば、コミュニティ/障害を持つ患者指定のケアマネージャーである場合もある。ケアチームの記録には使用されない。これらはケアプランまたはEpisodeOfCareリソースにリンクされるCareTeamリソースに含まれている必要がある。複数のGPは、学期中の大学GPと共にリストされた家庭GPなどの学生や、「フライイン/フライアウト」労働者など、さまざまな理由で患者に対して記録される場合がある。また、医学的問題を認識し続けるために家庭GPに含まれる。
管轄区域は、必要に応じてこれを1、またはタイプごとに1にプロファイルできると決定する場合がある。

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

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

Organization that is the custodian of the patient record. 患者記録の管理者である組織。

Organization that is the custodian of the patient record.

Control0..1
TypeReference(JP_Organization|Organization))
Requirements

Need to know who recognizes this patient record, manages and updates it.

この患者記録を誰が認識し、管理し、更新するかを知る必要がある。

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

特定の患者記録を管理する組織は1つだけである。他の組織には独自の患者レコードがあり、Linkプロパティを使用してレコードを結合する場合がある(または、関連付けの信頼性評価を含めることができる個人リソース)

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

Link to another patient resource that concerns the same actual patient.

事実上の同一患者をリンクする別のPatientリソース。

Control0..*
TypeBackboneElement
Is Modifiertrue
Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers

複数のユースケースがある。

  • 事務的なエラーのため一貫して人間を特定することが困難であり患者の記録が重複している
  • 複数のサーバにわたり患者情報が配布されている

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers.
Comments

There is no assumption that linked patient records have mutual links.

リンクされた患者記録に相互リンクがあるという仮定はない。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. Patient.link.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 Namesextensions, user content, modifiers
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())
57. Patient.link.other
Definition

The other patient resource that the link refers to.

リンクが参照する他の患者リソース。

Control1..1
TypeReference(JP_Patient|RelatedPerson|Patient))
Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

ここでRelatedPersonを参照すると、Personレコードを使用して患者とRelatedPersonを同じ個人として関連付ける必要がなくなる。

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

The type of link between this patient resource and another patient resource.

この患者リソースと別の患者リソース間のリンクのタイプ。

Control1..1
BindingThe codes SHALL be taken from LinkType

The type of link between this patient resource and another patient resource.

Typecode
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size
この患者リソースと別の患者リソース間のリンクのタイプをValueSet(LinkType)より選択する。

  • replaced-by : このリンクを含む患者リソースは使用しないこと
  • replaces : このリンクを含む患者リソースは、現在アクティブな患者レコードである
  • refer : このリンクを含む患者リソースは使用中であり、有効であるが、患者に関する主な情報源とは見なされていない
  • seealso : このリンクを含む患者リソースは使用中で有効であるが、同じ人物に関するデータが含まれていることがわかっている別の患者リソースを指す
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
1. Patient
Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

ケアまたはその他の健康関連サービスを受けている個人または動物に関する人口統計およびその他の管理情報。

Control0..*
Alternate NamesSubjectOfCare Client Resident
2. Patient.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. Patient.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. Patient.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. Patient.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. Patient.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. Patient.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. Patient.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 Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. Patient.extension:religion
SliceNamereligion
Definition

The patient's professed religious affiliations. 患者の公言された宗教的所属。

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(religion) (Extension Type: CodeableConcept)
Comments

患者の宗教をValueSet(v3.ReligiousAffiliation)より選択する。輸血や食事で考慮が必要な場合がある。

  • 1013 キリスト教
  • 1020 ヒンドゥー教
  • 1023 イスラム教

など

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. Patient.extension:birthPlace
SliceNamebirthPlace
Definition

The registered place of birth of the patient. A system may use the address.text if they don't store the birthPlace address in discrete elements. 患者の登録された出生地。システムは、birthPlaceアドレスを個別の要素に格納しない場合、address.textを使用してよい。

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(birthPlace) (Extension Type: Address)
Comments

患者の生誕地をAddress型で表現する

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. Patient.extension:race
SliceNamerace
Definition

Optional Extension Element - found in all resources. オプションの拡張要素-すべてのリソースで使用できる。

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(JP_Patient_Race) (Extension Type: CodeableConcept)
Comments

患者の人種をValueSet(Race)より選択する。

  • 2034-7 中国人
  • 2039-6 日本人
  • 2040-4 韓国人
  • 2108-9 ヨーロッパ人
  • 2110-5 英国人
  • 2111-3 フランス人
  • 2112-1 ドイツ人

など

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())
12. Patient.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())
13. Patient.identifier
Definition

An identifier for this patient.

