臺灣榮總腦中風實作指引（TW VGH Stroke IG）
1.0.0 - release

臺灣榮總腦中風實作指引（TW VGH Stroke IG）, published by 高雄榮民總醫院 (VGHKS). 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/SitatechCo/TWVGHStroke_IG_Build/ and changes regularly. See the Directory of published versions

Resource Profile: 腦中風－mRS 評估

Official URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/StrokeMRS Version: 1.0.0
Draft as of 2026-10-20 Computable Name: StrokeMRS

此 Profile 說明本 IG 如何進一步定義 FHIR 的 Observation Resource，以呈現修正版 Rankin 量表（mRS）的評估結果。

每次 mRS 評估建立一筆 Observation，每一筆評估原樣保留，同一次原始評估只建一筆。EVT 登錄的中風前、離院與 3 個月追蹤 mRS 分開建立，以 assessmentPhase 標示；個管系統的評估不區分次數或時點，不填 assessmentPhase，以評估日期（effectiveDateTime）與就醫事件（encounter）的入院、離院日期辨識。

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: doco
Observation C 0..* TWCoreObservationScreeningAssessment 健康狀態篩檢與評估
Constraints: obs-6, obs-7, tw-core-4, stroke-mrs-pre-stroke-range
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for extension.extension:assessmentPhase This element must be supported. 0..1 code 評估時點。[EVT 登錄填 pre-stroke／discharge／3-month；個管系統不填]
URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase
Binding: 腦中風－評估時點值集 (required)
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code 結果狀態。[填 final／amended／unknown 等]
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.Slices for category This element must be supported. 1..* CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 評估類別。[須包含 survey]
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for category.category:survey This element must be supported. 1..1 CodeableConcept 調查篩檢
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "survey"
    }
  ]
}
Observation.Slices for category.category:twcore This element must be supported. 0..* CodeableConcept Classification of type of observation
Binding: 臺灣衛福部資訊處Observation Screening Assessment類型值集 (required)
Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well mRS 分數。[固定為 LOINC 75859-9]
Binding: LOINC篩檢與評估值集 (preferred)
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "75859-9"
    }
  ]
}
Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(腦中風－病人基本資料) 病人。[應參照 StrokePatient]
Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(腦中風－就醫事件) 就醫事件。[應參照 StrokeEncounter]
Observation.effective[x] This element must be supported. This element is included in summaries. C 0..1 dateTime This type must be supported. 評估日期。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區]
Constraints: tw-core-3
Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam | TW Core RelatedPerson) 執行者
Observation.value[x] This element must be supported. This element is included in summaries. C 0..1 integer mRS 分數。[0–6 的整數；中風前為 0–5]
Constraints: tw-core-5
Min Value: 0
Max Value: 6
Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 缺值原因。[分數無法使用時填]
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse | MolecularSequence) 關聯成員
Observation.derivedFrom This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse This type must be supported. | TW Core DocumentReference | ImagingStudy | Media | MolecularSequence) 來源參照

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:survey Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:twcore Base required 臺灣衛福部資訊處Observation Screening Assessment類型值集 📦0.3.0 臺灣核心實作指引 v1.0
Observation.code Base preferred LOINC篩檢與評估值集 📦2.81 臺灣核心實作指引 v1.0
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
stroke-mrs-pre-stroke-range error Observation 中風前（pre-stroke）mRS 分數須介於 0 至 5。 extension.where(url = 'http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase').value.ofType(code).where($this = 'pre-stroke').exists() implies value.ofType(integer).all($this <= 5)
tw-core-3 error Observation.effective[x] Datetime must be at least to day. $this is dateTime implies $this.toString().length() >= 10
tw-core-4 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
tw-core-5 error Observation.value[x] SHALL use UCUM for coded quantity units. ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'

