HL7 FHIR JP Core ImplementationGuide
1.1.0 - release Japan flag

HL7 FHIR JP Core ImplementationGuide - Local Development build (v1.1.0). See the Directory of published versions

Resource Profile: JP_MedicationAdministrationBase - Detailed Descriptions

Active as of 2022-10-24

Definitions for the jp-medicationadministrationBase resource profile.

1. MedicationAdministration
2. MedicationAdministration.extension
SlicingThis element introduces a set of slices on MedicationAdministration.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
3. MedicationAdministration.extension:requestDepartment
SliceNamerequestDepartment
Control0..1
TypeExtension(JP_MedicationAdministration_RequestDepartment) (Extension Type: CodeableConcept)
4. MedicationAdministration.extension:requestAuthoredOn
SliceNamerequestAuthoredOn
Control0..1
TypeExtension(JP_MedicationAdministration_RequestAuthoredOn) (Extension Type: dateTime)
5. MedicationAdministration.extension:location
SliceNamelocation
Control0..1
TypeExtension(JP_MedicationAdministration_Location) (Extension Type: Reference(JP_Location)))
6. MedicationAdministration.extension:requester
SliceNamerequester
Control0..*
TypeExtension(JP_MedicationAdministration_Requester) (Extension Type: Reference(JP_Practitioner)))
7. MedicationAdministration.identifier
Definition

このインスタンスが外部から参照されるために使われるIDである。処方箋全体としてのIDとしては使用しない。 処方箋内で同一の用法をまとめて表記されるRp番号はこのIdentifier elementの別スライスで表現する。それ以外に任意のIDを付与してもよい。 このIDは業務手順によって定められた処方オーダに対して、直接的なURL参照が適切でない場合も含めて関連付けるために使われる。この業務手順のIDは実施者によって割り当てられたものであり、リソースが更新されたりサーバからサーバに転送されたとしても固定のものとして存続する。

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

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

これは業務IDであって、リソースに対するIDではない。

This is a business identifier, not a resource identifier.

SlicingThis element introduces a set of slices on MedicationAdministration.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
8. MedicationAdministration.identifier:rpNumber
SliceNamerpNumber
Definition

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

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

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

9. MedicationAdministration.identifier:rpNumber.system
Definition

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

Control1..?
Fixed Valueurn:oid:1.2.392.100495.20.3.81
10. MedicationAdministration.identifier:rpNumber.value
Definition

Rp番号(剤グループ番号)。"1"など。

Control1..?
Comments

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

11. MedicationAdministration.identifier:requestIdentifier
SliceNamerequestIdentifier
Definition

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

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
12. MedicationAdministration.identifier:requestIdentifier.system
Control1..?
Fixed Valuehttp://jpfhir.jp/fhir/core/IdSystem/resourceInstance-identifier
13. MedicationAdministration.identifier:requestIdentifier.value
Control1..?
14. MedicationAdministration.instantiates
Definition

A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event.

このイベントによって全体的または部分的に順守されたプロトコル、ガイドライン、オーダセット、またはその他の定義。

15. MedicationAdministration.partOf
Definition

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

この特定のイベントがコンポーネントまたはステップであるようなより大きな親イベント。

16. MedicationAdministration.status
Definition

Will generally be set to show that the administration has been completed. For some long running administrations such as infusions, it is possible for an administration to be started but not completed or it may be paused while some other process is under way.

通常、管理が完了したことを示すように設定される。輸液などの長期にわたる投与では、投与を開始しても完了しない場合や、他のプロセスの進行中に一時停止する場合がある。

【JP Core仕様】 completed or stopped に限定される。

Binding

患者への投与状況

A set of codes indicating the current status of a MedicationAdministration.

17. MedicationAdministration.statusReason
Definition

A code indicating why the administration was not performed. 投与が実施されていない理由を示すコード

A code indicating why the administration was not performed.

Comments

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

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

18. MedicationAdministration.category
Definition

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

薬が消費または投与されると予想される場所区分(入院、外来、家庭等)を示す。 inpatient | outpatient | community (http://terminology.hl7.org/CodeSystem/medication-admin-category)

19. MedicationAdministration.medication[x]
Definition

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

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

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

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

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

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

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

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

20. MedicationAdministration.subject
Definition

The person or animal or group receiving the medication. 投与を受ける患者

The person or animal or group receiving the medication.

TypeReference(JP_Patient|Patient|Group))
Comments

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

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

21. MedicationAdministration.context
Definition

The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.

投薬が行われた患者と医療提供者の間の訪問、入院、またはその他の接触。 受診情報や入院情報を表すEncounterへの参照。

TypeReference(JP_Encounter|EpisodeOfCare|Encounter))
Comments

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

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

22. MedicationAdministration.supportingInformation
Definition

Additional information (for example, patient height and weight) that supports the administration of the medication.