この患者の識別子。

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

Patients are almost always assigned specific numerical identifiers.

ほとんどの場合、患者には特定の数値識別子が割り当てられる。

Comments

IDの名前空間を表す Patient.identifier.system と ID値そのものを表す Patient.identifier.value の組み合わせとして表現する。
Patient.identifier.system には、urn:oid:1.2.392.100495.20.3.51.医療機関識別OID番号を使用する。
医療機関識別OID番号は患者IDの発行者である機関の医療機関コード(10桁)の先頭に1をつけた11桁とする。医療機関コード(10桁)の詳細はこちらのリンクを参照すること。

例:医療機関コード「1312345670」の場合「urn:oid:1.2.392.100495.20.3.51.11312345670」

なお、urn:oid:1.2.392.100495.20.3.51の部分は、「処方情報 HL7FHIR 記述仕様」表19 識別子名前空間一覧において医療機関等の患者IDとして割り当てられたOIDのURL型である。地域医療連携ネットワークの地域患者IDを指定する場合も同様に、地域患者IDを識別する名前空間(IHE ITI PIX等で使用されるOID等)をsystemに使用することができる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Patient.identifier.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.
15. Patient.identifier.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 Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. Patient.identifier.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.
IDの種別をValueSet(IdentifierUse)より選択する。

  • usual : 一般
  • official : 公式(マイナンバーなど、最も信頼できると見なされる場合に使用)
  • temp : 一時的
  • secondary : 二次利用
  • old : 過去の識別子
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Patient.identifier.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.
IDの種別をValueSet(Identifier Type Codes)より選択する。

  • DL : 運転免許証番号
  • PPN : パスポート番号
  • BRN : 血統登録番号
  • MR : カルテ番号

など

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

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

Control0..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.
Patient.identifier.system には、urn:oid:1.2.392.100495.20.3.51.医療機関識別OID番号を使用する。
医療機関識別OID番号は患者IDの発行者である機関の医療機関コード(10桁)の先頭に1をつけた11桁とする。医療機関コード(10桁)の詳細はこちらのリンクを参照すること。

例:医療機関コード「1312345670」の場合「urn:oid:1.2.392.100495.20.3.51.11312345670」

なお、urn:oid:1.2.392.100495.20.3.51の部分は、「処方情報 HL7FHIR 記述仕様」表19 識別子名前空間一覧において医療機関等の患者IDとして割り当てられたOIDのURL型である。地域医療連携ネットワークの地域患者IDを指定する場合も同様に、地域患者IDを識別する名前空間(IHE ITI PIX等で使用されるOID等)をsystemに使用することができる。

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()))
19. Patient.identifier.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 processor to be confident that non-case-sensitive processing is safe.

患者を一意的に識別するID(例えば、患者IDやカルテ番号など)を設定。

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

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

Control0..1
TypePeriod
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.

IDが使われていた/使われている期間。

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

Organization that issued/manages the identifier.

Control0..1
TypeReference(JP_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.

IDを発行した組織(テキストのみでも可)

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

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
この患者記録がアクティブに使用されているかどうか。多くのシステムは、このプロパティを使用して、組織のビジネスルールに基づいて一定期間見られなかった患者など、非現在の患者としてマークする。
非アクティブな患者を除外するために患者リストをフィルタリングするためによく使用される。
死亡した患者は、同じ理由で不活性とマークされる場合があるが、死後しばらくは活性である場合がある。

Control0..1
Typeboolean
Is Modifiertrue
Requirements

Need to be able to mark a patient record as not to be used because it was created in error.
患者レコードが誤って作成された場合のため、使用されないレコードとしてマークできる必要がある。

Comments

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
この患者の記録が有効かどうか
誤って患者を登録して削除したい場合などにfalseにする

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Patient.name
Definition

A name associated with the individual.

