臺灣中醫實作指引
0.1.0 - ci-build

臺灣中醫實作指引, published by 衛生福利部國家中醫藥研究所. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/nricmig/Nricm_TWCMIG/ and changes regularly. See the Directory of published versions

## Resource Profile: ObservationTWCM - Detailed Descriptions

Draft as of 2026-08-31

Definitions for the observation-twcm resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Definition | 對病人、設備或其他對象進行的測量和簡單判定。 Measurements and simple assertions made about a patient, device or other subject.
Short | 檢驗檢查，測量及簡單的判定。Measurements and simple assertions
Comments | Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Vital Signs, Measurement, Results, Tests
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (`dataAbsentReason.empty() or value.empty()`) obs-7: 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()`) tw-core-4: If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (`(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())`) observation-code-match: Observation.code 必須與對應的 ServiceRequest.code 相同 (`basedOn.exists() implies (basedOn.resolve().ofType(ServiceRequest).code = code)`) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty()) obs-7: 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())
2. Observation.implicitRules
Definition | 構建resource時遵循的一系列規則的參照，在處理內容時必須理解這些規則。通常這是對IG所定義之特殊規則及其他profiles的參照。 A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | 創建此內容所依據的一組規則A set of rules under which this content was created
Comments | 宣告這套規則限制了內容只能被有限的交易夥伴所理解。這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，還沒有準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應該避免使用這個資料項目。通常在使用時，此URL是對IG的參照，此IG將這些特殊規則與其他profiles、value sets等一起定義為其敘述的一部分。 Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Observation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Observation.partOf
Definition | 此特定的檢驗檢查（Observation）是一個更大事件中的一個組成或步驟。例如：一項處置裡的一項檢驗檢查。 A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.
Short | 此檢驗檢查是哪個參照事件的一部分Part of referenced event
Comments | 使用encounter將一個檢驗檢查（Observation）與一個就醫（Encounter）連結起來。關於參照另一個Observation的作法，請參閱下面的Notes小節。 To link an Observation to an Encounter use `encounter`. See the Notes below for guidance on referencing another Observation.
Control | 0..*
Type | Reference(MedicationAdministration, TW Core MedicationDispense, TW Core MedicationStatement, 中醫-處置或手術(Procedure TWCM), TW Core Immunization, TW Core ImagingStudy, MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy)
Is Modifier | false
Summary | true
Alternate Names | Container
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Observation.status
Definition | 結果值的狀態 The status of the result value.
Short | registered ｜ preliminary ｜ final ｜ amended +registered | preliminary | final | amended +
Comments | 這個資料項目被標記為修飾語／修飾用，因為附加到其他文件上的文件，其本身是不完整的文件。 This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` ) 檢驗檢查的狀態代碼；應填入所綁定值集中的其中一個代碼。 Codes providing the status of an observation.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要追踪單個結果狀態，有些結果在整個報告確定之前就已經確定了。 Need to track the status of individual results. Some results are finalized before the whole report is finalized.
Pattern Value | `final`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Observation.category
Definition | 可以正式參照一個專門術語或本體論來定義一個概念，或者也可以文字表述此概念。 A code that classifies the general type of observation being made.
Short | 概念（concept）－參照一個專門術語或只是純文字。Classification of type of observation
Comments | 並非所有的專門術語使用都符合這個一般模式。在某些情況下，資料模型不應該使用CodeableConcept而應直接使用Coding，並提供他們自己的結構來管理text、codings、translation、資料項目之間的關係、以及先組合配對／前組合式（pre-coordination）和後組合配對／後組合式（post-coordination）。 In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 10..*
Binding | The codes SHOULD be taken from ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/observation-category` ) 高層次的檢驗檢查分類；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 Codes for high level observation categories.
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Requirements | 用於篩選取得及顯示之檢驗檢查 Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
12. Observation.category:twcore
Slice Name | twcore
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 10..1*
Binding | The codes SHALL be taken from The codes SHOULD be taken from 臺灣衛福部資訊處Observation Clinical Result類型值集 http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/observation-clinical-result-category` ) 此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。 Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", "code" : "laboratory" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Observation.code
Definition | 可以透過正式參照一個專門術語或本體論來定義一個概念，或者也可以文字表述此概念。 Describes what was observed. Sometimes this is called the observation "name".