This structure is derived from TWCoreObservationScreeningAssessment

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* TWCoreObservationScreeningAssessment 健康狀態篩檢與評估
Constraints: stroke-mrs-pre-stroke-range
Observation.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for extension.extension:assessmentPhase This element must be supported. 0..1 code 評估時點。[EVT 登錄填 pre-stroke／discharge／3-month；個管系統不填]
URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase
Binding: 腦中風－評估時點值集 (required)
Observation.status 1..1 code 結果狀態。[填 final／amended／unknown 等]
Observation.category 1..* CodeableConceptTW 評估類別。[須包含 survey]
Observation.subject 1..1 Reference(腦中風－病人基本資料) 病人。[應參照 StrokePatient]
Observation.encounter This element must be supported. 0..1 Reference(腦中風－就醫事件) 就醫事件。[應參照 StrokeEncounter]
Observation.effective[x] 0..1 dateTime 評估日期。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區]
Observation.value[x] 0..1 integer mRS 分數。[0–6 的整數；中風前為 0–5]
Min Value: 0
Max Value: 6
Observation.dataAbsentReason 0..1 CodeableConceptTW 缺值原因。[分數無法使用時填]

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
stroke-mrs-pre-stroke-range error Observation 中風前（pre-stroke）mRS 分數須介於 0 至 5。 extension.where(url = 'http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase').value.ofType(code).where($this = 'pre-stroke').exists() implies value.ofType(integer).all($this <= 5)
NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* TWCoreObservationScreeningAssessment 健康狀態篩檢與評估
Constraints: obs-6, obs-7, tw-core-4, stroke-mrs-pre-stroke-range
Observation.id This element is included in summaries. 0..1 id Logical id of this artifact
Observation.meta This element is included in summaries. 0..1 Meta Metadata about the resource
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
Observation.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Observation.contained 0..* Resource Contained, inline Resources
Observation.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for extension.extension:assessmentPhase This element must be supported. 0..1 code 評估時點。[EVT 登錄填 pre-stroke／discharge／3-month；個管系統不填]
URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase
Binding: 腦中風－評估時點值集 (required)
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.identifier This element is included in summaries. 0..* Identifier Business Identifier for observation
Observation.basedOn This element is included in summaries. 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Observation.partOf This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code 結果狀態。[填 final／amended／unknown 等]
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.Slices for category This element must be supported. 1..* CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 評估類別。[須包含 survey]
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for category.category:survey This element must be supported. 1..1 CodeableConcept 調查篩檢
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "survey"
    }
  ]
}
Observation.Slices for category.category:twcore This element must be supported. 0..* CodeableConcept Classification of type of observation
Binding: 臺灣衛福部資訊處Observation Screening Assessment類型值集 (required)
Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well mRS 分數。[固定為 LOINC 75859-9]
Binding: LOINC篩檢與評估值集 (preferred)
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "75859-9"
    }
  ]
}
Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(腦中風－病人基本資料) 病人。[應參照 StrokePatient]
Observation.focus This element is included in summaries. 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(腦中風－就醫事件) 就醫事件。[應參照 StrokeEncounter]
Observation.effective[x] This element must be supported. This element is included in summaries. C 0..1 dateTime This type must be supported. 評估日期。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區]
Constraints: tw-core-3
Observation.issued This element is included in summaries. 0..1 instant Date/Time this version was made available
Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam | TW Core RelatedPerson) 執行者
Observation.value[x] This element must be supported. This element is included in summaries. C 0..1 integer mRS 分數。[0–6 的整數；中風前為 0–5]
Constraints: tw-core-5
Min Value: 0
Max Value: 6
Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 缺值原因。[分數無法使用時填]
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.note 0..* Annotation Comments about the observation
Observation.bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen 0..1 Reference(Specimen) Specimen used for this observation
Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
Observation.referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
Observation.referenceRange.id 0..1 string Unique id for inter-element referencing
Observation.referenceRange.extension 0..* Extension Additional content defined by implementations
Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.referenceRange.low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
Constraints: sqty-1
