Name Flags Card. Type Description & Constraints Procedure 0..* Procedure Procedureリソース identifier 0..* Identifier External Identifiers for this procedure use 0..1 code usual | official | temp | secondary | old (If known) type 0..1 CodeableConcept Description of identifier system 0..1 uri The namespace for the identifier value value 0..1 string The value that is unique period 0..1 Period Time period when id is/was valid for use assigner 0..1 Reference(Organization) Organization that issued id (may be just text) instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition instantiatesUri 0..* uri Instantiates external protocol or definition basedOn 0..* Reference(CarePlan | ServiceRequest) A request for this procedure このプロシージャの依頼情報 reference 0..1 string Literal reference, Relative, internal or absolute URL type 0..1 uri Type the reference refers to (e.g. "Patient") identifier 0..1 Identifier Logical reference, when literal reference is not known display 0..1 string Text alternative for the resource partOf 0..* Reference(Procedure | Observation | MedicationAdministration) Part of referenced event reference 0..1 string Literal reference, Relative, internal or absolute URL type 0..1 uri Type the reference refers to (e.g. "Patient") identifier 0..1 Identifier Logical reference, when literal reference is not known display 0..1 string Text alternative for the resource status 1..1 code preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown statusReason 0..1 CodeableConcept Reason for current status category 1..1 CodeableConcept Classification of the procedure coding 0..* Coding Code defined by a terminology system ターミノロジーによって定義されたコード text 0..1 string Plain text representation of the concept この概念のシンプルなテキスト記述 code 1..1 CodeableConcept Identification of the procedure プロシジャーの識別子 Binding: ProcedureCodes(SNOMEDCT) (required): Procedureコード subject 1..1 Reference(Patient) Who the procedure was performed on プロシジャーが実施された対象人 encounter 0..1 Reference(Encounter) Encounter created as part of 一部として作成されたエンカウンター performed[x] 1..1 When the procedure was performed プロシジャーが実施された時期 performedDateTime dateTime performedPeriod Period recorder 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Who recorded the procedure プロシジャーを記録した人 asserter 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Person who asserts this procedure プロシジャーを実施したと報告する人 performer 0..* BackboneElement The people who performed the procedure プロシジャーを実施した人々 function 0..1 CodeableConcept Type of performance actor 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) The reference to the practitioner 医療従事者への参照 onBehalfOf 0..1 Reference(Organization) Organization the device or practitioner was acting for 従事した組織 location 0..1 Reference(Location) Where the procedure happened プロシジャーが実施された場所 reasonCode 0..* CodeableConcept Coded reason procedure performed プロシジャーが実施された理由コード reasonReference 0..* Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) The justification that the procedure was performed プロシジャーが実施された正当性 bodySite 0..* CodeableConcept Target body sites 対象の人体部位 outcome 0..1 CodeableConcept The result of procedure プロシジャーの結果 report 0..* Reference(DiagnosticReport | DocumentReference | Composition) Any report resulting from the procedure プロシジャーからのなんらかの結果報告 <a href="StructureDefinition-JP-Procedure-definitions.html#Procedure.complication" title="Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues. プロシジャー中、またはその実施直後の期間に発生した合併症。これらは通常、note要素とは別に記録されます。note要素は通常、「プロシジャー後」の問題ではなく、プロシジャー自体を説明するものである。">complication 0..* CodeableConcept Complication following the procedure プロシジャーに起こった合併症 complicationDetail 0..* Reference(Condition) A condition that is a result of the procedure プロシジャーの結果であるような患者状態 followUp 0..* CodeableConcept Instructions for follow up フォローアップの指示 note 0..* Annotation Additional information about the procedure プロシジャーの関する追加情報 focalDevice 0..* BackboneElement Manipulated, implanted, or removed device 操作、埋め込み、または削除されたデバイス action 0..1 CodeableConcept Kind of change to device manipulated 1..1 Reference(Device) Device that was changed usedReference 0..* Reference(Device | Medication | Substance) Items used during procedure プロシジャー中に使用されるアイテム usedCode 0..* CodeableConcept Coded items used during the procedure プロシジャー中に使用したアイテムのコード Documentation for this format
このプロファイルはProcedureリソースに対して、患者に対する医療的な処置のデータを送受信するための共通の制約と拡張を定めたものである。
An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy. 患者に対して、または患者のために実行されているか実行されたアクション。これは、手術のような身体的介入、または長期サービス、カウンセリング、催眠療法のような低侵襲性である可能性がある。
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
これは、ビジネスプロセスによって定義され、リソース自体への直接のURL参照が適切でない場合に参照するために使用される、このProcedureに関連する識別子を記録する。
これはビジネス識別子であり、リソース識別子ではありません（議論参照）。識別子は1つのリソースインスタンスにのみ表示されることがベストですが、ビジネス上の慣習により、同じ識別子を持つ複数のリソースインスタンスが存在することがあるかもしれません。例えば、複数のPatientとPersonリソースインスタンスが同じ社会保険番号を共有しているかもしれない。
Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.
Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
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.
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Instantiates FHIR protocol or definition
本Procedureの全部または一部を遵守するFHIR定義のプロトコル、ガイドライン、オーダーセット、その他の定義を指すURL.
Instantiates external protocol or definition
本Procedrure全体または一部を遵守する、外部で管理されているプロトコル、ガイドライン、オーダーセット、またはその他の定義を指すURL。
This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
A request for this procedure このプロシージャの依頼情報
このプロシージャの依頼情報の詳細を含むリソースへの参照。
参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない（アクセス制御、一時的な利用不能などを可能にする）。解決には、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規の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ができる。 【JPーCORE】 Observation_LabResultにならい、任意。
.outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
A larger event of which this particular procedure is a component or step.【JP仕様】https://www.hl7.org/fhir/procedure.htmlを参照
The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration). MedicationAdministrationリソースにはProcedureへのpartOf参照があるが、これは循環参照ではない。たとえば、麻酔MedicationAdministrationは外科的処置の一部である（MedicationAdministration.partOf = Procedure）。 また、たとえば、IV投薬管理用にIVポートを挿入する手順は、投薬管理の一部である（Procedure.partOf = MedicationAdministration）。 【JP-CORE】 Observation_LabResultにならい、任意。
.inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. 「不明な」コードは、他のステータスを伝えるために使用されるべきではない。ステータスの1つが当てはまる場合、「不明」コードを使用する必要があるが、オーサリングシステムはプロシージャの現在の状態を認識していない。 ステータスにリソースを現在無効としてマークするコードが含まれているため、この要素は修飾子としてラベル付けされる。
This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
A code specifying the state of the procedure.
プロシージャの現在の状態の理由を設定する。
This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here. これは通常、「未完了」、「一時停止」、「中止」などの「例外」ステータスにのみ使用される。イベントを実行する理由は、ここではなく、reasonCodeに設定する。
A code that identifies the reason a procedure was not performed.
すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供する必要があります。 【JPーCORE】JP_Conditionに合わせて必須。
A code that classifies a procedure for searching, sorting and display purposes.
.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
Code defined by a terminology system ターミノロジーによって定義されたコード
A reference to a code defined by a terminology system. ターミノロジーによって定義されたコードへの参照。
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. コードは、列挙型またはコードリストで、SNOMED CTなどの非常に正式な定義まで、非常に柔軟に定義できます。詳細については、HL7v3コア原則を参照。コーディングの順序は定義されておらず、意味を推測するために使用してはならない。 一般に、コーディング値の多くても1つだけが UserSelected = true としてラベル付けされる。
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept この概念のシンプルなテキスト記述
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. データを入力したユーザーによって見られた/選択された/発声された、および/またはユーザーの意図された意味を表す概念の人間の言語表現。
Very often the text is the same as a displayName of one of the codings. 多くの場合、テキストはいずれかのコーディングのdisplayNameと同じです。
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. 用語のコードは、それらを使用する人間のすべてのニュアンスで常に正しい意味を捉えているとは限らない。または、適切なコードがまったくない場合もあります。このような場合、テキストはソースの完全な意味をキャプチャするために使用される。
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Identification of the procedure プロシジャーの識別子
行われた具体的な手順。手技の正確な性質がコード化できない場合はテキストを使用する（例：「腹腔鏡下虫垂切除術」）
すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供すべきである。
0..1 to account for primarily narrative only resources.
