同意書實作指引(Consent Form IG)
0.1.0 - CI Build
同意書實作指引(Consent Form IG)
0.1.0 - CI Build
This page is part of the 同意書實作指引 (v0.1.0: Releases Ballot 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
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<div xmlns="http://www.w3.org/1999/xhtml"><h3><b>Composition</b></h3><p><b>文件識別碼</b>：urn:uuid:078b37ed-0ea9-44e7-9fa7-c838ddd38491 (https://www.tph.mohw.gov.tw/)</p><p><b>文件狀態</b>：Final <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">(<a href="http://hl7.org/fhir/R4/valueset-composition-status.html">CompositionStatus</a>#final)</span></p><p><b>文件種類</b>：Consent Document <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://loinc.org/">LOINC</a>#59284-0)</span></p><p><b>文件創建日期</b>：2021-08-30 02:30:00+0800</p><p><b>文件創建單位</b>：<a href="Organization-org-hosp-example.html">Organization/org-hosp-example</a> "衛生福利部臺北醫院"</p><h4><b>安寧療護意願書</b></h4><p><b>同意書識別碼</b>：urn:uuid:debe91e0-f732-4e9f-8646-17eb03bed2d5 (https://www.tph.mohw.gov.tw/)</p><p><b>同意書的狀態</b>：active <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">(<a href="http://hl7.org/fhir/R4/valueset-consent-state-codes.html">ConsentState</a>#active)</span></p><p><b>同意書的規模</b>：Privacy Consent <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://terminology.hl7.org/5.0.0/CodeSystem-consentscope.html">Consent Scope Codes</a>#patient-privacy)</span></p><p><b>同意書的類別</b>：安寧療護意願書 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="CodeSystem-consent-category.html">Consent Category</a>#CFPC)</span></p><p><b>病人</b>：<a href="Patient-pat-example.html">Patient/pat-example</a> "陳加玲"</p><p><b>日期</b>：2021-12-01</p><p><b>同意政策和規則的機構</b>：<a href="Organization-doma-example.html">Organization/doma-example</a> "醫事司"</p><p><b>參照的文件</b>：<a href="DocumentReference-doc-example.html">DocumentReference/doc-example</a></p><p><b>政策規則</b>：安寧緩和醫療條例 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="CodeSystem-policy-rule.html">同意書政策依據</a>#hospice-palliative-care-act)</span></p><p><b>補充說明</b>：<br/>1、依據安寧緩和醫療條例第四條之規定，疾病末期之病人簽署意願書，應有具完全行為能力者二人以上在場見證，但實施安寧緩和醫療及執行意願人維生醫療抉擇之醫療機構所屬人員不得為見證人。<br/>2、依據安寧緩和醫療條例第七條第一項第二款之規定，未成年人簽署意願書時，應得其法定代理人之同意。<br/>3、依據安寧緩和醫療條例第五條之規定，意願人得預立醫療委任代理人，並以書面載明委任意旨，於其無法表達意願時，由代理人代為簽署。</p><h5>Provisions</h5><p><b>類型</b>：Opt In <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://hl7.org/fhir/R4/valueset-consent-provision-type.html">ConsentProvisionType</a>#permit)</span></p><p><b>Action</b>：Access <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://terminology.hl7.org/CodeSystem/consentaction">Consent Action Codes</a>#access)</span></p><p><b>SecurityLabel</b>：treatment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://terminology.hl7.org/CodeSystem/v3-ActReason">ActReason</a>#TREAT)</span></p><p><b>Class</b>：ITI BPPC (Details: http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode code urn:ihe:iti:bppc:2007 = 'urn:ihe:iti:bppc:2007', stated as 'ITI BPPC')</p><p><b>Code</b>：Consent Document <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://loinc.org/">LOINC</a>#59284-0)</span></p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><h3><b>安寧療護意願書</b></h3><p><b>同意書識別碼</b>：urn:uuid:debe91e0-f732-4e9f-8646-17eb03bed2d5 (https://www.tph.mohw.gov.tw/)</p><p><b>同意書的狀態</b>：active <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">(<a href="http://hl7.org/fhir/R4/valueset-consent-state-codes.html">ConsentState</a>#active)</span></p><p><b>同意書的規模</b>：Privacy Consent <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://terminology.hl7.org/5.0.0/CodeSystem-consentscope.html">Consent Scope Codes</a>#patient-privacy)</span></p><p><b>同意書的類別</b>：安寧療護意願書 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="CodeSystem-consent-category.html">Consent Category</a>#CFPC)</span></p><p><b>病人</b>：<a