Short | 概念(concept)－參照一個專門術語或只是純文字。[應填入門診病摘健保檢驗檢查代碼Test NHICode(code)及檢驗檢查名稱Test Name(text)。若為非健保署規範的院內碼，可另加一組coding表示，system請填入醫事機構自訂的代碼系統]Type of observation (code / type)
Comments | 並非所有的專門術語使用都符合這個一般模式。在某些情況下，資料模型不應該使用CodeableConcept而應直接使用Coding，並提供他們自己的結構來管理text、codings、translation、資料項目之間的關係、以及先組合配對／前組合式（pre-coordination）和後組合配對／後組合式（post-coordination）。 All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/observation-codes` ) 鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 Codes identifying names of simple observations.
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 知道正在進行的是哪種檢驗檢查是理解檢驗檢查的關鍵 Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names | Name
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Observation.code.coding
Definition | 由專門術語系統（terminology system）所定義之代碼的參照。 A reference to a code defined by a terminology system.
Short | 由專門術語系統（terminology system）定義的代碼Code defined by a terminology system
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，如SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..2* This element is affected by the following invariants: ele-1
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許使用者在不知道識別碼系統的情況下利用識別碼 Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.code.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ system
18. Observation.code.coding:LOINCObservationCode
Slice Name | LOINCObservationCode
Definition | 由專門術語系統（terminology system）所定義之代碼的參照。 A reference to a code defined by a terminology system.
Short | LOINC®為Regenstrief Institute, Inc.維護的檢驗事件描述代碼，可免費使用，可優先選用此代碼。Code defined by a terminology system
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，如SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1* This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from For codes, see LOINC實驗室檢驗檢查值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-observation-code` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許使用者在不知道識別碼系統的情況下利用識別碼 Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Observation.code.coding:LOINCObservationCode.system
Definition | 定義代碼中符號意義的代碼系統識別。 The identification of the code system that defines the meaning of the symbol in the code.
Short | 專門術語系統（terminology system）的識別Identity of the terminology system
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。 The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源 Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `http://loinc.org`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Observation.code.coding:LOINCObservationCode.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。 A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 系統定義的語法之符號Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼 Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Observation.code.coding:LOINCObservationCode.display
Definition | 遵循系統的規則以呈現代碼含義的表示法 A representation of the meaning of the code in the system, following the rules of the system.
Short | 由系統定義的表示法Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義 Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Observation.code.coding:TWLaboratoryCategory
Slice Name | TWLaboratoryCategory
Definition | 由專門術語系統（terminology system）所定義之代碼的參照。 A reference to a code defined by a terminology system.
Short | 此為中央健康保險署(NHI)維護之醫療服務給付項目-檢驗相關代碼，主要針對申報使用，更新頻率相對頻繁，可免費使用，可依情境選用此代碼。Code defined by a terminology system
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，如SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1* This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from For codes, see 臺灣健保署醫療服務給付項目-檢驗值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/laboratory-category-tw` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許使用者在不知道識別碼系統的情況下利用識別碼 Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Observation.code.coding:TWLaboratoryCategory.system
Definition | 定義代碼中符號意義的代碼系統識別。 The identification of the code system that defines the meaning of the symbol in the code.
Short | 專門術語系統（terminology system）的識別Identity of the terminology system
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。 The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源 Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Observation.code.coding:TWLaboratoryCategory.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。 A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 系統定義的語法之符號Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼 Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Observation.code.coding:TWLaboratoryCategory.display
Definition | 遵循系統的規則以呈現代碼含義的表示法 A representation of the meaning of the code in the system, following the rules of the system.
Short | 由系統定義的表示法Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義 Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Observation.code.text
Definition | 輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。 A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | 概念的文字表示法Plain text representation of the concept
Comments | 很多時候，此文字表述與其中一個代碼的顯示名稱相同。 Very often the text is the same as a displayName of one of the codings.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。 The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Observation.subject
Definition | 此檢驗檢查是關於一位病人、一群病人、地點、或設備。如果檢驗檢查的實際焦點與對象（或其樣本、其部分或其區域）不同，則焦點資料項目或代碼本身會具體說明檢驗檢查的實際焦點。 The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.
