臺灣健保癌症用藥事前審查實作指引
1.0.6 - ci-build

臺灣健保癌症用藥事前審查實作指引, 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 1.0.6 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

視覺化邏輯模型

癌藥事前審查之Bundle架構(Bundle Applying)

癌藥事前審查申請透過Bundle打包以下資料(相關對應表可以參照申請(Apply)癌藥事前審查之資料模型中的Mappings):
  • 事前審查-Bundle TWPAS
  • 事前審查-Claim TWPAS
  • 醫事機構-Organization TWPAS
  • 基因檢測機構-Organization Genetic Testing TWPAS
  • 就醫科別-Encounter TWPAS
  • 病人資訊-Patient TWPAS
  • 影像報告-DiagnosticReport Image TWPAS
  • DICOM影像-ImagingStudy TWPAS
  • 非DICOM影像-Media TWPAS
  • 癌症分期量表-Observation Cancer Stage TWPAS
  • 檢查報告-DiagnosticReport TWPAS
  • 基因資訊-Observation Diagnostic TWPAS
  • 檢驗檢查-Observation Laboratory Result
  • 病人狀態評估-Observation Patient Assessment TWPAS
  • 用藥品項-MedicationRequest Treat TWPAS
  • 放射治療-Procedure TWPAS
  • 放射治療總劑量-Substance TWPAS
  • 文件參照-DocumentReference
  • 治療後疾病狀態評估-Observation Treatment Assessment TWPAS
  • 事前審查品項-MedicationRequest Apply TWPAS
  • 自主審查報備-ClaimResponse Self Assessment TWPAS
  • 醫事人員-Practitioner TWPAS
  • 健保事前審查計畫-Coverage
  • 臺灣核心-政府機構(TW Core Organization Government)

Bundle架構圖

Bundle_Apply架構圖


癌藥事前審查回覆之Bundle架構(Bundle Response)

透過查詢參數搜尋癌藥事前審查狀態時,若操作語法有誤且執行失敗,將透過系統回應訊息-OperationOutcome TWPAS回應錯誤訊息; 若操作語法正確且執行成功,將透過事前審查回覆-Bundle Response TWPAS打包以下資料:
  • 事前審查結果-ClaimResponse TWPAS

Bundle架構圖

Bundle_Response架構圖


圖例說明圖

圖例說明