臺灣健保事前審查實作指引
1.1.0 - ci-build

臺灣健保事前審查實作指引, 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 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TWNHIFHIR/pas/ and changes regularly. See the Directory of published versions

## Resource Profile: 病人狀態評估-Observation Patient Assessment TWPAS

Official URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas | Version: 1.1.0
Active as of 2025-12-29 | Computable Name: ObservationPatientAssessmentTWPAS

此病人狀態評估-Observation Patient Assessment TWPAS Profile說明本IG如何進一步定義FHIR的Observation Resource以呈現事前審查中評估資訊之病人狀態評估

Usages:

- Use this Profile: 免疫製劑事前審查-Bundle Immunologic Aagent TWPAS and 癌藥事前審查-Bundle TWPAS
- Refer to this Profile: 免疫製劑事前審查-Claim Immunologic Aagent TWPAS and 癌藥事前審查-Claim TWPAS
- Examples for this Profile: Observation/obs-pat-ctcae, Observation/obs-pat-nyha and Observation/obs-pat-pdai
- CapabilityStatements using this Profile: 臺灣事前審查-用戶端(TWPAS Client) and 臺灣事前審查-伺服端(TWPAS Server)

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.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, pat-ast-value
meta | Σ | 1..1 | Meta | Metadata about the resource
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 1..1 | CodeableConcept | 因設計而須必填。 Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment
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
code | S Σ | 1..1 | CodeableConcept | 病人狀態評估項目代碼 Binding: LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 (required): 最新參考代碼清單請參考此檔案。
coding | Σ | 1..1 | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 1..1 | Reference(病人資訊-Patient TWPAS) | Who and/or what the observation is about
effective[x] | S Σ | 1..1 | dateTime | 病人狀態評估日期，YYYY-MM-DD，西元年月日。
performer | S Σ | 1..1 | Reference(醫事人員-Practitioner TWPAS) | 評估項目醫事人員身分證號
value[x] | S Σ C | 0..1 |  | 病人狀態評估結果
valueString |  |  | string |
valueInteger |  |  | integer |
derivedFrom | Σ | 0..* | Reference(文件參照-DocumentReference TWPAS) | 病人狀態評估報告（檔案路徑）及病人狀態評估報告名稱
Slices for component | Σ | 0..* | BackboneElement | Component results Slice: Unordered, Closed by pattern:code.coding
component:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
component:hearing-impaired | S Σ | 0..1 | BackboneElement | Hearing impaired
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Hearing impaired Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143528
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
value[x] | S Σ | 1..1 | string | grade1~5
component:peripheral-motor-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral motor neuropathy
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Peripheral motor neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143750
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
value[x] | S Σ | 1..1 | string | grade1~5
component:peripheral-sensory-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral sensory neuropathy
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Peripheral sensory neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143752
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
value[x] | S Σ | 1..1 | string | grade1~5
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.code | Base | required | LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 | 📦1.1.0 | This IG
