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

Resource Profile: 長照 SDK-照顧計畫(CS100)

Official URL: http://ltc-ig.fhir.tw/StructureDefinition/LTC-CarePlan-CS100 Version: 1.0.0
Draft as of 2026-03-01 Computable Name: LTCCarePlanCS100

此 Profile 說明本 IG 如何進一步定義 FHIR 的 CarePlan Resource,以呈現 CS100 個案總查詢之照顧計畫資料,規則同 LTCCarePlanPayload。

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* LTCCarePlanPayload Healthcare plan for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 0..1 Narrative CarePlan Resource之內容摘要以供人閱讀
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... status S 1..1 code generated | additional
Binding: 臺灣衛福部資訊處Narrative狀態值集 (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Required Pattern: plan
... Slices for category SΣ 1..* CodeableConcept Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... category:AssessPlan SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

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: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/careplan-category-tw
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
...... 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
... subject SΣ 1..1 Reference(長期照顧-住民基本資料) Who the care plan is for
... period SΣ 0..1 Period Time period plan covers
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
... careTeam 0..* Reference(長期照顧-照顧團隊) Who's involved in plan?
... supportingInfo 0..* Reference(CoverageEligibilityResponse) Information considered as part of plan
... activity SC 1..* BackboneElement Action to occur as part of plan
Constraints: cpl-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... detail SC 1..1 BackboneElement In-line definition of activity
..... Slices for extension Content/Rules for all slices
...... extension:unitPrice 0..1 Money 單價
URL: http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-UnitPrice
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 1..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
..... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
..... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
..... Slices for scheduled[x] 0..1 Timing When activity is to occur
Slice: Unordered, Closed by type:$this
...... scheduled[x]:scheduledTiming 0..1 Timing When activity is to occur
..... performer 0..* Reference(長期照顧-服務人員角色 | 長期照顧-照顧服務提供者 | 長期照顧-機構) Who will be responsible?
..... Slices for product[x] 0..1 What is to be administered/supplied
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
...... productCodeableConcept CodeableConcept
...... productReference Reference(Medication | Substance)
...... product[x]:productReference 0..1 Reference(TW Core Medication | Substance) What is to be administered/supplied

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.text.status Base required 臺灣衛福部資訊處Narrative狀態值集 📦0.3.0 臺灣核心實作指引 v0.3
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.category:AssessPlan Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

This structure is derived from LTCCarePlanPayload

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* LTCCarePlanPayload Healthcare plan for patient or group
... period
.... start S 1..1 dateTime Starting time with inclusive boundary
... careTeam 0..* Reference(長期照顧-照顧團隊) Who's involved in plan?
... supportingInfo 0..* Reference(CoverageEligibilityResponse) Information considered as part of plan
.... detail
..... scheduled[x] 0..1 Timing When activity is to occur
..... performer 0..* Reference(長期照顧-服務人員角色 | 長期照顧-照顧服務提供者 | 長期照顧-機構) Who will be responsible?

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* LTCCarePlanPayload Healthcare plan for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text S 0..1 Narrative CarePlan Resource之內容摘要以供人閱讀
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code generated | additional
Binding: 臺灣衛福部資訊處Narrative狀態值集 (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(TW Core CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(TW Core CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(TW Core CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Required Pattern: plan
... Slices for category SΣ 1..* CodeableConcept Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... category:AssessPlan SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