href="Patient-pat-example.html">Patient/pat-example</a> "陳加玲"</p><p><b>日期</b>：2021-12-01</p><p><b>同意政策和規則的機構</b>：<a href="Organization-doma-example.html">Organization/doma-example</a> "醫事司"</p><p><b>參照的文件</b>：<a href="DocumentReference-doc-example.html">DocumentReference/doc-example</a></p><p><b>政策規則</b>：安寧緩和醫療條例 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="CodeSystem-policy-rule.html">同意書政策依據</a>#hospice-palliative-care-act)</span></p><p><b>補充說明</b>：<br/>1、依據安寧緩和醫療條例第四條之規定，疾病末期之病人簽署意願書，應有具完全行為能力者二人以上在場見證，但實施安寧緩和醫療及執行意願人維生醫療抉擇之醫療機構所屬人員不得為見證人。<br/>2、依據安寧緩和醫療條例第七條第一項第二款之規定，未成年人簽署意願書時，應得其法定代理人之同意。<br/>3、依據安寧緩和醫療條例第五條之規定，意願人得預立醫療委任代理人，並以書面載明委任意旨，於其無法表達意願時，由代理人代為簽署。</p><h4>Provisions</h4><p><b>類型</b>：Opt In <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://hl7.org/fhir/R4/valueset-consent-provision-type.html">ConsentProvisionType</a>#permit)</span></p><p><b>Action</b>：Access <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://terminology.hl7.org/CodeSystem/consentaction">Consent Action Codes</a>#access)</span></p><p><b>SecurityLabel</b>：treatment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://terminology.hl7.org/CodeSystem/v3-ActReason">ActReason</a>#TREAT)</span></p><p><b>Class</b>：ITI BPPC (Details: http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode code urn:ihe:iti:bppc:2007 = 'urn:ihe:iti:bppc:2007', stated as 'ITI BPPC')</p><p><b>Code</b>：Consent Document <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://loinc.org/">LOINC</a>#59284-0)</span></p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><h3><b>病人基本資料</b></h3><blockquote><p><b>識別碼型別</b>：全國的個人識別碼 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="https://twcore.mohw.gov.tw/tsfhir/CodeSystem/v2-0203">Identifier Type Codes</a>#NNTWN）</span><br/><b>身分證字號（official）</b>：A123456789 （http://www.moi.gov.tw/）</p></blockquote><blockquote><p><b>識別碼型別</b>：Medical record number <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="http://terminology.hl7.org/CodeSystem/v2-0203">Identifier Type Codes</a>#MR）</span><br/><b>病歷號（official）</b>：8862168 （https://www.tph.mohw.gov.tw/）</p></blockquote><p><b>病人的紀錄（active）</b>：使用中</p><p><b>姓名（official）</b>：陳加玲 Chan, Chia Lin</p><p><b>性別</b>：女性</p><p><b>出生日期</b>：1952-05-02</p><p><b>年齡[extension: <a href="https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition-person-age.html">person-age</a>]</b>：70</p><p><b>聯絡方式</b>：Phone <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="https://hl7.org/fhir/R4/valueset-contact-point-system.html">ContactPointSystem</a>#phone）</span><br/><b>聯絡電話</b>：（Mobile）0911327999 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="https://build.fhir.org/codesystem-contact-point-use.html">ContactPointUse</a>#mobile）</span><br/><b>聯絡電話使用效期</b>：2022-07-31至2024-07-31</p><p><b>聯絡地址</b>：(103)臺北市大同區大有里19鄰承德路三段52巷6弄210號2樓B室</p><p><b>婚姻狀態</b>：unmarried <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus">臺灣婚姻狀態值集</a>#U）</span></p><p><b>聯絡人（official）</b>：李立偉 Li, Li Wei<br/><b> 關係</b>：father <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="http://terminology.hl7.org/CodeSystem/v3-RoleCode">PatientRelationshipType</a>#FTH）</span><br/><b> 聯絡方式</b>：Phone <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="https://hl7.org/fhir/R4/valueset-contact-point-system.html">ContactPointSystem</a>#phone）</span><br/><b> 聯絡電話</b>：（Mobile）0917159753 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="https://build.fhir.org/codesystem-contact-point-use.html">ContactPointUse</a>#mobile）</span><br/><b> 聯絡電話使用效期</b>：2022-07-31至2024-07-31</p><p><b>向病人說明健康狀態時所使用的語言</b>：中文</p><p><b>紀錄的保管機構</b>： <a href="Organization-org-hosp-example.html">Organization/org-hosp-example</a> "衛生福利部臺北醫院"</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><h3><b>參照的文件</b></h3><p><b>狀態</b>：current</p><p><b>文件分類</b>：安寧療護意願書 