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:hearing-impaired.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​code | Base | example | LOINC 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-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()`
pat-ast-value | error | Observation | 若病人狀態評估項目代碼(code)為88020-3，結果值(valueString)須填寫class1/class2/class3/class4其中一項； 若病人狀態評估項目代碼(code)為98153-0，結果值(valueString)須填寫A/B/C其中一項； 若病人狀態評估項目代碼(code)為89247-1，結果值(valueInteger)須填寫0~5其中的值； 若病人狀態評估項目代碼(code)為89243-0，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為IPS，結果值(valueInteger)須填寫0~7其中的值； 若病人狀態評估項目代碼(code)為PDAI，結果值(valueInteger)須填寫0~263其中的值； 若病人狀態評估項目代碼(code)為CIRS，結果值(valueInteger)須填寫0~56其中的值； 若病人狀態評估項目代碼(code)為75633-8，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為HCTCI，結果值(valueInteger)須填寫0~26其中的值； 若病人狀態評估項目代碼(code)為MPNSAFTSS，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為MPN10，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為711434002，結果值(component.valueString)須填寫grade1/grade2/grade3/grade4/grade5其中一項； 若病人狀態評估項目代碼(code)為429712009，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為GPPGA，結果值(valueInteger)須填寫0~4其中的值； 若病人狀態評估項目代碼(code)為273364009，結果值(valueInteger)須填寫0~600其中的值； 若病人狀態評估項目代碼(code)為Mayo，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為MayoE，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為PUCAI，結果值(valueInteger)須填寫0~90其中的值。 | `((code.coding.exists(code='88020-3')) implies (value.ofType(string) = 'class1' or value.ofType(string) = 'class2' or value.ofType(string) = 'class3' or value.ofType(string) = 'class4')) and ((code.coding.exists(code='98153-0')) implies (value.ofType(string) = 'A' or value.ofType(string) = 'B' or value.ofType(string) = 'C')) and ((code.coding.exists(code='89247-1')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 5)) and ((code.coding.exists(code='IPS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 7)) and ((code.coding.exists(code='PDAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 263)) and ((code.coding.exists(code='CIRS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 56)) and ((code.coding.exists(code='75633-8')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='HCTCI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 26)) and ((code.coding.exists(code='MPNSAFTSS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='MPN10')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='711434002')) implies (component.all(value.ofType(string) = 'grade1' or value.ofType(string) = 'grade2' or value.ofType(string) = 'grade3' or value.ofType(string) = 'grade4' or value.ofType(string) = 'grade5'))) and ((code.coding.exists(code='429712009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='GPPGA')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 4)) and ((code.coding.exists(code='273364009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 600)) and ((code.coding.exists(code='Mayo')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='MayoE')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='PUCAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 90))`

