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_Procedure - Detailed Descriptions

Active as of 2022-10-24

Definitions for the jp-procedure resource profile.

1. Procedure
Definition

An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

患者に対して、または患者のために実行されているか実行されたアクション。これは、手術のような身体的介入、または長期サービス、カウンセリング、催眠療法のような低侵襲性である可能性がある。

2. Procedure.text
3. Procedure.identifier
Definition

これは、ビジネスプロセスによって定義され、リソース自体への直接のURL参照が適切でない場合に参照するために使用される、このProcedureに関連する識別子を記録する。

Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

NoteThis is a business identifier, not a resource identifier (see discussion)
Comments

これはビジネス識別子であり、リソース識別子ではない(議論参照)。識別子は1つのリソースインスタンスにのみ表示されることがベストだが、ビジネス上の慣習により、同じ識別子を持つ複数のリソースインスタンスが存在することがあるかもしれない。例えば、複数のPatientとPersonリソースインスタンスが同じ社会保険番号を共有しているかもしれない。

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

4. Procedure.instantiatesCanonical
Definition

本Procedureの全部または一部を遵守するFHIR定義のプロトコル、ガイドライン、オーダセット、その他の定義を指すURL。

The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

5. Procedure.instantiatesUri
Definition

本Procedure全体または一部を遵守する、外部で管理されているプロトコル、ガイドライン、オーダセット、またはその他の定義を指すURL。

The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

6. Procedure.basedOn
Definition

このプロシージャの依頼情報の詳細を含むリソースへの参照。

A reference to a resource that contains details of the request for this procedure.

Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決には、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することができる。

【JP Core仕様】Observation_LabResultにならい、任意。

7. Procedure.partOf
Definition

A larger event of which this particular procedure is a component or step.【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

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

TypeReference(JP_Procedure|JP_Observation_Common|JP_MedicationAdministration|Procedure|Observation|MedicationAdministration))
Comments

The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

MedicationAdministrationリソースにはProcedureへのpartOf参照があるが、これは循環参照ではない。たとえば、麻酔MedicationAdministrationは外科的処置の一部である(MedicationAdministration.partOf = Procedure)。 また、たとえば、IV投薬管理用にIVポートを挿入する手順は、投薬管理の一部である(Procedure.partOf = MedicationAdministration)。

【JP Core仕様】Observation_LabResultにならい、任意。

8. Procedure.status
Definition

プロシージャの状態を指定するコードである。一般的には、進行中または完了した状態になる。【JP Core仕様】http://hl7.org/fhir/us/core/STU3.1/StructureDefinition-us-core-procedure.htmlを参照

A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

Comments

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

「不明な」コードは、他のステータスを伝えるために使用されるべきではない。ステータスの1つが当てはまる場合、「不明」コードを使用する必要があるが、オーサリングシステムはプロシージャの現在の状態を認識していない。 ステータスにリソースを現在無効としてマークするコードが含まれているため、この要素は修飾子としてラベル付けされる。

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

9. Procedure.statusReason
Definition

プロシージャの現在の進捗の理由を設定する。

Captures the reason for the current state of the procedure.

BindingFor example codes, see JP Core Procedure Not Performed Reason ValueSetFor example codes, see ProcedureNotPerformedReason(SNOMED-CT)
Comments

This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

これは通常、「未完了」、「一時停止」、「中止」などの「例外」ステータスにのみ使用される。イベントを実行する理由は、ここではなく、reasonCodeに設定する。

10. Procedure.category
BindingFor example codes, see JP Core Procedure Category ValueSetFor example codes, see ProcedureCategoryCodes(SNOMEDCT)
11. Procedure.code
Definition

行われた具体的な手順。手技の正確な性質がコード化できない場合はテキストを使用する(例:「腹腔鏡下虫垂切除術」)

The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

BindingFor example codes, see JP Core Procedure Codes Medical ValueSetFor example codes, see ProcedureCodes(SNOMEDCT)
Comments

すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供すべきである。

12. Procedure.code.coding
Control0..?
SlicingThis element introduces a set of slices on Procedure.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
13. Procedure.code.coding:medical
SliceNamemedical
Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes Medical ValueSet
14. Procedure.code.coding:medical.system
Control1..?
Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesMedical_CS
15. Procedure.code.coding:stem7
SliceNamestem7
Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes STEM7 ValueSet
16. Procedure.code.coding:stem7.system
Control1..?
Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesSTEM7_CS
17. Procedure.code.coding:dental
SliceNamedental
Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes Dental ValueSet
18. Procedure.code.coding:dental.system
Control1..?
Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesDental_CS
19. Procedure.code.coding:nurse
SliceNamenurse
Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes Nurse ValueSet
20. Procedure.code.coding:nurse.system
Control1..?
Fixed Valueurn:oid:1.2.392.200119.4.701
21. Procedure.code.coding:ichi
SliceNameichi
Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes ICHI ValueSet
22. Procedure.code.coding:ichi.system
Control1..?
Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_Undefined_CS
23. Procedure.subject
Definition

The person, animal or group on which the procedure was performed. プロシジャーが実行された対象の人、動物、またはグループ。

The person, animal or group on which the procedure was performed.

TypeReference(JP_Patient|Patient|Group))
Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決は、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

24. Procedure.encounter
Definition

プロシジャーが作成または実行された受療の状況、またはこの記録の作成が緊密に関連している受療の状況。

The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.