個人に関連付けられた名前。

Control0..* This element is affected by the following invariants: ele-1
TypeHumanName(JP_HumanName)
Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

複数の名前で患者を追跡できる必要がある。例としては、正式名とパートナー名がある。

Comments

Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
患者は、用途や適用期間が異なる複数の名前を持つ場合がある。動物の場合、名前は人間によって割り当てられて使用され、同じパターンを持つという意味で「HumanName」を使用する。
FHIRデータ型仕様に従って、以下の内容を採用する。

  • 姓名分割できる場合は、名前パート HumanName.familyとHumanName.givenに指定する
  • ミドルネームがある場合は、given に指定する(givenは繰り返し可能)
  • 姓名に分割できない場合は、HumanName.text にフルネームを指定する
  • 各名前パートとtext は、両方存在してもよい
  • 漢字氏名、カナ氏名の区別は、iso21090-EN-representation を使用する
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Patient.telecom
Definition

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

個人に連絡するための連絡先の詳細(電話番号や電子メールアドレスなど)。

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

人々は、電話、電子メールなどの何らかの方法で彼らに連絡する(プライマリ)方法を持っている。

Comments

A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

患者は、さまざまな用途または適用期間違いで連絡先を複数の方法を持っている場合がある。緊急時連絡先として、また身元確認を支援するためのオプションが必要になる場合がある。患者当人に直接連絡できない場合があるが、患者を代理できる別の関係者(自宅の電話、またはペットの所有者の電話)を設定する場合もある。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Patient.telecom.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.
26. Patient.telecom.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 Patient.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
27. Patient.telecom.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control0..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem Telecommunications form for contact point
Typecode
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size
患者の連絡先の種別をValueSet(ContactPointSystem)より選択する。

  • phone : 電話
  • fax : Fax
  • email : 電子メール
  • pager : ポケットベル
  • url : 電話、ファックス、ポケットベル、または電子メールアドレスではなく、URLとして表される連絡先
    これはWebサイト、ブログ、Skype、Twitter、Facebookなどのさまざまな機関または個人の連絡先を対象としている。電子メールアドレスには使用しないこと。
  • sms : SMSメッセージの送信に使用できる連絡先(携帯電話、一部の固定電話など)
  • other : 電話、Fax、ポケットベル、または電子メールアドレスではなく、URLとして表現できない連絡先
    例:内部メールアドレス。これは、URLとして表現できる連絡先(Skype、Twitter、Facebookなど)には使用しないこと。
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Patient.telecom.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control0..1
Typestring
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

連絡先の番号やメールアドレス

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

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse Use of contact point
Typecode
Is Modifiertrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
患者の連絡先の種別をValueSet(ContactPointUse)より選択する。

  • home : 自宅
  • work : 職場
  • temp : 一時的
  • old : 以前の
  • mobile : モバイル機器
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Patient.telecom.rank
Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Control0..1
TypepositiveInt
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

連絡先の使用順序(1 = 最高)

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

Time period when the contact point was/is in use.

Control0..1
TypePeriod
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.
連絡先が使用されていた/されている期間

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

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. 管理上の性別-患者が管理および記録管理の目的で持つと見なされる性別。

Control0..1
BindingThe codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes
Typecode
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

患者の性別をValueSet(AdministrativeGender)より選択する。 male 男性 female 女性 other その他 unknown 不明

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

The date of birth for the individual. 個人の生年月日

Control0..1
Typedate
Requirements

Age of the individual drives many clinical processes.