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: pat-ast-value
meta |  | 1..1 | Meta | Metadata about the resource
profile |  | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas
category |  | 1..1 | CodeableConcept | 因設計而須必填。 Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment
code | S | 1..1 | CodeableConcept | 病人狀態評估項目代碼 Binding: LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 (required): 最新參考代碼清單請參考此檔案。
coding |  | 1..1 | Coding | Code defined by a terminology system
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
subject | S | 1..1 | Reference(病人資訊-Patient TWPAS) | Who and/or what the observation is about
effective[x] | S | 1..1 | dateTime | 病人狀態評估日期，YYYY-MM-DD，西元年月日。
performer | S | 1..1 | Reference(醫事人員-Practitioner TWPAS) | 評估項目醫事人員身分證號
value[x] | S | 0..1 |  | 病人狀態評估結果
valueString |  |  | string |
valueInteger |  |  | integer |
derivedFrom |  | 0..* | Reference(文件參照-DocumentReference TWPAS) | 病人狀態評估報告（檔案路徑）及病人狀態評估報告名稱
Slices for component |  | 0..* | BackboneElement | Component results Slice: Unordered, Closed by pattern:code.coding
component:hearing-impaired | S | 0..1 | BackboneElement | Hearing impaired
code |  | 1..1 | CodeableConcept | Hearing impaired
coding |  | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143528
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
value[x] | S | 1..1 | string | grade1~5
component:peripheral-motor-neuropathy | S | 0..1 | BackboneElement | Peripheral motor neuropathy
code |  | 1..1 | CodeableConcept | Peripheral motor neuropathy
coding |  | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143750
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
value[x] | S | 1..1 | string | grade1~5
component:peripheral-sensory-neuropathy | S | 0..1 | BackboneElement | Peripheral sensory neuropathy
code |  | 1..1 | CodeableConcept | Peripheral sensory neuropathy
coding |  | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143752
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
value[x] | S | 1..1 | string | grade1~5
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.code | Base | required | LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 | 📦1.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
pat-ast-value | error | Observation | 若病人狀態評估項目代碼(code)為88020-3，結果值(valueString)須填寫class1/class2/class3/class4其中一項； 若病人狀態評估項目代碼(code)為98153-0，結果值(valueString)須填寫A/B/C其中一項； 若病人狀態評估項目代碼(code)為89247-1，結果值(valueInteger)須填寫0~5其中的值； 若病人狀態評估項目代碼(code)為89243-0，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為IPS，結果值(valueInteger)須填寫0~7其中的值； 若病人狀態評估項目代碼(code)為PDAI，結果值(valueInteger)須填寫0~263其中的值； 若病人狀態評估項目代碼(code)為CIRS，結果值(valueInteger)須填寫0~56其中的值； 若病人狀態評估項目代碼(code)為75633-8，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為HCTCI，結果值(valueInteger)須填寫0~26其中的值； 若病人狀態評估項目代碼(code)為MPNSAFTSS，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為MPN10，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為711434002，結果值(component.valueString)須填寫grade1/grade2/grade3/grade4/grade5其中一項； 若病人狀態評估項目代碼(code)為429712009，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為GPPGA，結果值(valueInteger)須填寫0~4其中的值； 若病人狀態評估項目代碼(code)為273364009，結果值(valueInteger)須填寫0~600其中的值； 若病人狀態評估項目代碼(code)為Mayo，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為MayoE，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為PUCAI，結果值(valueInteger)須填寫0~90其中的值。 | `((code.coding.exists(code='88020-3')) implies (value.ofType(string) = 'class1' or value.ofType(string) = 'class2' or value.ofType(string) = 'class3' or value.ofType(string) = 'class4')) and ((code.coding.exists(code='98153-0')) implies (value.ofType(string) = 'A' or value.ofType(string) = 'B' or value.ofType(string) = 'C')) and ((code.coding.exists(code='89247-1')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 5)) and ((code.coding.exists(code='IPS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 7)) and ((code.coding.exists(code='PDAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 263)) and ((code.coding.exists(code='CIRS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 56)) and ((code.coding.exists(code='75633-8')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='HCTCI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 26)) and ((code.coding.exists(code='MPNSAFTSS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='MPN10')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='711434002')) implies (component.all(value.ofType(string) = 'grade1' or value.ofType(string) = 'grade2' or value.ofType(string) = 'grade3' or value.ofType(string) = 'grade4' or value.ofType(string) = 'grade5'))) and ((code.coding.exists(code='429712009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='GPPGA')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 4)) and ((code.coding.exists(code='273364009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 600)) and ((code.coding.exists(code='Mayo')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='MayoE')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='PUCAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 90))`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, pat-ast-value
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 1..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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 Bindings | Purpose
AllLanguages | Max Binding
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
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 | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 1..1 | CodeableConcept | 因設計而須必填。 Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment
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
