重大傷病-Condition TWCI - 臺灣重大傷病實作指引 v1.0.0

臺灣重大傷病實作指引
1.0.0 - ci-build

臺灣重大傷病實作指引, published by 衛生福利部中央健康保險署. 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/TWNHIFHIR/ci/ and changes regularly. See the Directory of published versions

Resource Profile: 重大傷病-Condition TWCI

Official URL: https://nhicore.nhi.gov.tw/ci/StructureDefinition/Condition-twci				Version: 1.0.0
Active as of 2025-06-09				Computable Name: ConditionTWCI

此重大傷病-Condition TWCI Profile說明TWCI IG如何進一步定義臺灣核心-病情、問題或診斷（TW Core Condition） Profile以呈現重大傷病之內容

Usages:

Use this Profile: 重大傷病申請證明-Bundle TWCI
Refer to this Profile: 重大傷病申請書回覆-QuestionnaireResponse TWCI and 重大傷病申請-Task TWCI
Examples for this Profile: Condition/con-min
CapabilityStatements using this Profile: 臺灣重大傷病-用戶端(TWCI Client) and 臺灣重大傷病-伺服端(TWCI Server)

Formal Views of Profile Content

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

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Condition	C	0..*	TWCoreCondition	有關病情、問題或診斷的詳細資訊 Constraints: con-3, con-4, con-5
implicitRules	?!Σ	0..1	uri	創建此內容所依據的一組規則
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	S	1..1	CodeableConceptTW	active \| recurrence \| relapse \| inactive \| remission \| resolved ，病情、問題或診斷的臨床狀態。 Binding: ConditionClinicalStatusCodes (required): 應填入所綁定值集中的其中一個代碼。
verificationStatus	S	0..1	CodeableConceptTW	unconfirmed \| provisional \| differential \| confirmed \| refuted \| entered-in-error ，支持或拒絕病情、問題或診斷的臨床狀態的驗證狀態。 Binding: ConditionVerificationStatus (required): 應填入所綁定值集中的其中一個代碼。
category	S	1..1	CodeableConceptTW	重大傷病類別 Binding: NHI-健保重大傷病-重大傷病類別值集 (required)
coding	S	1..1	CodingTW	由專門術語系統（terminology system）定義的代碼
system	SΣ	0..1	uri	專門術語系統（terminology system）的識別 Required Pattern: https://nhicore.nhi.gov.tw/ci/CodeSystem/nhi-category
code	SΣ	1..1	code	固定填「01」(癌症)。 Required Pattern: 01
display	SΣ	0..1	string	由系統定義的表示法
text	SΣ	0..1	string	概念的文字表示法
severity	S	0..1	CodeableConceptTW	病情、問題或診斷的主觀嚴重程度 Binding: Condition/DiagnosisSeverity (extensible): 臨床醫生對病情、問題或診斷嚴重程度的主觀評價；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
code	S	0..1	CodeableConceptTW	病情、問題或診斷的識別 Binding: Condition/Problem/DiagnosisCodes (example): 此資料項目為可擴充綁定預設國際標準值集，但實作者可視實務專案需求只綁定以下slices中的任一值集。目前未只限定綁定預設值集是因為尚無slice值集與預設國際標準值集的代碼對應表，待後續有相對的代碼對應表後將建議採用國際標準值集作為唯一綁定值集並針對該值集進行擴充與管理，以利進行跨國與跨系統之資料交換。
Slices for coding	S	0..*	CodingTW	由專門術語系統（terminology system）定義的代碼。此資料項目為可擴充綁定預設國際標準值集，但實作者可視實務專案需求只綁定以下slices中的任一值集。目前未只限定綁定預設值集是因為尚無slice值集與預設國際標準值集的代碼對應表，待後續有相對的代碼對應表後將建議採用國際標準值集作為唯一綁定值集並針對該值集進行擴充與管理，以利進行跨國與跨系統之資料交換。 Slice: Unordered, Open by pattern:$this
coding:icd10-cm-2023	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼 Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (required)
coding:icd10-cm-2021	S	0..1	CodingTW	此為臺灣衛生福利部中央健康保險署維護之2021年中文版ICD-10-CM代碼，涵蓋範圍相對完整，可免費使用，可優先選用此代碼。 Binding: 臺灣健保署2021年中文版ICD-10-CM值集 (required): 病情、問題或診斷的識別；應填入所綁定值集中的其中一個代碼。
coding:icd10-cm-2014	S	0..1	CodingTW	此為臺灣衛生福利部中央健康保險署維護之2014年中文版ICD-10-CM代碼，涵蓋範圍相對完整，可免費使用，可優先選用此代碼。 Binding: 臺灣健保署2014年中文版ICD-10-CM值集 (required): 病情、問題或診斷的識別；應填入所綁定值集中的其中一個代碼。
coding:icd9-cm-2001	S	0..1	CodingTW	由專門術語系統（terminology system）定義的代碼 Binding: 臺灣健保署2001年中文版ICD-9-CM值集 (required)
