1.0.0 - ci-build

JPCoreV1 - Local Development build (v1.0.0). See the Directory of published versions

Resource Profile: JP_MedicationDispense - Detailed Descriptions

Definitions for the JP-MedicationDispense resource profile.

1. MedicationDispense
Definition

指定された患者・個人へ薬剤が払い出されたか払い出される予定のものを示す。これには(供給される)提供される製品についての説明や薬剤の服用に関する指示も含まれる。薬剤払い出しは薬剤オーダーに対して薬局システムが対応した結果となる。

Control0..*
InvariantsDefined on this element
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
mdd-1: whenHandedOver cannot be before whenPrepared (: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.id
Definition

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

Control0..1
Typestring
Comments

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

3. MedicationDispense.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Control0..1
TypeMeta
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. MedicationDispense.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

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

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
Max Binding: AllLanguages A human language.
Typecode
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

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

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

8. MedicationDispense.extension
Definition

An Extension

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

薬剤単位の調剤結果

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

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

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

Control0..*
TypeExtension
Is Modifiertrue
Requirements

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

Alternate Namesextensions, user content
Comments

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

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

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

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

This is a business identifier, not a resource identifier.

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

The procedure that trigger the dispense.

この調剤の契機となったProcedureリソースへの参照。

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

A code specifying the state of the set of dispense events.

一連の調剤イベントの状態を指定するコード。

Control1..1
BindingThe codes SHALL be taken from MedicationDispense Status Codes A coded concept specifying the state of the dispense event.
Typecode
Is Modifiertrue
Comments

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

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

Indicates the reason why a dispense was not performed.

調剤が実行されなかった理由を示します。

Control0..1
BindingFor example codes, see MedicationDispense Status Reason Codes A code describing why a dispense was not performed.
TypeChoice of: CodeableConcept, Reference(DetectedIssue)
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. MedicationDispense.category
Definition

Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

投薬のタイプを示します(たとえば、薬剤が消費または投与されると予想される場所(つまり、入院患者または外来患者))。 入院、外来、退院、自宅など。

Control0..1
BindingThe codes SHOULD be taken from MedicationDispense Category Codes A code describing where the dispensed medication is expected to be consumed or administered.
TypeCodeableConcept
Comments

The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.

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

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

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

Control1..1
BindingFor example codes, see SNOMEDCTMedicationCodes A coded concept identifying which substance or product can be dispensed.
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Comments

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

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

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

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

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

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

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

リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない任意の文字列値にすることができる。

Control0..1
Typestring
18. MedicationDispense.medication[x].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 Namesextensions, user content
Comments

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

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

A reference to a code defined by a terminology system.

コード集で定義された医薬品コードへの情報

Control1..*
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. 【JP-CORE】

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. MedicationDispense.medication[x].coding.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
21. MedicationDispense.medication[x].coding.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 Namesextensions, user content
Comments

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

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

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

Control1..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()))
25. MedicationDispense.medication[x].coding.display
Definition

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

Control1..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()))
26. MedicationDispense.medication[x].coding.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()))
27. MedicationDispense.medication[x].text
Definition

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

Control0..1
Typestring
Requirements

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

Comments

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

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

The person or animal or group receiving the medication.

投与を受ける患者

Control0..1
TypeReference(Patient | Group)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Comments

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.

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

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

The encounter or episode of care that establishes the context for this event.

調剤ベントに関連するエンカウンターやエピソードへの参照。

Control0..1
TypeReference(Encounter | EpisodeOfCare)
Comments

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.

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

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

Additional information that supports the medication being dispensed.

調剤される薬剤をサポートする追加情報への任意のリソースへの参照。

Control0..*
TypeReference(Resource)
Comments

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.

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

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

Indicates who or what performed the event. 調剤した人を示す

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

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

Control0..1
Typestring
33. MedicationDispense.performer.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

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

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

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

Control0..*
TypeExtension
Is Modifiertrue
Requirements

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

Alternate Namesextensions, user content, modifiers
Comments

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

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

Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

Control0..1
BindingFor example codes, see MedicationDispense Performer Function Codes A code describing the role an individual played in dispensing a medication.
TypeCodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

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

The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

Control1..1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. MedicationDispense.location
Definition

The principal physical location where the dispense was performed.

調剤が実施された場所を示すLocationリソースへの参照。

Control0..1
TypeReference(Location)
Comments

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.

