描述為實現一個或多個目標而將為一位患者(或一群患者)進行的活動的計畫，包括診斷、監測、評估、治療、藥物治療、追蹤等。

構建 resource 時遵循的一系列規則的參照，在處理內容時必須理解這些規則。通常這是對 IG 所定義之特殊規則及其他 profiles 的參照。

宣告這套規則限制了內容只能被有限的交易夥伴所理解。這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，還沒有準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應該避免使用這個資料項目。通常在使用時，此 URL 是對 IG 的參照，此 IG 將這些特殊規則與其他 profiles、value sets 等一起定義為其敘述的一部分。

人可讀的敘述，包含 resource 的摘要，可用於向人表述 resource 的內容。敘述不需要對所有的結構化資料進行編碼，但需要包含足夠的細節使人在閱讀敘述時理解「臨床安全性」。resource 定義有哪些內容應該在敘述中表示，以確保臨床安全。

內嵌(contained)的 resource 沒有敘述，非內嵌(contained)的 resource 則 建議應該(SHOULD) 有敘述。有時 resource 可能只有文字表述，很少或沒有額外的結構化資料(只要滿足所有 minOccurs=1 的資料項目)。這可能出現在舊系統的資料，當資訊以 「文字表述區塊(text blob)」的形式被取得，或者文字表述是原始輸入或說明，而編碼資訊稍後再添加。

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

敘述狀態的受限值集。

The actual narrative content, a stripped down version of XHTML.

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

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).

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.

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.

此欄位表示該照護計畫是否處於啟用、草稿、完成等狀態；必填。

可以在 [[event.html#statemachine | 事件模式]] 文件中找到一個標準的狀態轉換圖。「未知」不代表「其他」狀態 - 必須使用其中一個已定義的狀態，「未知」用於表示不確定當前狀態。

指出計畫是否正在實施、代表未來意圖或是現在的歷史記錄。

指出計畫是否正在實施、代表未來意圖或是現在的歷史記錄。

標示這個照護計劃現在是提案、正式計畫、指令還是僅供參考的選項。

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

表示與照護計畫相關的權威性/意向性程度的代碼

Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

計畫的類型，例如：營養及飲食指導、惡化徵兆偵測及必要處理等。

There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

識別這是什麼「種類」的計畫，以支援多個共存計畫之間的區分；例如：「居家健康」、「精神科」、「氣喘」、「疾病管理」、「保健計畫」等。

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

Used for filtering what plan(s) are retrieved and displayed to different types of users.

本欄位用於簡要描述照護計畫的性質與目標，提供整體計畫的概要說明。

Provides more detail than conveyed by category.

指向台灣機器手訓練 Patient 資源，用於標記本照護計畫所屬的病患或病患群體。

識別計畫描述其意圖照護的病人或群體。

此欄位表示該照護計畫是否處於啟用、草稿、完成等狀態；必填。

標示這個照護計劃現在是提案、正式計畫、指令還是僅供參考的選項。

計畫的類型，例如：營養及飲食指導、惡化徵兆偵測及必要處理等。

本欄位用於簡要描述照護計畫的性質與目標，提供整體計畫的概要說明。

指向台灣機器手訓練 Patient 資源，用於標記本照護計畫所屬的病患或病患群體。

描述為實現一個或多個目標而將為一位患者(或一群患者)進行的活動的計畫，包括診斷、監測、評估、治療、藥物治療、追蹤等。

resource 的邏輯 ID，在 resource 的 URL 中使用。一旦指定，這個值永遠不會改變。

一個 resource 使用新增操作(create operation)提交給伺服器時，此 resource 沒有 id，它的 id 在 resource 被創建後由伺器分配/指定。

關於 resource 的 metadata。這是由基礎建設維護的內容。內容的更改可能並不總是與 resource 的版本更改相關聯。

構建 resource 時遵循的一系列規則的參照，在處理內容時必須理解這些規則。通常這是對 IG 所定義之特殊規則及其他 profiles 的參照。

宣告這套規則限制了內容只能被有限的交易夥伴所理解。這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，還沒有準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應該避免使用這個資料項目。通常在使用時，此 URL 是對 IG 的參照，此 IG 將這些特殊規則與其他 profiles、value sets 等一起定義為其敘述的一部分。

編寫此 resource 的語言

提供語言是為了支援索引和可存取性(通常，文字表述轉語音等服務使用此語言標籤)。html lanuage tag 適用於此敘述。resource 上的語言標籤可用於指定從 resource 中的資料所產成的其他表述之語言。不是所有的內容都必須使用此語言。不應該假定 Resource.language 自動適用於敘述。如果指定語言，它也應該被指定在 html 中的 div 資料項目(關於 xml:lang 和 html lang 屬性之間的關係，見 HTML5 中的規則)。

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。

人可讀的敘述，包含 resource 的摘要，可用於向人表述 resource 的內容。敘述不需要對所有的結構化資料進行編碼，但需要包含足夠的細節使人在閱讀敘述時理解「臨床安全性」。resource 定義有哪些內容應該在敘述中表示，以確保臨床安全。

內嵌(contained)的 resource 沒有敘述，非內嵌(contained)的 resource 則 建議應該(SHOULD) 有敘述。有時 resource 可能只有文字表述，很少或沒有額外的結構化資料(只要滿足所有 minOccurs=1 的資料項目)。這可能出現在舊系統的資料，當資訊以 「文字表述區塊(text blob)」的形式被取得，或者文字表述是原始輸入或說明，而編碼資訊稍後再添加。

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

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.

