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

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

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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.

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.

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.

The base language in which the resource is written.

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).

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.

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.

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

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.

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.

• value @ url

テキスト内容の全てがリソースのコンテンツから生成されたことを示す。

本リソースの構造化情報から生成したテキスト表現をいれてもよい。 XHTML形式。 例：田中一郎、男、1980/7/1生、東京都中央区日本橋１－１－１, 03_1234_5678

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

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.

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.

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.

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.

• value @ url

The patient's professed religious affiliations.

The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.

人種(Race)に関する情報を格納するためのExtension。

人種に関する情報を表現する拡張。 ValueSetとして http://terminology.hl7.org/CodeSystem/v3-Race を使用する。 例： Code : Description 2103-3 : White 2039-6 : Japanese 2040-4 : Korean 等

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).

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.

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.

An identifier for this patient.

この患者の識別子。

Patients are almost always assigned specific numerical identifiers.

ほとんどの場合、患者には特定の数値識別子が割り当てられる。

【JP_CORE】 IDの名前空間を表す Patient.identifier.system と ID値そのものを表す Patient.identifier.value の組み合わせとして表現する。 Patient.identifier.system には、 　urn:oid:1.2.392.100495.20.3.51.医療機関識別OID番号 を使用する。 医療機関識別OID番号は、患者IDの発行者である医療機関の識別するもので、保険医療機関の場合、都道府県番号２桁から始まる10桁の医療機関番号（都道府県2桁、保険点数表コード1桁、保険医療機関番号７桁を連結したもの）または、特定健診・特定保健指導機関の医療機関番号10桁の先頭に１をつけた11桁とする。 保険点数表コード1桁は医科は１，歯科は３である。 医療機関コードを持たない場合、「[9]＋当該施設の電話番号下 9 桁」を医療機関コードとして、その先頭に１をつけた11桁とする。

例：医療機関コード「1312345670」の場合「urn:oid:1.2.392.100495.20.3.51.11312345670」 なお、urn:oid:1.2.392.100495.20.3.51　の部分は、厚生労働省 電子処方箋CDA 記述仕様第1版（平成30年7月）付表2 OID一覧において患者番号として割り当てられたOIDのURL型である。

地域医療連携ネットワークの地域患者IDを指定する場合も同様に、地域患者IDを識別する名前空間（IHE ITI PIX等で使用されるOID等）を system に使用することができる。

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

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.

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.

• value @ url

The purpose of this identifier.

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

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

IDの種別をValueSet(IdentifierUse)より選択する。

usual　　一般

official　公式（マイナンバーなど、最も信頼できると見なされる場合に使用）

temp　　一時的

secondary　二次利用

old　過去の識別子

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

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

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

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

DL 運転免許証番号

PPN パスポート番号

BRN 血統登録番号

MR カルテ番号

など

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

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.

Identifier.system is always case sensitive.

IDの名前空間を表す。 医療機関固有の患者ID（カルテNo）を表現する場合、system には、患者IDの発行者である医療機関を識別するuriを指定する。

医療機関を識別するために使用するOID について、もし適切なOID が存在しない場合で、その医療施設が保険医療機関の場合、特定健診・特定保健指導機関のルールに従い以下のルールで設定してもよい。

医療施設が固有のOID を持っている場合は、そのOID を指定する。医療施設が保険医療機関の場合、特定健診・特定保健指導機関の医療機関コードの OID「1.2.392.200119.6.102.」の末尾に「[1]＋医療機関コード（10 桁）」を指定する。医療機関コードを持たない場合、「[9]＋当該施設の電話番号下 9 桁」を医療機関コードとする。

例：医療機関コード「1312345670」の場合「1.2.392.200119.6.102.11312345670」

Patient.identifier.system は、uri 型のため、実際にインスタンスに設定される値は、上記の例であれば urn:oid:1.2.392.200119.6.102.11312345670 とする。

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

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.

患者を一意的に識別するID(例えば、患者IDやカルテ番号など)を設定。

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

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

Period is not used for a duration (a measure of elapsed time). See Duration.

IDが使われていた/使われている期間。

Organization that issued/manages the identifier.

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

IDを発行した組織（テキストのみでも可）

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

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.

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.

• value @ url

Bundleリソース内に記述される患者番号を付番した医療機関情報（Organization）のfullUrlに記述されるUUIDを設定。 例："urn:uuid:179f9f7f_e546_04c2_6888_a9e0b24e5720" 省略されたときには、処方発行機関での患者番号とみなす。 処方発行発行機関や処方医所属医療機関と異なる場合、Bundleリソース内に患者番号を付番した医療機関情報を記述したOrganizationリソースを記述し、それを参照する。

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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

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

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

この患者記録がアクティブに使用されているかどうか。多くのシステムは、このプロパティを使用して、組織のビジネスルールに基づいて一定期間見られなかった患者など、非現在の患者としてマークします。

非アクティブな患者を除外するために患者リストをフィルタリングするためによく使用されます

死亡した患者は、同じ理由で不活性とマークされる場合がありますが、死後しばらくは活性である場合があります。

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

患者レコードが誤って作成された場合のため、使用されないレコードとしてマークできる必要があります。

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

この患者の記録が有効かどうか 誤って患者を登録して削除したい場合などにfalseにする

A name associated with the individual.