薬の投与をサポートする追加情報(たとえば、患者の身長や体重)。

Comments

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

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

23. MedicationAdministration.effective[x]
Definition

A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.

投与が行われた(または「notGiven」属性がtrueの場合は行われなかった)特定の日時または時間間隔。錠剤を飲み込むなど、多くの管理では、dateTimeの使用がより適切である。

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

投与実施日時であり、JP Coreでは必須である。

24. MedicationAdministration.performer
Definition

Indicates who or what performed the medication administration and how they were involved. 投薬およびそれに関与した人

Indicates who or what performed the medication administration and how they were involved.

25. MedicationAdministration.performer.actor
TypeReference(JP_Practitioner|JP_PractitionerRole|JP_Patient|RelatedPerson|Device|Practitioner|PractitionerRole|Patient))
26. MedicationAdministration.reasonCode
Definition

A code indicating why the medication was given. 投薬が実施された理由を示すコード

A code indicating why the medication was given.

27. MedicationAdministration.reasonReference
Definition

Condition or observation that supports why the medication was administered.

薬が投与された理由を裏付ける状態または観察

TypeReference(JP_Condition|JP_Observation_Common|JP_DiagnosticReport_Common|Condition|Observation|DiagnosticReport))
Comments

This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

これは、投薬要求の理由である状態への参照。コードのみが存在する場合は、reasonCodeを使用する。

28. MedicationAdministration.request
Definition

The original request, instruction or authority to perform the administration.

投与を実行する元になった投与指示や権限への参照情報。

Requirements

これは、インテント(意図)がorderまたはinstance-orderのいずれかであるMedicationRequestへの参照である。 インテントが他の値である場合は、MedicationRequestsを参照しないこと。

Comments

This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.

これは、orderまたはinstance-orderのいずれかであるMedicationRequestへの参照。インテントが他の値である場合は、MedicationRequestsを参照しないこと。

29. MedicationAdministration.device
Definition

The device used in administering the medication to the patient. For example, a particular infusion pump.

患者に薬を投与する際に使用されるデバイスへの参照。たとえば、特定の輸液ポンプ。

Comments

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

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

30. MedicationAdministration.note
Definition

Extra information about the medication administration that is not conveyed by the other attributes.

他の属性では伝えられない投薬管理に関する追加情報。

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).

構造化された注釈情報がないシステムの場合、この要素によって作成者や作成時刻情報なしで単一の注釈を簡単に伝達できる。投与情報に付帯する潜在的な情報や修飾的な情報を伝えるために、この要素に叙述的な記述でそれらを含める必要がある場合がある。 注釈は、計算可能な「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である)。

31. MedicationAdministration.dosage
Definition

Describes the medication dosage information details e.g. dose, rate, site, route, etc. 投薬量情報の詳細を説明する。線量、率、場所、ルートなど。

Describes the medication dosage information details e.g. dose, rate, site, route, etc.

32. MedicationAdministration.dosage.text
Definition

Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

The dosage instructions should reflect the dosage of the medication that was administered.

フリーテキストの投与量用法は、投与される投与量や用法が複雑すぎてコーディングできない場合に使用できる。コード化された投与量や用法が存在する場合、フリーテキストの投与量や用法は、人間に表示するためにまだ存在している可能性がある。 投与量や用法のこの指示は、実際に投与される薬の投与量や用法を反映する必要がある。

33. MedicationAdministration.dosage.site
Definition

A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

薬が最初に体内に入った解剖学的部位のコード化された記述。たとえば、「左腕」。

BindingThe codes SHOULD be taken from JP Core Medication JAMI External Body Site ValueSetFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
Comments

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

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)、標準の拡張機能[bodySite](extension-bodysite.html)を使用する。要約コード、または場所の非常に正確な定義への参照、あるいはその両方である可能性がある。

34. MedicationAdministration.dosage.route
Definition

A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

患者への、または患者への治療薬の投与経路または生理学的経路を指定するコード。たとえば、局所、静脈内など。

BindingThe codes SHOULD be taken from JP Core Medication HL70162-based Route ValueSetFor example codes, see SNOMEDCTRouteCodes
Comments

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

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

35. MedicationAdministration.dosage.method
Definition

投与方法

A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV.

Requirements

コード化された値は体内に薬剤が投与される方法を示している。注射ではよく使われる。たとえば、緩徐に注入、深部に静注など。

Comments

ターミノロジは投与する経路あるいは剤型をあらかじめ指定するために用いられる。

One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.