Who the procedure was performed on プロシジャーが実施された対象人
The person, animal or group on which the procedure was performed. プロシジャーが実行された対象の人、動物、またはグループ。
参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない（アクセス制御、一時的な利用不能などを可能にする）。解決は、URLからの検索、またはリソースタイプによって該当する場合は、絶対参照を正規の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。
Encounter created as part of 一部として作成されたエンカウンター
プロシジャーが作成または実行されたエンカウンター、またはこの記録の作成が緊密に関連しているエンカウンター。
これは通常、イベントが発生した出会いの中で行われますが、活動によっては、出会いの公式な終了前または終了後に開始されても、出会いの文脈と結びついている場合があります。
.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
When the procedure was performed プロシジャーが実施された時期
Procedureが行われた推定または実際の日付、日時、期間、または年齢。複数の日付にまたがる複雑なProcdedureをサポートするために期間を許可し、Procdedureの長さを把握することも可能。
Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone. 年齢は一般的に、患者が手技が行われた年齢を報告するときに使用される。 範囲は、一般的に、患者が手順が実行されたときに年齢範囲を報告する場合に使用される。たとえば、20〜25歳の間など。 dateTimeは、ミリ秒の精度を持たない可能性がある過去の手順として報告される一部の手順と、エンカウンターの期間において実施され文書化された他の手順が、タイムゾーンでより正確なUTCタイムスタンプを持つ可能性があるため、さまざまな精度をサポートする。
Individual who recorded the record and takes responsibility for its content. 記録を記録し、その内容に責任を負う個人。
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、内容に辿り着ける（解決できる）必要があります（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。
Person who asserts this procedure プロシジャーを実施したと報告する人
Individual who is making the procedure statement. プロシジャー記録を作成している個人
The people who performed the procedure プロシジャーを実施した人々
Limited to "real" people rather than equipment. 医療機器ではなく「生身の人間」に限定。
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. プロシジャーへの実施者の関与のタイプを区別します。たとえば、外科医、麻酔科医、内視鏡医。
すべての用語の使用がこの一般的なパターンに当てはまるわけではない。場合によっては、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係や事前・事後の調整を管理するための独自の構造を提供するべきです。 【JP-CORE】 当面利用しない。
Allows disambiguation of the types of involvement of different performers.
A code that identifies the role of a performer of the procedure.
Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25
The reference to the practitioner 医療従事者への参照
The practitioner who was involved in the procedure. プロシジャーに関わった医療従事者。
参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない（アクセス制御、一時的な利用不可などを可能にする）。解決には、URLからの検索、またはリソースタイプによって適用可能な場合は、絶対参照を正規の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ができる。
A reference to Device supports use cases, such as pacemakers.
Organization the device or practitioner was acting for 従事した組織
The organization the device or practitioner was acting on behalf of. 従事した組織
参照は、実際のFHIRリソースへの参照であり、解決可能でなければならない（アクセス制御、一時的な利用不能などを可能にする）。解決には、URLからの検索によるものと、リソースタイプによって該当する場合は、絶対参照を正規の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ものがある。
Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.
Where the procedure happened プロシジャーが実施された場所
プロシジャーが実施された場所。 例：自宅での出生、レストランで気管切開など。
Ties a procedure to where the records are likely kept.
Coded reason procedure performed プロシジャーが実施された理由コード
処置が行われたコード化された理由。 これはある種のコード化された実体であるかもしれないし、単にテキストとして存在するかもしれない。
Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure. ひとつのコードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference のいずれかにより、非常に精緻な理由の定義を参照することもできる。 もしプロシージャの異なる理由を説明しているのであれば、Procedure.reasonCodeとProcedure.reasonReferenceの両方を使用できる。
A code that identifies the reason a procedure is required.