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

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

Indicates the medication order that is being dispensed against. 調剤の元になった処方オーダを表すMedicationRequestリソースへの参照。

Control0..*
TypeReference(MedicationRequest)
Comments

Maps to basedOn in Event logical model.

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

Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. 実行される調剤イベントのタイプを示します。たとえば、トライアルフィル、トライアルの完了、部分フィル、緊急フィル、サンプルなどです。

Control0..1
BindingFor example codes, see ActPharmacySupplyType Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
TypeCodeableConcept
Comments

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

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

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

調剤総量。 JP Coreでは必須 払い出される薬剤の量。計測単位を含む。

Control1..1
TypeQuantity(SimpleQuantity)
Must Supporttrue
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.

使用状況によって、これがどのような量であるか、したがってどのような単位を使用できるかが定義される場合がかなりあります。使用状況によっては、比較演算子の値も制限される場合がある。

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. MedicationDispense.quantity.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
42. MedicationDispense.quantity.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 Namesextensions, user content
Comments

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

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

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Control1..1
Typedecimal
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

Not allowed to be used in this context

Control0..0
BindingThe codes SHALL be taken from QuantityComparator How the Quantity should be understood and represented.
Typecode
Is Modifiertrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning if MissingIf there is no comparator, then there is no modification of the value
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. MedicationDispense.quantity.unit
Definition

A human-readable form of the unit.

Control1..1
Typestring
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

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

The identification of the system that provides the coded form of the unit.

Control1..1 This element is affected by the following invariants: qty-3
Typeuri
Requirements

Need to know the system that defines the coded form of the unit.

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

A computer processable form of the unit in some unit representation system.

Control1..1
Typecode
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

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

The amount of medication expressed as a timing amount.

タイミングとして表される投薬量。すなわち、XX日分、XX回分などの数量。

Control0..1
TypeQuantity(SimpleQuantity)
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.

使用状況によって、これがどのような量であるか、したがってどのような単位を使用できるかが定義される場合がかなりあります。使用状況によっては、比較演算子の値も制限される場合がある。

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

The time when the dispensed product was packaged and reviewed.

調剤がパッケージ化され、レビューされた日時

Control0..1
TypedateTime
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. MedicationDispense.whenHandedOver
Definition

The time the dispensed product was provided to the patient or their representative.

【JP Core】 必須。 患者あるいはその代理人に払い出される薬剤が提供された日時。

Control1..1
TypedateTime
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. MedicationDispense.destination
Definition

Identification of the facility/location where the medication was shipped to, as part of the dispense event.

調剤イベントの一環として、薬剤が出荷された行先先の施設/場所のLocarionリソースへの参照。

Control0..1
TypeReference(Location)
Comments

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.

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

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

Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

薬を受け取った人を識別する。これは通常、患者またはその介護者だが、医療専門家になる場合もある。

Control0..*
TypeReference(Patient | Practitioner)
Comments

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.

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

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

Extra information about the dispense that could not be conveyed in the other attributes.

他の要素では伝達できなかった調剤に関する追加情報。

Control0..*
TypeAnnotation
Comments

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

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

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

Indicates how the medication is to be used by the patient.

薬が患者によってどのように使用されるか、または介護者によってどのように投与されるか。

Control0..*
TypeDosage
Comments

When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

投与量または投与量が投与期間全体にわたって変更されることを意図している場合(例えば、漸減投与量処方)、異なる投与量/投与量を伝えるために投与指示の複数のインスタンスを提供する必要があります。 薬剤師は、調剤する前に投薬順序を確認し、調剤される実際の製品に基づいて投薬指示を更新します。

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

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

リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない任意の文字列値にすることができる。

Control0..1
Typestring
56. MedicationDispense.dosageInstruction.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 Namesextensions, user content
Comments

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

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

実服用日数を格納する拡張。 実服用日数(実投与日数)とは、投与期間において実際に服用(投与)が行われる実日数であり、休薬日を含まない。 全期間が7日で、用法が隔日投与の場合には、1日目、3日目、5日目、7日目の4日間に服用することになるので、実服用日数は4日となる。

Control0..1
TypeExtension(JP_MedicationRequest_DosageInstruction_UsageDuration) (Extension Type: Duration)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
58. MedicationDispense.dosageInstruction.extension:PeriodOfUse
SliceNamePeriodOfUse
Definition

投与期間を明示的に記述する拡張。 この拡張を使用する場合には、開始日は必須。

Control0..1
TypeExtension(JP_MedicationRequest_DosageInstruction_PeriodOfUse) (Extension Type: Period)
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())
59. MedicationDispense.dosageInstruction.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())
60. MedicationDispense.dosageInstruction.sequence
Definition

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

投与量の指示が適用または解釈されるべき順序を示す。

Control0..1
Typeinteger
Requirements

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.