36. MedicationAdministration.dosage.method.coding
Control0..?
SlicingThis element introduces a set of slices on MedicationAdministration.dosage.method.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
37. MedicationAdministration.dosage.method.coding:unitDigit1
SliceNameunitDigit1
Definition

投与⽅法に対応するJAMI 用法コード表基本用法1桁コードを識別するURI。

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication JAMI Basic Usage Type ValueSet
Requirements

他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

Comments

コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

38. MedicationAdministration.dosage.method.coding:unitDigit1.system
Control1..?
Fixed Valueurn:oid:1.2.392.200250.2.2.20.30
39. MedicationAdministration.dosage.method.coding:unitDigit2
SliceNameunitDigit2
Definition

投与⽅法に対応するJAMI 用法コード表基本用法2桁コードを識別するURI。2桁コードurn:oid:1.2.392.200250.2.2.20.40

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication JAMI Detail Usage ValueSet
Requirements

他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

Comments

コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

40. MedicationAdministration.dosage.method.coding:unitDigit2.system
Control1..?
Fixed Valueurn:oid:1.2.392.200250.2.2.20.40
41. MedicationAdministration.dosage.method.text
Definition

投与⽅法のテキスト表現。コードで指定できない場合、本要素で文字列として指定してもよい。

Control0..?
Requirements

ターミノロジ由来のコードは必ずしも人間が使う言葉の全てのニュアンスを含めた正確な意味を捉えているわけではなく、適切なコードが見つからない場合もある。そのような場合でもtextエレメントは元々の意味のすべてを捉えるために使うことができる。

Comments

textエレメントはcodingのdisplayNameエレメントと一致することがよくある。

42. MedicationAdministration.dosage.dose
Definition

The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

1回の投与イベントで投与される薬剤の量。この値は、投与が錠剤の飲み込みや注射などの本質的に瞬間的なイベントである場合に使用する。

TypeQuantity(JP_MedicationSimpleQuantity, SimpleQuantity)
43. MedicationAdministration.dosage.rate[x]
Definition

Identifies the speed with which the medication was or will be introduced into the patient. Typically, the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time, e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.

薬が患者に導入された、または導入される予定の速度を識別する。 通常、注入の速度。 1時間あたり100mlまたは100ml/時。単位時間あたりのレートとして表すこともできる。 2時間あたり500ml。その他の例:200mcg/分または200mcg/1分。 1リットル/8時間。

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

If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.

レートが時間の経過とともに変化し、これをMedicationAdministrationで記述する場合は、各変更を、特定のMedicationAdministration.dosage.rateと、レート変更が発生した日時を使用して、個別のMedicationAdministrationとして記述する必要がある。通常、MedicationAdministration.dosage.rate要素は、平均レートを伝達するためには使用されない。

44. MedicationAdministration.eventHistory
Definition

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

投与が確認されたときなど、発生した関連のあるベントのサマリー。

1. MedicationAdministration
Definition

Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.

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. MedicationAdministration.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. MedicationAdministration.extension
Definition

An Extension

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationAdministration.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. MedicationAdministration.extension:requestDepartment
SliceNamerequestDepartment
Definition

依頼科を格納するための拡張

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationAdministration_RequestDepartment) (Extension Type: CodeableConcept)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
5. MedicationAdministration.extension:requestAuthoredOn
SliceNamerequestAuthoredOn
Definition

依頼日時を格納するための拡張

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationAdministration_RequestAuthoredOn) (Extension Type: dateTime)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
6. MedicationAdministration.extension:location
SliceNamelocation
Definition

実施場所を格納するための拡張。 実施場所を記述した Locationリソースへの参照。

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationAdministration_Location) (Extension Type: Reference(JP_Location)))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
7. MedicationAdministration.extension:requester
SliceNamerequester
Definition

依頼医を格納するための拡張。 依頼医を記述した Practitioner リソースへの参照。

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationAdministration_Requester) (Extension Type: Reference(JP_Practitioner)))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
8. MedicationAdministration.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())
9. MedicationAdministration.identifier
Definition

このインスタンスが外部から参照されるために使われるIDである。処方箋全体としてのIDとしては使用しない。 処方箋内で同一の用法をまとめて表記されるRp番号はこのIdentifier elementの別スライスで表現する。それ以外に任意のIDを付与してもよい。 このIDは業務手順によって定められた処方オーダに対して、直接的なURL参照が適切でない場合も含めて関連付けるために使われる。この業務手順のIDは実施者によって割り当てられたものであり、リソースが更新されたりサーバからサーバに転送されたとしても固定のものとして存続する。

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

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

これは業務IDであって、リソースに対するIDではない。

This is a business identifier, not a resource identifier.

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

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

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

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

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

This is a business identifier, not a resource identifier.

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

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Requirements

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

Comments

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

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

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

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

Control10..1
Typeuri
Requirements

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

Comments

Identifier.system is always case sensitive.

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

Rp番号(剤グループ番号)。"1"など。

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

Control10..1
Typestring
Comments

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

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

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

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

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

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

This is a business identifier, not a resource identifier.

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

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Requirements

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

Comments

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

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

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

Control10..1
Typeuri
Requirements

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

Comments

Identifier.system is always case sensitive.

