醫查實作指引 - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: ProcedureAnesthesiaMode IMRI

此麻醉模式(ProcedureAnesthesiaMode IMRI)Profile說明本IG如何進一步定義臺灣核心-處置或手術（TW Core Procedure) Profile以呈現麻醉模式。

Usage:

• Use this Resource Profile: BundleOperationNote IMRI
• Refer to this Resource Profile: CompositionOperationNote IMRI
• Examples for this Resource Profile: Procedure/ProcedureAnesthesiaMode-min

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 TWCoreProcedure

Name	Flags	Card.	Type	Description & Constraints
Procedure			TWCoreProcedure
basedOn		0..*	Reference(CarePlan IMRI | ServiceRequest)	此Procedure是基於什麼而履行
partOf		0..*	Reference(ProcedureOperation IMRI)	參照事件的一部分
status		1..1	code	preparation ｜ in-progress ｜ not-done ｜on-hold ｜stopped ｜ completed ｜ entered-in-error ｜ unknown Required Pattern: completed
category		1..1	CodeableConceptTW	處置/手術的分類。 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 399097000
code		1..1	CodeableConceptTW	即為「麻醉模式」。 Binding: SNOMED CT Anesthesia值集 (required)
Slices for coding				Content/Rules for all slices
coding:icd10-pcs-2021		0..0
coding:icd10-pcs-2014		0..0
coding:medical-service-payment		0..0
coding:sct-procedures		0..0
coding:SCTAnesthesia	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼。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: SNOMED CT Anesthesia值集 (required)
subject		1..1	Reference(Patient IMRI)	處置/手術服務的對象
encounter		0..1	Reference(Encounter IMRI)	就醫（Encounter）紀錄作為處置/手術的一部分
recorder		0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	誰記錄此處置/手術
asserter		0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	聲稱有此處置/手術的人
performer		0..*	BackboneElement	即為「麻醉醫師」，執行麻醉的人員
actor		1..1	Reference(PractitionerRole IMRI)	參照至健康照護服務提供者
onBehalfOf		0..1	Reference(Organization Hospital Department IMRI)	此裝置（Device）或健康照護服務提供者所屬機構（Organization）
location		0..1	Reference(Location IMRI)	處置/手術發生的地點（Location）？
reasonReference		0..*	Reference(ConditionChiefComplaint IMRI | ObservationLaboratory IMRI | DiagnosticReport | DocumentReference)	執行此處置/手術的原因
report		0..*	Reference(DiagnosticReport | DocumentReference | CompositionOperationNote IMRI)	此處置/手術產生的任何報告
complicationDetail		0..*	Reference(ConditionComorbiditiesandComplications IMRI)	處置/手術後發生的病情、問題或診斷
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.code	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.code.coding:SCTAnesthesia	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	TWCoreProcedure	正在或曾經對病人執行的動作
implicitRules	?!Σ	0..1	uri	創建此內容所依據的一組規則
modifierExtension	?!	0..*	Extension	此擴充的資料項目可能會完全修正或改變其他資料項目的意涵，需特別留意。
basedOn	Σ	0..*	Reference(CarePlan IMRI | ServiceRequest)	此Procedure是基於什麼而履行
partOf	Σ	0..*	Reference(ProcedureOperation IMRI)	參照事件的一部分
status	?!SΣ	1..1	code	preparation ｜ in-progress ｜ not-done ｜on-hold ｜stopped ｜ completed ｜ entered-in-error ｜ unknown Binding: EventStatus (required): 應填入所綁定值集中的其中一個代碼 Required Pattern: completed
category		1..1	CodeableConceptTW	處置/手術的分類。 Binding: ProcedureCategoryCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 399097000
code	S	1..1	CodeableConceptTW	即為「麻醉模式」。 Binding: SNOMED CT Anesthesia值集 (required)
Slices for coding	S	0..*	CodingTW	由專門術語系統（terminology system）定義的代碼。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。 Slice: Unordered, Open by pattern:$this
coding:loinc-procedures	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼 Binding: LOINC處置或手術值集 (required)
coding:SCTAnesthesia	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼。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: SNOMED CT Anesthesia值集 (required)
text	SΣ	0..1	string	概念的文字表示法