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
実際の生年月日が不明な場合は、少なくとも推定年を推測として提供する必要があり、時間が必要な場合(出産/乳児ケアシステムなど)に使用できる標準の拡張extension「patient-birthTime」がある。
患者の生年月日をYYYY-MM-DD形式で入れる。
例:1945-08-23

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
LOINC Code21112-8
34. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not. 個人が死亡しているかどうかを示す。

Control0..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
値がない場合は、個人が死亡したかどうかについてのステートメントがないことを意味し、ほとんどのシステムは、値がないことを人が生きていることの兆候として解釈する。
患者が死亡しているかどうかを示す
deceasedBooleanまたはdeceasedDateTimeのどちらかに値が入る

  • deceasedBoolean : true(死亡) / false(生存)
  • deceasedDateTime : 患者の死亡日時
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Patient.address
Definition

An address for the individual. 個人の住所。

Control0..*
TypeAddress
Requirements

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Comments

Patient may have multiple addresses with different uses or applicable periods. 患者は、異なる用途または適用可能な期間で複数の住所を持っている可能性がある。

【JP Core仕様】FHIRデータ型仕様に従って、以下の案とした。

  • 住所が構造化されている場合、住所パート Address.country、Address.postalcode、Address.state、Address.city、Address.line に分割して記載する
  • 住所が構造化されていない場合は、Address.text に記述する
  • 各住所パートとtext は、両方存在してもよい

※診療文書構造化記述規約等では、streetAddressLine (FHIRではlineに対応) に指定するとなっていた。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Patient.address.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.
37. Patient.address.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 Patient.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
38. Patient.address.use
Definition

The purpose of this address. 住所の用途

Control0..1
BindingThe codes SHALL be taken from AddressUse The use of an address
Typecode
Is Modifiertrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

住所の用途をValueSet(AddressUse)より選択する。

  • home : 自宅
  • work : 職場
  • temp : 一時的
  • old : 以前の
  • billing : 請求書、インボイス、領収書などの送付用
Example
General:home
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Patient.address.type
Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

住所(訪問できる住所)と郵送先住所(私書箱や気付住所など)を区別する。ほとんどのアドレスは両方。

Control0..1
BindingThe codes SHALL be taken from AddressType The type of an address (physical / postal)
Typecode
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).
住所の種類をValueSet(AddressType)より選択する。

  • postal : 郵送先 - 私書箱、気付の住所
  • physical : 訪れることのできる物理的な住所
  • both : postalとphysicalの両方
Example
General:both
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Patient.address.text
Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.
表示するアドレス全体を指定する
例:郵便ラベル。これは、特定の部品の代わりに、または特定の部品と同様に提供される場合がある。

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
テキスト表現とパーツの両方を提供できる。アドレスを更新するアプリケーションは、テキストとパーツの両方が存在する場合、パーツにないコンテンツはテキストに含まれないようにする必要がある。

  • 住所を(都道府県や市町村などに)分離して管理していない場合は、textに入れる。
  • 住所を(都道府県や市町村などに)分離して管理している場合でも、まとめてtextに入れること。
  • 郵便番号は含めない。

例:東京都文京区本郷7-3-1

Example
General:137 Nowhere Street, Erewhon 9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Patient.address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. このコンポーネントには、家番号、アパート番号、通りの名前、通りの方向、P.O。が含まれる。ボックス番号、配達のヒント、および同様の住所情報など。

Control0..*
Typestring
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
【JP Core仕様】state要素とcity要素で表現しなかったそのあとの住所部分を番地以降の部分も含めてすべていれる。
英数字は半角でも全角でもよい。文字列の前後および途中に空白文字を含めないこと。
繰り返し要素が許されているので、区切りを表現したい場合には、複数要素に分けて格納してもよい。

例:本郷7-3-1
例:大字石神976
例:藤崎町大字藤崎字西村1-2 春山荘201号室

Example
General:137 Nowhere Street
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Patient.address.city
Definition

The name of the city, town, suburb, village or other community or delivery center. 市、町、郊外、村、その他のコミュニティまたは配達センターの名前。

Control0..1
Typestring
Alternate NamesMunicpality
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
【JP Core仕様】郡市区町村部分だけを「郡」「市」「区」「町」「村」などの文字を含めて設定する。 例:文京区

Example
General:Erewhon
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
43. Patient.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
Alternate NamesCounty
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. 【JP Core仕様】日本の住所では使用しない。

Example
General:Madison
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Patient.address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). 国の主権が制限されている国のサブユニット。日本の場合、都道府県名。

Control0..1
Typestring
Alternate NamesProvinceTerritory
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
都道府県名。「都」「道」「府」「県」のそれぞれの文字を含める。 例:東京都

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

A postal code designating a region defined by the postal service.