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

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

Control10..1
Typestring
Comments

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

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

A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event.

このイベントによって全体的または部分的に順守されたプロトコル、ガイドライン、オーダセット、またはその他の定義。

Control0..*
Typeuri
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. MedicationAdministration.partOf
Definition

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

この特定のイベントがコンポーネントまたはステップであるようなより大きな親イベント。

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

Will generally be set to show that the administration has been completed. For some long running administrations such as infusions, it is possible for an administration to be started but not completed or it may be paused while some other process is under way.

通常、管理が完了したことを示すように設定される。輸液などの長期にわたる投与では、投与を開始しても完了しない場合や、他のプロセスの進行中に一時停止する場合がある。

【JP Core仕様】 completed or stopped に限定される。

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

患者への投与状況

A set of codes indicating the current status of a MedicationAdministration.

Typecode
Is Modifiertrue
Comments

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

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

A code indicating why the administration was not performed. 投与が実施されていない理由を示すコード

A code indicating why the administration was not performed.

Control0..*
BindingFor example codes, see SNOMEDCTReasonMedicationNotGivenCodes

A set of codes indicating the reason why the MedicationAdministration is negated.

TypeCodeableConcept
Comments

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

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

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

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

薬が消費または投与されると予想される場所区分(入院、外来、家庭等)を示す。 inpatient | outpatient | community (http://terminology.hl7.org/CodeSystem/medication-admin-category)

Control0..1
BindingThe codes SHOULD be taken from MedicationAdministration Category Codes

A coded concept describing where the medication administered is expected to occur.

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

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

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

Control1..1
BindingFor example codes, see SNOMEDCTMedicationCodes

Codes identifying substance or product that can be administered.

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

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

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

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

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

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

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

The person or animal or group receiving the medication. 投与を受ける患者

The person or animal or group receiving the medication.

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

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

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

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

The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.

投薬が行われた患者と医療提供者の間の訪問、入院、またはその他の接触。 受診情報や入院情報を表すEncounterへの参照。

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

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

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

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

Additional information (for example, patient height and weight) that supports the administration of the medication.

薬の投与をサポートする追加情報(たとえば、患者の身長や体重)。

Control0..*
TypeReference(Resource))
Comments

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

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

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

A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.

投与が行われた(または「notGiven」属性がtrueの場合は行われなかった)特定の日時または時間間隔。錠剤を飲み込むなど、多くの管理では、dateTimeの使用がより適切である。

Control1..1
TypeChoice of: dateTime, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

投与実施日時であり、JP Coreでは必須である。

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

Indicates who or what performed the medication administration and how they were involved. 投薬およびそれに関与した人

Indicates who or what performed the medication administration and how they were involved.

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

Indicates who or what performed the medication administration.

Control1..1
TypeReference(JP_Practitioner|JP_PractitionerRole|JP_Patient|RelatedPerson|Device|Practitioner|PractitionerRole|Patient))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. MedicationAdministration.reasonCode
Definition

A code indicating why the medication was given. 投薬が実施された理由を示すコード

A code indicating why the medication was given.

Control0..*
BindingFor example codes, see ReasonMedicationGivenCodes

A set of codes indicating the reason why the MedicationAdministration was made.

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

Condition or observation that supports why the medication was administered.

薬が投与された理由を裏付ける状態または観察

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

This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

これは、投薬要求の理由である状態への参照。コードのみが存在する場合は、reasonCode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()))
33. MedicationAdministration.request
Definition

The original request, instruction or authority to perform the administration.

投与を実行する元になった投与指示や権限への参照情報。

Control0..1
TypeReference(MedicationRequest))
Requirements

これは、インテント(意図)がorderまたはinstance-orderのいずれかであるMedicationRequestへの参照である。 インテントが他の値である場合は、MedicationRequestsを参照しないこと。

Comments

This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.

これは、orderまたはinstance-orderのいずれかであるMedicationRequestへの参照。インテントが他の値である場合は、MedicationRequestsを参照しないこと。

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

The device used in administering the medication to the patient. For example, a particular infusion pump.

患者に薬を投与する際に使用されるデバイスへの参照。たとえば、特定の輸液ポンプ。

Control0..*
TypeReference(Device))
Comments

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

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

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

Extra information about the medication administration that is not conveyed by the other attributes.

他の属性では伝えられない投薬管理に関する追加情報。

Control0..*
TypeAnnotation
Comments

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

構造化された注釈情報がないシステムの場合、この要素によって作成者や作成時刻情報なしで単一の注釈を簡単に伝達できる。投与情報に付帯する潜在的な情報や修飾的な情報を伝えるために、この要素に叙述的な記述でそれらを含める必要がある場合がある。 注釈は、計算可能な「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である)。

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

Describes the medication dosage information details e.g. dose, rate, site, route, etc. 投薬量情報の詳細を説明する。線量、率、場所、ルートなど。

Describes the medication dosage information details e.g. dose, rate, site, route, etc.