subject	SΣ	1..1	Reference(Patient IMRI)	處置/手術服務的對象
encounter	Σ	0..1	Reference(Encounter IMRI)	就醫（Encounter）紀錄作為處置/手術的一部分
performed[x]	SΣ	0..1		此處置/手術何時執行的？
performedDateTime			dateTime
recorder	Σ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	誰記錄此處置/手術
asserter	SΣ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	聲稱有此處置/手術的人
performer	SΣ	0..*	BackboneElement	即為「麻醉醫師」，執行麻醉的人員
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	SΣ	1..1	Reference(PractitionerRole IMRI)	參照至健康照護服務提供者
onBehalfOf	S	0..1	Reference(Organization Hospital Department IMRI)	此裝置（Device）或健康照護服務提供者所屬機構（Organization）
location	Σ	0..1	Reference(Location IMRI)	處置/手術發生的地點（Location）？
reasonReference	Σ	0..*	Reference(ConditionChiefComplaint IMRI | ObservationLaboratory IMRI | DiagnosticReport | DocumentReference)	執行此處置/手術的原因
bodySite	S	0..*	CodeableConceptTW	目標身體部位。 Binding: SNOMEDCTBodyStructures (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
report		0..*	Reference(DiagnosticReport | DocumentReference | CompositionOperationNote IMRI)	此處置/手術產生的任何報告
complicationDetail		0..*	Reference(ConditionComorbiditiesandComplications IMRI)	處置/手術後發生的病情、問題或診斷
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.category	extensible	Pattern: SNOMED-CT Code 399097000 http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.code	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.code.coding:loinc-procedures	required	LOINCProcedureCodes (a valid code from LOINC) https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-procedure-code
Procedure.code.coding:SCTAnesthesia	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.bodySite	extensible	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	TWCoreProcedure	正在或曾經對病人執行的動作
id	Σ	0..1	id	不重複的ID用以識別儲存在特定FHIR Server中的Procedure紀錄，通常又稱為邏輯性ID。
meta	Σ	0..1	Meta	此Procedure Resource的metadata
implicitRules	?!Σ	0..1	uri	創建此內容所依據的一組規則
language		0..1	code	用以表述Procedure Resource內容的語言。 Binding: CommonLanguages (preferred): 人類語言；鼓勵使用CommonLanguages代碼表中的代碼，但不強制一定要使用此代碼表，你也可使用其他代碼表的代碼或單純以文字表示。 Additional Bindings Purpose AllLanguages Max Binding Example Value: zh-TW
text		0..1	Narrative	Procedure Resource之內容摘要以供人閱讀
contained		0..*	Resource	內嵌的（contained）、行內的Resources
extension		0..*	Extension	擴充的資料項目
modifierExtension	?!	0..*	Extension	此擴充的資料項目可能會完全修正或改變其他資料項目的意涵，需特別留意。
identifier	Σ	0..*	Identifier	此處置/手術的外部識別碼
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	實例化FHIR計畫書（protocol）或定義
instantiatesUri	Σ	0..*	uri	實例化外部計畫書（protocol）或定義
basedOn	Σ	0..*	Reference(CarePlan IMRI | ServiceRequest)	此Procedure是基於什麼而履行
partOf	Σ	0..*	Reference(ProcedureOperation IMRI)	參照事件的一部分
status	?!SΣ	1..1	code	preparation ｜ in-progress ｜ not-done ｜on-hold ｜stopped ｜ completed ｜ entered-in-error ｜ unknown Binding: EventStatus (required): 應填入所綁定值集中的其中一個代碼 Required Pattern: completed
statusReason		0..1	CodeableConceptTW	當前狀態的原因。 Binding: ProcedureNotPerformedReason(SNOMED-CT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
category		1..1	CodeableConceptTW	處置/手術的分類。 Binding: ProcedureCategoryCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 399097000
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	S	1..1	CodeableConceptTW	即為「麻醉模式」。 Binding: SNOMED CT Anesthesia值集 (required)
id		0..1	string	唯一可識別ID，以供資料項目間相互參照。
extension		0..*	Extension	擴充的資料項目 Slice: Unordered, Open by value:url
Slices for coding	S	0..*	CodingTW	由專門術語系統（terminology system）定義的代碼。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。 Slice: Unordered, Open by pattern:$this
coding:loinc-procedures	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼 Binding: LOINC處置或手術值集 (required)