Observation.referenceRange.high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
Constraints: sqty-1
Observation.referenceRange.type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age 0..1 Range Applicable age range, if relevant
Observation.referenceRange.text 0..1 string Text based reference range in an observation
Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse | MolecularSequence) 關聯成員
Observation.derivedFrom This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse This type must be supported. | TW Core DocumentReference | ImagingStudy | Media | MolecularSequence) 來源參照
Observation.component This element is included in summaries. 0..* BackboneElement Component results
Observation.component.id 0..1 string Unique id for inter-element referencing
Observation.component.extension 0..* Extension Additional content defined by implementations
Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.component.code This element is included in summaries. 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x] This element is included in summaries. 0..1 Actual component result
Observation.component.value[x].valueQuantity Quantity
Observation.component.value[x].valueCodeableConcept CodeableConcept
Observation.component.value[x].valueString string
Observation.component.value[x].valueBoolean boolean
Observation.component.value[x].valueInteger integer
Observation.component.value[x].valueRange Range
Observation.component.value[x].valueRatio Ratio
Observation.component.value[x].valueSampledData SampledData
Observation.component.value[x].valueTime time
Observation.component.value[x].valueDateTime dateTime
Observation.component.value[x].valuePeriod Period
Observation.component.dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.component.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.component.referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:survey Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:twcore Base required 臺灣衛福部資訊處Observation Screening Assessment類型值集 📦0.3.0 臺灣核心實作指引 v1.0
Observation.code Base preferred LOINC篩檢與評估值集 📦2.81 臺灣核心實作指引 v1.0
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()
stroke-mrs-pre-stroke-range error Observation 中風前（pre-stroke）mRS 分數須介於 0 至 5。 extension.where(url = 'http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase').value.ofType(code).where($this = 'pre-stroke').exists() implies value.ofType(integer).all($this <= 5)
tw-core-3 error Observation.effective[x] Datetime must be at least to day. $this is dateTime implies $this.toString().length() >= 10
tw-core-4 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
tw-core-5 error Observation.value[x] SHALL use UCUM for coded quantity units. ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* TWCoreObservationScreeningAssessment 健康狀態篩檢與評估
Constraints: obs-6, obs-7, tw-core-4, stroke-mrs-pre-stroke-range
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for extension.extension:assessmentPhase This element must be supported. 0..1 code 評估時點。[EVT 登錄填 pre-stroke／discharge／3-month；個管系統不填]
URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase
Binding: 腦中風－評估時點值集 (required)
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code 結果狀態。[填 final／amended／unknown 等]
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.Slices for category This element must be supported. 1..* CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 評估類別。[須包含 survey]
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for category.category:survey This element must be supported. 1..1 CodeableConcept 調查篩檢
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "survey"
    }
  ]
}
Observation.Slices for category.category:twcore This element must be supported. 0..* CodeableConcept Classification of type of observation
Binding: 臺灣衛福部資訊處Observation Screening Assessment類型值集 (required)
Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well mRS 分數。[固定為 LOINC 75859-9]
Binding: LOINC篩檢與評估值集 (preferred)
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "75859-9"
    }
  ]
}
Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(腦中風－病人基本資料) 病人。[應參照 StrokePatient]
Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(腦中風－就醫事件) 就醫事件。[應參照 StrokeEncounter]
Observation.effective[x] This element must be supported. This element is included in summaries. C 0..1 dateTime This type must be supported. 評估日期。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區]
Constraints: tw-core-3
Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam | TW Core RelatedPerson) 執行者
Observation.value[x] This element must be supported. This element is included in summaries. C 0..1 integer mRS 分數。[0–6 的整數；中風前為 0–5]
Constraints: tw-core-5
Min Value: 0
Max Value: 6
Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 缺值原因。[分數無法使用時填]
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse | MolecularSequence) 關聯成員
Observation.derivedFrom This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse This type must be supported. | TW Core DocumentReference | ImagingStudy | Media | MolecularSequence) 來源參照