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: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/careplan-category-tw
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
...... 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
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(長期照顧-住民基本資料) Who the care plan is for
... encounter Σ 0..1 Reference(TW Core Encounter) Encounter created as part of
... period SΣ 0..1 Period Time period plan covers
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
.... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... created Σ 0..1 dateTime Date record was first recorded
... author Σ 0..1 Reference(TW Core Patient | TW Core Practitioner | TW Core PractitionerRole | TW Core Implantable Device | TW Core RelatedPerson | TW Core Organization | TW Core CareTeam) Who is the designated responsible party
... contributor 0..* Reference(TW Core Patient | TW Core Practitioner | TW Core PractitionerRole | TW Core Implantable Device | TW Core RelatedPerson | TW Core Organization | TW Core CareTeam) Who provided the content of the care plan
... careTeam 0..* Reference(長期照顧-照顧團隊) Who's involved in plan?
... addresses Σ 0..* Reference(TW Core Condition) Health issues this plan addresses
... supportingInfo 0..* Reference(CoverageEligibilityResponse) Information considered as part of plan
... goal 0..* Reference(Goal) Desired outcome of plan
... activity SC 1..* BackboneElement Action to occur as part of plan
Constraints: cpl-3
.... 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
.... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
.... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
.... progress 0..* Annotation Comments about the activity status/progress
.... reference C 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | TW Core MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup) Activity details defined in specific resource
.... detail SC 1..1 BackboneElement In-line definition of activity
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:unitPrice 0..1 Money 單價
URL: http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-UnitPrice
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... kind 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
..... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
..... instantiatesUri 0..* uri Instantiates external protocol or definition
..... code S 1..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
..... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): 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.
..... reasonReference 0..* Reference(TW Core Condition | TW Core Observation Clinical Result | TW Core DiagnosticReport | TW Core DocumentReference) Why activity is needed
..... goal 0..* Reference(Goal) Goals this activity relates to
..... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
..... statusReason 0..1 CodeableConcept Reason for current status
..... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
..... Slices for scheduled[x] 0..1 Timing When activity is to occur
Slice: Unordered, Closed by type:$this
...... scheduled[x]:scheduledTiming 0..1 Timing When activity is to occur
..... location 0..1 Reference(TW Core Location) Where it should happen
..... performer 0..* Reference(長期照顧-服務人員角色 | 長期照顧-照顧服務提供者 | 長期照顧-機構) Who will be responsible?
..... Slices for product[x] 0..1 What is to be administered/supplied
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
...... productCodeableConcept CodeableConcept
...... productReference Reference(Medication | Substance)
...... product[x]:productReference 0..1 Reference(TW Core Medication | Substance) What is to be administered/supplied
..... dailyAmount 0..1 SimpleQuantity How to consume/day?
..... quantity 0..1 SimpleQuantity How much to administer/supply/consume
..... description 0..1 string Extra info describing activity to perform
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.language Base preferred Common Languages 📦4.0.1 FHIR Std.
CarePlan.text.status Base required 臺灣衛福部資訊處Narrative狀態值集 📦0.3.0 臺灣核心實作指引 v0.3
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.category:AssessPlan Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.activity.outcomeCodeableConcept Base example Care Plan Activity Outcome 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​reasonCode Base example SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* LTCCarePlanPayload Healthcare plan for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 0..1 Narrative CarePlan Resource之內容摘要以供人閱讀
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... status S 1..1 code generated | additional
Binding: 臺灣衛福部資訊處Narrative狀態值集 (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Required Pattern: plan
... Slices for category SΣ 1..* CodeableConcept Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... category:AssessPlan SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

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: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/careplan-category-tw
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
...... 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
... subject SΣ 1..1 Reference(長期照顧-住民基本資料) Who the care plan is for
... period SΣ 0..1 Period Time period plan covers
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
... careTeam 0..* Reference(長期照顧-照顧團隊) Who's involved in plan?
... supportingInfo 0..* Reference(CoverageEligibilityResponse) Information considered as part of plan
... activity SC 1..* BackboneElement Action to occur as part of plan
Constraints: cpl-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... detail SC 1..1 BackboneElement In-line definition of activity
..... Slices for extension Content/Rules for all slices
...... extension:unitPrice 0..1 Money 單價
URL: http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-UnitPrice
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 1..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
..... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
..... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
..... Slices for scheduled[x] 0..1 Timing When activity is to occur
Slice: Unordered, Closed by type:$this
...... scheduled[x]:scheduledTiming 0..1 Timing When activity is to occur
..... performer 0..* Reference(長期照顧-服務人員角色 | 長期照顧-照顧服務提供者 | 長期照顧-機構) Who will be responsible?
..... Slices for product[x] 0..1 What is to be administered/supplied
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
...... productCodeableConcept CodeableConcept
...... productReference Reference(Medication | Substance)
...... product[x]:productReference 0..1 Reference(TW Core Medication | Substance) What is to be administered/supplied

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.text.status Base required 臺灣衛福部資訊處Narrative狀態值集 📦0.3.0 臺灣核心實作指引 v0.3
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.category:AssessPlan Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

Differential View

This structure is derived from LTCCarePlanPayload

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* LTCCarePlanPayload Healthcare plan for patient or group
... period
.... start S 1..1 dateTime Starting time with inclusive boundary
... careTeam 0..* Reference(長期照顧-照顧團隊) Who's involved in plan?
... supportingInfo 0..* Reference(CoverageEligibilityResponse) Information considered as part of plan
.... detail
..... scheduled[x] 0..1 Timing When activity is to occur
..... performer 0..* Reference(長期照顧-服務人員角色 | 長期照顧-照顧服務提供者 | 長期照顧-機構) Who will be responsible?