The justification that the procedure was performed プロシジャーが実施された正当性
なぜそのようなPlocedureを行ったのか、その正当性を示す。
It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure. ある手順が別の手順（硬膜外など）の理由（帝王切開など）になる可能性があります。他の例には、拡張および生検（診断および治療用途の組み合わせ）のための内視鏡検査が含まれます。 コードが理由を十分に説明している場合は、Procedure.reasonCodeを使用する。 リソースを参照する場合は、Procedure.reasonReferenceを使用する。これにより、開始日など、より多くの情報を伝達できる。 Procedure.reasonCodeとProcedure.reasonReferenceは、重複することを意図したものではない。単一の理由で、Procedure.reasonCodeまたはProcedure.reasonReferenceのいずれかだけを使用できる。 Procedure.reasonCodeは要約コードの場合もあれば、Procedure.reasonReferenceを使用して、Condition | Observation | Procedure | DiagnosticReport | DocumentReference
詳細かつ構造化された解剖学的な位置情報。複数の場所を指定することができる。例えば、1つの病変に対して複数のパンチングバイオプシーを行うことができる。
If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [procedure-targetbodystructure](extension-procedure-targetbodystructure.html). 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extension [procedure-targetbodystructure]（extension-procedure-targetbodystructure.html）を使用します。
Codes describing anatomical locations. May include laterality.
The outcome of the procedure - did it resolve the reasons for the procedure being performed? Procedureの結果 - Procedureが行われた理由が解決されたか？
If outcome contains narrative text only, it can be captured using the CodeableConcept.text. 結果に叙述的記述トのみが含まれている場合は、CodeableConcept.textを使用してその情報を格納できる。
An outcome of a procedure - whether it was resolved or otherwise.
Any report resulting from the procedure プロシジャーからのなんらかの結果報告
This could be a histology result, pathology report, surgical report, etc. これは、組織学的結果、病理学的報告書、手術報告書などであろう。
There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports. 複数のレポートが存在する可能性がある -例：これが複数の生検を行ったプロシジャーであって、いくつもの解剖病理学報告が得られた場合。
.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
Complication following the procedure プロシジャーに起こった合併症
Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues. プロシジャー中、またはその実施直後の期間に発生した合併症。これらは通常、note要素とは別に記録されます。note要素は通常、「プロシジャー後」の問題ではなく、プロシジャー自体を説明するものである。
If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text. 合併症が叙述的なテキストによってのみ表現されている場合は、CodeableConcept.textに格納できる。
Codes describing complications that resulted from a procedure.
.outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
A condition that is a result of the procedure プロシジャーの結果であるような患者状態
Any complications that occurred during the procedure, or in the immediate post-performance period. Procedureの実施中、または実施直後に発生した全ての合併症。
This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure. これは、プロシジャーの理由であった状態ではなく、プロシジャーの結果である状態を文書化するために使用される。
If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used. 処置が特別なフォローアップを必要とする場合（例：抜糸）、フォローアップはシンプルなnote として表現してもよいが、より複雑になる可能性もあり、その場合はケアプランリソースを使用することができる。
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調整前後の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。
Specific follow up required for a procedure e.g. removal of sutures.
.outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
Additional information about the procedure プロシジャーの関する追加情報
Any other notes and comments about the procedure. Procedureに関する注意点やコメントなど。
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）。
.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
Manipulated, implanted, or removed device 操作、埋め込み、または削除されたデバイス
A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure. Procedureが行われる局所に、あるいは、そこから、埋め込まれる、取り外される、またはその他の操作（キャリブレーション、バッテリー交換、プロテーゼの装着、陰圧ドレインバックの装着など）が行われるデバイス。
A kind of change that happened to the device during the procedure.
.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
Items used during procedure プロシジャー中に使用されるアイテム
Identifies medications, devices and any other substance used as part of the procedure. プロシジャーの一部として使用される薬剤、機器およびその他の物質を特定する。
For devices actually implanted or removed, use Procedure.device. 実際に埋め込まれた、または取り外されたデバイスについては、Procedure.deviceを使用すること。
.participation[typeCode=DEV].role[classCode=MANU] or .participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)
Coded items used during the procedure プロシジャー中に使用したアイテムのコード
Identifies coded items that were used as part of the procedure. Procedureの一部として使用されたコード化されたアイテムを識別する。
Codes describing items used during a procedure.