TypeReference(JP_Encounter|Encounter))
Comments

これは通常、イベントが発生した出会いの中で行われるが、活動によっては、出会いの公式な終了前または終了後に開始されても、出会いの文脈と結びついている場合がある。

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

25. Procedure.performed[x]
Definition

Procedureが行われた推定または実際の日付、日時、期間、または年齢。複数の日付にまたがる複雑なProcedureをサポートするために期間を許可し、Procedureの長さを把握することも可能。

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

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

Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

年齢は一般的に、患者が手技が行われた年齢を報告するときに使用される。 範囲は、一般的に、患者が手順が実行されたときに年齢範囲を報告する場合に使用される。たとえば、20〜25歳の間など。 dateTimeは、ミリ秒の精度を持たない可能性がある過去の手順として報告される一部の手順と、Encounterの期間において実施され文書化された他の手順が、タイムゾーンでより正確なUTCタイムスタンプを持つ可能性があるため、さまざまな精度をサポートする。

26. Procedure.recorder
Definition

Individual who recorded the record and takes responsibility for its content. 記録を記録し、その内容に責任を負う個人。

Individual who recorded the record and takes responsibility for its content.

TypeReference(JP_Patient|RelatedPerson|JP_Practitioner|JP_PractitionerRole|Patient|Practitioner|PractitionerRole))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

27. Procedure.asserter
Definition

Individual who is making the procedure statement. プロシジャーの実施記録を作成した個人。

Individual who is making the procedure statement.

TypeReference(JP_Patient|RelatedPerson|JP_Practitioner|JP_PractitionerRole|Patient|Practitioner|PractitionerRole))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

28. Procedure.performer
Definition

Limited to "real" people rather than equipment. 医療機器ではなく「生身の人間」に限定。

Limited to "real" people rather than equipment.

29. Procedure.performer.function
Definition

Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. プロシジャーへの実施者の関与のタイプを区別する。たとえば、外科医、麻酔科医、内視鏡医。

Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.

BindingFor example codes, see JP Core Procedure Performer Role ValueSetFor example codes, see ProcedurePerformerRoleCodes
Comments

すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供するべきである。

【JP Core仕様】当面利用しない。

30. Procedure.performer.actor
Definition

The practitioner who was involved in the procedure. プロシジャーに関わった医療従事者。

The practitioner who was involved in the procedure.

TypeReference(JP_Practitioner|JP_PractitionerRole|JP_Organization|JP_Patient|RelatedPerson|Device|Practitioner|PractitionerRole|Organization|Patient))
Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不可などを可能にする)。解決には、URLからの検索、またはリソースタイプによって適用可能な場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することができる。

31. Procedure.performer.onBehalfOf
Definition

The organization the device or practitioner was acting on behalf of. 従事した組織。

The organization the device or practitioner was acting on behalf of.

TypeReference(JP_Organization|Organization))
Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決には、URLからの検索によるものと、リソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索するものがある。

32. Procedure.location
Definition

プロシジャーが実施された場所。 例:自宅での出生、レストランで気管切開など。

The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.

TypeReference(JP_Location|Location))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

33. Procedure.reasonCode
Definition

処置が行われたコード化された理由。 これはある種のコード化された実体であるかもしれないし、単にテキストとして存在するかもしれない。

The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text.

BindingFor example codes, see JP Core Procedure Reason ValueSetFor example codes, see ProcedureReasonCodes
Comments

Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

ひとつのコードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference のいずれかにより、非常に精緻な理由の定義を参照することもできる。 もしプロシージャの異なる理由を説明しているのであれば、Procedure.reasonCodeとProcedure.reasonReferenceの両方を使用できる。

Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

34. Procedure.reasonReference
Definition

なぜそのようなProcedureを行ったのか、その正当性を示す。

The justification of why the procedure was performed.

TypeReference(JP_Condition|JP_Observation_Common|JP_Procedure|JP_DiagnosticReport_Common|DocumentReference|Condition|Observation|Procedure|DiagnosticReport))
Comments

It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

ある手順が別の手順(硬膜外など)の理由(帝王切開など)になる可能性がある。他の例には、拡張および生検(診断および治療用途の組み合わせ)のための内視鏡検査が含まれる。 コードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference

35. Procedure.bodySite
Definition

詳細かつ構造化された解剖学的な位置情報。複数の場所を指定することができる。例えば、1つの病変に対して複数のパンチングバイオプシーを行うことができる。

Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

BindingFor example codes, see JP Core Procedure BodySite ValueSetFor example codes, see SNOMEDCTBodyStructures
Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

ユースケースでBodySiteリソースの属性が必要な場合(たとえば、個別に識別して追跡するため)、標準の拡張extension [procedure-targetbodystructure](extension-procedure-targetbodystructure.html)を使用する。

36. Procedure.outcome
Definition

The outcome of the procedure - did it resolve the reasons for the procedure being performed? Procedureの結果 - Procedureが行われた理由が解決されたか?

The outcome of the procedure - did it resolve the reasons for the procedure being performed?

BindingFor example codes, see JP Core Procedure Outcome ValueSetFor example codes, see ProcedureOutcomeCodes(SNOMEDCT)
Comments

If outcome contains narrative text only, it can be captured using the CodeableConcept.text. 結果に叙述的記述トのみが含まれている場合は、CodeableConcept.textを使用してその情報を格納できる。

If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

37. Procedure.report
Definition

This could be a histology result, pathology report, surgical report, etc. これは、組織学的結果、病理学的報告書、手術報告書などであろう。

This could be a histology result, pathology report, surgical report, etc.