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="CodeSystem-consent-category.html">同意書類別</a>#CFPC）</span></p><p><b>認證者</b>：<a href="Organization-org-hosp-example.html">Organization/org-hosp-example</a> "衛生福利部臺北醫院"</p><blockquote><p><b>內容規格</b>：application/pdf <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="http://hl7.org/fhir/R4/valueset-mimetypes.html">MimeType</a>#application/pdf）</span></p><p><b>url</b>：<a href="https://drive.google.com/file/d/1JDUq2a3o4PkaUn7n6sYwZAiBOOup-BST/view?usp=sharing">https://drive.google.com/file/d/1JDUq2a3o4PkaUn7n6sYwZAiBOOup-BST/view?usp=sharing</a></p></blockquote></div>
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<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><h3><b>醫事機構基本資料</b></h3><p><b>機構名稱</b>：衛生福利部臺北醫院</p><p><b>識別碼型別</b>：Healthcare Organization Identifier<span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="https://twcore.mohw.gov.tw/ig/twcore/CodeSystem-v2-0203.html">臺灣識別碼類型值集</a>#HOI）</span><br/><b>機構代碼（official）</b>：0622020017 (https://twcore.mohw.gov.tw/tsfhir/CodeSystem/organization-identifier-tw)</p><p><b>機構種類</b>：Healthcare Provider <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://hl7.org/fhir/R4/codesystem-organization-type.html">OrganizationType</a>#prov)</span></p><p><b>聯絡方式</b>：Phone<span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> （ <a href="https://hl7.org/fhir/R4/valueset-contact-point-system.html">ContactPointSystem</a>#phone）</span><br/><b>聯絡電話</b>：0222765566</p></div>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="https://twcore.mohw.gov.tw/tsfhir/CodeSystem/v2-0203"/>
<code value="HOI"/>
</coding>
</type>
<system
value="https://twcore.mohw.gov.tw/tsfhir/CodeSystem/organization-identifier-tw"/>
<value value="0131060029"/>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
</coding>
</type>
<name value="衛生福利部臺北醫院"/>
<telecom>
<system value="phone"/>
<value value="0222765566"/>
</telecom>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:f93d3bd7-1ac6-4c90-aa1b-1d076521acfc"/>
<resource>
<Organization>
<id value="Inline-Organization-gov-palliativeCare-example"/>
<meta>
<profile
value="https://twcore.mohw.gov.tw/fhir/StructureDefinition/Organization-govt-twcore"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><h3><b>政府機構基本資料</b></h3><p><b>機構名稱</b>：醫事司</p><p><b>識別碼型別</b>：Government Organization Identifier<span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">（ <a href="https://twcore.mohw.gov.tw/ig/twcore/CodeSystem-v2-0203.html">臺灣識別碼類型值集</a>#GOI）</span><br/><b>機關OID（official）</b>：2.16.886.101.20003.20065.20005 (https://oid.nat.gov.tw/)</p><p><b>機構種類</b>：Government <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://hl7.org/fhir/R4/codesystem-organization-type.html">OrganizationType</a>#govt)</span></p></div>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="https://twcore.mohw.gov.tw/tsfhir/CodeSystem/v2-0203"/>
<code value="GOI"/>
</coding>
</type>
<system value="https://oid.nat.gov.tw/"/>
<value value="2.16.886.101.20003.20065.20005"/>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="govt"/>
</coding>
</type>
<name value="醫事司"/>
</Organization>
</resource>
</entry>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.11"/>
<display value="Consent Witness Signature"/>
</type>
<when value="2021-08-31T14:30:00+01:00"/>
<who>
<reference value="urn:uuid:70e901fc-3147-4d97-ba79-9a35b525d38b"/>
</who>
<data
value="JbuZIFILUSYF+aYl8kjqjbsk/cZg6rTDexO+RtamBIOUG+742R1LXTraOB63/mb2EzixN1+MyodFp1hLYzOgsg=="/>
</signature>
</Bundle>
IG © 2022+ ABC科技股份有限公司. Package tw.abc.consentForm#0.1.0 based on FHIR 4.0.1. Generated 2023-05-16
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