Control0..1
Typestring
Alternate NamesZip
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size 1MBを超えないこと。
郵便番号。日本の郵便番号の場合には3桁数字とハイフン1文字と4桁数字からなる半角8文字、または最初の3桁だけの3文字のいずれかとする。 例:113-8655

Example
General:9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Patient.address.country
Definition

Country - a nation as commonly understood or generally accepted. 国-一般的に理解されている、または一般的に受け入れられている国の国名かコード。

Control0..1
Typestring
Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.
ISO 3166 3文字コードは、人間が読める国名の代わりに使用する。
ISO 3166の2文字または3文字のコード
日本であれば、jpまたはjpn

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

Time period when address was/is in use. 住所が使用されていた(いる)期間

Control0..1
TypePeriod
Requirements

Allows addresses to be placed in historical context.

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
住所が使用されていた/されている期間。
期間は時間の範囲を指定する。使用状況はその期間全体に適用されるか、範囲から1つの値が適用される。
期間は、時間間隔(経過時間の測定値)には使用されない。

Example
General:<valuePeriod xmlns="http://hl7.org/fhir">
  <start value="2010-03-23"/>
  <end value="2010-07-01"/>
</valuePeriod>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. Patient.maritalStatus
Definition

This field contains a patient's most recent marital (civil) status. このフィールドは患者の最新の婚姻(市民)状態が含む。

Control0..1
BindingThe codes SHALL be taken from Marital Status Codes; other codes may be used where these codes are not suitable The domestic partnership status of a person
TypeCodeableConcept
Requirements

Most, if not all systems capture it.

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.
患者の婚姻関係をValueSet(Marital Status Codes)より選択する。

  • A : 婚姻取消・無効
  • D : 離婚
  • I : 暫定法令
  • L : 法的別居中
  • M : 既婚
  • P : 一夫多妻制
  • S : 生涯独身・非婚
  • T : 同棲
  • U : 未婚
  • W : 未亡人
  • UNK : 不明
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Patient.multipleBirth[x]
Definition

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). 患者が多胎児の一人であるか(boolean)、実際の出生順位(integer)であるかを示す。

Control0..1
TypeChoice of: boolean, integer
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. 多産児の曖昧性解消、特にラボなど、医療提供者が患者に会わない場合に関連する。

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).
multipleBirthBooleanまたはmultipleBirthIntegerのどちらかに値が入る

  • multipleBirthBoolean : 多胎出産時かどうか
    3つ子の例にbooleanが指定された場合、3つの患者レコードすべてがvalueBoolean = trueになる(順序は示されない)
  • multipleBirthInteger : 多胎出産時の出生順位
    たとえば、3つ子の2番目の生まれはvalueInteger = 2で、3番目の生まれはvalueInteger = 3になる
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Patient.photo
Definition

Image of the patient. 患者の画像。

Control0..*
TypeAttachment
Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

多くのEHRシステムには、患者の画像をキャプチャする機能がある。より新しいソーシャルメディアの使用にも適合する。

Comments

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates

ガイドライン:

  • 臨床写真ではなく、身分証明写真を使用すること
  • 寸法をサムネイルに制限する
  • リソースの更新を容易にするため、バイト数を少なくすること
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. Patient.contact
Definition

A contact party (e.g. guardian, partner, friend) for the patient.

患者の連絡先者(例:保護者、パートナー、友人)。

Control0..*
TypeBackboneElement
Requirements

Need to track people you can contact about the patient.