複数の投与量のシーケンス番号が同じである場合、命令は同時として扱われることを意味する。シーケンス番号が異なる場合、投与量は連続するように意図されています。

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

Free text dosage instructions e.g. SIG. フリーテキストの投与方法の説明 SIG:用法

【JP-CORE】 フリーテキストの用法指示であり、JP Coreでは必須である。

Control1..1
Typestring
Requirements

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.

指示が複雑すぎてコーディングできない場合は、フリーテキストの投与指示を使用できる。この属性の内容には、薬の名前や説明は含まれない。コード化された指示が存在する場合、フリーテキストの指示は、薬を服用または投与している人間に表示するために存在している場合がある。テキストの指示は常に入力されることが期待されます。 dose.timing属性も同時に入力されている場合、dudgement.textはタイミングと同じ情報を反映している必要があり、薬の投与または準備に関する追加情報をテキストとして含める必要がある。

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

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").

薬の服用方法に関する補足的な指示(例:「食事と一緒に」または「食事の30分から1時間前に服用」)または薬に関する患者への警告(例:「眠気を引き起こす可能性がある」または「皮膚の露出を避ける」直射日光またはサンランプ」)。

Control0..*
BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
TypeCodeableConcept
Requirements

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

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()))
63. MedicationDispense.dosageInstruction.patientInstruction
Definition

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

患者または消費者が理解できる用語での指示。

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. MedicationDispense.dosageInstruction.timing
Definition

When medication should be administered. 

投与日時、服用タイミング。 【JP-CORE】 必須。dosageInstruction.timing.code.coding.code, dosageInstruction.timing.code.coding.system が必ず存在しなければならない。

Control1..1
TypeTiming
Must Supporttrue
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

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()))
65. MedicationDispense.dosageInstruction.timing.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
66. MedicationDispense.dosageInstruction.timing.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 Namesextensions, user content
Comments

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

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

Identifies specific times when the event occurs.

Control0..*
TypedateTime
Requirements

In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

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

A set of rules that describe when the event is scheduled.

Control0..1
TypeElement
Requirements

Many timing schedules are determined by regular repetitions.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
tim-1: if there's a duration, there needs to be duration units (: duration.empty() or durationUnit.exists())
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (: timeOfDay.empty() or when.empty())
tim-2: if there's a period, there needs to be period units (: period.empty() or periodUnit.exists())
tim-4: duration SHALL be a non-negative value (: duration.exists() implies duration >= 0)
tim-5: period SHALL be a non-negative value (: period.exists() implies period >= 0)
tim-6: If there's a periodMax, there must be a period (: periodMax.empty() or period.exists())
tim-7: If there's a durationMax, there must be a duration (: durationMax.empty() or duration.exists())
tim-8: If there's a countMax, there must be a count (: countMax.empty() or count.exists())
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (: offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
70. MedicationDispense.dosageInstruction.timing.repeat.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
71. MedicationDispense.dosageInstruction.timing.repeat.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 Namesextensions, user content
Comments

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

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

Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

Control0..1
TypeChoice of: Duration, Range, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. MedicationDispense.dosageInstruction.timing.repeat.count
Definition

A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

Control0..1
TypepositiveInt
Requirements

Repetitions may be limited by end time or total occurrences.

Comments

If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. MedicationDispense.dosageInstruction.timing.repeat.countMax
Definition

If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

Control0..1
TypepositiveInt
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. MedicationDispense.dosageInstruction.timing.repeat.duration
Definition

How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

Control0..1
Typedecimal
Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
76. MedicationDispense.dosageInstruction.timing.repeat.durationMax
Definition

If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

Control0..1
Typedecimal
Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. MedicationDispense.dosageInstruction.timing.repeat.durationUnit
Definition

The units of time for the duration, in UCUM units.

Control0..1
BindingThe codes SHALL be taken from UnitsOfTime A unit of time (units from UCUM).
Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
78. MedicationDispense.dosageInstruction.timing.repeat.frequency
Definition

The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

Control0..1
TypepositiveInt
Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. MedicationDispense.dosageInstruction.timing.repeat.frequencyMax
Definition

If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

Control0..1
TypepositiveInt
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. MedicationDispense.dosageInstruction.timing.repeat.period
Definition

Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

Control0..1
Typedecimal
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. MedicationDispense.dosageInstruction.timing.repeat.periodMax
Definition

If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

Control0..1
Typedecimal
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
82. MedicationDispense.dosageInstruction.timing.repeat.periodUnit
Definition

The units of time for the period in UCUM units.

Control0..1
BindingThe codes SHALL be taken from UnitsOfTime A unit of time (units from UCUM).
Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
83. MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek
Definition

If one or more days of week is provided, then the action happens only on the specified day(s).

Control0..*
BindingThe codes SHALL be taken from DaysOfWeek
Typecode
Comments

If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. MedicationDispense.dosageInstruction.timing.repeat.timeOfDay
Definition

Specified time of day for action to take place.

Control0..*
Typetime
Comments

When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
85. MedicationDispense.dosageInstruction.timing.repeat.when
Definition

An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

Control0..*
BindingThe codes SHALL be taken from EventTiming Real world event relating to the schedule.
Typecode
Requirements

Timings are frequently determined by occurrences such as waking, eating and sleep.

Comments

When more than one event is listed, the event is tied to the union of the specified events.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
86. MedicationDispense.dosageInstruction.timing.repeat.offset
Definition

The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

Control0..1
TypeunsignedInt
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
87. MedicationDispense.dosageInstruction.timing.code
Definition

A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

Control0..1
BindingThe codes SHOULD be taken from TimingAbbreviation Code for a known / defined timing pattern.
TypeCodeableConcept
Comments

BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

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

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

Control0..1
Typestring
89. MedicationDispense.dosageInstruction.timing.code.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

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

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. MedicationDispense.dosageInstruction.timing.code.coding.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
92. MedicationDispense.dosageInstruction.timing.code.coding.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 Namesextensions, user content
Comments

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

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
94. MedicationDispense.dosageInstruction.timing.code.coding.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()))
95. MedicationDispense.dosageInstruction.timing.code.coding.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).

Control1..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()))
96. MedicationDispense.dosageInstruction.timing.code.coding.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()))
97. MedicationDispense.dosageInstruction.timing.code.coding.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()))
98. MedicationDispense.dosageInstruction.timing.code.text
Definition

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

Control0..1
Typestring
Requirements

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

Comments

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

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

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).

特定の投薬スケジュール内で必要な場合にのみ薬を服用するか(ブールオプション)、または薬を服用するための前提条件(CodeableConcept)を示す。

Control0..1
BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
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".

ブール値= Trueを設定することにより、理由なしに「必要に応じて」表現できる。この場合、CodeableConceptは設定されないか、またはCodeableConceptを含めることで、理由を付けて「必要に応じて」表現することもできる。この場合、ブール値はTrueであると見なされます。 ブール値をFalseに設定すると、投与量はスケジュールに従って与えられ、「prn」( =as needed/as requiredの略記号)または「必要に応じて」ではありません。

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

Body site to administer to.  投与部位(人体の部位)

Control0..1
BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes A coded concept describing the site location the medicine enters into or onto the body.
TypeCodeableConcept
Requirements

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

Comments

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

ユースケースでBodySiteリソースの属性が必要な場合(たとえば、個別に識別して追跡するため)、標準の拡張機能[bodySite](extension-bodysite.html)を使用する。要約コード、または場所の非常に正確な定義への参照、あるいはその両方である可能性がある。

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

How drug should enter body. 薬が身体に入る経路

【JP-CORE】 HL7 V2(HL7表0162)

Control0..1
BindingFor example codes, see SNOMEDCTRouteCodes A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
TypeCodeableConcept
Requirements

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

患者の体内または体内へ​​の治療薬の投与経路または生理学的経路を指定するコード。

Comments

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

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

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

Technique for administering medication.