coding:SCTAnesthesia	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼。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: SNOMED CT Anesthesia值集 (required)
text	SΣ	0..1	string	概念的文字表示法
subject	SΣ	1..1	Reference(Patient IMRI)	處置/手術服務的對象
encounter	Σ	0..1	Reference(Encounter IMRI)	就醫（Encounter）紀錄作為處置/手術的一部分
performed[x]	SΣ	0..1		此處置/手術何時執行的？
performedDateTime			dateTime S
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
recorder	Σ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	誰記錄此處置/手術
asserter	SΣ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	聲稱有此處置/手術的人
performer	SΣ	0..*	BackboneElement	即為「麻醉醫師」，執行麻醉的人員
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConceptTW	執行的型別 Binding: ProcedurePerformerRoleCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
actor	SΣ	1..1	Reference(PractitionerRole IMRI)	參照至健康照護服務提供者
onBehalfOf	S	0..1	Reference(Organization Hospital Department IMRI)	此裝置（Device）或健康照護服務提供者所屬機構（Organization）
location	Σ	0..1	Reference(Location IMRI)	處置/手術發生的地點（Location）？
reasonCode		0..*	CodeableConceptTW	處置/手術執行原因代碼 Binding: ProcedureReasonCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
reasonReference	Σ	0..*	Reference(ConditionChiefComplaint IMRI | ObservationLaboratory IMRI | DiagnosticReport | DocumentReference)	執行此處置/手術的原因
bodySite	S	0..*	CodeableConceptTW	目標身體部位。 Binding: SNOMEDCTBodyStructures (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
outcome		0..1	CodeableConceptTW	處置/手術的結果。 Binding: ProcedureOutcomeCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
report		0..*	Reference(DiagnosticReport | DocumentReference | CompositionOperationNote IMRI)	此處置/手術產生的任何報告
complication		0..*	CodeableConceptTW	處置/手術後的併發症 Binding: Condition/Problem/DiagnosisCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
complicationDetail		0..*	Reference(ConditionComorbiditiesandComplications IMRI)	處置/手術後發生的病情、問題或診斷
followUp		0..*	CodeableConceptTW	追蹤說明。 Binding: ProcedureFollowUpCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
note		0..*	Annotation	關於此處置/手術的附加資訊
focalDevice		0..*	BackboneElement	處理、植入的或移除的裝置
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConceptTW	改變裝置的種類 Binding: ProcedureDeviceActionCodes (preferred): 鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。
manipulated		1..1	Reference(Device)	被改變的裝置
usedReference		0..*	Reference(Device | Medication | Substance)	處置/手術中使用的項目／物品
usedCode		0..*	CodeableConceptTW	處置/手術中使用的項目之代碼 Binding: FHIRDeviceTypes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Procedure.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.statusReason	extensible	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	extensible	Pattern: SNOMED-CT Code 399097000 http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.code	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.code.coding:loinc-procedures	required	LOINCProcedureCodes (a valid code from LOINC) https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-procedure-code
Procedure.code.coding:SCTAnesthesia	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.performer.function	extensible	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	extensible	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Procedure.bodySite	extensible	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Procedure.outcome	extensible	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	extensible	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	extensible	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	extensible	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

This structure is derived from TWCoreProcedure

Summary

Mandatory: 1 element
Must-Support: 1 element
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• CarePlan IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/careplan-imri)
• ProcedureOperation IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/procedureoperation-imri)
• Patient IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/patient-imri)
• Encounter IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/encounter-imri)
• Practitioner IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/practitioner-imri)
• PractitionerRole IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/practitionerrole-imri)
• Organization Hospital Department IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/organization-hosp-imri)
• Location IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/location-imri)
• ConditionChiefComplaint IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/conditionchiefcomplaint-imri)
• ObservationLaboratory IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/observation-laboratory-imri)
• CompositionOperationNote IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/composition-operationnote-imri)
• ConditionComorbiditiesandComplications IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/conditioncomorbiditiesandcomplications-imri)

Differential View

This structure is derived from TWCoreProcedure

Name	Flags	Card.	Type	Description & Constraints
Procedure			TWCoreProcedure
basedOn		0..*	Reference(CarePlan IMRI | ServiceRequest)	此Procedure是基於什麼而履行
partOf		0..*	Reference(ProcedureOperation IMRI)	參照事件的一部分
status		1..1	code	preparation ｜ in-progress ｜ not-done ｜on-hold ｜stopped ｜ completed ｜ entered-in-error ｜ unknown Required Pattern: completed
category		1..1	CodeableConceptTW	處置/手術的分類。 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 399097000
code		1..1	CodeableConceptTW	即為「麻醉模式」。 Binding: SNOMED CT Anesthesia值集 (required)
Slices for coding				Content/Rules for all slices
coding:icd10-pcs-2021		0..0
coding:icd10-pcs-2014		0..0
coding:medical-service-payment		0..0
coding:sct-procedures		0..0
coding:SCTAnesthesia	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼。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: SNOMED CT Anesthesia值集 (required)
subject		1..1	Reference(Patient IMRI)	處置/手術服務的對象
encounter		0..1	Reference(Encounter IMRI)	就醫（Encounter）紀錄作為處置/手術的一部分
recorder		0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	誰記錄此處置/手術
asserter		0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	聲稱有此處置/手術的人
performer		0..*	BackboneElement	即為「麻醉醫師」，執行麻醉的人員
actor		1..1	Reference(PractitionerRole IMRI)	參照至健康照護服務提供者
onBehalfOf		0..1	Reference(Organization Hospital Department IMRI)	此裝置（Device）或健康照護服務提供者所屬機構（Organization）
location		0..1	Reference(Location IMRI)	處置/手術發生的地點（Location）？
reasonReference		0..*	Reference(ConditionChiefComplaint IMRI | ObservationLaboratory IMRI | DiagnosticReport | DocumentReference)	執行此處置/手術的原因
report		0..*	Reference(DiagnosticReport | DocumentReference | CompositionOperationNote IMRI)	此處置/手術產生的任何報告
complicationDetail		0..*	Reference(ConditionComorbiditiesandComplications IMRI)	處置/手術後發生的病情、問題或診斷
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.code	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.code.coding:SCTAnesthesia	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	TWCoreProcedure	正在或曾經對病人執行的動作
implicitRules	?!Σ	0..1	uri	創建此內容所依據的一組規則
modifierExtension	?!	0..*	Extension	此擴充的資料項目可能會完全修正或改變其他資料項目的意涵，需特別留意。
basedOn	Σ	0..*	Reference(CarePlan IMRI | ServiceRequest)	此Procedure是基於什麼而履行
partOf	Σ	0..*	Reference(ProcedureOperation IMRI)	參照事件的一部分
status	?!SΣ	1..1	code	preparation ｜ in-progress ｜ not-done ｜on-hold ｜stopped ｜ completed ｜ entered-in-error ｜ unknown Binding: EventStatus (required): 應填入所綁定值集中的其中一個代碼 Required Pattern: completed
category		1..1	CodeableConceptTW	處置/手術的分類。 Binding: ProcedureCategoryCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 399097000
code	S	1..1	CodeableConceptTW	即為「麻醉模式」。 Binding: SNOMED CT Anesthesia值集 (required)
Slices for coding	S	0..*	CodingTW	由專門術語系統（terminology system）定義的代碼。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。 Slice: Unordered, Open by pattern:$this
coding:loinc-procedures	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼 Binding: LOINC處置或手術值集 (required)