code | S Σ | 1..1 | CodeableConcept | 病人狀態評估項目代碼 Binding: LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 (required): 最新參考代碼清單請參考此檔案。
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(病人資訊-Patient TWPAS) | Who and/or what the observation is about
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | S Σ | 1..1 | dateTime | 病人狀態評估日期，YYYY-MM-DD，西元年月日。
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 1..1 | Reference(醫事人員-Practitioner TWPAS) | 評估項目醫事人員身分證號
value[x] | S Σ C | 0..1 |  | 病人狀態評估結果
valueString |  |  | string |
valueInteger |  |  | integer |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note |  | 0..* | Annotation | Comments about the observation
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-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
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(文件參照-DocumentReference TWPAS) | 病人狀態評估報告（檔案路徑）及病人狀態評估報告名稱
Slices for component | Σ | 0..* | BackboneElement | Component results Slice: Unordered, Closed by pattern:code.coding
component:All Slices |  |  |  | Content/Rules for all slices
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
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:hearing-impaired | S Σ | 0..1 | BackboneElement | Hearing impaired
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
code | Σ | 1..1 | CodeableConcept | Hearing impaired Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143528
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | S Σ | 1..1 | string | grade1~5
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:peripheral-motor-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral motor neuropathy
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
code | Σ | 1..1 | CodeableConcept | Peripheral motor neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143750
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | S Σ | 1..1 | string | grade1~5
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:peripheral-sensory-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral sensory neuropathy
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
code | Σ | 1..1 | CodeableConcept | Peripheral sensory neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143752
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | S Σ | 1..1 | string | grade1~5
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Observation.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
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.code | Base | required | LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 | 📦1.1.0 | This IG
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.
Observation.component:hearing-impaired.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:hearing-impaired.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:hearing-impaired.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​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()`
pat-ast-value | error | Observation | 若病人狀態評估項目代碼(code)為88020-3，結果值(valueString)須填寫class1/class2/class3/class4其中一項； 若病人狀態評估項目代碼(code)為98153-0，結果值(valueString)須填寫A/B/C其中一項； 若病人狀態評估項目代碼(code)為89247-1，結果值(valueInteger)須填寫0~5其中的值； 若病人狀態評估項目代碼(code)為89243-0，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為IPS，結果值(valueInteger)須填寫0~7其中的值； 若病人狀態評估項目代碼(code)為PDAI，結果值(valueInteger)須填寫0~263其中的值； 若病人狀態評估項目代碼(code)為CIRS，結果值(valueInteger)須填寫0~56其中的值； 若病人狀態評估項目代碼(code)為75633-8，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為HCTCI，結果值(valueInteger)須填寫0~26其中的值； 若病人狀態評估項目代碼(code)為MPNSAFTSS，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為MPN10，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為711434002，結果值(component.valueString)須填寫grade1/grade2/grade3/grade4/grade5其中一項； 若病人狀態評估項目代碼(code)為429712009，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為GPPGA，結果值(valueInteger)須填寫0~4其中的值； 若病人狀態評估項目代碼(code)為273364009，結果值(valueInteger)須填寫0~600其中的值； 若病人狀態評估項目代碼(code)為Mayo，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為MayoE，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為PUCAI，結果值(valueInteger)須填寫0~90其中的值。 | `((code.coding.exists(code='88020-3')) implies (value.ofType(string) = 'class1' or value.ofType(string) = 'class2' or value.ofType(string) = 'class3' or value.ofType(string) = 'class4')) and ((code.coding.exists(code='98153-0')) implies (value.ofType(string) = 'A' or value.ofType(string) = 'B' or value.ofType(string) = 'C')) and ((code.coding.exists(code='89247-1')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 5)) and ((code.coding.exists(code='IPS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 7)) and ((code.coding.exists(code='PDAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 263)) and ((code.coding.exists(code='CIRS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 56)) and ((code.coding.exists(code='75633-8')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='HCTCI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 26)) and ((code.coding.exists(code='MPNSAFTSS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='MPN10')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='711434002')) implies (component.all(value.ofType(string) = 'grade1' or value.ofType(string) = 'grade2' or value.ofType(string) = 'grade3' or value.ofType(string) = 'grade4' or value.ofType(string) = 'grade5'))) and ((code.coding.exists(code='429712009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='GPPGA')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 4)) and ((code.coding.exists(code='273364009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 600)) and ((code.coding.exists(code='Mayo')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='MayoE')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='PUCAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 90))`

This structure is derived from Observation

Summary

Mandatory: 9 elements(12 nested mandatory elements)
Must-Support: 11 elements

Structures

This structure refers to these other structures:

- 病人資訊-Patient TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/Patient-twpas)
- 醫事人員-Practitioner TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/Practitioner-twpas)
- 文件參照-DocumentReference TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/DocumentReference-twpas)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.component (Closed)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, pat-ast-value
meta | Σ | 1..1 | Meta | Metadata about the resource
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 1..1 | CodeableConcept | 因設計而須必填。 Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment
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
code | S Σ | 1..1 | CodeableConcept | 病人狀態評估項目代碼 Binding: LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 (required): 最新參考代碼清單請參考此檔案。
coding | Σ | 1..1 | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 1..1 | Reference(病人資訊-Patient TWPAS) | Who and/or what the observation is about
effective[x] | S Σ | 1..1 | dateTime | 病人狀態評估日期，YYYY-MM-DD，西元年月日。
performer | S Σ | 1..1 | Reference(醫事人員-Practitioner TWPAS) | 評估項目醫事人員身分證號
value[x] | S Σ C | 0..1 |  | 病人狀態評估結果
valueString |  |  | string |
valueInteger |  |  | integer |
derivedFrom | Σ | 0..* | Reference(文件參照-DocumentReference TWPAS) | 病人狀態評估報告（檔案路徑）及病人狀態評估報告名稱
Slices for component | Σ | 0..* | BackboneElement | Component results Slice: Unordered, Closed by pattern:code.coding
component:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
component:hearing-impaired | S Σ | 0..1 | BackboneElement | Hearing impaired
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Hearing impaired Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143528
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
value[x] | S Σ | 1..1 | string | grade1~5
component:peripheral-motor-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral motor neuropathy
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Peripheral motor neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143750
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
value[x] | S Σ | 1..1 | string | grade1~5
component:peripheral-sensory-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral sensory neuropathy
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Peripheral sensory neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143752
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | Σ | 1..1 | uri | Identity of the terminology system
code | Σ | 1..1 | code | Symbol in syntax defined by the system
value[x] | S Σ | 1..1 | string | grade1~5
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.code | Base | required | LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 | 📦1.1.0 | This IG
Observation.component.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:hearing-impaired.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​code | Base | example | LOINC 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-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()`
pat-ast-value | error | Observation | 若病人狀態評估項目代碼(code)為88020-3，結果值(valueString)須填寫class1/class2/class3/class4其中一項； 若病人狀態評估項目代碼(code)為98153-0，結果值(valueString)須填寫A/B/C其中一項； 若病人狀態評估項目代碼(code)為89247-1，結果值(valueInteger)須填寫0~5其中的值； 若病人狀態評估項目代碼(code)為89243-0，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為IPS，結果值(valueInteger)須填寫0~7其中的值； 若病人狀態評估項目代碼(code)為PDAI，結果值(valueInteger)須填寫0~263其中的值； 若病人狀態評估項目代碼(code)為CIRS，結果值(valueInteger)須填寫0~56其中的值； 若病人狀態評估項目代碼(code)為75633-8，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為HCTCI，結果值(valueInteger)須填寫0~26其中的值； 若病人狀態評估項目代碼(code)為MPNSAFTSS，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為MPN10，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為711434002，結果值(component.valueString)須填寫grade1/grade2/grade3/grade4/grade5其中一項； 若病人狀態評估項目代碼(code)為429712009，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為GPPGA，結果值(valueInteger)須填寫0~4其中的值； 若病人狀態評估項目代碼(code)為273364009，結果值(valueInteger)須填寫0~600其中的值； 若病人狀態評估項目代碼(code)為Mayo，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為MayoE，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為PUCAI，結果值(valueInteger)須填寫0~90其中的值。 | `((code.coding.exists(code='88020-3')) implies (value.ofType(string) = 'class1' or value.ofType(string) = 'class2' or value.ofType(string) = 'class3' or value.ofType(string) = 'class4')) and ((code.coding.exists(code='98153-0')) implies (value.ofType(string) = 'A' or value.ofType(string) = 'B' or value.ofType(string) = 'C')) and ((code.coding.exists(code='89247-1')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 5)) and ((code.coding.exists(code='IPS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 7)) and ((code.coding.exists(code='PDAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 263)) and ((code.coding.exists(code='CIRS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 56)) and ((code.coding.exists(code='75633-8')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='HCTCI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 26)) and ((code.coding.exists(code='MPNSAFTSS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='MPN10')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='711434002')) implies (component.all(value.ofType(string) = 'grade1' or value.ofType(string) = 'grade2' or value.ofType(string) = 'grade3' or value.ofType(string) = 'grade4' or value.ofType(string) = 'grade5'))) and ((code.coding.exists(code='429712009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='GPPGA')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 4)) and ((code.coding.exists(code='273364009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 600)) and ((code.coding.exists(code='Mayo')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='MayoE')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='PUCAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 90))`