Short | 檢驗檢查有關的對象及（或）事物Who and/or what the observation is about
Comments | 人們期望這個資料項目的cardinality為1...1。唯一可能缺少對象的情況是當檢驗檢查是由一個不認識病人的設備進行的。在這種情況下，應透過一些情境／通道對應（context／channel matching）技術將檢驗檢查與病人對應，此時，應更新檢驗檢查資訊。 One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.
Control | 10..1
Type | Reference(病人資料(Patient TWCM), Patient, Group, Device, Location)
Is Modifier | false
Must Support | true
Summary | true
Requirements | 如果你不知道他們是誰或關於什麼，檢驗檢查不會有值。 Observations have no value if you don't know who or what they're about.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Observation.encounter
Definition | 執行檢驗檢查的健康照護事件（例如：病人及健康照護提供人員的互動） The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.
Short | 檢驗檢查是哪一次就醫時執行的Healthcare event during which this observation is made
Comments | 這通常指檢驗檢查發生於哪次就醫，但有些檢驗檢查可能是在就醫前或就醫後發生，但仍與就醫的情境有關（如入院前的實驗室檢驗檢查）。 This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
Control | 0..1
Type | Reference(就醫事件(Encounter TWCM), Encounter)
Is Modifier | false
Must Support | true
Summary | true
Requirements | 對於某些檢驗檢查來說，知道某個檢驗檢查和某個特定的就醫事件之間的連結可能很重要。 For some observations it may be important to know the link between an observation and a particular encounter.
Alternate Names | Context
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Observation.effective[x]
Definition | 宣告檢驗檢查值的產出時間或時間區段是真的。對於生物學研究對象—例如病人—這通常被稱為「生理相關時間」。這通常是處置的時間或採樣的時間，但很多時候不知道日期或時間的來源，只知道日期或時間本身。 The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.
Short | 檢驗檢查執行日期或時間區間Clinically relevant time/time-period for observation
Comments | 除非這是一份檢驗檢查的歷史報告，否則至少應該有一個日期。為了記錄不精確或「模煳」的時間（例如：測量「早餐後 」血糖），使用Timing datatype以允許測量能與常規生活事件連結。 At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.
Control | 10..1
Type | dateTime, Period, Timing, instant
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | dateTime
Summary | true
Requirements | 知道一項檢驗檢查何時被認為是真的，對其相關性和確定趨勢都很重要。 Knowing when an observation was deemed true is important to its relevance as well as determining trends.
Alternate Names | Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) tw-core-3: Datetime must be at least to day. (`$this is dateTime implies $this.toString().length() >= 10`)
Slicing | This element introduces a set of slices on `Observation.effective[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
42. Observation.effective[x]:effectiveDateTime
Slice Name | effectiveDateTime
Definition | 宣告檢驗檢查值的產出時間或時間區段是真的。對於生物學研究對象—例如病人—這通常被稱為「生理相關時間」。這通常是處置的時間或採樣的時間，但很多時候不知道日期或時間的來源，只知道日期或時間本身。 The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.
Short | 檢驗檢查執行日期或時間區間。[應填入門診病摘之檢查日期Exam Date]Clinically relevant time/time-period for observation
Comments | 除非這是一份檢驗檢查的歷史報告，否則至少應該有一個日期。為了記錄不精確或「模煳」的時間（例如：測量「早餐後 」血糖），使用Timing datatype以允許測量能與常規生活事件連結。 At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.
Control | 10..1
Type | dateTime, Period, Timing, instant
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | dateTime
Summary | true
Requirements | 知道一項檢驗檢查何時被認為是真的，對其相關性和確定趨勢都很重要。 Knowing when an observation was deemed true is important to its relevance as well as determining trends.
Alternate Names | Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) tw-core-3: Datetime must be at least to day. (`$this is dateTime implies $this.toString().length() >= 10`)
44. Observation.issued
Definition | 此版本的檢驗檢查資訊可供健康照護提供人員取得的日期和時間，通常是在結果被審查與核實之後。 The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.
Short | [應填入檢驗檢查完成的日期或時間]Date/Time this version was made available
Comments | 對於不需要審查和核實的檢驗檢查值，發佈日期時間可能與resource本身的最後更新日期時間相同。對於需要對某些更新進行審查和核實的檢驗檢查，若為非臨床上的重要更新則不需要對新版本進行再次審查和驗證，所以發佈日期時間可能與resource本身的最後更新日期時間不一樣。 For Observations that don’t require review and verification, it may be the same as the `lastUpdated` time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.
Control | 10..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Observation.performer
Definition | 誰負責宣告檢驗檢查結果值為「真的」 Who was responsible for asserting the observed value as "true".
Short | [應填入檢驗檢查執行醫事機構代碼Exam Hospital ID與檢驗檢查執行醫事機構名稱Exam Hospital Name]Who is responsible for the observation
Control | 10..1*
Type | Reference(檢驗檢查機構(OrganizationInspection TWCM), Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
Is Modifier | false
Must Support | true
Summary | true
Requirements | 可以對此檢驗檢查有一定程度的信任，並指出後續問題的方向。 May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Observation.value[x]
Definition | 如果此資訊有一個簡單的值，則將其作為此項檢驗檢查的結果。 The information determined as a result of making the observation, if the information has a simple value.
Short | [應填入門診病摘檢驗檢查結果值Test Result及檢驗檢查結果單位Result Unit]。Actual result
Comments | 一項檢驗檢查可能有：（1）單一值、（2）一個值及一組相關或組成之檢驗檢查的多個值、或者（3）只有一組相關或組成之檢驗檢查的多個值。如果有一個值，這個資料項目的datatype應該由Observation.code決定。如果這個資料項目是編碼或者如果與Observation.code相關的type定義一個編碼值，那麼將使用只有文字表述的CodeableConcept來代替字串。若需要更多的說明，請參閱下面Notes小節。 An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | Choice of: Quantity, CodeableConcept, string
Summary | true
Requirements | 通常一項檢驗檢查就會有一個值，雖然若它有錯誤或者它代表一組檢驗檢查可能不會有值。 An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) tw-core-5: SHALL use UCUM for coded quantity units. (`ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'`)
50. Observation.dataAbsentReason
Definition | 提供資料項目Observation.value[x]中的預期值缺少的原因 Provides a reason why the expected value in the element Observation.value[x] is missing.
Short | 缺少檢驗檢查結果的原因Why the result is missing
Comments | 空值（Null）或例外值可以在FHIR Observations中以兩種方式表示，一種方法是簡單地將它們含括在值集中，並在值中表示例外。例如：血清檢測的測量值可以是「檢測到」、「未檢測到」、「不確定」或「檢測未完成」。 另一種方法是使用資料項目value呈現實際檢驗檢查值，並使用資料項目dataAbsentReason來明確記錄例外值。例如：當測量沒有完成，可使用dataAbsentReason代碼「error」。請注意，只有在有值的情況下，才可以報告檢驗檢查。例如：只有在>0的情況下才可能報告細胞計數的差值。由於有這些選項，所以需要有使用案例協議（use-case agreements）來解釋一般檢驗檢查的例外值。 Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.
Control | 0..1 This element is affected by the following invariants: ele-1, obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason` ) 代碼具體說明檢驗檢查結果缺少的原因；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。 Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 對於許多結果，必須處理測量中的異常值。 For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Observation.interpretation
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A categorical assessment of an observation value. For example, high, low, normal.
Short | 高、低、正常等。[應填入門診病摘檢驗檢查結果判斷註記Result Flag]High, low, normal, etc.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation` ) 代碼指明檢驗檢查結果的解釋；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。 Codes identifying interpretations of observations.
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 對於某些結果，特別是數值結果，需有一個解釋以便完全理解結果之意義。 For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Observation.note
Definition | 關於檢驗檢查或結果的解說 Comments about the observation or the results.
Short | 關於此檢驗檢查之解說[應填入門診病摘檢驗檢查結果備註說明Result Comment]Comments about the observation
Comments | 可包括關於檢驗檢查的一般陳述，或關於重要的、非預期的或不可靠的結果值的陳述，或與資料項目interpretation有關的來源資訊。 May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.
Control | 0..*
Type | Annotation
Is Modifier | false
Must Support | true
Summary | false
Requirements | 需能提供純文字表述的附加資訊 Need to be able to provide free text additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Observation.hasMember
Definition | 這項檢驗檢查是一組檢驗檢查，例如：一個套組（battery）、一個檢驗套組（panel）或一組生命徵象測量，其組成的檢驗檢查為此資料項目的目標resource。 This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.
