事前審查品項-MedicationRequest Apply TWPAS - 臺灣健保癌症用藥事前審查實作指引 v1.0.1

This page is part of the 臺灣癌症用藥事前審查實作指引(TWPAS IG) (v1.0.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: 事前審查品項-MedicationRequest Apply TWPAS

Official URL: https://twcore.mohw.gov.tw/ig/pas/StructureDefinition/MedicationRequest-apply-twpas				Version: 1.0.1
Active as of 2024-12-12				Computable Name: MedicationRequestApplyTWPAS

此事前審查品項-MedicationRequest Apply TWPAS Profile說明本IG如何進一步定義臺灣核心-藥品請求(TW Core MedicationRequest) Profile以呈現癌藥事前審查中申請項目之事前審查品項

Usage:

Use this Resource Profile: 事前審查-Bundle TWPAS
Refer to this Resource Profile: RequestedService
Examples for this Resource Profile: MedicationRequest/medReq-apply-2 and MedicationRequest/medReq-apply

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

Differential Table
Key Elements Table
Snapshot Table
Statistics/References
All

This structure is derived from TWCoreMedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest			TWCoreMedicationRequest
status		1..1	code	active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown Required Pattern: on-hold
intent		1..1	code	proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Required Pattern: plan
medication[x]	C	1..1	CodeableConceptTW	事前審查品項代碼，事前審查醫令代碼。
Slices for medication[x]				Content/Rules for all slices
medication[x]:medicationReference		0..0
medication[x]:medicationCodeableConcept		0..1	CodeableConceptTW	服用的藥品。此資料項目為可擴充綁定預設國際標準值集，但實作者可視實務專案需求只綁定以下slices中的任一值集。目前未只限定綁定預設值集是因為尚無slice值集與預設國際標準值集的代碼對應表，待後續有相對的代碼對應表後將建議採用國際標準值集作為唯一綁定值集並針對該值集進行擴充與管理，以利進行跨國與跨系統之資料交換。
coding		1..*	CodingTW	由專門術語系統（terminology system）定義的代碼
Slices for coding				Content/Rules for all slices
coding:fda-medication-tw		0..0
coding:nhi-medication-tw		1..1	CodingTW	此為中央健康保險署(NHI)維護之藥品代碼，主要針對申報使用，更新頻率相對頻繁，可免費使用，可依情境選用此代碼。
coding:rxnorm-medication-us-core		0..0
coding:atc-medication-code		0..0
coding:snomedct-medication-codes		0..0
subject		1..1	Reference(病人資訊-Patient TWPAS)	為誰或哪個實體集合（例如：特定的一群人）所開立的藥品請求
dosageInstruction		1..*	Dosage	應該如何用藥
timing		1..1	Timing	應該何時給藥；時間的寫法請參照Timimg datatype。
repeat	S	1..1	Element	事件定期重複發生的時間
bounds[x]	S	1..1	Period	時間或期間長度／長度範圍，或（開始和／或結束）限制
start	S	1..1	dateTime	事前審查藥物預定處方起始日期，YYYY-MM-DD，西元年月日。
end	S	1..1	dateTime	事前審查藥物預定處方終止日期，YYYY-MM-DD，西元年月日。
count	S	1..1	positiveInt	事前審查藥品處方頻次(cycles)。
code		1..1	CodeableConceptTW	事前審查藥品使用頻率及服用時間。 Binding: HL7 TimingAbbreviation + 臺灣健保署-健保事前審查-藥品使用頻率值集 (required)
coding		1..*	CodingTW	事前審查藥品使用頻率及服用時間。 Binding: HL7 TimingAbbreviation + 臺灣健保署-健保事前審查-藥品使用頻率值集 (required)
route		1..1	CodeableConceptTW	給藥途徑／作用部位。 Binding: SNOMED CT + 臺灣健保署-健保事前審查-給藥途徑值集 (required)
coding		1..1	CodingTW	給藥途徑／作用部位。 Binding: SNOMED CT + 臺灣健保署-健保事前審查-給藥途徑值集 (required)
doseAndRate	S	1..1	Element	用藥量
dose[x]	S	1..1	SimpleQuantity	A fixed quantity (no comparator)
value	S	1..1	decimal	事前審查藥品每次處方劑量，數字。
code	S	1..1	code	事前審查藥品每次處方劑量單位，每次使用之顆數、mL數、支數等。 Binding: Common UCUM units (required): 用藥單位的代碼範圍請參考Common UCUM units。
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationRequest.dosageInstruction.timing.code	required	NHIMedicationFrequencyHL7 `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-frequency-hl7-nhi` from this IG
MedicationRequest.dosageInstruction.timing.code.coding	required	NHIMedicationFrequencyHL7 `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-frequency-hl7-nhi` from this IG
MedicationRequest.dosageInstruction.route	required	TWPCSMedicationPathSCT `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-path-sct-tw` from this IG
MedicationRequest.dosageInstruction.route.coding	required	TWPCSMedicationPathSCT `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-path-sct-tw` from this IG