個人に関連付けられた名前。

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

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

Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

患者は、用途や適用期間が異なる複数の名前を持つ場合があります。動物の場合、名前は人間によって割り当てられて使用され、同じパターンを持つという意味で「HumanName」です。

--------SWG3 コメント-----------

FHIRデータ型仕様に従って、以下の案とした。

・姓名分割できる場合は、名前パート HumanName.familyとHumanName.givenに指定する。

・ミドルネームがある場合は、given に指定する（givenは繰り返し可能）

・姓名に分割できない場合は、HumanName.text にフルネームを指定する。

・各名前パートとtext は、両方存在してもよい。

　※診療文書構造化記述規約等では、姓に指定するとなっていた。

・漢字氏名、カナ氏名の区別は、iso21090-EN-representation を使用する。

・漢字、カナの指定がない場合やローマ字名の場合などはデフォルトスライスが適用される。

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

個人に連絡するための連絡先の詳細（電話番号や電子メールアドレスなど）。

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

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

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

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

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

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.

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.

• value @ url

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

Note that FHIR strings SHALL NOT exceed 1MB in size

患者の連絡先の種別をValueSet(ContactPointSystem)より選択する。

phone : 電話

fax : Fax

email : 電子メール

pager : ポケットベル

url : 電話、ファックス、ポケットベル、または電子メールアドレスではなく、URLとして表される連絡先。これは、Webサイト、ブログ、Skype、Twitter、Facebookなどのさまざまな機関または個人の連絡先を対象としています。電子メールアドレスには使用しないでください。

sms : SMSメッセージの送信に使用できる連絡先（携帯電話、一部の固定電話など）

other : 電話、Fax、ポケットベル、または電子メールアドレスではなく、URLとして表現できない連絡先。例：内部メールアドレス。これは、URLとして表現できる連絡先（Skype、Twitter、Facebookなど）には使用しないでください。

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

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

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

連絡先の番号やメールアドレス

Identifies the purpose for the contact point.

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

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

患者の連絡先の種別をValueSet(ContactPointUse)より選択する。

home 自宅

work 職場

temp 一時的

old 以前の

mobile モバイル機器

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

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

連絡先の使用順序（1 = 最高）

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

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

Period is not used for a duration (a measure of elapsed time). See Duration.

連絡先が使用されていた/されている期間

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

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

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

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

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

Age of the individual drives many clinical processes.

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

患者の生年月日をYYYY-MM-DD形式で入れる 例：1945-08-23

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

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

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

患者が死亡しているかどうかを示す deceasedBoolean　または　deceasedDateTime　のどちらかに値が入る deceasedBoolean : true(死亡) / false(生存) deceasedDateTime : 患者の死亡日時

An address for the individual. 個人の住所。 麻薬処方箋として発行するデータの場合には、患者の住所は必須。それ以外の用途ではなくてもよい。

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

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

【JPーCORE】 FHIRデータ型仕様に従って、以下の案とした。 ・住所が構造化されている場合、住所パート Address.contry、Address.postalcode、Address.state、Address.city、Address.line に分割して記載する。 ・住所が構造化されていない場合は、Address.text に記述する。 ・各住所パートとtext は、両方存在してもよい。 ※診療文書構造化記述規約等では、streetAddressLine (FHIRではlineに対応) に指定するとなっていた。

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

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.

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.

• value @ url

The purpose of this address. 住所の用途

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

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

住所の用途をValueSet(AddressUse)より選択する。

home 自宅 work 職場 temp 一時的 old 以前の billing 請求書、インボイス、領収書などの送付用

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

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

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

住所の種類をValueSet(AddressType)より選択する。

postal　　　郵送先 - 私書箱、気付の住所

physical　　訪れることのできる物理的な住所。

both　　　　postalとphysicalの両方

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

A renderable, unencoded form.

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

住所を(都道府県や市町村などに)分離して管理していない場合は、textに入れる。 住所を(都道府県や市町村などに)分離して管理している場合でも、まとめてtextに入れること。 郵便番号は含めない。 例：東京都文京区本郷7-3-1

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

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

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

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

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

The name of the administrative area (county).

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

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

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

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

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

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

ISO 3166 3 letter codes can be used in place of a human readable country name. ISO 3166 3文字コードは、人間が読める国名の代わりに使用する。

ISO 3166の2文字または3文字のコード 日本であれば、jp　または　jpn

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

Allows addresses to be placed in historical context.

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

住所が使用されていた/されている期間。 期間は時間の範囲を指定する。使用状況はその期間全体に適用されるか、範囲から1つの値が適用される。 期間は、時間間隔（経過時間の測定値）には使用されない。

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

Most, if not all systems capture it.

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

患者の婚姻関係をValueSet(Marital Status Codes)より選択する。 A 婚姻取消・無効 D 離婚 I 暫定法令 L 法的別居中 M 既婚 P 一夫多妻制 S 生涯独身・非婚 T 同棲 U 未婚 W 未亡人 UNK 不明

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

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

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

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

Image of the patient. 患者の画像。

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

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

Guidelines:

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

ガイドライン： 臨床写真ではなく、身分証明写真を使用してください。 寸法をサムネイルに制限します。 リソースの更新を容易にするため、バイト数を少なくしてください。

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

患者の連絡先者（例：保護者、パートナー、友人）。

Need to track people you can contact about the patient.

患者について連絡できる人を確認する必要があります。

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

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

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

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.

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.

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).

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.

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.

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

患者と連絡先の関係性。

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

状況に応じて、アプローチするのに最適な関係者を決定するために使用されます。

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

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

C 緊急連絡先

E 雇用者

F 連邦政府機関

I 保険会社

N 近親者

S 州政府機関

U 不明

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

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.

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.

• value @ url

A reference to a code defined by a terminology system.

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

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.

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

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.

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.

• value @ url

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

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

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.

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.

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.

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).

Need to refer to a particular code in the system.

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

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

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

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.

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.

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.

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.

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

A name associated with the contact person.

連絡先に登録された名前。

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

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

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

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.

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.

• value @ url

Identifies the purpose for this name.

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

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

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

A renderable, unencoded form.

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

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Given name.

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Indicates the period of time when this name was valid for the named person.

Allows names to be placed in historical context.

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

連絡先に登録された連絡方法（電話番号やメールアドレスなど）。

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

電話、電子メールなどの（優先する）連絡方法を確認する必要があります。

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

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

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

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.

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.

• value @ url

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

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

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

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

Identifies the purpose for the contact point.

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

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

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

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

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

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

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

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

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

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

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

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

連絡先に関連する組織

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

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

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

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

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

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.

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.

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).

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.

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.

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

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. 多言語の国のほとんどのシステムは、言語を伝えたいでしょう。 すべてのシステムが実際に地域の方言を必要とするわけではありません。

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

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

de ドイツ語

en 英語

fr フランス語

ja 日本語

ko 韓国語 など

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

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.

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.

• value @ url

A reference to a code defined by a terminology system.

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

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.

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

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.

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.

• value @ url

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

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

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.

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.

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.

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).

Need to refer to a particular code in the system.

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

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

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

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.

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.

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. コードだけでは十分な情報が記述できいない場合に限り、追加的な情報をテキストで記述する。

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.

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

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

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

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

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

This language is specifically identified for communicating healthcare information.

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

Patient's nominated care provider. 患者が指名するケア提供者。 登録されているかかりつけ医がある場合に記述することができる。

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

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

----以下の翻訳は検討中の内容を含む---- これはプライマリケア提供者(GPを含む)である場合もあれば、コミュニティ/障害を持つ患者指定のケアマネージャーである場合もあります。ケアチームの記録には使用されません。これらは、ケアプランまたはEpisodeOfCareリソースにリンクされるCareTeamリソースに含まれている必要があります。複数のGPは、学期中の大学GPと共にリストされた家庭GPなどの学生や、「フライイン/フライアウト」労働者など、さまざまな理由で患者に対して記録される場合があります。また、医学的問題を認識し続けるために家庭GPに含まれています。 管轄区域は、必要に応じてこれを1、またはタイプごとに1にプロファイルできると決定する場合があります。

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

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.

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.

• value @ url

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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

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

この患者記録を誰が認識し、管理し、更新するかを知る必要があります。

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

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

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

事実上の同一患者をリンクする別のPatientリソース。

There are multiple use cases:

• Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
• Distribution of patient information across multiple servers 複数のユースケースがあります： ・事務的なエラーのため、一貫して人間を特定することが困難であり患者の記録が重複している。 ・複数のサーバーにわたり患者情報が配布されている。

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

リンクされた患者記録に相互リンクがあるという仮定はありません。

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

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.

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.

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).

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.

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.

The other patient resource that the link refers to.

リンクが参照する他の患者リソース。

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

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

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

この患者リソースと別の患者リソース間のリンクのタイプ。

Note that FHIR strings SHALL NOT exceed 1MB in size

この患者リソースと別の患者リソース間のリンクのタイプをValueSet(LinkType)より選択する。

replaced-by　このリンクを含む患者リソースは使用しないでください。

replaces　　　このリンクを含む患者リソースは、現在アクティブな患者レコードです。

refer　　　　このリンクを含む患者リソースは使用中であり、有効ですが、患者に関する主な情報源とは見なされていません。

seealso　　このリンクを含む患者リソースは使用中で有効ですが、同じ人物に関するデータが含まれていることがわかっている別の患者リソースを指しています。