Short | 屬於此組檢驗檢查的相關ResourceRelated resource that belongs to the Observation group
Comments | 使用這個資料項目時，一項檢驗檢查通常會有一個值或者一組相關的resources，儘管在某些情況下兩者都可能存在。有關討論如何將Observations組合在一起的方法，請參閱下面的Notes小節。請注意，系統可能針對問卷調查的結果（ QuestionnaireResponse）計算成一個最終的分數，並將這個分數表示為一個Observation。 When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.
Control | 0..*
Type | Reference(檢驗檢查(Observation TWCM), TW Core QuestionnaireResponse, MolecularSequence, Observation, QuestionnaireResponse, MolecularSequence)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Observation.derivedFrom
Definition | 目標resource為一種測量，此檢驗檢查就是從那個測量中得出。例如：陰離子間隙（an anion gap）或胎兒的測量值是從超音波影像計算而得。 The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.
Short | 檢驗檢查源自哪些相關測量Related measurements the observation is made from
Comments | 在這個資料項目中列出可以代表臨床檢檢查和其他測量的所有參照選項，可能是衍生值的來源。最常見參照另一個Observation，關於Observations如何組合在一起的討論，請參閱下面的Notes小節。 All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.
Control | 0..*
Type | Reference(文件參照(DocumentReference TWCM), TW Core ImagingStudy, TW Core Media, TW Core QuestionnaireResponse, 檢驗檢查(Observation TWCM), MolecularSequence, DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Observation.component
Definition | 有有些檢驗檢查有多個組成之檢驗檢查，這些組成之檢驗檢查被表達為具有相同屬性的獨立的代碼值對（code value pair）。例子包括血壓測量的收縮壓和舒張壓即為組成之檢驗檢查（component observations），以及遺傳學檢驗檢查的多個組成之檢驗檢查。 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
Short | 組成之（部分）檢驗檢查的檢驗結果。若為檢驗套組此項目為必填。Component results
Comments | 有關如何組合Observations的方法討論，請參閱下面的Notes小節。 For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Requirements | 組成之檢驗檢查在Obsrvation resource中與主要檢驗檢查共享相同的屬性，並且總是被視為單個檢驗檢查的一部分（它們是不可分離的）。然而，主要檢驗檢查的參考範圍值並不被組成之檢驗檢查所繼承，在適當的時候需給予每項組成之檢驗檢查參考範圍值。 Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Observation.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. Observation.component.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Describes what was observed. Sometimes this is called the observation "code".
Short | [應填入健保檢驗檢查代碼Test NHICode(Code)與檢驗檢查名稱Test Name(text)]Type of component observation (code / type)
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see LOINC實驗室檢驗檢查值集 http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-observation-code` )
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 知道正在進行的是哪種檢驗檢查是理解檢驗檢查的關鍵 Knowing what kind of observation is being made is essential to understanding the observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Observation.component.code.coding
Definition | 由專門術語系統（terminology system）所定義之代碼的參照 A reference to a code defined by a terminology system.
Short | 由專門術語系統（terminology system）定義的代碼Code defined by a terminology system
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。 Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.component.code.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ system
68. Observation.component.code.coding:LOINCObservationCode
Slice Name | LOINCObservationCode
Definition | 由專門術語系統（terminology system）所定義之代碼的參照 A reference to a code defined by a terminology system.
Short | LOINC®為Regenstrief Institute, Inc.維護的檢驗事件描述代碼，可免費使用，可優先選用此代碼。Code defined by a terminology system
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1* This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from For codes, see LOINC實驗室檢驗檢查值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-observation-code` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。 Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Observation.component.code.coding:LOINCObservationCode.system
Definition | 定義代碼中符號意義的代碼系統識別 The identification of the code system that defines the meaning of the symbol in the code.
Short | 專門術語系統（terminology system）的識別Identity of the terminology system
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。 The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源 Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `http://loinc.org`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. Observation.component.code.coding:LOINCObservationCode.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。 A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 系統定義的語法之符號Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼 Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Observation.component.code.coding:LOINCObservationCode.display
Definition | 遵循系統的規則以呈現代碼含義的表示法 A representation of the meaning of the code in the system, following the rules of the system.