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: pat-ast-value
meta |  | 1..1 | Meta | Metadata about the resource
profile |  | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas
category |  | 1..1 | CodeableConcept | 因設計而須必填。 Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment
code | S | 1..1 | CodeableConcept | 病人狀態評估項目代碼 Binding: LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 (required): 最新參考代碼清單請參考此檔案。
coding |  | 1..1 | Coding | Code defined by a terminology system
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
subject | S | 1..1 | Reference(病人資訊-Patient TWPAS) | Who and/or what the observation is about
effective[x] | S | 1..1 | dateTime | 病人狀態評估日期，YYYY-MM-DD，西元年月日。
performer | S | 1..1 | Reference(醫事人員-Practitioner TWPAS) | 評估項目醫事人員身分證號
value[x] | S | 0..1 |  | 病人狀態評估結果
valueString |  |  | string |
valueInteger |  |  | integer |
derivedFrom |  | 0..* | Reference(文件參照-DocumentReference TWPAS) | 病人狀態評估報告（檔案路徑）及病人狀態評估報告名稱
Slices for component |  | 0..* | BackboneElement | Component results Slice: Unordered, Closed by pattern:code.coding
component:hearing-impaired | S | 0..1 | BackboneElement | Hearing impaired
code |  | 1..1 | CodeableConcept | Hearing impaired
coding |  | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143528
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
value[x] | S | 1..1 | string | grade1~5
component:peripheral-motor-neuropathy | S | 0..1 | BackboneElement | Peripheral motor neuropathy
code |  | 1..1 | CodeableConcept | Peripheral motor neuropathy
coding |  | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143750
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
value[x] | S | 1..1 | string | grade1~5
component:peripheral-sensory-neuropathy | S | 0..1 | BackboneElement | Peripheral sensory neuropathy
code |  | 1..1 | CodeableConcept | Peripheral sensory neuropathy
coding |  | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143752
system |  | 1..1 | uri | Identity of the terminology system
code |  | 1..1 | code | Symbol in syntax defined by the system
value[x] | S | 1..1 | string | grade1~5
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Observation.code | Base | required | LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 | 📦1.1.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
pat-ast-value | error | Observation | 若病人狀態評估項目代碼(code)為88020-3，結果值(valueString)須填寫class1/class2/class3/class4其中一項； 若病人狀態評估項目代碼(code)為98153-0，結果值(valueString)須填寫A/B/C其中一項； 若病人狀態評估項目代碼(code)為89247-1，結果值(valueInteger)須填寫0~5其中的值； 若病人狀態評估項目代碼(code)為89243-0，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為IPS，結果值(valueInteger)須填寫0~7其中的值； 若病人狀態評估項目代碼(code)為PDAI，結果值(valueInteger)須填寫0~263其中的值； 若病人狀態評估項目代碼(code)為CIRS，結果值(valueInteger)須填寫0~56其中的值； 若病人狀態評估項目代碼(code)為75633-8，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為HCTCI，結果值(valueInteger)須填寫0~26其中的值； 若病人狀態評估項目代碼(code)為MPNSAFTSS，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為MPN10，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為711434002，結果值(component.valueString)須填寫grade1/grade2/grade3/grade4/grade5其中一項； 若病人狀態評估項目代碼(code)為429712009，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為GPPGA，結果值(valueInteger)須填寫0~4其中的值； 若病人狀態評估項目代碼(code)為273364009，結果值(valueInteger)須填寫0~600其中的值； 若病人狀態評估項目代碼(code)為Mayo，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為MayoE，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為PUCAI，結果值(valueInteger)須填寫0~90其中的值。 | `((code.coding.exists(code='88020-3')) implies (value.ofType(string) = 'class1' or value.ofType(string) = 'class2' or value.ofType(string) = 'class3' or value.ofType(string) = 'class4')) and ((code.coding.exists(code='98153-0')) implies (value.ofType(string) = 'A' or value.ofType(string) = 'B' or value.ofType(string) = 'C')) and ((code.coding.exists(code='89247-1')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 5)) and ((code.coding.exists(code='IPS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 7)) and ((code.coding.exists(code='PDAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 263)) and ((code.coding.exists(code='CIRS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 56)) and ((code.coding.exists(code='75633-8')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='HCTCI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 26)) and ((code.coding.exists(code='MPNSAFTSS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='MPN10')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='711434002')) implies (component.all(value.ofType(string) = 'grade1' or value.ofType(string) = 'grade2' or value.ofType(string) = 'grade3' or value.ofType(string) = 'grade4' or value.ofType(string) = 'grade5'))) and ((code.coding.exists(code='429712009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='GPPGA')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 4)) and ((code.coding.exists(code='273364009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 600)) and ((code.coding.exists(code='Mayo')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='MayoE')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='PUCAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 90))`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions Constraints: obs-6, obs-7, pat-ast-value
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 1..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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 Bindings | Purpose
AllLanguages | Max Binding
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
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 | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 1..1 | CodeableConcept | 因設計而須必填。 Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. 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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment
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
code | S Σ | 1..1 | CodeableConcept | 病人狀態評估項目代碼 Binding: LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 (required): 最新參考代碼清單請參考此檔案。
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(病人資訊-Patient TWPAS) | Who and/or what the observation is about
focus | Σ | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | S Σ | 1..1 | dateTime | 病人狀態評估日期，YYYY-MM-DD，西元年月日。
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | S Σ | 1..1 | Reference(醫事人員-Practitioner TWPAS) | 評估項目醫事人員身分證號
value[x] | S Σ C | 0..1 |  | 病人狀態評估結果
valueString |  |  | string |
valueInteger |  |  | integer |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note |  | 0..* | Annotation | Comments about the observation
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-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
low | C | 0..1 | SimpleQuantity(4.0.1) | Low Range, if relevant
high | C | 0..1 | SimpleQuantity(4.0.1) | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group
derivedFrom | Σ | 0..* | Reference(文件參照-DocumentReference TWPAS) | 病人狀態評估報告（檔案路徑）及病人狀態評估報告名稱
Slices for component | Σ | 0..* | BackboneElement | Component results Slice: Unordered, Closed by pattern:code.coding
component:All Slices |  |  |  | Content/Rules for all slices
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
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:hearing-impaired | S Σ | 0..1 | BackboneElement | Hearing impaired
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
code | Σ | 1..1 | CodeableConcept | Hearing impaired Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143528
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | S Σ | 1..1 | string | grade1~5
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:peripheral-motor-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral motor neuropathy
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
code | Σ | 1..1 | CodeableConcept | Peripheral motor neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143750
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | S Σ | 1..1 | string | grade1~5
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
component:peripheral-sensory-neuropathy | S Σ | 0..1 | BackboneElement | Peripheral sensory neuropathy
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
code | Σ | 1..1 | CodeableConcept | Peripheral sensory neuropathy Binding: LOINCCodes (example): Codes identifying names of simple observations.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-pat-ast
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: C143752
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
value[x] | S Σ | 1..1 | string | grade1~5
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Observation.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