TypeReference(JP_DiagnosticReport_Common|DocumentReference|Composition|DiagnosticReport))
Comments

There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

複数のレポートが存在する可能性がある -例:これが複数の生検を行ったプロシジャーであって、いくつもの解剖病理学報告が得られた場合。

38. Procedure.complication
Definition

Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

プロシジャー中、またはその実施直後の期間に発生した合併症。これらは通常、note要素とは別に記録される。note要素は通常、「プロシジャー後」の問題ではなく、プロシジャー自体を説明するものである。

BindingFor example codes, see JP Core Procedure Condition ValueSetFor example codes, see Condition/Problem/DiagnosisCodes
Comments

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text. 合併症が叙述的なテキストによってのみ表現されている場合は、CodeableConcept.textに格納できる。

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

39. Procedure.complicationDetail
Definition

Any complications that occurred during the procedure, or in the immediate post-performance period. Procedureの実施中、または実施直後に発生した全ての合併症。

Any complications that occurred during the procedure, or in the immediate post-performance period.

TypeReference(JP_Condition|Condition))
Requirements

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure. これは、プロシジャーの理由であった状態ではなく、プロシジャーの結果である状態を文書化するために使用される。

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

40. Procedure.followUp
Definition

If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.

処置が特別なフォローアップを必要とする場合(例:抜糸)、フォローアップはシンプルなnote として表現してもよいが、より複雑になる可能性もあり、その場合はケアプランリソースを使用することができる。

BindingFor example codes, see JP Core Procedure Follow Up ValueSetFor example codes, see ProcedureFollowUpCodes(SNOMEDCT)
Comments

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

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

41. Procedure.note
Definition

Any other notes and comments about the procedure. このプロシジャーに関する注意点やコメントなど。

Any other notes and comments about the procedure.

Comments

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

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

42. Procedure.focalDevice
Definition

A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

Procedureが行われる局所に、あるいは、そこから、埋め込まれる、取り外される、またはその他の操作(キャリブレーション、バッテリー交換、プロテーゼの装着、陰圧ドレインバックの装着など)が行われるデバイス。

43. Procedure.focalDevice.action
Definition

Procedure中にデバイスに起こった変化の種類。【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

The kind of change that happened to the device during the procedure.

BindingThe codes SHOULD be taken from JP Core Procedure Device Action ValueSetThe codes SHOULD be taken from ProcedureDeviceActionCodes
44. Procedure.focalDevice.manipulated
Definition

Procedure中に操作(変更)されたデバイス。【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

The device that was manipulated (changed) during the procedure.

45. Procedure.usedReference
Definition

Identifies medications, devices and any other substance used as part of the procedure.

プロシジャーの一部として使用される薬剤、機器およびその他の物質を特定する。

TypeReference(Device|JP_Medication|Substance|Medication))
Comments

For devices actually implanted or removed, use Procedure.device.

実際に埋め込まれた、または取り外されたデバイスについては、Procedure.deviceを使用すること。

46. Procedure.usedCode
Definition

Identifies coded items that were used as part of the procedure. Procedureの一部として使用されたコード化されたアイテムを識別する。

Identifies coded items that were used as part of the procedure.

BindingFor example codes, see JP Core Procedure Device Kind ValueSetFor example codes, see FHIRDeviceTypes
Comments

For devices actually implanted or removed, use Procedure.device. 実際に埋め込まれた、または取り外されたデバイスについては、Procedure.deviceを使用すること。

For devices actually implanted or removed, use Procedure.device.

1. Procedure
Definition

An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

患者に対して、または患者のために実行されているか実行されたアクション。これは、手術のような身体的介入、または長期サービス、カウンセリング、催眠療法のような低侵襲性である可能性がある。

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

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
5. Procedure.identifier
Definition

これは、ビジネスプロセスによって定義され、リソース自体への直接のURL参照が適切でない場合に参照するために使用される、このProcedureに関連する識別子を記録する。

Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

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

Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

Comments

これはビジネス識別子であり、リソース識別子ではない(議論参照)。識別子は1つのリソースインスタンスにのみ表示されることがベストだが、ビジネス上の慣習により、同じ識別子を持つ複数のリソースインスタンスが存在することがあるかもしれない。例えば、複数のPatientとPersonリソースインスタンスが同じ社会保険番号を共有しているかもしれない。

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

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

本Procedureの全部または一部を遵守するFHIR定義のプロトコル、ガイドライン、オーダセット、その他の定義を指すURL。

The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

Control0..*
Typecanonical(PlanDefinition|ActivityDefinition|Measure|OperationDefinition|Questionnaire))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Procedure.instantiatesUri
Definition

本Procedure全体または一部を遵守する、外部で管理されているプロトコル、ガイドライン、オーダセット、またはその他の定義を指すURL。

The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

Control0..*
Typeuri
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

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

このプロシージャの依頼情報の詳細を含むリソースへの参照。

A reference to a resource that contains details of the request for this procedure.

Control0..*
TypeReference(CarePlan|ServiceRequest))
Alternate Namesfulfills
Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決には、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することができる。

【JP Core仕様】Observation_LabResultにならい、任意。

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

A larger event of which this particular procedure is a component or step.【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

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

Control0..*
TypeReference(JP_Procedure|JP_Observation_Common|JP_MedicationAdministration|Procedure|Observation|MedicationAdministration))
Alternate Namescontainer
Comments

The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

MedicationAdministrationリソースにはProcedureへのpartOf参照があるが、これは循環参照ではない。たとえば、麻酔MedicationAdministrationは外科的処置の一部である(MedicationAdministration.partOf = Procedure)。 また、たとえば、IV投薬管理用にIVポートを挿入する手順は、投薬管理の一部である(Procedure.partOf = MedicationAdministration)。

【JP Core仕様】Observation_LabResultにならい、任意。

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

プロシージャの状態を指定するコードである。一般的には、進行中または完了した状態になる。【JP Core仕様】http://hl7.org/fhir/us/core/STU3.1/StructureDefinition-us-core-procedure.htmlを参照

A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

Control1..1
BindingThe codes SHALL be taken from EventStatus

A code specifying the state of the procedure.