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] (: dose.exists() or rate.exists())
37. MedicationAdministration.dosage.modifierExtension
Definition

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

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

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())
38. MedicationAdministration.dosage.text
Definition

Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

The dosage instructions should reflect the dosage of the medication that was administered.

フリーテキストの投与量用法は、投与される投与量や用法が複雑すぎてコーディングできない場合に使用できる。コード化された投与量や用法が存在する場合、フリーテキストの投与量や用法は、人間に表示するためにまだ存在している可能性がある。 投与量や用法のこの指示は、実際に投与される薬の投与量や用法を反映する必要がある。

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. MedicationAdministration.dosage.site
Definition

A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

薬が最初に体内に入った解剖学的部位のコード化された記述。たとえば、「左腕」。

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication JAMI External Body Site ValueSetFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
TypeCodeableConcept
Comments

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

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)、標準の拡張機能[bodySite](extension-bodysite.html)を使用する。要約コード、または場所の非常に正確な定義への参照、あるいはその両方である可能性がある。

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

A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

患者への、または患者への治療薬の投与経路または生理学的経路を指定するコード。たとえば、局所、静脈内など。

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication HL70162-based Route ValueSetFor example codes, see SNOMEDCTRouteCodes
TypeCodeableConcept
Comments

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

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

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

投与方法

A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV.

Control0..1
BindingFor example codes, see SNOMEDCTAdministrationMethodCodes

A coded concept describing the technique by which the medicine is administered.

TypeCodeableConcept
Requirements

コード化された値は体内に薬剤が投与される方法を示している。注射ではよく使われる。たとえば、緩徐に注入、深部に静注など。

Comments

ターミノロジは投与する経路あるいは剤型をあらかじめ指定するために用いられる。

One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. MedicationAdministration.dosage.method.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 MedicationAdministration.dosage.method.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
43. MedicationAdministration.dosage.method.coding:unitDigit1
SliceNameunitDigit1
Definition

投与⽅法に対応するJAMI 用法コード表基本用法1桁コードを識別するURI。

A reference to a code defined by a terminology system.

Control0..1*
BindingThe codes SHOULD be taken from JP Core Medication JAMI Basic Usage Type ValueSetFor codes, see (unbound)
TypeCoding
Requirements

他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

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

Comments

コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. MedicationAdministration.dosage.method.coding:unitDigit1.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:1.2.392.200250.2.2.20.30
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. MedicationAdministration.dosage.method.coding:unitDigit2
SliceNameunitDigit2
Definition

投与⽅法に対応するJAMI 用法コード表基本用法2桁コードを識別するURI。2桁コードurn:oid:1.2.392.200250.2.2.20.40

A reference to a code defined by a terminology system.

Control0..1*
BindingThe codes SHOULD be taken from JP Core Medication JAMI Detail Usage ValueSetFor codes, see (unbound)
TypeCoding
Requirements

他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

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

Comments

コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. MedicationAdministration.dosage.method.coding:unitDigit2.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:1.2.392.200250.2.2.20.40
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. MedicationAdministration.dosage.method.text
Definition

投与⽅法のテキスト表現。コードで指定できない場合、本要素で文字列として指定してもよい。

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

Control0..1
Typestring
Requirements

ターミノロジ由来のコードは必ずしも人間が使う言葉の全てのニュアンスを含めた正確な意味を捉えているわけではなく、適切なコードが見つからない場合もある。そのような場合でもtextエレメントは元々の意味のすべてを捉えるために使うことができる。

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

Comments

textエレメントはcodingのdisplayNameエレメントと一致することがよくある。

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

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

The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

1回の投与イベントで投与される薬剤の量。この値は、投与が錠剤の飲み込みや注射などの本質的に瞬間的なイベントである場合に使用する。

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

薬剤に関する簡易的な数量と単位を定めている。ValueおよびCodeを必須とし、comparatorは記述不可。単位についてはMERIT9医薬品単位略号の利用を推進している。(SHOULD)

If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.

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

Identifies the speed with which the medication was or will be introduced into the patient. Typically, the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time, e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.

薬が患者に導入された、または導入される予定の速度を識別する。 通常、注入の速度。 1時間あたり100mlまたは100ml/時。単位時間あたりのレートとして表すこともできる。 2時間あたり500ml。その他の例:200mcg/分または200mcg/1分。 1リットル/8時間。

Control0..1
TypeChoice of: Ratio, Quantity(SimpleQuantity)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.

レートが時間の経過とともに変化し、これをMedicationAdministrationで記述する場合は、各変更を、特定のMedicationAdministration.dosage.rateと、レート変更が発生した日時を使用して、個別のMedicationAdministrationとして記述する必要がある。通常、MedicationAdministration.dosage.rate要素は、平均レートを伝達するためには使用されない。

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

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

投与が確認されたときなど、発生した関連のあるベントのサマリー。

Control0..*
TypeReference(Provenance))
Comments

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

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

Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.

