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

Data Type Profile: JP_MedicationDosageBase - Detailed Descriptions

Active as of 2022-10-24

Definitions for the jp-medicationdosagebase data type profile.

1. Dosage
Definition

薬の服用方法・服用した方法、または服用すべき方法

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

2. Dosage.sequence
Definition

どの服用指示を適応するか判断するかについての順序を示したもの

Indicates the order in which the dosage instructions should be applied or interpreted.

Requirements

もし、複数の服用法(Dosage)でsequenceの数値が同じであれば、その指示が同時に扱われることを示している。sequenceの数値が異なれば、服用指示(Dosage)の順番を意図している。

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Comments

32 bitの数値。これ以上の値であれば10進数を使うこと。

3. Dosage.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。

Free text dosage instructions e.g. SIG.

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。

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

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。

4. Dosage.additionalInstruction
Definition

どのように薬剤を内服するかについての患者への補足指示(たとえば、「食事と一緒に」や「30分から1時間前に内服」)や薬剤についての注意書き(たとえば、「眠くなることがある」や「日光や紫外線が皮膚にあたららないようにすること」)

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

BindingThe codes SHOULD be taken from JP Core Medication JAMI Additional Usage ValueSetFor example codes, see SNOMEDCTAdditionalDosageInstructions
Requirements

補足指示はコード化されるように意図されているが、コードがない場合はエレメントはテキストだけで表現することができる。たとえば、「大量の水で服用する」という指示はコード化されていることもあれば、されていないことおある。

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

薬剤投与や調剤についての情報(たとえば、「腹膜内ポートに可能な限り迅速に注入」や「薬剤Xの直後に」)であり、dosage.textにも複製されるべきである。

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

5. Dosage.patientInstruction
Definition

患者あるいは消費者に理解してもらうための指示。

Instructions in terms that are understood by the patient or consumer.

Comments

FHIRの文字列は1MB以上の大きさとなってなはらない(SHALL NOT)。

6. Dosage.timing
TypeTiming(JP_MedicationTiming)
7. Dosage.asNeeded[x]
Definition

【JP Core仕様】頓用型の用法を指定する場合に”true”を指定し、そのコードを指定する場合は用法コードとして指定する。 Medication(薬剤)が必要なときに指定された量とスケジュールのみで投薬するか(Booleanで選択される)、投薬する前提条件はTiming.Code(CodeableConcept)を示している。

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

TypeChoice of: , CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
8. Dosage.site
Definition

投与される身体部位。外用薬で部位を指定する場合に使用する。

Body site to administer to.

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

もし、BodySite resourceの属性が必要な場合(たとえば、部位の指定や別々に投与経路を設定する場合)は、bodySiteの標準拡張を使うこと。要約コードや非常に正確な位置の定義へのreferenceを使用することもできる。
【JP Core仕様】JAMI外用部位3桁コードを使用することが望ましいが、ローカルコードも使用可能。

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.

9. Dosage.route
Definition

投与経路

How drug should enter body.

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

投与経路の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。
【JP Core仕様】HL7表0162をベースにした投与経路コードを使用することが望ましいが、ローカルコードも使用可能。

10. Dosage.method
Definition

投与方法

Technique for administering medication.

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。

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

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。

Terminologies used often pre-coordinate this term with the route and or form of administration.

11. Dosage.method.coding
Control0..?
SlicingThis element introduces a set of slices on Dosage.method.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
12. 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。

13. Dosage.method.coding:unitDigit1.system
Control1..?
Fixed Valueurn:oid:1.2.392.200250.2.2.20.30
14. 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。

15. Dosage.method.coding:unitDigit2.system
Control1..?
Fixed Valueurn:oid:1.2.392.200250.2.2.20.40
16. 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。

17. Dosage.doseAndRate
Definition

薬剤が投与される量

The amount of medication administered.

18. Dosage.doseAndRate.type
Definition

力価区分

The kind of dose or rate specified, for example, ordered or calculated.

BindingThe codes SHOULD be taken from JP Core Medication IngredientStrength StrengthType ValueSetFor example codes, see DoseAndRateType
Requirements

このtypeに値が指定されていなければ、"ordered"であることが想定される。

If the type is not populated, assume to be "ordered".

Comments

投与速度・量の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。

19. Dosage.doseAndRate.dose[x]
TypeChoice of: (SimpleQuantity), Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
20. Dosage.doseAndRate.rate[x]
Definition

薬剤が投与される量の速度

Amount of medication per unit of time.

[x] NoteSee Choice of Data Types for further information about how to use [x]
21. Dosage.maxDosePerPeriod
Definition

単位時間当たりの投薬量の上限

Upper limit on medication per unit of time.

TypeRatio(JP_MedicationRatio_DosePerPeriod)
22. Dosage.maxDosePerAdministration
Definition

1回あたりの投薬量の上限

Upper limit on medication per administration.

TypeQuantity(JP_MedicationSimpleQuantity, SimpleQuantity)
23. Dosage.maxDosePerLifetime
Definition

生涯の投薬量の上限

Upper limit on medication per lifetime of the patient.

TypeQuantity(JP_MedicationSimpleQuantity, SimpleQuantity)
1. Dosage
Definition

薬の服用方法・服用した方法、または服用すべき方法

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

Control0..*
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
2. 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())
3. Dosage.sequence
Definition

どの服用指示を適応するか判断するかについての順序を示したもの

Indicates the order in which the dosage instructions should be applied or interpreted.

Control0..1
Typeinteger
Requirements

もし、複数の服用法(Dosage)でsequenceの数値が同じであれば、その指示が同時に扱われることを示している。sequenceの数値が異なれば、服用指示(Dosage)の順番を意図している。

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Comments

32 bitの数値。これ以上の値であれば10進数を使うこと。

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

Free text dosage instructions e.g. SIG.

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。

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

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()))
5. Dosage.additionalInstruction
Definition

どのように薬剤を内服するかについての患者への補足指示(たとえば、「食事と一緒に」や「30分から1時間前に内服」)や薬剤についての注意書き(たとえば、「眠くなることがある」や「日光や紫外線が皮膚にあたららないようにすること」)

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Control0..*
BindingThe codes SHOULD be taken from JP Core Medication JAMI Additional Usage ValueSetFor example codes, see SNOMEDCTAdditionalDosageInstructions
TypeCodeableConcept
Requirements

補足指示はコード化されるように意図されているが、コードがない場合はエレメントはテキストだけで表現することができる。たとえば、「大量の水で服用する」という指示はコード化されていることもあれば、されていないことおある。

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

薬剤投与や調剤についての情報(たとえば、「腹膜内ポートに可能な限り迅速に注入」や「薬剤Xの直後に」)であり、dosage.textにも複製されるべきである。

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

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

患者あるいは消費者に理解してもらうための指示。

Instructions in terms that are understood by the patient or consumer.

Control0..1
Typestring
Comments

FHIRの文字列は1MB以上の大きさとなってなはらない(SHALL NOT)。

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

投与日時

When medication should be administered.

Control0..1
TypeTiming(JP_MedicationTiming)
Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events.

A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure.

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

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

【JP Core仕様】頓用型の用法を指定する場合に”true”を指定し、そのコードを指定する場合は用法コードとして指定する。 Medication(薬剤)が必要なときに指定された量とスケジュールのみで投薬するか(Booleanで選択される)、投薬する前提条件はTiming.Code(CodeableConcept)を示している。

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

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

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

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

投与される身体部位。外用薬で部位を指定する場合に使用する。

Body site to administer to.

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

A coded specification of the anatomic site where the medication first enters the body.

Comments

もし、BodySite resourceの属性が必要な場合(たとえば、部位の指定や別々に投与経路を設定する場合)は、bodySiteの標準拡張を使うこと。要約コードや非常に正確な位置の定義へのreferenceを使用することもできる。
【JP Core仕様】JAMI外用部位3桁コードを使用することが望ましいが、ローカルコードも使用可能。

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.

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

投与経路

How drug should enter body.

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

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

投与経路の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。
【JP Core仕様】HL7表0162をベースにした投与経路コードを使用することが望ましいが、ローカルコードも使用可能。

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

投与方法

Technique for administering medication.

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。

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

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。

Terminologies used often pre-coordinate this term with the route and or form of administration.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. 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 Dosage.method.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
13. 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()))
14. 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()))
15. 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()))
16. 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()))
17. 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()))
18. Dosage.doseAndRate
Definition

薬剤が投与される量

The amount of medication administered.

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

力価区分

The kind of dose or rate specified, for example, ordered or calculated.

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication IngredientStrength StrengthType ValueSetFor example codes, see DoseAndRateType
TypeCodeableConcept
Requirements

このtypeに値が指定されていなければ、"ordered"であることが想定される。

If the type is not populated, assume to be "ordered".

Comments

投与速度・量の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。

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

The comparator is not used on a SimpleQuantity

Amount of medication per dose.

Control0..1 This element is affected by the following invariants: ele-1
TypeChoice of: Quantity(SimpleQuantity), Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

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

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

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())
21. Dosage.doseAndRate.rate[x]
Definition

薬剤が投与される量の速度

Amount of medication per unit of time.

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

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. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

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

単位時間当たりの投薬量の上限

Upper limit on medication per unit of time.

Control0..1 This element is affected by the following invariants: ele-1
TypeRatio(JP_MedicationRatio_DosePerPeriod)
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present (: (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
23. Dosage.maxDosePerAdministration
Definition

1回あたりの投薬量の上限

Upper limit on medication per administration.

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

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

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)

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

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())
24. Dosage.maxDosePerLifetime
Definition

生涯の投薬量の上限

Upper limit on medication per lifetime of the patient.

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

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

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())
1. Dosage
Definition

薬の服用方法・服用した方法、または服用すべき方法

Control0..*
2. 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.
3. 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())
SlicingThis element introduces a set of slices on Dosage.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. 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())
5. Dosage.sequence
Definition

どの服用指示を適応するか判断するかについての順序を示したもの

Control0..1
Typeinteger
Requirements

もし、複数の服用法(Dosage)でsequenceの数値が同じであれば、その指示が同時に扱われることを示している。sequenceの数値が異なれば、服用指示(Dosage)の順番を意図している。

Comments

32 bitの数値。これ以上の値であれば10進数を使うこと。

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

どのように薬剤を内服するかについての患者への補足指示(たとえば、「食事と一緒に」や「30分から1時間前に内服」)や薬剤についての注意書き(たとえば、「眠くなることがある」や「日光や紫外線が皮膚にあたららないようにすること」)

Control0..*
BindingThe codes SHOULD be taken from JP Core Medication JAMI Additional Usage ValueSet
TypeCodeableConcept
Requirements

補足指示はコード化されるように意図されているが、コードがない場合はエレメントはテキストだけで表現することができる。たとえば、「大量の水で服用する」という指示はコード化されていることもあれば、されていないことおある。

Comments

薬剤投与や調剤についての情報(たとえば、「腹膜内ポートに可能な限り迅速に注入」や「薬剤Xの直後に」)であり、dosage.textにも複製されるべきである。

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

患者あるいは消費者に理解してもらうための指示。

Control0..1
Typestring
Comments

FHIRの文字列は1MB以上の大きさとなってなはらない(SHALL NOT)。

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

投与日時

Control0..1
TypeTiming(JP_MedicationTiming)
Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events.

A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure.

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

【JP Core仕様】頓用型の用法を指定する場合に”true”を指定し、そのコードを指定する場合は用法コードとして指定する。 Medication(薬剤)が必要なときに指定された量とスケジュールのみで投薬するか(Booleanで選択される)、投薬する前提条件はTiming.Code(CodeableConcept)を示している。

Control0..1
Typeboolean
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

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

投与される身体部位。外用薬で部位を指定する場合に使用する。

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication JAMI External Body Site ValueSet
TypeCodeableConcept
Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

もし、BodySite resourceの属性が必要な場合(たとえば、部位の指定や別々に投与経路を設定する場合)は、bodySiteの標準拡張を使うこと。要約コードや非常に正確な位置の定義へのreferenceを使用することもできる。
【JP Core仕様】JAMI外用部位3桁コードを使用することが望ましいが、ローカルコードも使用可能。

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

投与経路

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication HL70162-based Route ValueSet
TypeCodeableConcept
Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

投与経路の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。
【JP Core仕様】HL7表0162をベースにした投与経路コードを使用することが望ましいが、ローカルコードも使用可能。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. 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()))
14. 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.
15. 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 Dosage.method.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. 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 Dosage.method.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
17. 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()))
18. 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.
19. 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 Dosage.method.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
20. 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()))
21. 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()))
22. 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()))
23. 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()))
24. 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()))
25. 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()))
26. 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.
27. 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 Dosage.method.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
28. 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()))
29. 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()))
30. 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()))
31. 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()))
32. 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()))
33. 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()))
34. Dosage.doseAndRate
Definition

薬剤が投与される量

Control0..*
TypeElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Dosage.doseAndRate.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.
36. Dosage.doseAndRate.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 Dosage.doseAndRate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
37. Dosage.doseAndRate.type
Definition

力価区分

Control0..1
BindingThe codes SHOULD be taken from JP Core Medication IngredientStrength StrengthType ValueSet
TypeCodeableConcept
Requirements

このtypeに値が指定されていなければ、"ordered"であることが想定される。

Comments

投与速度・量の一般的パターンに全てのターミノロジが適応しているわけではない。情報モデルはCodeableConceptではなく、直接Codingをを使用してテキストやコーディング、翻訳、そしてエレメントと事前条件、事後条件の関係について管理するためにその構造を提示する必要がある。

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

The comparator is not used on a SimpleQuantity

Control0..1 This element is affected by the following invariants: ele-1
TypeQuantity(SimpleQuantity)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

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

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())
39. Dosage.doseAndRate.rate[x]
Definition

薬剤が投与される量の速度

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

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. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

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

単位時間当たりの投薬量の上限

Control0..1 This element is affected by the following invariants: ele-1
TypeRatio(JP_MedicationRatio_DosePerPeriod)
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present (: (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
41. Dosage.maxDosePerAdministration
Definition

1回あたりの投薬量の上限

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

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

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())
42. Dosage.maxDosePerLifetime
Definition

生涯の投薬量の上限

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

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

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())