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:survey Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:twcore Base required 臺灣衛福部資訊處Observation Screening Assessment類型值集 📦0.3.0 臺灣核心實作指引 v1.0
Observation.code Base preferred LOINC篩檢與評估值集 📦2.81 臺灣核心實作指引 v1.0
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
stroke-mrs-pre-stroke-range error Observation 中風前（pre-stroke）mRS 分數須介於 0 至 5。 extension.where(url = 'http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase').value.ofType(code).where($this = 'pre-stroke').exists() implies value.ofType(integer).all($this <= 5)
tw-core-3 error Observation.effective[x] Datetime must be at least to day. $this is dateTime implies $this.toString().length() >= 10
tw-core-4 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
tw-core-5 error Observation.value[x] SHALL use UCUM for coded quantity units. ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'

Differential View

This structure is derived from TWCoreObservationScreeningAssessment

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* TWCoreObservationScreeningAssessment 健康狀態篩檢與評估
Constraints: stroke-mrs-pre-stroke-range
Observation.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for extension.extension:assessmentPhase This element must be supported. 0..1 code 評估時點。[EVT 登錄填 pre-stroke／discharge／3-month；個管系統不填]
URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase
Binding: 腦中風－評估時點值集 (required)
Observation.status 1..1 code 結果狀態。[填 final／amended／unknown 等]
Observation.category 1..* CodeableConceptTW 評估類別。[須包含 survey]
Observation.code 1..1 CodeableConceptTW mRS 分數。[固定為 LOINC 75859-9]
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "75859-9"
    }
  ]
}
Observation.subject 1..1 Reference(腦中風－病人基本資料) 病人。[應參照 StrokePatient]
Observation.encounter This element must be supported. 0..1 Reference(腦中風－就醫事件) 就醫事件。[應參照 StrokeEncounter]
Observation.effective[x] 0..1 dateTime 評估日期。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區]
Observation.value[x] 0..1 integer mRS 分數。[0–6 的整數；中風前為 0–5]
Min Value: 0
Max Value: 6
Observation.dataAbsentReason 0..1 CodeableConceptTW 缺值原因。[分數無法使用時填]

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
stroke-mrs-pre-stroke-range error Observation 中風前（pre-stroke）mRS 分數須介於 0 至 5。 extension.where(url = 'http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase').value.ofType(code).where($this = 'pre-stroke').exists() implies value.ofType(integer).all($this <= 5)