coding:SCTAnesthesia	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼。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: SNOMED CT Anesthesia值集 (required)
text	SΣ	0..1	string	概念的文字表示法
subject	SΣ	1..1	Reference(Patient IMRI)	處置/手術服務的對象
encounter	Σ	0..1	Reference(Encounter IMRI)	就醫（Encounter）紀錄作為處置/手術的一部分
performed[x]	SΣ	0..1		此處置/手術何時執行的？
performedDateTime			dateTime
recorder	Σ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	誰記錄此處置/手術
asserter	SΣ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	聲稱有此處置/手術的人
performer	SΣ	0..*	BackboneElement	即為「麻醉醫師」，執行麻醉的人員
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	SΣ	1..1	Reference(PractitionerRole IMRI)	參照至健康照護服務提供者
onBehalfOf	S	0..1	Reference(Organization Hospital Department IMRI)	此裝置（Device）或健康照護服務提供者所屬機構（Organization）
location	Σ	0..1	Reference(Location IMRI)	處置/手術發生的地點（Location）？
reasonReference	Σ	0..*	Reference(ConditionChiefComplaint IMRI | ObservationLaboratory IMRI | DiagnosticReport | DocumentReference)	執行此處置/手術的原因
bodySite	S	0..*	CodeableConceptTW	目標身體部位。 Binding: SNOMEDCTBodyStructures (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
report		0..*	Reference(DiagnosticReport | DocumentReference | CompositionOperationNote IMRI)	此處置/手術產生的任何報告
complicationDetail		0..*	Reference(ConditionComorbiditiesandComplications IMRI)	處置/手術後發生的病情、問題或診斷
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.category	extensible	Pattern: SNOMED-CT Code 399097000 http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.code	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.code.coding:loinc-procedures	required	LOINCProcedureCodes (a valid code from LOINC) https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-procedure-code
Procedure.code.coding:SCTAnesthesia	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.bodySite	extensible	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	TWCoreProcedure	正在或曾經對病人執行的動作
id	Σ	0..1	id	不重複的ID用以識別儲存在特定FHIR Server中的Procedure紀錄，通常又稱為邏輯性ID。
meta	Σ	0..1	Meta	此Procedure Resource的metadata
implicitRules	?!Σ	0..1	uri	創建此內容所依據的一組規則
language		0..1	code	用以表述Procedure Resource內容的語言。 Binding: CommonLanguages (preferred): 人類語言；鼓勵使用CommonLanguages代碼表中的代碼，但不強制一定要使用此代碼表，你也可使用其他代碼表的代碼或單純以文字表示。 Additional Bindings Purpose AllLanguages Max Binding Example Value: zh-TW
text		0..1	Narrative	Procedure Resource之內容摘要以供人閱讀
contained		0..*	Resource	內嵌的（contained）、行內的Resources
extension		0..*	Extension	擴充的資料項目
modifierExtension	?!	0..*	Extension	此擴充的資料項目可能會完全修正或改變其他資料項目的意涵，需特別留意。
identifier	Σ	0..*	Identifier	此處置/手術的外部識別碼
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	實例化FHIR計畫書（protocol）或定義
instantiatesUri	Σ	0..*	uri	實例化外部計畫書（protocol）或定義
basedOn	Σ	0..*	Reference(CarePlan IMRI | ServiceRequest)	此Procedure是基於什麼而履行
partOf	Σ	0..*	Reference(ProcedureOperation IMRI)	參照事件的一部分
status	?!SΣ	1..1	code	preparation ｜ in-progress ｜ not-done ｜on-hold ｜stopped ｜ completed ｜ entered-in-error ｜ unknown Binding: EventStatus (required): 應填入所綁定值集中的其中一個代碼 Required Pattern: completed
statusReason		0..1	CodeableConceptTW	當前狀態的原因。 Binding: ProcedureNotPerformedReason(SNOMED-CT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
category		1..1	CodeableConceptTW	處置/手術的分類。 Binding: ProcedureCategoryCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 399097000
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	S	1..1	CodeableConceptTW	即為「麻醉模式」。 Binding: SNOMED CT Anesthesia值集 (required)
id		0..1	string	唯一可識別ID，以供資料項目間相互參照。
extension		0..*	Extension	擴充的資料項目 Slice: Unordered, Open by value:url
Slices for coding	S	0..*	CodingTW	由專門術語系統（terminology system）定義的代碼。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。 Slice: Unordered, Open by pattern:$this
coding:loinc-procedures	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼 Binding: LOINC處置或手術值集 (required)
coding:SCTAnesthesia	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼。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: SNOMED CT Anesthesia值集 (required)
text	SΣ	0..1	string	概念的文字表示法
subject	SΣ	1..1	Reference(Patient IMRI)	處置/手術服務的對象
encounter	Σ	0..1	Reference(Encounter IMRI)	就醫（Encounter）紀錄作為處置/手術的一部分
performed[x]	SΣ	0..1		此處置/手術何時執行的？
performedDateTime			dateTime S
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
recorder	Σ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	誰記錄此處置/手術
asserter	SΣ	0..1	Reference(Patient IMRI | Practitioner IMRI | PractitionerRole IMRI | RelatedPerson)	聲稱有此處置/手術的人
performer	SΣ	0..*	BackboneElement	即為「麻醉醫師」，執行麻醉的人員