患者について連絡できる人を確認する必要がある。

Comments

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

連絡先には、家族、取引先、保護者、介護者など、あらゆる種類の連絡先が含まれる。連絡先として使用しない親戚や家族を登録するためには適用されない。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
pat-1: SHALL at least contain a contact's details or a reference to an organization (: name.exists() or telecom.exists() or address.exists() or organization.exists())
52. Patient.contact.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.
53. Patient.contact.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())
54. Patient.contact.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())
55. Patient.contact.relationship
Definition

The nature of the relationship between the patient and the contact person.

患者と連絡先の関係性。

Control0..*
BindingThe codes SHALL be taken from PatientContactRelationship; other codes may be used where these codes are not suitable The nature of the relationship between a patient and a contact person for that patient
TypeCodeableConcept
Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

状況に応じて、アプローチするのに最適な関係者を決定するために使用される。

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.
患者との関係性をValueSet(PatientContactRelationship)より選択する。

  • C : 緊急連絡先
  • E : 雇用者
  • F : 連邦政府機関
  • I : 保険会社
  • N : 近親者
  • S : 州政府機関
  • U : 不明
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. Patient.contact.name
Definition

A name associated with the contact person.

連絡先に登録された名前。

Control0..1
TypeHumanName
Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

連絡先は名前で識別する必要があるが、その連絡先に複数の名前が必要になることはまれである。

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

A contact detail for the person, e.g. a telephone number or an email address.

連絡先に登録された連絡方法(電話番号やメールアドレスなど)。

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

電話、電子メールなどの(優先する)連絡方法を確認する必要がある。

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

連絡先には、さまざまな用途または適用期間で連絡を取るための複数の方法がある。その人に緊急に連絡する際の連絡先を確認する必要がある。

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

Address for the contact person. 連絡先の住所。

Control0..1
TypeAddress
Requirements

Need to keep track where the contact person can be contacted per postal mail or visited. 郵送ないし訪問により連絡を取ることができるよう注意する必要があるため。

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

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. 管理上の性別-連絡先担当者が管理および記録管理のために持っていると考えられる性別。

Control0..1
BindingThe codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes
Typecode
Requirements

Needed to address the person correctly. その人に正しく話しかけるために必要である。

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

Organization on behalf of which the contact is acting or for which the contact is working. 連絡先が主として活動する、または勤務している組織。

Control0..1 This element is affected by the following invariants: pat-1
TypeReference(JP_Organization))
Requirements

For guardians or business related contacts, the organization is relevant.

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.

連絡先に関連する組織

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

The period during which this contact person or organization is valid to be contacted relating to this patient. この患者に関連して、この連絡担当者または組織に連絡することが有効な期間。

Control0..1
TypePeriod
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. Patient.communication
Definition

A language which may be used to communicate with the patient about his or her health. 彼または彼女の健康について患者と会話する際に使用する言語。

Control0..*
TypeBackboneElement
Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
患者が現地の言語を話さない場合、通訳が必要になる場合があるため、話せる言語と習熟度は、患者と関心のある他の人の両方にとって注意すべき重要な事項である。

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
言語が指定されていない場合、デフォルトのローカル言語が話されていることを意味する。複数のモードの習熟度を伝える必要がある場合は、複数のPatient.Communicationアソシエーションが必要である。動物の場合、言語は関連するフィールドではないため、インスタンスから除外する必要がある。患者がデフォルトの現地言語を話さない場合、通訳者が必要であることを明示的に宣言するために、通訳者必須基準を使用できる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. Patient.communication.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.
64. Patient.communication.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())
65. Patient.communication.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())
66. Patient.communication.language
Definition

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
ISO-639-1 alpha 2コード小文字で言語を、またオプションとしてハイフンとISO-3166-1 alpha 2コード大文字を続けて地域を表す。たとえば、英語の場合は「en」、アメリカ英語の場合は「en-US」、イギリス英語の場合は「en-EN」である。