Typecode
Is Modifiertrue
Comments

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

「不明な」コードは、他のステータスを伝えるために使用されるべきではない。ステータスの1つが当てはまる場合、「不明」コードを使用する必要があるが、オーサリングシステムはプロシージャの現在の状態を認識していない。 ステータスにリソースを現在無効としてマークするコードが含まれているため、この要素は修飾子としてラベル付けされる。

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

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

プロシージャの現在の進捗の理由を設定する。

Captures the reason for the current state of the procedure.

Control0..1
BindingFor example codes, see JP Core Procedure Not Performed Reason ValueSetFor example codes, see ProcedureNotPerformedReason(SNOMED-CT)
TypeCodeableConcept
Alternate NamesSuspended Reason, Cancelled Reason
Comments

This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

これは通常、「未完了」、「一時停止」、「中止」などの「例外」ステータスにのみ使用される。イベントを実行する理由は、ここではなく、reasonCodeに設定する。

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

A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

Control0..1
BindingFor example codes, see JP Core Procedure Category ValueSetFor example codes, see ProcedureCategoryCodes(SNOMEDCT)
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Procedure.code
Definition

行われた具体的な手順。手技の正確な性質がコード化できない場合はテキストを使用する(例:「腹腔鏡下虫垂切除術」)

The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

Control0..1
BindingFor example codes, see JP Core Procedure Codes Medical ValueSetFor example codes, see ProcedureCodes(SNOMEDCT)
TypeCodeableConcept
Requirements

0..1 to account for primarily narrative only resources.

Alternate Namestype
Comments

すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供すべきである。

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

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

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

A reference to a code defined by a terminology system.

Control0..1*
BindingThe codes SHALL be taken from JP Core Procedure Codes Medical ValueSetFor codes, see (unbound)
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Procedure.code.coding:medical.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control10..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesMedical_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Procedure.code.coding:stem7
SliceNamestem7
Definition

A reference to a code defined by a terminology system.

Control0..1*
BindingThe codes SHALL be taken from JP Core Procedure Codes STEM7 ValueSetFor codes, see (unbound)
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Procedure.code.coding:stem7.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control10..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesSTEM7_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Procedure.code.coding:dental
SliceNamedental
Definition

A reference to a code defined by a terminology system.

Control0..1*
BindingThe codes SHALL be taken from JP Core Procedure Codes Dental ValueSetFor codes, see (unbound)
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Procedure.code.coding:dental.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control10..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesDental_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Procedure.code.coding:nurse
SliceNamenurse
Definition

A reference to a code defined by a terminology system.

Control0..1*
BindingThe codes SHALL be taken from JP Core Procedure Codes Nurse ValueSetFor codes, see (unbound)
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Procedure.code.coding:nurse.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control10..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valueurn:oid:1.2.392.200119.4.701
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Procedure.code.coding:ichi
SliceNameichi
Definition

A reference to a code defined by a terminology system.

Control0..1*
BindingThe codes SHALL be taken from JP Core Procedure Codes ICHI ValueSetFor codes, see (unbound)
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Procedure.code.coding:ichi.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control10..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_Undefined_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Procedure.subject
Definition

The person, animal or group on which the procedure was performed. プロシジャーが実行された対象の人、動物、またはグループ。

The person, animal or group on which the procedure was performed.

Control1..1
TypeReference(JP_Patient|Patient|Group))
Alternate Namespatient
Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決は、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

プロシジャーが作成または実行された受療の状況、またはこの記録の作成が緊密に関連している受療の状況。

The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.

Control0..1
TypeReference(JP_Encounter|Encounter))
Comments

これは通常、イベントが発生した出会いの中で行われるが、活動によっては、出会いの公式な終了前または終了後に開始されても、出会いの文脈と結びついている場合がある。

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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

Procedureが行われた推定または実際の日付、日時、期間、または年齢。複数の日付にまたがる複雑なProcedureをサポートするために期間を許可し、Procedureの長さを把握することも可能。

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

Control0..1
TypeChoice of: dateTime, Period, string, Age, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

年齢は一般的に、患者が手技が行われた年齢を報告するときに使用される。 範囲は、一般的に、患者が手順が実行されたときに年齢範囲を報告する場合に使用される。たとえば、20〜25歳の間など。 dateTimeは、ミリ秒の精度を持たない可能性がある過去の手順として報告される一部の手順と、Encounterの期間において実施され文書化された他の手順が、タイムゾーンでより正確なUTCタイムスタンプを持つ可能性があるため、さまざまな精度をサポートする。

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

Individual who recorded the record and takes responsibility for its content. 記録を記録し、その内容に責任を負う個人。

Individual who recorded the record and takes responsibility for its content.

Control0..1
TypeReference(JP_Patient|RelatedPerson|JP_Practitioner|JP_PractitionerRole|Patient|Practitioner|PractitionerRole))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

Individual who is making the procedure statement. プロシジャーの実施記録を作成した個人。

Individual who is making the procedure statement.

Control0..1
TypeReference(JP_Patient|RelatedPerson|JP_Practitioner|JP_PractitionerRole|Patient|Practitioner|PractitionerRole))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

Limited to "real" people rather than equipment. 医療機器ではなく「生身の人間」に限定。

Limited to "real" people rather than equipment.

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

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate 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())
32. Procedure.performer.function
Definition

Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. プロシジャーへの実施者の関与のタイプを区別する。たとえば、外科医、麻酔科医、内視鏡医。

Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.

Control0..1
BindingFor example codes, see JP Core Procedure Performer Role ValueSetFor example codes, see ProcedurePerformerRoleCodes
TypeCodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

Comments

すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供するべきである。

【JP Core仕様】当面利用しない。

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

The practitioner who was involved in the procedure. プロシジャーに関わった医療従事者。

The practitioner who was involved in the procedure.

Control1..1
TypeReference(JP_Practitioner|JP_PractitionerRole|JP_Organization|JP_Patient|RelatedPerson|Device|Practitioner|PractitionerRole|Organization|Patient))
Requirements

A reference to Device supports use cases, such as pacemakers.

Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不可などを可能にする)。解決には、URLからの検索、またはリソースタイプによって適用可能な場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することができる。

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

The organization the device or practitioner was acting on behalf of. 従事した組織。

The organization the device or practitioner was acting on behalf of.

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

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決には、URLからの検索によるものと、リソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索するものがある。

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

プロシジャーが実施された場所。 例:自宅での出生、レストランで気管切開など。

The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.

Control0..1
TypeReference(JP_Location|Location))
Requirements

Ties a procedure to where the records are likely kept.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

処置が行われたコード化された理由。 これはある種のコード化された実体であるかもしれないし、単にテキストとして存在するかもしれない。

The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text.

Control0..*
BindingFor example codes, see JP Core Procedure Reason ValueSetFor example codes, see ProcedureReasonCodes
TypeCodeableConcept
Comments

Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

ひとつのコードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference のいずれかにより、非常に精緻な理由の定義を参照することもできる。 もしプロシージャの異なる理由を説明しているのであれば、Procedure.reasonCodeとProcedure.reasonReferenceの両方を使用できる。

Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

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

なぜそのようなProcedureを行ったのか、その正当性を示す。

The justification of why the procedure was performed.

Control0..*
TypeReference(JP_Condition|JP_Observation_Common|JP_Procedure|JP_DiagnosticReport_Common|DocumentReference|Condition|Observation|Procedure|DiagnosticReport))
Comments

It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

ある手順が別の手順(硬膜外など)の理由(帝王切開など)になる可能性がある。他の例には、拡張および生検(診断および治療用途の組み合わせ)のための内視鏡検査が含まれる。 コードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference

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

詳細かつ構造化された解剖学的な位置情報。複数の場所を指定することができる。例えば、1つの病変に対して複数のパンチングバイオプシーを行うことができる。

Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

Control0..*
BindingFor example codes, see JP Core Procedure BodySite ValueSetFor example codes, see SNOMEDCTBodyStructures
TypeCodeableConcept
Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

ユースケースでBodySiteリソースの属性が必要な場合(たとえば、個別に識別して追跡するため)、標準の拡張extension [procedure-targetbodystructure](extension-procedure-targetbodystructure.html)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()))
39. Procedure.outcome
Definition

The outcome of the procedure - did it resolve the reasons for the procedure being performed? Procedureの結果 - Procedureが行われた理由が解決されたか?

The outcome of the procedure - did it resolve the reasons for the procedure being performed?

Control0..1
BindingFor example codes, see JP Core Procedure Outcome ValueSetFor example codes, see ProcedureOutcomeCodes(SNOMEDCT)
TypeCodeableConcept
Comments

If outcome contains narrative text only, it can be captured using the CodeableConcept.text. 結果に叙述的記述トのみが含まれている場合は、CodeableConcept.textを使用してその情報を格納できる。

If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

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

This could be a histology result, pathology report, surgical report, etc. これは、組織学的結果、病理学的報告書、手術報告書などであろう。

This could be a histology result, pathology report, surgical report, etc.

Control0..*
TypeReference(JP_DiagnosticReport_Common|DocumentReference|Composition|DiagnosticReport))
Comments

There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

複数のレポートが存在する可能性がある -例:これが複数の生検を行ったプロシジャーであって、いくつもの解剖病理学報告が得られた場合。

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

Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

プロシジャー中、またはその実施直後の期間に発生した合併症。これらは通常、note要素とは別に記録される。note要素は通常、「プロシジャー後」の問題ではなく、プロシジャー自体を説明するものである。

Control0..*
BindingFor example codes, see JP Core Procedure Condition ValueSetFor example codes, see Condition/Problem/DiagnosisCodes
TypeCodeableConcept
Comments

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text. 合併症が叙述的なテキストによってのみ表現されている場合は、CodeableConcept.textに格納できる。

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

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

Any complications that occurred during the procedure, or in the immediate post-performance period. Procedureの実施中、または実施直後に発生した全ての合併症。

Any complications that occurred during the procedure, or in the immediate post-performance period.

Control0..*
TypeReference(JP_Condition|Condition))
Requirements

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure. これは、プロシジャーの理由であった状態ではなく、プロシジャーの結果である状態を文書化するために使用される。

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.

処置が特別なフォローアップを必要とする場合(例:抜糸)、フォローアップはシンプルなnote として表現してもよいが、より複雑になる可能性もあり、その場合はケアプランリソースを使用することができる。

Control0..*
BindingFor example codes, see JP Core Procedure Follow Up ValueSetFor example codes, see ProcedureFollowUpCodes(SNOMEDCT)
TypeCodeableConcept
Comments

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

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

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

Any other notes and comments about the procedure. このプロシジャーに関する注意点やコメントなど。

Any other notes and comments about the procedure.

Control0..*
TypeAnnotation
Comments

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

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

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

A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

Procedureが行われる局所に、あるいは、そこから、埋め込まれる、取り外される、またはその他の操作(キャリブレーション、バッテリー交換、プロテーゼの装着、陰圧ドレインバックの装着など)が行われるデバイス。

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Procedure.focalDevice.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())
47. Procedure.focalDevice.action
Definition

Procedure中にデバイスに起こった変化の種類。【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

The kind of change that happened to the device during the procedure.

Control0..1
BindingThe codes SHOULD be taken from JP Core Procedure Device Action ValueSetThe codes SHOULD be taken from ProcedureDeviceActionCodes
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. Procedure.focalDevice.manipulated
Definition

Procedure中に操作(変更)されたデバイス。【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

The device that was manipulated (changed) during the procedure.

Control1..1
TypeReference(Device))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Procedure.usedReference
Definition

Identifies medications, devices and any other substance used as part of the procedure.

プロシジャーの一部として使用される薬剤、機器およびその他の物質を特定する。

Control0..*
TypeReference(Device|JP_Medication|Substance|Medication))
Requirements

Used for tracking contamination, etc.

Comments

For devices actually implanted or removed, use Procedure.device.

実際に埋め込まれた、または取り外されたデバイスについては、Procedure.deviceを使用すること。

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

Identifies coded items that were used as part of the procedure. Procedureの一部として使用されたコード化されたアイテムを識別する。

Identifies coded items that were used as part of the procedure.

Control0..*
BindingFor example codes, see JP Core Procedure Device Kind ValueSetFor example codes, see FHIRDeviceTypes
TypeCodeableConcept
Comments

For devices actually implanted or removed, use Procedure.device. 実際に埋め込まれた、または取り外されたデバイスについては、Procedure.deviceを使用すること。

For devices actually implanted or removed, use Procedure.device.

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

An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

患者に対して、または患者のために実行されているか実行されたアクション。これは、手術のような身体的介入、または長期サービス、カウンセリング、催眠療法のような低侵襲性である可能性がある。

Control0..*
2. Procedure.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. Procedure.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. Procedure.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. Procedure.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. Procedure.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. Procedure.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. Procedure.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

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())
9. Procedure.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())
10. Procedure.identifier
Definition

これは、ビジネスプロセスによって定義され、リソース自体への直接のURL参照が適切でない場合に参照するために使用される、このProcedureに関連する識別子を記録する。

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

Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

Comments

これはビジネス識別子であり、リソース識別子ではない(議論参照)。識別子は1つのリソースインスタンスにのみ表示されることがベストだが、ビジネス上の慣習により、同じ識別子を持つ複数のリソースインスタンスが存在することがあるかもしれない。例えば、複数のPatientとPersonリソースインスタンスが同じ社会保険番号を共有しているかもしれない。

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

本Procedureの全部または一部を遵守するFHIR定義のプロトコル、ガイドライン、オーダセット、その他の定義を指すURL。

Control0..*
Typecanonical(PlanDefinitionActivityDefinitionMeasureOperationDefinitionQuestionnaire))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Procedure.instantiatesUri
Definition

本Procedure全体または一部を遵守する、外部で管理されているプロトコル、ガイドライン、オーダセット、またはその他の定義を指すURL。

Control0..*
Typeuri
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

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

このプロシージャの依頼情報の詳細を含むリソースへの参照。

Control0..*
TypeReference(CarePlanServiceRequest))
Alternate Namesfulfills
Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決には、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することができる。

【JP Core仕様】Observation_LabResultにならい、任意。

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

A larger event of which this particular procedure is a component or step.【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

Control0..*
TypeReference(JP_ProcedureJP_Observation_CommonJP_MedicationAdministration))
Alternate Namescontainer
Comments

The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

MedicationAdministrationリソースにはProcedureへのpartOf参照があるが、これは循環参照ではない。たとえば、麻酔MedicationAdministrationは外科的処置の一部である(MedicationAdministration.partOf = Procedure)。 また、たとえば、IV投薬管理用にIVポートを挿入する手順は、投薬管理の一部である(Procedure.partOf = MedicationAdministration)。

【JP Core仕様】Observation_LabResultにならい、任意。

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

プロシージャの状態を指定するコードである。一般的には、進行中または完了した状態になる。【JP Core仕様】http://hl7.org/fhir/us/core/STU3.1/StructureDefinition-us-core-procedure.htmlを参照

Control1..1
BindingThe codes SHALL be taken from EventStatus A code specifying the state of the procedure
Typecode
Is Modifiertrue
Comments

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

「不明な」コードは、他のステータスを伝えるために使用されるべきではない。ステータスの1つが当てはまる場合、「不明」コードを使用する必要があるが、オーサリングシステムはプロシージャの現在の状態を認識していない。 ステータスにリソースを現在無効としてマークするコードが含まれているため、この要素は修飾子としてラベル付けされる。

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

プロシージャの現在の進捗の理由を設定する。

Control0..1
BindingFor example codes, see JP Core Procedure Not Performed Reason ValueSet
TypeCodeableConcept
Alternate NamesSuspended ReasonCancelled Reason
Comments

This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

これは通常、「未完了」、「一時停止」、「中止」などの「例外」ステータスにのみ使用される。イベントを実行する理由は、ここではなく、reasonCodeに設定する。

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

A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

Control0..1
BindingFor example codes, see JP Core Procedure Category ValueSet
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Procedure.code
Definition

行われた具体的な手順。手技の正確な性質がコード化できない場合はテキストを使用する(例:「腹腔鏡下虫垂切除術」)

Control0..1
BindingFor example codes, see JP Core Procedure Codes Medical ValueSet
TypeCodeableConcept
Requirements

0..1 to account for primarily narrative only resources.