投与手技 【JP-CORE】 JAMI処方・注射オーダ標準用法規格(用法詳細区分)。

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

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

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()))
103. MedicationDispense.dosageInstruction.doseAndRate
Definition

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()))
104. MedicationDispense.dosageInstruction.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
105. MedicationDispense.dosageInstruction.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 Namesextensions, user content
Comments

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

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

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

Control0..1
BindingFor example codes, see DoseAndRateType The kind of dose or rate specified.
TypeCodeableConcept
Requirements

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

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

Amount of medication per dose.

Control0..1
TypeChoice of: Range, Quantity(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

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()))
108. MedicationDispense.dosageInstruction.doseAndRate.rate[x]
Definition

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()))
109. MedicationDispense.dosageInstruction.maxDosePerPeriod
Definition

Upper limit on medication per unit of time.

Control0..1
TypeRatio
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

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()))
110. MedicationDispense.dosageInstruction.maxDosePerAdministration
Definition

Upper limit on medication per administration.

Control0..1
TypeQuantity(SimpleQuantity)
Requirements

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

Comments

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()))
111. MedicationDispense.dosageInstruction.maxDosePerLifetime
Definition

Upper limit on medication per lifetime of the patient.

Control0..1
TypeQuantity(SimpleQuantity)
Requirements

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

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

Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. 調剤の一部として置換が行われたかどうかを示す。場合によっては、置換が期待されるが発生しない場合もあれば、置換が予期されないが発生する場合もある。このブロックは、置換が行われたか行われなかったか、およびその理由を説明する。何も指定されていない場合、置換は行われていない。

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
113. MedicationDispense.substitution.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
114. MedicationDispense.substitution.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 Namesextensions, user content
Comments

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

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

True if the dispenser dispensed a different drug or product from what was prescribed. 処方されたものとは異なる薬剤または製品を調剤した場合に、'true'を設定する。

Control1..1
Typeboolean
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
117. MedicationDispense.substitution.type
Definition

A code signifying whether a different drug was dispensed from what was prescribed.

処方されたものとは異なる薬が調剤されたかどうかを示すコード。 【JP-CORE】 HL7 v3 Value Set ActSubstanceAdminSubstitutionCode から以下のコードが使用できる。 E: 別の生物学的同等および治療的に同等の製品で置換が行われたか、許可された。 EC: 代替品が発生したか、次のような別の製品で許可されています:同じ有効成分を含むが異なる塩で処方された代替医薬品、同じ有効成分を持つエステル医薬品同等物、強度、剤形、投与経路. BC: 代替が発生したか、同等のブランド間で許可されていますが、ジェネリックでは許可されない。 G: 代替が発生したか、同等のジェネリック間で許可されていますが、ブランド間では許可されていません。 TE:同じ治療目的と安全性プロファイルを持つ別の製品で代替が発生したか、許可された。 TB:ジェネリック医薬品ではなく、治療的に同等のブランド間で代替品が発生したか、許可されています TG:治療的に同等のジェネリック間で置換が発生したか、許可されていますが、ブランドは許可されない。 F:処方ガイドラインに準拠。 N:置換は発生しなかったか、許可されていない。

Control0..1
BindingFor example codes, see ActSubstanceAdminSubstitutionCode A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
TypeCodeableConcept
Comments

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

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

Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

処方されたものからの置換(または置換の欠如)の理由を示します。 HL7 v3 Value Set SubstanceAdminSubstitutionReason では以下のコードが定義されている。 CT:治療継続性確保のため、FP:処方方針、 OS: 在庫欠品、 RR:代替えを義務付けまたは禁止する規制要件に従った

Control0..*
BindingFor example codes, see SubstanceAdminSubstitutionReason A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
TypeCodeableConcept
Comments

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

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

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

The person or organization that has primary responsibility for the substitution.

置換の主な責任を負う個人または組織。Practitioner PractitionerRole リソースへの参照。

Control0..*
TypeReference(Practitioner | PractitionerRole)
Comments

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.

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

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

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

患者に対する1つまたは複数のアクティブまたは提案された臨床アクションを伴う、またはそれらの間の実際のまたは潜在的な臨床問題を示す。例えば薬物間相互作用、重複治療、投与量アラートなど。 DetectedIssue リソースへの参照。

Control0..*
TypeReference(DetectedIssue)
Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
Comments

This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

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

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

調剤が確認されたときなど、発生した対象のイベントのサマリー。

Control0..*
TypeReference(Provenance)
Comments

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

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