coding:absentOrUnknownProblem	S	0..1	CodingTW	不存在的問題或未知問題的代碼 Binding: Absent or Unknown Problems - IPS (required): 應填入所綁定值集中的其中一個代碼。
coding:sct	S	0..1	CodingTW	此為SNOMED CT診斷代碼，若機構已有購買相關授權，亦可使用。 Binding: SNOMED CT診斷代碼值集 (required): 應填入所綁定值集中的其中一個代碼。
text	SΣ	0..1	string	概念的文字表示法
bodySite	S	0..*	CodeableConceptTW	如果相關請填寫解剖位置 Binding: SNOMEDCTBodyStructures (extensible): 描述解剖位置的代碼。可包括側面；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。
subject	SΣ	1..1	Reference(病人資訊-Patient TWCI)	誰有此病情、問題或診斷？
onset[x]	SΣ	0..1		估計的或實際的日期、日期—時間或年齡。
onsetDateTime			dateTime
abatement[x]	SC	0..1		何時解決/緩解
abatementDateTime			dateTime
asserter	SΣ	0..1	Reference(TW Core Practitioner \| TW Core PractitionerRole \| TW Core Patient \| TW Core RelatedPerson)	聲稱有此病情、問題或診斷的人
note	S	0..*	Annotation	關於此Condition的附加資訊
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.clinicalStatus	required	ConditionClinicalStatusCodes `http://hl7.org/fhir/ValueSet/condition-clinical\|4.0.1` From the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus `http://hl7.org/fhir/ValueSet/condition-ver-status\|4.0.1` From the FHIR Standard
Condition.category	required	NHICICategory `https://nhicore.nhi.gov.tw/ci/ValueSet/nhi-category` From this IG
Condition.severity	extensible	Condition/DiagnosisSeverity `http://hl7.org/fhir/ValueSet/condition-severity` From the FHIR Standard
Condition.code	example	Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
Condition.code.coding:icd10-cm-2023	required	TW2023ICD10CM `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw`
Condition.code.coding:icd10-cm-2021	required	TW2021ICD10CM `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2021-tw`
Condition.code.coding:icd10-cm-2014	required	TW2014ICD10CM `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2014-tw`
Condition.code.coding:icd9-cm-2001	required	TW2001ICD9CM `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-9-cm-2001-tw`
Condition.code.coding:absentOrUnknownProblem	required	AbsentOrUnknownProblemsUvIps `http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-problems-uv-ips`
Condition.code.coding:sct	required	TWConditionCodeSCT `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/condition-code-sct-tw`
Condition.bodySite	extensible	SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
con-3	best practice	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item : clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5	error	Condition	Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Condition	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	Condition	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	Condition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Condition	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()

This structure is derived from TWCoreCondition

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Condition		TWCoreCondition
category	1..1	CodeableConceptTW	重大傷病類別 Binding: NHI-健保重大傷病-重大傷病類別值集 (required)
coding	1..1	CodingTW	由專門術語系統（terminology system）定義的代碼
system	0..1	uri	專門術語系統（terminology system）的識別 Required Pattern: https://nhicore.nhi.gov.tw/ci/CodeSystem/nhi-category
code	1..1	code	固定填「01」(癌症)。 Required Pattern: 01
subject	1..1	Reference(病人資訊-Patient TWCI)	誰有此病情、問題或診斷？
Documentation for this format