Short | 由系統定義的表示法Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義 Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Observation.component.code.coding:TWLaboratoryCategory
Slice Name | TWLaboratoryCategory
Definition | 由專門術語系統（terminology system）所定義之代碼的參照 A reference to a code defined by a terminology system.
Short | 此為中央健康保險署(NHI)維護之醫療服務給付項目相關代碼，主要針對申報使用，更新頻率相對頻繁，可免費使用，可依情境選用此代碼。Code defined by a terminology system
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1* This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from For codes, see 臺灣健保署醫療服務給付項目-檢驗值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/laboratory-category-tw` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。 Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Observation.component.code.coding:TWLaboratoryCategory.system
Definition | 定義代碼中符號意義的代碼系統識別 The identification of the code system that defines the meaning of the symbol in the code.
Short | 專門術語系統（terminology system）的識別Identity of the terminology system
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。 The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源 Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Observation.component.code.coding:TWLaboratoryCategory.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。 A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 系統定義的語法之符號Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼 Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. Observation.component.code.coding:TWLaboratoryCategory.display
Definition | 遵循系統的規則以呈現代碼含義的表示法 A representation of the meaning of the code in the system, following the rules of the system.
Short | 由系統定義的表示法Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義 Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Observation.component.code.text
Definition | 輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。 A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | 概念的文字表示法Plain text representation of the concept
Comments | 很多時候，此文字表述與其中一個代碼的顯示名稱相同。 Very often the text is the same as a displayName of one of the codings.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。 The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Observation.component.value[x]
Definition | 如果資訊中帶有一個值（simple value）則其可作為檢驗檢查的結果。 The information determined as a result of making the observation, if the information has a simple value.
Short | [應填入門診病摘組成之檢驗檢查結果值Test Result及檢驗檢查結果單位Result Unit]Actual component result
Comments | 一項檢驗檢查可能有一個值（如Apgar評分）和組成之檢驗檢查值（Apgar評分所來自多項檢驗檢查）。如果有一個值，這個資料項目的datatype應該由Observation.code決定。如果這個資料項目是編碼或者如果與Observation.code相關的type定義一個編碼值，那麼將使用只有文字表述的CodeableConcept來代替字串。若需要更多的說明，請參閱下面Notes小節。 Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | 通常一項檢驗檢查就會有一個值，雖然若它有錯誤或者它代表一組檢驗檢查可能不會有值。 An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. Observation.component.interpretation
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. A categorical assessment of an observation value. For example, high, low, normal.
Short | 高、低、正常等。[應填入門診病摘檢驗檢查結果判斷註記Result Flag]High, low, normal, etc.
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation` ) 用以指明檢驗檢查的解釋之代碼。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。 Codes identifying interpretations of observations.
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 對於某些結果，特別是數值結果，需有一個解釋以便完全理解結果之意義。 For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. Observation.component.interpretation.coding
Definition | 由專門術語系統（terminology system）所定義之代碼的參照 A reference to a code defined by a terminology system.
Short | 由專門術語系統（terminology system）定義的代碼Code defined by a terminology system
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。 Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. Observation.component.interpretation.text
Definition | 輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。 A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | [應填入門診病摘檢驗檢查結果備註說明Result Comment]Plain text representation of the concept
Comments | 很多時候，此文字表述與其中一個代碼的顯示名稱相同。 Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。 The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Invariants | observation-code-match: Observation.code 必須與對應的 ServiceRequest.code 相同 (`basedOn.exists() implies (basedOn.resolve().ofType(ServiceRequest).code = code)`)
2. Observation.partOf
Type | Reference(MedicationAdministration, TW Core MedicationDispense, TW Core MedicationStatement, 中醫-處置或手術(Procedure TWCM), TW Core Immunization, TW Core ImagingStudy)
4. Observation.status
Pattern Value | `final`
6. Observation.code
Short | 概念(concept)－參照一個專門術語或只是純文字。[應填入門診病摘健保檢驗檢查代碼Test NHICode(code)及檢驗檢查名稱Test Name(text)。若為非健保署規範的院內碼，可另加一組coding表示，system請填入醫事機構自訂的代碼系統]
8. Observation.code.coding
Control | 1..2
10. Observation.code.text
Control | 1..?