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConceptTW	執行的型別 Binding: ProcedurePerformerRoleCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
actor	SΣ	1..1	Reference(PractitionerRole IMRI)	參照至健康照護服務提供者
onBehalfOf	S	0..1	Reference(Organization Hospital Department IMRI)	此裝置（Device）或健康照護服務提供者所屬機構（Organization）
location	Σ	0..1	Reference(Location IMRI)	處置/手術發生的地點（Location）？
reasonCode		0..*	CodeableConceptTW	處置/手術執行原因代碼 Binding: ProcedureReasonCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
reasonReference	Σ	0..*	Reference(ConditionChiefComplaint IMRI | ObservationLaboratory IMRI | DiagnosticReport | DocumentReference)	執行此處置/手術的原因
bodySite	S	0..*	CodeableConceptTW	目標身體部位。 Binding: SNOMEDCTBodyStructures (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
outcome		0..1	CodeableConceptTW	處置/手術的結果。 Binding: ProcedureOutcomeCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
report		0..*	Reference(DiagnosticReport | DocumentReference | CompositionOperationNote IMRI)	此處置/手術產生的任何報告
complication		0..*	CodeableConceptTW	處置/手術後的併發症 Binding: Condition/Problem/DiagnosisCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
complicationDetail		0..*	Reference(ConditionComorbiditiesandComplications IMRI)	處置/手術後發生的病情、問題或診斷
followUp		0..*	CodeableConceptTW	追蹤說明。 Binding: ProcedureFollowUpCodes(SNOMEDCT) (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
note		0..*	Annotation	關於此處置/手術的附加資訊
focalDevice		0..*	BackboneElement	處理、植入的或移除的裝置
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConceptTW	改變裝置的種類 Binding: ProcedureDeviceActionCodes (preferred): 鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。
manipulated		1..1	Reference(Device)	被改變的裝置
usedReference		0..*	Reference(Device | Medication | Substance)	處置/手術中使用的項目／物品
usedCode		0..*	CodeableConceptTW	處置/手術中使用的項目之代碼 Binding: FHIRDeviceTypes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Procedure.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.statusReason	extensible	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	extensible	Pattern: SNOMED-CT Code 399097000 http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.code	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.code.coding:loinc-procedures	required	LOINCProcedureCodes (a valid code from LOINC) https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-procedure-code
Procedure.code.coding:SCTAnesthesia	required	SCTAnesthesia https://hitstdio.ntunhs.edu.tw/imri/ValueSet/anesthesia-sct from this IG
Procedure.performer.function	extensible	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	extensible	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Procedure.bodySite	extensible	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Procedure.outcome	extensible	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	extensible	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	extensible	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	extensible	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

This structure is derived from TWCoreProcedure

Summary

Mandatory: 1 element
Must-Support: 1 element
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• CarePlan IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/careplan-imri)
• ProcedureOperation IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/procedureoperation-imri)
• Patient IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/patient-imri)
• Encounter IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/encounter-imri)
• Practitioner IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/practitioner-imri)
• PractitionerRole IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/practitionerrole-imri)
• Organization Hospital Department IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/organization-hosp-imri)
• Location IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/location-imri)
• ConditionChiefComplaint IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/conditionchiefcomplaint-imri)
• ObservationLaboratory IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/observation-laboratory-imri)
• CompositionOperationNote IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/composition-operationnote-imri)
• ConditionComorbiditiesandComplications IMRI (https://hitstdio.ntunhs.edu.tw/imri/StructureDefinition/conditioncomorbiditiesandcomplications-imri)

Other representations of profile: CSV, Excel, Schematron