Control1..1
BindingThe codes SHOULD be taken from CommonLanguages A human language
Additional BindingsPurpose
AllLanguagesMax Binding
TypeCodeableConcept
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. 多言語の国のほとんどのシステムは、言語を伝えたいと考えられる。 すべてのシステムが実際に地域の方言を必要とするわけではない。

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

患者とコミュニケーションするときに使用できる言語をValueSet(CommonLanguages)より選択する。

  • de : ドイツ語
  • en : 英語
  • fr : フランス語
  • ja : 日本語
  • ko : 韓国語
    など
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Patient.communication.preferred
Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

患者がこの言語を優先するかどうかを示す(他の言語よりも特定レベルまで習得している)。

Control0..1
Typeboolean
Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

特定のレベルまで複数の言語を習得している人は、複数の言語を選択する可能性がある。つまり、特定の言語でのコミュニケーションに自信を持ち、他の言語を一種の備えとしている。

Comments

This language is specifically identified for communicating healthcare information.

この言語は、医療情報を伝えるために特に識別される。 患者がこの言語を習得している場合はtrue、そうでなければfalseを設定する。

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

Patient's nominated care provider. 患者が指名するケア提供者

Control0..*
TypeReference(JP_OrganizationJP_PractitionerJP_PractitionerRole))
Alternate NamescareProvider
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.
Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
これはプライマリケア提供者(GPを含む)である場合もあれば、コミュニティ/障害を持つ患者指定のケアマネージャーである場合もある。ケアチームの記録には使用されない。これらはケアプランまたはEpisodeOfCareリソースにリンクされるCareTeamリソースに含まれている必要がある。複数のGPは、学期中の大学GPと共にリストされた家庭GPなどの学生や、「フライイン/フライアウト」労働者など、さまざまな理由で患者に対して記録される場合がある。また、医学的問題を認識し続けるために家庭GPに含まれる。
管轄区域は、必要に応じてこれを1、またはタイプごとに1にプロファイルできると決定する場合がある。

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

Organization that is the custodian of the patient record. 患者記録の管理者である組織。

Control0..1
TypeReference(JP_Organization))
Requirements

Need to know who recognizes this patient record, manages and updates it.

この患者記録を誰が認識し、管理し、更新するかを知る必要がある。

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

特定の患者記録を管理する組織は1つだけである。他の組織には独自の患者レコードがあり、Linkプロパティを使用してレコードを結合する場合がある(または、関連付けの信頼性評価を含めることができる個人リソース)

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

Link to another patient resource that concerns the same actual patient.

事実上の同一患者をリンクする別のPatientリソース。

Control0..*
TypeBackboneElement
Is Modifiertrue
Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers

複数のユースケースがある。

  • 事務的なエラーのため一貫して人間を特定することが困難であり患者の記録が重複している
  • 複数のサーバにわたり患者情報が配布されている
Comments

There is no assumption that linked patient records have mutual links.

リンクされた患者記録に相互リンクがあるという仮定はない。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. Patient.link.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.
72. Patient.link.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())
73. Patient.link.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())
74. Patient.link.other
Definition

The other patient resource that the link refers to.

リンクが参照する他の患者リソース。

Control1..1
TypeReference(JP_PatientRelatedPerson))
Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

ここでRelatedPersonを参照すると、Personレコードを使用して患者とRelatedPersonを同じ個人として関連付ける必要がなくなる。

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

The type of link between this patient resource and another patient resource.

この患者リソースと別の患者リソース間のリンクのタイプ。

Control1..1
BindingThe codes SHALL be taken from LinkType The type of link between this patient resource and another patient resource
Typecode
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size
この患者リソースと別の患者リソース間のリンクのタイプをValueSet(LinkType)より選択する。

  • replaced-by : このリンクを含む患者リソースは使用しないこと
  • replaces : このリンクを含む患者リソースは、現在アクティブな患者レコードである
  • refer : このリンクを含む患者リソースは使用中であり、有効であるが、患者に関する主な情報源とは見なされていない
  • seealso : このリンクを含む患者リソースは使用中で有効であるが、同じ人物に関するデータが含まれていることがわかっている別の患者リソースを指す
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))