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* TWCoreObservationScreeningAssessment 健康狀態篩檢與評估
Constraints: obs-6, obs-7, tw-core-4, stroke-mrs-pre-stroke-range
Observation.id This element is included in summaries. 0..1 id Logical id of this artifact
Observation.meta This element is included in summaries. 0..1 Meta Metadata about the resource
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
Observation.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Observation.contained 0..* Resource Contained, inline Resources
Observation.Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for extension.extension:assessmentPhase This element must be supported. 0..1 code 評估時點。[EVT 登錄填 pre-stroke／discharge／3-month；個管系統不填]
URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase
Binding: 腦中風－評估時點值集 (required)
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.identifier This element is included in summaries. 0..* Identifier Business Identifier for observation
Observation.basedOn This element is included in summaries. 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Observation.partOf This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
Observation.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1 code 結果狀態。[填 final／amended／unknown 等]
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.Slices for category This element must be supported. 1..* CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 評估類別。[須包含 survey]
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Observation.Slices for category.category:survey This element must be supported. 1..1 CodeableConcept 調查篩檢
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "survey"
    }
  ]
}
Observation.Slices for category.category:twcore This element must be supported. 0..* CodeableConcept Classification of type of observation
Binding: 臺灣衛福部資訊處Observation Screening Assessment類型值集 (required)
Observation.code This element must be supported. This element is included in summaries. 1..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well mRS 分數。[固定為 LOINC 75859-9]
Binding: LOINC篩檢與評估值集 (preferred)
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "75859-9"
    }
  ]
}
Observation.subject This element must be supported. This element is included in summaries. 1..1 Reference(腦中風－病人基本資料) 病人。[應參照 StrokePatient]
Observation.focus This element is included in summaries. 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Observation.encounter This element must be supported. This element is included in summaries. 0..1 Reference(腦中風－就醫事件) 就醫事件。[應參照 StrokeEncounter]
Observation.effective[x] This element must be supported. This element is included in summaries. C 0..1 dateTime This type must be supported. 評估日期。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區]
Constraints: tw-core-3
Observation.issued This element is included in summaries. 0..1 instant Date/Time this version was made available
Observation.performer This element must be supported. This element is included in summaries. 0..* Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam | TW Core RelatedPerson) 執行者
Observation.value[x] This element must be supported. This element is included in summaries. C 0..1 integer mRS 分數。[0–6 的整數；中風前為 0–5]
Constraints: tw-core-5
Min Value: 0
Max Value: 6
Observation.dataAbsentReason This element must be supported. C 0..1 CodeableConceptTW The snapshot does not say whether the constraints on the root of this type profile have been applied to this element, so assume they have not. Check the type profile directly as well 缺值原因。[分數無法使用時填]
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.note 0..* Annotation Comments about the observation
Observation.bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen 0..1 Reference(Specimen) Specimen used for this observation
Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
Observation.referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
Observation.referenceRange.id 0..1 string Unique id for inter-element referencing
Observation.referenceRange.extension 0..* Extension Additional content defined by implementations
Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.referenceRange.low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
Constraints: sqty-1
Observation.referenceRange.high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
Constraints: sqty-1
Observation.referenceRange.type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age 0..1 Range Applicable age range, if relevant
Observation.referenceRange.text 0..1 string Text based reference range in an observation
Observation.hasMember This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse | MolecularSequence) 關聯成員
Observation.derivedFrom This element must be supported. This element is included in summaries. 0..* Reference(TW Core Observation Screening Assessment | TW Core QuestionnaireResponse This type must be supported. | TW Core DocumentReference | ImagingStudy | Media | MolecularSequence) 來源參照
Observation.component This element is included in summaries. 0..* BackboneElement Component results
Observation.component.id 0..1 string Unique id for inter-element referencing
Observation.component.extension 0..* Extension Additional content defined by implementations
Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.component.code This element is included in summaries. 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x] This element is included in summaries. 0..1 Actual component result
Observation.component.value[x].valueQuantity Quantity
Observation.component.value[x].valueCodeableConcept CodeableConcept
Observation.component.value[x].valueString string
Observation.component.value[x].valueBoolean boolean
Observation.component.value[x].valueInteger integer
Observation.component.value[x].valueRange Range
Observation.component.value[x].valueRatio Ratio
Observation.component.value[x].valueSampledData SampledData
Observation.component.value[x].valueTime time
Observation.component.value[x].valueDateTime dateTime
Observation.component.value[x].valuePeriod Period
Observation.component.dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.component.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.component.referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:survey Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:twcore Base required 臺灣衛福部資訊處Observation Screening Assessment類型值集 📦0.3.0 臺灣核心實作指引 v1.0
Observation.code Base preferred LOINC篩檢與評估值集 📦2.81 臺灣核心實作指引 v1.0
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
sqty-1 error Observation.referenceRange.low, Observation.referenceRange.high The comparator is not used on a SimpleQuantity comparator.empty()
stroke-mrs-pre-stroke-range error Observation 中風前（pre-stroke）mRS 分數須介於 0 至 5。 extension.where(url = 'http://vgh-stroke-ig.fhir.tw/StructureDefinition/assessment-phase').value.ofType(code).where($this = 'pre-stroke').exists() implies value.ofType(integer).all($this <= 5)
tw-core-3 error Observation.effective[x] Datetime must be at least to day. $this is dateTime implies $this.toString().length() >= 10
tw-core-4 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
tw-core-5 error Observation.value[x] SHALL use UCUM for coded quantity units. ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'

 

Other representations of profile: CSV, Excel, Schematron