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* LTCCarePlanPayload Healthcare plan for patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text S 0..1 Narrative CarePlan Resource之內容摘要以供人閱讀
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code generated | additional
Binding: 臺灣衛福部資訊處Narrative狀態值集 (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(TW Core CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(TW Core CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(TW Core CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Required Pattern: plan
... Slices for category SΣ 1..* CodeableConcept Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... category:AssessPlan SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

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: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/careplan-category-tw
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
...... 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
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(長期照顧-住民基本資料) Who the care plan is for
... encounter Σ 0..1 Reference(TW Core Encounter) Encounter created as part of
... period SΣ 0..1 Period Time period plan covers
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC 1..1 dateTime Starting time with inclusive boundary
.... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... created Σ 0..1 dateTime Date record was first recorded
... author Σ 0..1 Reference(TW Core Patient | TW Core Practitioner | TW Core PractitionerRole | TW Core Implantable Device | TW Core RelatedPerson | TW Core Organization | TW Core CareTeam) Who is the designated responsible party
... contributor 0..* Reference(TW Core Patient | TW Core Practitioner | TW Core PractitionerRole | TW Core Implantable Device | TW Core RelatedPerson | TW Core Organization | TW Core CareTeam) Who provided the content of the care plan
... careTeam 0..* Reference(長期照顧-照顧團隊) Who's involved in plan?
... addresses Σ 0..* Reference(TW Core Condition) Health issues this plan addresses
... supportingInfo 0..* Reference(CoverageEligibilityResponse) Information considered as part of plan
... goal 0..* Reference(Goal) Desired outcome of plan
... activity SC 1..* BackboneElement Action to occur as part of plan
Constraints: cpl-3
.... 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
.... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
.... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
.... progress 0..* Annotation Comments about the activity status/progress
.... reference C 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | TW Core MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup) Activity details defined in specific resource
.... detail SC 1..1 BackboneElement In-line definition of activity
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:unitPrice 0..1 Money 單價
URL: http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-UnitPrice
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... kind 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
..... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
..... instantiatesUri 0..* uri Instantiates external protocol or definition
..... code S 1..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
..... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): 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.
..... reasonReference 0..* Reference(TW Core Condition | TW Core Observation Clinical Result | TW Core DiagnosticReport | TW Core DocumentReference) Why activity is needed
..... goal 0..* Reference(Goal) Goals this activity relates to
..... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
..... statusReason 0..1 CodeableConcept Reason for current status
..... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
..... Slices for scheduled[x] 0..1 Timing When activity is to occur
Slice: Unordered, Closed by type:$this
...... scheduled[x]:scheduledTiming 0..1 Timing When activity is to occur
..... location 0..1 Reference(TW Core Location) Where it should happen
..... performer 0..* Reference(長期照顧-服務人員角色 | 長期照顧-照顧服務提供者 | 長期照顧-機構) Who will be responsible?
..... Slices for product[x] 0..1 What is to be administered/supplied
Slice: Unordered, Open by type:$this
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
...... productCodeableConcept CodeableConcept
...... productReference Reference(Medication | Substance)
...... product[x]:productReference 0..1 Reference(TW Core Medication | Substance) What is to be administered/supplied
..... dailyAmount 0..1 SimpleQuantity How to consume/day?
..... quantity 0..1 SimpleQuantity How much to administer/supply/consume
..... description 0..1 string Extra info describing activity to perform
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.language Base preferred Common Languages 📦4.0.1 FHIR Std.
CarePlan.text.status Base required 臺灣衛福部資訊處Narrative狀態值集 📦0.3.0 臺灣核心實作指引 v0.3
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.category:AssessPlan Base example Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.activity.outcomeCodeableConcept Base example Care Plan Activity Outcome 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​reasonCode Base example SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

 

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