Control0..*
2. MedicationAdministration.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. MedicationAdministration.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. MedicationAdministration.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. MedicationAdministration.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. MedicationAdministration.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. MedicationAdministration.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. MedicationAdministration.extension
Definition

An Extension

Control0..*
TypeExtension
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationAdministration.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. MedicationAdministration.extension:requestDepartment
SliceNamerequestDepartment
Definition

依頼科を格納するための拡張

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

依頼日時を格納するための拡張

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationAdministration_RequestAuthoredOn) (Extension Type: dateTime)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. MedicationAdministration.extension:location
SliceNamelocation
Definition

実施場所を格納するための拡張。 実施場所を記述した Locationリソースへの参照。

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationAdministration_Location) (Extension Type: Reference(JP_Location)))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
12. MedicationAdministration.extension:requester
SliceNamerequester
Definition

依頼医を格納するための拡張。 依頼医を記述した Practitioner リソースへの参照。

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(JP_MedicationAdministration_Requester) (Extension Type: Reference(JP_Practitioner)))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. MedicationAdministration.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())
14. MedicationAdministration.identifier
Definition

このインスタンスが外部から参照されるために使われるIDである。処方箋全体としてのIDとしては使用しない。 処方箋内で同一の用法をまとめて表記されるRp番号はこのIdentifier elementの別スライスで表現する。それ以外に任意のIDを付与してもよい。 このIDは業務手順によって定められた処方オーダに対して、直接的なURL参照が適切でない場合も含めて関連付けるために使われる。この業務手順のIDは実施者によって割り当てられたものであり、リソースが更新されたりサーバからサーバに転送されたとしても固定のものとして存続する。

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

これは業務IDであって、リソースに対するIDではない。

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

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

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

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

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

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
17. MedicationAdministration.identifier:rpNumber.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationAdministration.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
18. MedicationAdministration.identifier:rpNumber.use
Definition

The purpose of this identifier.

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

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

Comments

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

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

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

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

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

Comments

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

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

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

Control1..1
Typeuri
Requirements

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

Comments

Identifier.system is always case sensitive.

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

Rp番号(剤グループ番号)。"1"など。

Control1..1
Typestring
Comments

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

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

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

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

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization))
Comments

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

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

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

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

This is a business identifier, not a resource identifier.

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

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
26. MedicationAdministration.identifier:requestIdentifier.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensionsuser content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationAdministration.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
27. MedicationAdministration.identifier:requestIdentifier.use
Definition

The purpose of this identifier.

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

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

Comments

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

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

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

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

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

Comments

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

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

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

Control1..1
Typeuri
Requirements

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

Comments

Identifier.system is always case sensitive.

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

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

Control1..1
Typestring
Comments

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

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

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

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

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization))
Comments

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

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

A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event.

このイベントによって全体的または部分的に順守されたプロトコル、ガイドライン、オーダセット、またはその他の定義。

Control0..*
Typeuri
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. MedicationAdministration.partOf
Definition

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

この特定のイベントがコンポーネントまたはステップであるようなより大きな親イベント。

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

Will generally be set to show that the administration has been completed. For some long running administrations such as infusions, it is possible for an administration to be started but not completed or it may be paused while some other process is under way.

通常、管理が完了したことを示すように設定される。輸液などの長期にわたる投与では、投与を開始しても完了しない場合や、他のプロセスの進行中に一時停止する場合がある。

【JP Core仕様】 completed or stopped に限定される。

Control1..1
BindingThe codes SHALL be taken from MedicationAdministration Status Codes 患者への投与状
Typecode
Is Modifiertrue
Comments

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

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

A code indicating why the administration was not performed. 投与が実施されていない理由を示すコード

Control0..*
BindingFor example codes, see SNOMEDCTReasonMedicationNotGivenCodes A set of codes indicating the reason why the MedicationAdministration is negated
TypeCodeableConcept
Comments

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

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

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

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

薬が消費または投与されると予想される場所区分(入院、外来、家庭等)を示す。 inpatient | outpatient | community (http://terminology.hl7.org/CodeSystem/medication-admin-category)

Control0..1
BindingThe codes SHOULD be taken from MedicationAdministration Category Codes A coded concept describing where the medication administered is expected to occur
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. MedicationAdministration.medication[x]
Definition

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

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

Control1..1
BindingFor example codes, see SNOMEDCTMedicationCodes Codes identifying substance or product that can be administered
TypeChoice of: CodeableConcept, Reference(Medication))
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

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

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

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

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

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

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

The person or animal or group receiving the medication. 投与を受ける患者

Control1..1
TypeReference(JP_Patient))
Comments

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

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

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

The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.