MedicationRequest.dosageInstruction.doseAndRate.dose[x].code	required	Common UCUM units `http://hl7.org/fhir/ValueSet/ucum-common` from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	TWCoreMedicationRequest	為病人或實體集合（例如：特定的一群人）開立的藥品請求 dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	創建此內容所依據的一組規則 ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	S	0..*	Identifier	此藥品請求的外部識別碼 ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	active \| on-hold \| cancelled \| completed \| entered-in-error \| stopped \| draft \| unknown Binding: medicationrequest Status (required): 應填入所綁定值集中的其中一個代碼 ele-1: All FHIR elements must have a @value or children Required Pattern: on-hold
intent	?!SΣ	1..1	code	proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Binding: medicationRequest Intent (required): 應填入所綁定值集中的其中一個代碼 ele-1: All FHIR elements must have a @value or children Required Pattern: plan
category	S	0..*	CodeableConceptTW	用藥型別 Binding: medicationRequest Category Codes (example): 可參考所綁定值集，但此值集只是針對這個欄位的一個可能值的範例，不預期也不鼓勵使用者一定要使用此值集的代碼。 ele-1: All FHIR elements must have a @value or children
doNotPerform	?!Σ	0..1	boolean	如果藥品請求是禁止活動，則為真。 ele-1: All FHIR elements must have a @value or children
Slices for medication[x]	SΣC	1..1	CodeableConceptTW	事前審查品項代碼，事前審查醫令代碼。 Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): 此資料項目為可擴充綁定預設國際標準值集，但實作者可視實務專案需求只綁定以下slices中的任一值集。目前未只限定綁定預設值集是因為尚無slice值集與預設國際標準值集的代碼對應表，待後續有相對的代碼對應表後將建議採用國際標準值集作為唯一綁定值集並針對該值集進行擴充與管理，以利進行跨國與跨系統之資料交換。 ele-1: All FHIR elements must have a @value or children
medication[x]:medicationCodeableConcept		0..1	CodeableConceptTW	服用的藥品。此資料項目為可擴充綁定預設國際標準值集，但實作者可視實務專案需求只綁定以下slices中的任一值集。目前未只限定綁定預設值集是因為尚無slice值集與預設國際標準值集的代碼對應表，待後續有相對的代碼對應表後將建議採用國際標準值集作為唯一綁定值集並針對該值集進行擴充與管理，以利進行跨國與跨系統之資料交換。 Binding: SNOMEDCTMedicationCodes (example) ele-1: All FHIR elements must have a @value or children
Slices for coding	S	1..*	CodingTW	由專門術語系統（terminology system）定義的代碼 Slice: Unordered, Open by pattern:$this ele-1: All FHIR elements must have a @value or children
coding:nhi-medication-tw	S	1..1	CodingTW	此為中央健康保險署(NHI)維護之藥品代碼，主要針對申報使用，更新頻率相對頻繁，可免費使用，可依情境選用此代碼。 Binding: 臺灣健保署用藥品項代碼值集 (required): 應填入所綁定值集中的其中一個代碼。 ele-1: All FHIR elements must have a @value or children
coding:nhi-medication-ch-herb-tw	S	0..1	CodingTW	此為中央健康保險署(NHI)維護之中藥藥品代碼，主要針對申報使用，更新頻率相對頻繁，可免費使用，可依情境選用此代碼。 Binding: 臺灣健保署中藥用藥品項值集 (required): 應填入所綁定值集中的其中一個代碼。 ele-1: All FHIR elements must have a @value or children
text	SΣ	0..1	string	概念的文字表示法 ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(病人資訊-Patient TWPAS)	為誰或哪個實體集合（例如：特定的一群人）所開立的藥品請求 ele-1: All FHIR elements must have a @value or children
encounter	S	0..1	Reference(TW Core Encounter)	連結至一個或一組即將給予藥品的人 ele-1: All FHIR elements must have a @value or children
authoredOn	SΣ	0..1	dateTime	藥品請求請求最初何時被撰寫？ ele-1: All FHIR elements must have a @value or children
requester	SΣ	0..1	Reference(TW Core Practitioner \| TW Core PractitionerRole \| TW Core Organization \| TW Core Patient \| TW Core RelatedPerson \| Device)	誰／什麼提出藥品請求請求？ ele-1: All FHIR elements must have a @value or children
reasonReference	S	0..*	Reference(TW Core Condition \| TW Core Observation Laboratory Result)	開立處方的原因，例如：病情、問題或診斷（condition）或者檢驗檢查（observation） ele-1: All FHIR elements must have a @value or children
note	S	0..*	Annotation	關於處方的資訊 ele-1: All FHIR elements must have a @value or children
dosageInstruction	S	1..*	Dosage	應該如何用藥 ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text	SΣ	0..1	string	純文字表述的劑量指示，例如：SIG。 ele-1: All FHIR elements must have a @value or children
timing	SΣ	1..1	Timing	應該何時給藥；時間的寫法請參照Timimg datatype。 ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
repeat	SΣC	1..1	Element	事件定期重複發生的時間 ele-1: All FHIR elements must have a @value or children tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
bounds[x]	SΣ	1..1	Period	時間或期間長度／長度範圍，或（開始和／或結束）限制 ele-1: All FHIR elements must have a @value or children
start	SΣC	1..1	dateTime	事前審查藥物預定處方起始日期，YYYY-MM-DD，西元年月日。 ele-1: All FHIR elements must have a @value or children
end	SΣC	1..1	dateTime	事前審查藥物預定處方終止日期，YYYY-MM-DD，西元年月日。 ele-1: All FHIR elements must have a @value or children
count	SΣ	1..1	positiveInt	事前審查藥品處方頻次(cycles)。 ele-1: All FHIR elements must have a @value or children