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.code | Base | required | LOINC + SCT + NHI-健保事前審查-病人狀態評估項目值集 | 📦1.1.0 | This IG
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.
Observation.component:hearing-impaired.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:hearing-impaired.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:hearing-impaired.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-motor-neuropathy.​interpretation | Base | extensible | Observation Interpretation Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​code | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​dataAbsentReason | Base | extensible | DataAbsentReason | 📍4.0.1 | FHIR Std.
Observation.component:peripheral-sensory-neuropathy.​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()`
pat-ast-value | error | Observation | 若病人狀態評估項目代碼(code)為88020-3，結果值(valueString)須填寫class1/class2/class3/class4其中一項； 若病人狀態評估項目代碼(code)為98153-0，結果值(valueString)須填寫A/B/C其中一項； 若病人狀態評估項目代碼(code)為89247-1，結果值(valueInteger)須填寫0~5其中的值； 若病人狀態評估項目代碼(code)為89243-0，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為IPS，結果值(valueInteger)須填寫0~7其中的值； 若病人狀態評估項目代碼(code)為PDAI，結果值(valueInteger)須填寫0~263其中的值； 若病人狀態評估項目代碼(code)為CIRS，結果值(valueInteger)須填寫0~56其中的值； 若病人狀態評估項目代碼(code)為75633-8，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為HCTCI，結果值(valueInteger)須填寫0~26其中的值； 若病人狀態評估項目代碼(code)為MPNSAFTSS，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為MPN10，結果值(valueInteger)須填寫0~100其中的值； 若病人狀態評估項目代碼(code)為711434002，結果值(component.valueString)須填寫grade1/grade2/grade3/grade4/grade5其中一項； 若病人狀態評估項目代碼(code)為429712009，結果值(valueInteger)須填寫0~10其中的值； 若病人狀態評估項目代碼(code)為GPPGA，結果值(valueInteger)須填寫0~4其中的值； 若病人狀態評估項目代碼(code)為273364009，結果值(valueInteger)須填寫0~600其中的值； 若病人狀態評估項目代碼(code)為Mayo，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為MayoE，結果值(valueInteger)須填寫0~12其中的值； 若病人狀態評估項目代碼(code)為PUCAI，結果值(valueInteger)須填寫0~90其中的值。 | `((code.coding.exists(code='88020-3')) implies (value.ofType(string) = 'class1' or value.ofType(string) = 'class2' or value.ofType(string) = 'class3' or value.ofType(string) = 'class4')) and ((code.coding.exists(code='98153-0')) implies (value.ofType(string) = 'A' or value.ofType(string) = 'B' or value.ofType(string) = 'C')) and ((code.coding.exists(code='89247-1')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 5)) and ((code.coding.exists(code='IPS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 7)) and ((code.coding.exists(code='PDAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 263)) and ((code.coding.exists(code='CIRS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 56)) and ((code.coding.exists(code='75633-8')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='HCTCI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 26)) and ((code.coding.exists(code='MPNSAFTSS')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='MPN10')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 100)) and ((code.coding.exists(code='711434002')) implies (component.all(value.ofType(string) = 'grade1' or value.ofType(string) = 'grade2' or value.ofType(string) = 'grade3' or value.ofType(string) = 'grade4' or value.ofType(string) = 'grade5'))) and ((code.coding.exists(code='429712009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 10)) and ((code.coding.exists(code='GPPGA')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 4)) and ((code.coding.exists(code='273364009')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 600)) and ((code.coding.exists(code='Mayo')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='MayoE')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 12)) and ((code.coding.exists(code='PUCAI')) implies (value.ofType(integer) >= 0 and value.ofType(integer) <= 90))`

This structure is derived from Observation

Summary

Mandatory: 9 elements(12 nested mandatory elements)
Must-Support: 11 elements

Structures

This structure refers to these other structures:

- 病人資訊-Patient TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/Patient-twpas)
- 醫事人員-Practitioner TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/Practitioner-twpas)
- 文件參照-DocumentReference TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/DocumentReference-twpas)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Observation.component (Closed)

Other representations of profile: CSV, Excel, Schematron