本プロファイル説明は、患者に付属する一項目分のバイタルサイン情報について、情報の登録や検索、取得のために、JP_Observation_SocialHistoryリソースを使用するにあたっての、最低限の制約を記述したものである。 JP_Observation_SocialHistory リソースに対して本プロファイルに準拠する場合に必須となる要素や、サポートすべき拡張、用語、検索パラメータを定義する。

背景および想定シナリオ

本プロファイルは、以下のようなユースケースを想定している。

• Patientリソースから指定された日時、期間での患者生活背景情報の参照
• Patientリソースから指定された患者生活背景情報項目に対する、指定された期間での患者生活背景情報の参照
• 指定された期間や患者生活背景情報項目に対し、条件に合致する患者生活背景情報、または関連する他のリソース（Observationリソースや、Patientリソース等）の参照。

スコープ

Observationはヘルスケアの中心的な要素であり、診断の支援、進捗状況の監視、ベースラインやパターンの決定、さらには人口統計学的特性の把握に使用される。ほとんどのObservationは、いくつかのメタデータを持つ単純な名前/値のペアのアサーションであるが、いくつかの Observationは、他のObservationを論理的にグループ化したり、あるいはマルチコンポーネントのObservationであったりする。

本プロファイルでは上記想定シナリオにて用いられるObservationの用途がスコープであり、患者基本情報の中でも特に患者バイタルサインに該当する情報項目の１つを取り扱う際に、必要な要件を定義している。

プロファイル定義

• Text Summary
• Differential Table
• Snapshot Table
• Terminology Bindings
• Constraints
• All

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	JP_Observation_Common	生活背景の情報
Slices for category		1..*	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Slice: Unordered, Open by pattern:$this
category:socialHistory		1..1	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: social-history
code		1..1	CodeableConcept	Type of observation (code / type)　observation のタイプ（コードまたはタイプ） Binding: JP Core Observation SocialHistory Code ValueSet (preferred)
subject		1..1	Reference(JP Core Patient Profile)	Who and/or what the observation is about　観察対象者
effective[x]		0..1		Clinically relevant time/time-period for observation　臨床的に関連する時刻または時間
effectiveDateTime			dateTime
effectivePeriod			Period
value[x]		0..1		Actual result　実際の結果値
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
derivedFrom		0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | JP Core Observation Common Profile | MolecularSequence | JP Core Observation SocialHistory Profile)	Related measurements the observation is made from　observation が作られる元の関連する測定
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	JP_Observation_Common	生活背景の情報
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation　Observationのためのビジネス識別子
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | JP Core MedicationRequest Profile | JP Core MedicationRequest Injection Profile | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order　実施されるプラン、提案、依頼
partOf	Σ	0..*	Reference(JP Core MedicationAdministration Profile | JP Core MedicationAdministration Injection Profile | JP Core MedicationDispenseBase Profile | MedicationStatement | JP Core Procedure Profile | JP Core Immunization Profile | ImagingStudy)	Part of referenced event　参照されるイベントの一部分
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:socialHistory		1..1	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: social-history
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	Type of observation (code / type)　observation のタイプ（コードまたはタイプ） Binding: JP Core Observation SocialHistory Code ValueSet (preferred)
subject	Σ	1..1	Reference(JP Core Patient Profile)	Who and/or what the observation is about　観察対象者
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record　subject 要素が実際のobservationの対象でない場合に、observation の対象物
encounter	Σ	0..1	Reference(JP Core Encounter Profile)	Healthcare event during which this observation is made　このobservationが行われるヘルスケアイベント
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation　臨床的に関連する時刻または時間
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available　このバージョンが利用可能となった日時
performer	Σ	0..*	Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Organization Profile | CareTeam | JP Core Patient Profile | RelatedPerson)	Who is responsible for the observation　observationに責任をもつ者
value[x]	ΣC	0..1		Actual result　実際の結果値
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing　結果が欠損値である理由 Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation　結果に対するコメント
bodySite		0..1	CodeableConcept	Bindingについてはユースケースに応じて各プロファイルで定義すること Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	Bindingについてはユースケースに応じて各プロファイルで定義すること Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation　観察（観測、検査）に使われた検体材料
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device　測定機器
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation　解釈のためのガイドを与える
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(JP Core Observation Common Profile | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group　observationグループに属する関連リソース
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | JP Core Observation Common Profile | MolecularSequence | JP Core Observation SocialHistory Profile)	Related measurements the observation is made from　observation が作られる元の関連する測定
component	Σ	0..*	BackboneElement	Component results　　コンポーネント結果
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

This structure is derived from JP_Observation_Common

Summary

Mandatory: 3 elements

Structures

This structure refers to these other structures:

• JP Core Patient Profile (http://jpfhir.jp/fhir/core/StructureDefinition/JP_Patient)
• JP Core Observation Common Profile (http://jpfhir.jp/fhir/core/StructureDefinition/JP_Observation_Common)
• JP Core Observation SocialHistory Profile (http://jpfhir.jp/fhir/core/StructureDefinition/JP_Observation_SocialHistory)

Slices

This structure defines the following Slices:

• The element Observation.category is sliced based on the value of pattern:$this

Differential View

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	JP_Observation_Common	生活背景の情報
Slices for category		1..*	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Slice: Unordered, Open by pattern:$this
category:socialHistory		1..1	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: social-history
code		1..1	CodeableConcept	Type of observation (code / type)　observation のタイプ（コードまたはタイプ） Binding: JP Core Observation SocialHistory Code ValueSet (preferred)
subject		1..1	Reference(JP Core Patient Profile)	Who and/or what the observation is about　観察対象者
effective[x]		0..1		Clinically relevant time/time-period for observation　臨床的に関連する時刻または時間
effectiveDateTime			dateTime
effectivePeriod			Period
value[x]		0..1		Actual result　実際の結果値
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
derivedFrom		0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | JP Core Observation Common Profile | MolecularSequence | JP Core Observation SocialHistory Profile)	Related measurements the observation is made from　observation が作られる元の関連する測定
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	JP_Observation_Common	生活背景の情報
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation　Observationのためのビジネス識別子
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | JP Core MedicationRequest Profile | JP Core MedicationRequest Injection Profile | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order　実施されるプラン、提案、依頼
partOf	Σ	0..*	Reference(JP Core MedicationAdministration Profile | JP Core MedicationAdministration Injection Profile | JP Core MedicationDispenseBase Profile | MedicationStatement | JP Core Procedure Profile | JP Core Immunization Profile | ImagingStudy)	Part of referenced event　参照されるイベントの一部分
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category		1..*	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:socialHistory		1..1	CodeableConcept	Classification of type of observation　Observationの種類（タイプ）の分類 Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: social-history
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	Type of observation (code / type)　observation のタイプ（コードまたはタイプ） Binding: JP Core Observation SocialHistory Code ValueSet (preferred)
subject	Σ	1..1	Reference(JP Core Patient Profile)	Who and/or what the observation is about　観察対象者
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record　subject 要素が実際のobservationの対象でない場合に、observation の対象物
encounter	Σ	0..1	Reference(JP Core Encounter Profile)	Healthcare event during which this observation is made　このobservationが行われるヘルスケアイベント
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation　臨床的に関連する時刻または時間
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available　このバージョンが利用可能となった日時
performer	Σ	0..*	Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Organization Profile | CareTeam | JP Core Patient Profile | RelatedPerson)	Who is responsible for the observation　observationに責任をもつ者
value[x]	ΣC	0..1		Actual result　実際の結果値
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing　結果が欠損値である理由 Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation　結果に対するコメント
bodySite		0..1	CodeableConcept	Bindingについてはユースケースに応じて各プロファイルで定義すること Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	Bindingについてはユースケースに応じて各プロファイルで定義すること Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation　観察（観測、検査）に使われた検体材料
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device　測定機器
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation　解釈のためのガイドを与える
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(JP Core Observation Common Profile | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group　observationグループに属する関連リソース
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | JP Core Observation Common Profile | MolecularSequence | JP Core Observation SocialHistory Profile)	Related measurements the observation is made from　observation が作られる元の関連する測定
component	Σ	0..*	BackboneElement	Component results　　コンポーネント結果
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.category:socialHistory	preferred	Pattern: social-history
Observation.code	preferred	JP_ObservationSocialHistoryCode_VS (a valid code from http://jpfhir.jp/fhir/core/CodeSystem/JP_ObservationSocialHistoryCode_CS)
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	example	ObservationMethods
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()

必須要素

本プロファイルでは、次の要素を持たなければならない。

• status︓生活背景情報項目の状態は必須である
• category︓このリソースが示す生活背景情報項目を分類するための区分であり、このプロファイルでは必須とする
• code︓このリソースは何の生活背景情報項目であるかを示すため必須である
• subject︓このリソースが示す生活背景情報項目が、どの患者のものかを示すため、このプロファイルでは参照するpatientリソースの定義を必須とする

Extension定義

このプロファイルでは拡張定義は行っていない。

利用方法

OperationおよびSearch Parameter 一覧

Search Parameter一覧

生活背景情報ユースケースのSearch Parameter一覧は共通情報プロファイルに記載されている。

検索時のcategoryパラメータは”vital-sign”となる。

Observation共通情報プロファイル#Search Parameter一覧

Operation一覧

ObservationリソースのOperation一覧の定義はユースケースに依存せず共通であるため、共通情報プロファイルに記載されている。

Observation共通情報プロファイル#Operation一覧

サンプル

• 社会的背景（喫煙）