code	S	1..1	CodeableConceptTW	事前審查藥品使用頻率及服用時間。 Binding: HL7 TimingAbbreviation + 臺灣健保署-健保事前審查-藥品使用頻率值集 (required) ele-1: All FHIR elements must have a @value or children
coding	S	1..*	CodingTW	事前審查藥品使用頻率及服用時間。 Binding: HL7 TimingAbbreviation + 臺灣健保署-健保事前審查-藥品使用頻率值集 (required) ele-1: All FHIR elements must have a @value or children
text	SΣ	0..1	string	概念的文字標記法 ele-1: All FHIR elements must have a @value or children
route	S	1..1	CodeableConceptTW	給藥途徑／作用部位。 Binding: SNOMED CT + 臺灣健保署-健保事前審查-給藥途徑值集 (required) ele-1: All FHIR elements must have a @value or children
coding	S	1..1	CodingTW	給藥途徑／作用部位。 Binding: SNOMED CT + 臺灣健保署-健保事前審查-給藥途徑值集 (required) ele-1: All FHIR elements must have a @value or children
text	SΣ	0..1	string	概念的文字標記法 ele-1: All FHIR elements must have a @value or children
doseAndRate	SΣ	1..1	Element	用藥量 ele-1: All FHIR elements must have a @value or children
dose[x]	SC	1..1	SimpleQuantity	A fixed quantity (no comparator) ele-1: All FHIR elements must have a @value or children qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
value	SΣ	1..1	decimal	事前審查藥品每次處方劑量，數字。 ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	code	事前審查藥品每次處方劑量單位，每次使用之顆數、mL數、支數等。 Binding: Common UCUM units (required): 用藥單位的代碼範圍請參考Common UCUM units。 ele-1: All FHIR elements must have a @value or children
dispenseRequest	S	0..1	BackboneElement	藥品供應授權 ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
validityPeriod	S	0..1	Period	處方可用以配藥的有效期限 ele-1: All FHIR elements must have a @value or children
numberOfRepeatsAllowed	S	0..1	unsignedInt	可重複領藥的次數 ele-1: All FHIR elements must have a @value or children
expectedSupplyDuration	S	0..1	Duration	每次配藥可持續的天數 ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationRequest.status	required	Pattern: on-hold `http://hl7.org/fhir/ValueSet/medicationrequest-status\|4.0.1` from the FHIR Standard
MedicationRequest.intent	required	Pattern: plan `http://hl7.org/fhir/ValueSet/medicationrequest-intent\|4.0.1` from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` from the FHIR Standard
MedicationRequest.medication[x]	example	SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationRequest.medication[x]:medicationCodeableConcept.coding:nhi-medication-tw	required	TWMedicationNHI `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/medication-nhi-tw`
MedicationRequest.medication[x]:medicationCodeableConcept.coding:nhi-medication-ch-herb-tw	required	TWCHHerbMedicationNHI `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/nhi-medication-ch-herb-tw`
MedicationRequest.dosageInstruction.timing.code	required	NHIMedicationFrequencyHL7 `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-frequency-hl7-nhi` from this IG
MedicationRequest.dosageInstruction.timing.code.coding	required	NHIMedicationFrequencyHL7 `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-frequency-hl7-nhi` from this IG
MedicationRequest.dosageInstruction.route	required	TWPCSMedicationPathSCT `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-path-sct-tw` from this IG
MedicationRequest.dosageInstruction.route.coding	required	TWPCSMedicationPathSCT `https://twcore.mohw.gov.tw/ig/pas/ValueSet/medication-path-sct-tw` from this IG
MedicationRequest.dosageInstruction.doseAndRate.dose[x].code	required	Common UCUM units `http://hl7.org/fhir/ValueSet/ucum-common` from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	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	error	MedicationRequest	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	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
qty-3	error	MedicationRequest.dosageInstruction.doseAndRate.dose[x]	If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists()
sqty-1	error	MedicationRequest.dosageInstruction.doseAndRate.dose[x]	The comparator is not used on a SimpleQuantity : comparator.empty()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	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()))
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()