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.

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

敘述狀態的受限值集。

The actual narrative content, a stripped down version of XHTML.

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

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.

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.

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).

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.

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.

Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.

The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

識別此照護計畫所建立的父計畫。

參照可以是相對的、絕對的或內部的。

Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon.

識別被此照護計畫所取代的照護計畫。

參照可以是相對的、絕對的或內部的。

Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans.

此照護計畫是另一個照護計畫的一部分。例如，專門針對骨折修復或糖尿病控制的計畫可能是出院護理計畫的一部分。

參照可以是相對的、絕對的或內部的。

此欄位表示該照護計畫是否處於啟用、草稿、完成等狀態；必填。

可以在 [[event.html#statemachine | 事件模式]] 文件中找到一個標準的狀態轉換圖。「未知」不代表「其他」狀態 - 必須使用其中一個已定義的狀態，「未知」用於表示不確定當前狀態。

指出計畫是否正在實施、代表未來意圖或是現在的歷史記錄。

指出計畫是否正在實施、代表未來意圖或是現在的歷史記錄。

標示這個照護計劃現在是提案、正式計畫、指令還是僅供參考的選項。

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

表示與照護計畫相關的權威性/意向性程度的代碼

Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

計畫的類型，例如：營養及飲食指導、惡化徵兆偵測及必要處理等。

There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

識別這是什麼「種類」的計畫，以支援多個共存計畫之間的區分；例如：「居家健康」、「精神科」、「氣喘」、「疾病管理」、「保健計畫」等。

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

Used for filtering what plan(s) are retrieved and displayed to different types of users.

Human-friendly name for the care plan.

本欄位用於簡要描述照護計畫的性質與目標，提供整體計畫的概要說明。

Provides more detail than conveyed by category.

指向台灣機器手訓練 Patient 資源，用於標記本照護計畫所屬的病患或病患群體。

識別計畫描述其意圖照護的病人或群體。

此照護計畫是在哪個就醫情境產生的。

參照可以是相對的、絕對的或內部的。注意：如果 Encounter 參照是一個 Episode of Care 的一部分，則此資料點不足以隱含建立關聯。

Indicates when the plan did (or is intended to) come into effect and end.

Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).

Allows tracking what plan(s) are in effect at a particular time.

Represents when this particular CarePlan record was created in the system, which is often a system-generated date.

負責建立照護計畫內容的個人或組織。

參照可以是相對的、絕對的或內部的。

對照護計畫的建立提供資訊的個人或組織，但不對照護計畫負責。

參照可以是相對的、絕對的或內部的。

確定負責執行此照護計畫的照護團隊。

參照可以是相對的、絕對的或內部的。

Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions.

本照護計畫試圖解決的健康問題(例如：疾病、病情、問題)。

參照可以是相對的、絕對的或內部的。

Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns.

Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc.

Use "concern" to identify specific conditions addressed by the care plan.

Identifies barriers and other considerations associated with the care plan.

Describes the intended objective(s) of carrying out the care plan.

Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

Provides context for plan. Allows plan effectiveness to be evaluated by clinicians.

Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

Allows systems to prompt for performance of planned activities, and validate plans against best practice.

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

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.

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.

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).

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.

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.

Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

Note that this should not duplicate the activity status (e.g. completed or in progress).

Identifies the results of the activity.

Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

Links plan to resulting actions.

Notes about the adherence/status/progress of the activity.

This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

Can be used to capture information about adherence, progress, concerns, etc.

包含照護計畫之照護行動(診斷、治療等)明細的 request/request-like 資源。

參照可以是相對的、絕對的或內部的。

Details in a form consistent with other applications and contexts of use.

A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

Details in a simple form for generic care plan systems.

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

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.

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.

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).

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.

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.

A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.

Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.

May determine what types of extensions are permitted.

The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter.

Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.

Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

Allows matching performed to planned as well as validation against protocols.

Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.

This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead.

Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.

指出為何此行動是此照護計畫的一部分。

Conditions can be identified at the activity level that are not identified as reasons for the overall plan.

Internal reference that identifies the goals that this activity is intended to contribute towards meeting.

So that participants know the link explicitly.

Identifies what progress is being made for the specific activity.

Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
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 activity.

Codes that reflect the current state of a care plan activity within its overall life cycle.

Indicates progress against the plan, whether the activity is still relevant for the plan.

Provides reason why the activity isn't yet started, is on hold, was cancelled, etc.

Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.

If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan.

This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

Captures intention to not do something that may have been previously typical.

The period, timing or frequency upon which the described activity is to occur.

Allows prompting for activities and detection of missed planned activities.

預期要執行此行動的地點。

參照可以是相對的、絕對的或內部的。

Helps in planning of activity.

確定預期要執行此行動的特定人員或組織。

參照可以是相對的、絕對的或內部的。

Helps in planning of activity.

Identifies the food, drug or other product to be consumed or supplied in the activity.

A product supplied or administered as part of a care plan activity.

辨識行動所涉及的物料/主題/產品。

參照可以是相對的、絕對的或內部的。

Identifies the quantity expected to be consumed in a given day.

Allows rough dose checking.

Identifies the quantity expected to be supplied, administered or consumed by the subject.

This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc.

General notes about the care plan not covered elsewhere.

Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements.