臺灣長期照顧實作指引(TW LTC IG)
1.0.0 - STU 1.0.0

臺灣長期照顧實作指引(TW LTC IG), published by 經濟部產業發展署. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Lorex/TWLongTermCare_IG_Build/ and changes regularly. See the Directory of published versions

: 轉介單居家服務計畫範例 - JSON Representation

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{
  "resourceType" : "CarePlan",
  "id" : "ltc-careplan-referral-home-service-example",
  "meta" : {
    "profile" : [
      🔗 "http://ltc-ig.fhir.tw/StructureDefinition/LTCCarePlanReferral"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CarePlan ltc-careplan-referral-home-service-example</b></p><a name=\"ltc-careplan-referral-home-service-example\"> </a><a name=\"hcltc-careplan-referral-home-service-example\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-LTCCarePlanReferral.html\">轉介單－服務種類</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Proposal</p><p><b>category</b>: <span title=\"Codes:{https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/careplan-category-tw assess-plan}\">Assessment and Plan of Treatment</span></p><p><b>subject</b>: <a href=\"Patient-ltc-patient-referral-chen-ming-hui-example.html\">陳明慧 Female, DoB: 1945-03-15 ( National Person Identifier (TWN):\u00a0A123456789\u00a0(use:\u00a0official,\u00a0))</a></p><p><b>period</b>: 2024-02-01 --&gt; 2024-08-01</p><p><b>author</b>: <a href=\"PractitionerRole-ltc-practitioner-role-nurse-example.html\">PractitionerRole Registered nurse</a></p><p><b>goal</b>: <a href=\"Goal-ltc-goal-mobility-improvement-example.html\">Goal: lifecycleStatus = active; description = Advancing mobility; start[x] = 2024-01-15; note = 住民目前需要部分協助才能行走，期望透過復健訓練達到獨立行走的目標</a></p><blockquote><p><b>activity</b></p><h3>Details</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Status</b></td><td><b>Performer</b></td><td><b>Description</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/ReferralCarePlanCS-TWLTC home-care}\">居家護理</span></td><td>Not Started</td><td><a href=\"Organization-ltc-organization-example.html\">Organization 新北市私立安康老人長期照顧中心（養護型）</a></td><td>提供居家護理服務，如換藥、傷口照護、健康評估等</td></tr></table></blockquote><blockquote><p><b>activity</b></p><h3>Details</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Status</b></td><td><b>Performer</b></td><td><b>Description</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/ReferralCarePlanCS-TWLTC home-swallowing}\">居家吞嚥</span></td><td>Not Started</td><td><a href=\"Organization-ltc-organization-example.html\">Organization 新北市私立安康老人長期照顧中心（養護型）</a></td><td>提供居家吞嚥訓練與相關照護服務</td></tr></table></blockquote><p><b>note</b>: @2024-01-20</p><blockquote><div><p>個案需要居家照顧及復健服務，由照管中心評估後安排服務提供單位</p>\n</div></blockquote></div>"
  },
  "status" : "active",
  "intent" : "proposal",
  "category" : [
    {
      "coding" : [
        {
          "system" : "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/careplan-category-tw",
          "code" : "assess-plan"
        }
      ]
    }
  ],
  "subject" : {
    🔗 "reference" : "Patient/ltc-patient-referral-chen-ming-hui-example"
  },
  "period" : {
    "start" : "2024-02-01",
    "end" : "2024-08-01"
  },
  "author" : {
    🔗 "reference" : "PractitionerRole/ltc-practitioner-role-nurse-example"
  },
  "goal" : [
    {
      🔗 "reference" : "Goal/ltc-goal-mobility-improvement-example"
    }
  ],
  "activity" : [
    {
      "detail" : {
        "code" : {
          "coding" : [
            {
              "system" : "http://ltc-ig.fhir.tw/CodeSystem/ReferralCarePlanCS-TWLTC",
              "code" : "home-care",
              "display" : "居家護理"
            }
          ]
        },
        "status" : "not-started",
        "performer" : [
          {
            🔗 "reference" : "Organization/ltc-organization-example"
          }
        ],
        "description" : "提供居家護理服務，如換藥、傷口照護、健康評估等"
      }
    },
    {
      "detail" : {
        "code" : {
          "coding" : [
            {
              "system" : "http://ltc-ig.fhir.tw/CodeSystem/ReferralCarePlanCS-TWLTC",
              "code" : "home-swallowing",
              "display" : "居家吞嚥"
            }
          ]
        },
        "status" : "not-started",
        "performer" : [
          {
            🔗 "reference" : "Organization/ltc-organization-example"
          }
        ],
        "description" : "提供居家吞嚥訓練與相關照護服務"
      }
    }
  ],
  "note" : [
    {
      "time" : "2024-01-20",
      "text" : "個案需要居家照顧及復健服務，由照管中心評估後安排服務提供單位"
    }
  ]
}