投薬が行われた患者と医療提供者の間の訪問、入院、またはその他の接触。 受診情報や入院情報を表すEncounterへの参照。

Control0..1
TypeReference(JP_EncounterEpisodeOfCare))
Comments

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

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

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

Additional information (for example, patient height and weight) that supports the administration of the medication.

薬の投与をサポートする追加情報(たとえば、患者の身長や体重)。

Control0..*
TypeReference(Resource))
Comments

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

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

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

A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.

投与が行われた(または「notGiven」属性がtrueの場合は行われなかった)特定の日時または時間間隔。錠剤を飲み込むなど、多くの管理では、dateTimeの使用がより適切である。

Control1..1
TypeChoice of: dateTime, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

投与実施日時であり、JP Coreでは必須である。

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

Indicates who or what performed the medication administration and how they were involved. 投薬およびそれに関与した人

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. MedicationAdministration.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.
45. MedicationAdministration.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())
46. MedicationAdministration.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())
47. MedicationAdministration.performer.function
Definition

Distinguishes the type of involvement of the performer in the medication administration.

Control0..1
BindingFor example codes, see MedicationAdministration Performer Function Codes A code describing the role an individual played in administering the medication
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. MedicationAdministration.performer.actor
Definition

Indicates who or what performed the medication administration.

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

A code indicating why the medication was given. 投薬が実施された理由を示すコード

Control0..*
BindingFor example codes, see ReasonMedicationGivenCodes A set of codes indicating the reason why the MedicationAdministration was made
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. MedicationAdministration.reasonReference
Definition

Condition or observation that supports why the medication was administered.

薬が投与された理由を裏付ける状態または観察

Control0..*
TypeReference(JP_ConditionJP_Observation_CommonJP_DiagnosticReport_Common))
Comments

This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

これは、投薬要求の理由である状態への参照。コードのみが存在する場合は、reasonCode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()))
51. MedicationAdministration.request
Definition

The original request, instruction or authority to perform the administration.

投与を実行する元になった投与指示や権限への参照情報。

Control0..1
TypeReference(MedicationRequest))
Requirements

これは、インテント(意図)がorderまたはinstance-orderのいずれかであるMedicationRequestへの参照である。 インテントが他の値である場合は、MedicationRequestsを参照しないこと。

Comments

This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.

これは、orderまたはinstance-orderのいずれかであるMedicationRequestへの参照。インテントが他の値である場合は、MedicationRequestsを参照しないこと。

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

The device used in administering the medication to the patient. For example, a particular infusion pump.

患者に薬を投与する際に使用されるデバイスへの参照。たとえば、特定の輸液ポンプ。

Control0..*
TypeReference(Device))
Comments

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

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

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

Extra information about the medication administration that is not conveyed by the other attributes.

他の属性では伝えられない投薬管理に関する追加情報。

Control0..*
TypeAnnotation
Comments

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

構造化された注釈情報がないシステムの場合、この要素によって作成者や作成時刻情報なしで単一の注釈を簡単に伝達できる。投与情報に付帯する潜在的な情報や修飾的な情報を伝えるために、この要素に叙述的な記述でそれらを含める必要がある場合がある。 注釈は、計算可能な「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である)。

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

Describes the medication dosage information details e.g. dose, rate, site, route, etc. 投薬量情報の詳細を説明する。線量、率、場所、ルートなど。

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] (: dose.exists() or rate.exists())
55. MedicationAdministration.dosage.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
56. MedicationAdministration.dosage.extension
Definition

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

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())
57. MedicationAdministration.dosage.modifierExtension
Definition

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

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

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())
58. MedicationAdministration.dosage.text
Definition

Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

The dosage instructions should reflect the dosage of the medication that was administered.

フリーテキストの投与量用法は、投与される投与量や用法が複雑すぎてコーディングできない場合に使用できる。コード化された投与量や用法が存在する場合、フリーテキストの投与量や用法は、人間に表示するためにまだ存在している可能性がある。 投与量や用法のこの指示は、実際に投与される薬の投与量や用法を反映する必要がある。

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. MedicationAdministration.dosage.site
Definition

A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

薬が最初に体内に入った解剖学的部位のコード化された記述。たとえば、「左腕」。

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication JAMI External Body Site 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 bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

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)、標準の拡張機能[bodySite](extension-bodysite.html)を使用する。要約コード、または場所の非常に正確な定義への参照、あるいはその両方である可能性がある。

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

A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

患者への、または患者への治療薬の投与経路または生理学的経路を指定するコード。たとえば、局所、静脈内など。

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication HL70162-based Route 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pre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。

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

投与方法

Control0..1
BindingFor example codes, see SNOMEDCTAdministrationMethodCodes A coded concept describing the technique by which the medicine is administered
TypeCodeableConcept
Requirements

コード化された値は体内に薬剤が投与される方法を示している。注射ではよく使われる。たとえば、緩徐に注入、深部に静注など。

Comments

ターミノロジは投与する経路あるいは剤型をあらかじめ指定するために用いられる。

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

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
63. MedicationAdministration.dosage.method.extension
Definition

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

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 MedicationAdministration.dosage.method.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
64. MedicationAdministration.dosage.method.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 MedicationAdministration.dosage.method.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
65. MedicationAdministration.dosage.method.coding:unitDigit1
SliceNameunitDigit1
Definition

投与⽅法に対応するJAMI 用法コード表基本用法1桁コードを識別するURI。

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication JAMI Basic Usage Type ValueSet
TypeCoding
Requirements

他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

Comments

コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. MedicationAdministration.dosage.method.coding:unitDigit1.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
67. MedicationAdministration.dosage.method.coding:unitDigit1.extension
Definition

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

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 MedicationAdministration.dosage.method.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
68. MedicationAdministration.dosage.method.coding:unitDigit1.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:1.2.392.200250.2.2.20.30
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. MedicationAdministration.dosage.method.coding:unitDigit1.version
Definition

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

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()))
70. MedicationAdministration.dosage.method.coding:unitDigit1.code
Definition

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

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()))
71. MedicationAdministration.dosage.method.coding:unitDigit1.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()))
72. MedicationAdministration.dosage.method.coding:unitDigit1.userSelected
Definition

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

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()))
73. MedicationAdministration.dosage.method.coding:unitDigit2
SliceNameunitDigit2
Definition

投与⽅法に対応するJAMI 用法コード表基本用法2桁コードを識別するURI。2桁コードurn:oid:1.2.392.200250.2.2.20.40

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication JAMI Detail Usage ValueSet
TypeCoding
Requirements

他のコードシステムへの変換や代替のコードシステムを使ってエンコードしてもよい。

Comments

コードは臨時で列記したものや、コードのリストからSNOMED CTのように公式に定義されたものまである(HL7 v3 core principle を参照)。FHIR自体ではコーディング規約を定めてはいないし、意味を暗示するために利用されない(SHALL NOT)。一般的に UserSelected = trueの場合には一つのコードシステムが使われる。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. MedicationAdministration.dosage.method.coding:unitDigit2.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
75. MedicationAdministration.dosage.method.coding:unitDigit2.extension
Definition

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

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 MedicationAdministration.dosage.method.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
76. MedicationAdministration.dosage.method.coding:unitDigit2.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:1.2.392.200250.2.2.20.40
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. MedicationAdministration.dosage.method.coding:unitDigit2.version
Definition

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

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()))
78. MedicationAdministration.dosage.method.coding:unitDigit2.code
Definition

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

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()))
79. MedicationAdministration.dosage.method.coding:unitDigit2.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()))
80. MedicationAdministration.dosage.method.coding:unitDigit2.userSelected
Definition

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

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()))
81. MedicationAdministration.dosage.method.text
Definition

投与⽅法のテキスト表現。コードで指定できない場合、本要素で文字列として指定してもよい。

Control0..1
Typestring
Requirements

ターミノロジ由来のコードは必ずしも人間が使う言葉の全てのニュアンスを含めた正確な意味を捉えているわけではなく、適切なコードが見つからない場合もある。そのような場合でもtextエレメントは元々の意味のすべてを捉えるために使うことができる。

Comments

textエレメントはcodingのdisplayNameエレメントと一致することがよくある。

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

The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

1回の投与イベントで投与される薬剤の量。この値は、投与が錠剤の飲み込みや注射などの本質的に瞬間的なイベントである場合に使用する。

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

薬剤に関する簡易的な数量と単位を定めている。ValueおよびCodeを必須とし、comparatorは記述不可。単位についてはMERIT9医薬品単位略号の利用を推進している。(SHOULD)

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

Identifies the speed with which the medication was or will be introduced into the patient. Typically, the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time, e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.

薬が患者に導入された、または導入される予定の速度を識別する。 通常、注入の速度。 1時間あたり100mlまたは100ml/時。単位時間あたりのレートとして表すこともできる。 2時間あたり500ml。その他の例:200mcg/分または200mcg/1分。 1リットル/8時間。

Control0..1
TypeChoice of: Ratio, Quantity(SimpleQuantity)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.

レートが時間の経過とともに変化し、これをMedicationAdministrationで記述する場合は、各変更を、特定のMedicationAdministration.dosage.rateと、レート変更が発生した日時を使用して、個別のMedicationAdministrationとして記述する必要がある。通常、MedicationAdministration.dosage.rate要素は、平均レートを伝達するためには使用されない。

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

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

投与が確認されたときなど、発生した関連のあるベントのサマリー。

Control0..*
TypeReference(Provenance))
Comments

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

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