Alternate Namestype
Comments

すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供すべきである。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Procedure.code.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.
20. Procedure.code.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 Procedure.code.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
21. Procedure.code.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

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

A reference to a code defined by a terminology system.

Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes Medical ValueSet
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

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

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesMedical_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Procedure.code.coding:medical.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

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

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control0..1
Typecode
Requirements

Need to refer to a particular code in the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Procedure.code.coding:medical.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Procedure.code.coding:medical.userSelected
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Procedure.code.coding:stem7
SliceNamestem7
Definition

A reference to a code defined by a terminology system.

Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes STEM7 ValueSet
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Procedure.code.coding:stem7.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.
32. Procedure.code.coding:stem7.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 Procedure.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
33. Procedure.code.coding:stem7.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesSTEM7_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. Procedure.code.coding:stem7.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Procedure.code.coding:stem7.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control0..1
Typecode
Requirements

Need to refer to a particular code in the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Procedure.code.coding:stem7.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Procedure.code.coding:stem7.userSelected
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Procedure.code.coding:dental
SliceNamedental
Definition

A reference to a code defined by a terminology system.

Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes Dental ValueSet
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Procedure.code.coding:dental.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.
40. Procedure.code.coding:dental.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 Procedure.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
41. Procedure.code.coding:dental.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_ProcedureCodesDental_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Procedure.code.coding:dental.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

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

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control0..1
Typecode
Requirements

Need to refer to a particular code in the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Procedure.code.coding:dental.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. Procedure.code.coding:dental.userSelected
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Procedure.code.coding:nurse
SliceNamenurse
Definition

A reference to a code defined by a terminology system.

Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes Nurse ValueSet
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. Procedure.code.coding:nurse.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.
48. Procedure.code.coding:nurse.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 Procedure.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
49. Procedure.code.coding:nurse.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valueurn:oid:1.2.392.200119.4.701
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Procedure.code.coding:nurse.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

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

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control0..1
Typecode
Requirements

Need to refer to a particular code in the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Procedure.code.coding:nurse.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Procedure.code.coding:nurse.userSelected
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. Procedure.code.coding:ichi
SliceNameichi
Definition

A reference to a code defined by a terminology system.

Control0..1
BindingThe codes SHALL be taken from JP Core Procedure Codes ICHI ValueSet
TypeCoding
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. Procedure.code.coding:ichi.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.
56. Procedure.code.coding:ichi.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 Procedure.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
57. Procedure.code.coding:ichi.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_Undefined_CS
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. Procedure.code.coding:ichi.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

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

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control0..1
Typecode
Requirements

Need to refer to a particular code in the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. Procedure.code.coding:ichi.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Procedure.code.coding:ichi.userSelected
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

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

Control0..1
Typestring
Requirements

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

Comments

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

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

The person, animal or group on which the procedure was performed. プロシジャーが実行された対象の人、動物、またはグループ。

Control1..1
TypeReference(JP_Patient))
Alternate Namespatient
Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決は、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

プロシジャーが作成または実行された受療の状況、またはこの記録の作成が緊密に関連している受療の状況。

Control0..1
TypeReference(JP_Encounter))
Comments

これは通常、イベントが発生した出会いの中で行われるが、活動によっては、出会いの公式な終了前または終了後に開始されても、出会いの文脈と結びついている場合がある。

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

Procedureが行われた推定または実際の日付、日時、期間、または年齢。複数の日付にまたがる複雑なProcedureをサポートするために期間を許可し、Procedureの長さを把握することも可能。

Control0..1
TypeChoice of: dateTime, Period, string, Age, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

年齢は一般的に、患者が手技が行われた年齢を報告するときに使用される。 範囲は、一般的に、患者が手順が実行されたときに年齢範囲を報告する場合に使用される。たとえば、20〜25歳の間など。 dateTimeは、ミリ秒の精度を持たない可能性がある過去の手順として報告される一部の手順と、Encounterの期間において実施され文書化された他の手順が、タイムゾーンでより正確なUTCタイムスタンプを持つ可能性があるため、さまざまな精度をサポートする。

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

Individual who recorded the record and takes responsibility for its content. 記録を記録し、その内容に責任を負う個人。

Control0..1
TypeReference(JP_PatientRelatedPersonJP_PractitionerJP_PractitionerRole))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

Individual who is making the procedure statement. プロシジャーの実施記録を作成した個人。

Control0..1
TypeReference(JP_PatientRelatedPersonJP_PractitionerJP_PractitionerRole))
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

Limited to "real" people rather than equipment. 医療機器ではなく「生身の人間」に限定。

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

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
70. Procedure.performer.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
71. Procedure.performer.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensionsuser contentmodifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
72. Procedure.performer.function
Definition

Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. プロシジャーへの実施者の関与のタイプを区別する。たとえば、外科医、麻酔科医、内視鏡医。

Control0..1
BindingFor example codes, see JP Core Procedure Performer Role ValueSet
TypeCodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

Comments

すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供するべきである。

【JP Core仕様】当面利用しない。

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

The practitioner who was involved in the procedure. プロシジャーに関わった医療従事者。

Control1..1
TypeReference(JP_PractitionerJP_PractitionerRoleJP_OrganizationJP_PatientRelatedPersonDevice))
Requirements

A reference to Device supports use cases, such as pacemakers.

Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不可などを可能にする)。解決には、URLからの検索、またはリソースタイプによって適用可能な場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索することができる。

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

The organization the device or practitioner was acting on behalf of. 従事した組織。

Control0..1
TypeReference(JP_Organization))
Requirements

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

Comments

参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない(アクセス制御、一時的な利用不能などを可能にする)。解決には、URLからの検索によるものと、リソースタイプによって該当する場合は、絶対参照を正規のURLとして扱い、ローカルレジストリ/リポジトリで検索するものがある。

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

プロシジャーが実施された場所。 例:自宅での出生、レストランで気管切開など。

Control0..1
TypeReference(JP_Location))
Requirements

Ties a procedure to where the records are likely kept.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

処置が行われたコード化された理由。 これはある種のコード化された実体であるかもしれないし、単にテキストとして存在するかもしれない。

Control0..*
BindingFor example codes, see JP Core Procedure Reason ValueSet
TypeCodeableConcept
Comments

Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

ひとつのコードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference のいずれかにより、非常に精緻な理由の定義を参照することもできる。 もしプロシージャの異なる理由を説明しているのであれば、Procedure.reasonCodeとProcedure.reasonReferenceの両方を使用できる。

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

なぜそのようなProcedureを行ったのか、その正当性を示す。

Control0..*
TypeReference(JP_ConditionJP_Observation_CommonJP_ProcedureJP_DiagnosticReport_CommonDocumentReference))
Comments

It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

ある手順が別の手順(硬膜外など)の理由(帝王切開など)になる可能性がある。他の例には、拡張および生検(診断および治療用途の組み合わせ)のための内視鏡検査が含まれる。 コードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference

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

詳細かつ構造化された解剖学的な位置情報。複数の場所を指定することができる。例えば、1つの病変に対して複数のパンチングバイオプシーを行うことができる。

Control0..*
BindingFor example codes, see JP Core Procedure BodySite ValueSet
TypeCodeableConcept
Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

ユースケースでBodySiteリソースの属性が必要な場合(たとえば、個別に識別して追跡するため)、標準の拡張extension [procedure-targetbodystructure](extension-procedure-targetbodystructure.html)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()))
79. Procedure.outcome
Definition

The outcome of the procedure - did it resolve the reasons for the procedure being performed? Procedureの結果 - Procedureが行われた理由が解決されたか?

Control0..1
BindingFor example codes, see JP Core Procedure Outcome ValueSet
TypeCodeableConcept
Comments

If outcome contains narrative text only, it can be captured using the CodeableConcept.text. 結果に叙述的記述トのみが含まれている場合は、CodeableConcept.textを使用してその情報を格納できる。

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

This could be a histology result, pathology report, surgical report, etc. これは、組織学的結果、病理学的報告書、手術報告書などであろう。

Control0..*
TypeReference(JP_DiagnosticReport_CommonDocumentReferenceComposition))
Comments

There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

複数のレポートが存在する可能性がある -例:これが複数の生検を行ったプロシジャーであって、いくつもの解剖病理学報告が得られた場合。

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

Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

プロシジャー中、またはその実施直後の期間に発生した合併症。これらは通常、note要素とは別に記録される。note要素は通常、「プロシジャー後」の問題ではなく、プロシジャー自体を説明するものである。

Control0..*
BindingFor example codes, see JP Core Procedure Condition ValueSet
TypeCodeableConcept
Comments

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text. 合併症が叙述的なテキストによってのみ表現されている場合は、CodeableConcept.textに格納できる。

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

Any complications that occurred during the procedure, or in the immediate post-performance period. Procedureの実施中、または実施直後に発生した全ての合併症。

Control0..*
TypeReference(JP_Condition))
Requirements

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure. これは、プロシジャーの理由であった状態ではなく、プロシジャーの結果である状態を文書化するために使用される。

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

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

If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.

処置が特別なフォローアップを必要とする場合(例:抜糸)、フォローアップはシンプルなnote として表現してもよいが、より複雑になる可能性もあり、その場合はケアプランリソースを使用することができる。

Control0..*
BindingFor example codes, see JP Core Procedure Follow Up ValueSet
TypeCodeableConcept
Comments

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

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

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

Any other notes and comments about the procedure. このプロシジャーに関する注意点やコメントなど。

Control0..*
TypeAnnotation
Comments

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

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

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

A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

Procedureが行われる局所に、あるいは、そこから、埋め込まれる、取り外される、またはその他の操作(キャリブレーション、バッテリー交換、プロテーゼの装着、陰圧ドレインバックの装着など)が行われるデバイス。

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
86. Procedure.focalDevice.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.
87. Procedure.focalDevice.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())
88. Procedure.focalDevice.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())
89. Procedure.focalDevice.action
Definition

Procedure中にデバイスに起こった変化の種類。【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

Control0..1
BindingThe codes SHOULD be taken from JP Core Procedure Device Action ValueSet
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
90. Procedure.focalDevice.manipulated
Definition

Procedure中に操作(変更)されたデバイス。【JP Core仕様】https://www.hl7.org/fhir/R4/procedure.htmlを参照

Control1..1
TypeReference(Device))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. Procedure.usedReference
Definition

Identifies medications, devices and any other substance used as part of the procedure.

プロシジャーの一部として使用される薬剤、機器およびその他の物質を特定する。

Control0..*
TypeReference(DeviceJP_MedicationSubstance))
Requirements

Used for tracking contamination, etc.

Comments

For devices actually implanted or removed, use Procedure.device.

実際に埋め込まれた、または取り外されたデバイスについては、Procedure.deviceを使用すること。

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

Identifies coded items that were used as part of the procedure. Procedureの一部として使用されたコード化されたアイテムを識別する。

Control0..*
BindingFor example codes, see JP Core Procedure Device Kind ValueSet
TypeCodeableConcept
Comments

For devices actually implanted or removed, use Procedure.device. 実際に埋め込まれた、または取り外されたデバイスについては、Procedure.deviceを使用すること。

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