12. Observation.subject
Type | Reference(病人資料(Patient TWCM))
14. Observation.encounter
Type | Reference(就醫事件(Encounter TWCM))
16. Observation.effective[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Slicing | This element introduces a set of slices on `Observation.effective[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
18. Observation.effective[x]:effectiveDateTime
Slice Name | effectiveDateTime
Short | 檢驗檢查執行日期或時間區間。[應填入門診病摘之檢查日期Exam Date]
Control | 1..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | dateTime
20. Observation.issued
Short | [應填入檢驗檢查完成的日期或時間]
Control | 1..?
Must Support | true
22. Observation.performer
Short | [應填入檢驗檢查執行醫事機構代碼Exam Hospital ID與檢驗檢查執行醫事機構名稱Exam Hospital Name]
Control | 1..1
Type | Reference(檢驗檢查機構(OrganizationInspection TWCM))
24. Observation.value[x]
Short | [應填入門診病摘檢驗檢查結果值Test Result及檢驗檢查結果單位Result Unit]。
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
26. Observation.interpretation
Short | 高、低、正常等。[應填入門診病摘檢驗檢查結果判斷註記Result Flag]
Must Support | true
28. Observation.note
Short | 關於此檢驗檢查之解說[應填入門診病摘檢驗檢查結果備註說明Result Comment]
Must Support | true
30. Observation.hasMember
Type | Reference(檢驗檢查(Observation TWCM), TW Core QuestionnaireResponse, MolecularSequence)
32. Observation.derivedFrom
Type | Reference(文件參照(DocumentReference TWCM), TW Core ImagingStudy, TW Core Media, TW Core QuestionnaireResponse, 檢驗檢查(Observation TWCM), MolecularSequence)
34. Observation.component
Short | 組成之（部分）檢驗檢查的檢驗結果。若為檢驗套組此項目為必填。
36. Observation.component.code
Short | [應填入健保檢驗檢查代碼Test NHICode(Code)與檢驗檢查名稱Test Name(text)]
38. Observation.component.code.text
Control | 1..?
40. Observation.component.value[x]
Short | [應填入門診病摘組成之檢驗檢查結果值Test Result及檢驗檢查結果單位Result Unit]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
42. Observation.component.interpretation
Short | 高、低、正常等。[應填入門診病摘檢驗檢查結果判斷註記Result Flag]
Must Support | true
44. Observation.component.interpretation.text
Short | [應填入門診病摘檢驗檢查結果備註說明Result Comment]

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Definition | 對病人、設備或其他對象進行的測量和簡單判定。
Short | 檢驗檢查，測量及簡單的判定。
Comments | Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Vital Signs, Measurement, Results, Tests
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (`dataAbsentReason.empty() or value.empty()`) obs-7: 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()`) tw-core-4: If there is no component or hasMember element then either a value[x] or a data absent reason must be present. (`(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())`) observation-code-match: Observation.code 必須與對應的 ServiceRequest.code 相同 (`basedOn.exists() implies (basedOn.resolve().ofType(ServiceRequest).code = code)`)
2. Observation.id
Definition | resource的邏輯ID，在resource的URL中使用。一旦指定，這個值永遠不會改變。
Short | 不重複的ID用以識別儲存在特定FHIR Server中的Observation紀錄，通常又稱為邏輯性ID。
Comments | 一個resource使用新增操作（create operation）提交給伺服器時，此resource沒有id，它的id在resource被創建後由伺器分配/指定。
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Observation.meta
Definition | 關於resource的metadata。這是由基礎建設維護的內容。內容的更改可能並不總是與resource的版本更改相關聯。
Short | 此Observation Resource的metadata
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Observation.implicitRules
Definition | 構建resource時遵循的一系列規則的參照，在處理內容時必須理解這些規則。通常這是對IG所定義之特殊規則及其他profiles的參照。
Short | 創建此內容所依據的一組規則
Comments | 宣告這套規則限制了內容只能被有限的交易夥伴所理解。這從本質上限制了資料的長期有用性。然而，現有的健康生態體系高度分裂，還沒有準備好以普遍可計算的方式定義、收集和交換資料。只要有可能，實作者和/或規範編寫者應該避免使用這個資料項目。通常在使用時，此URL是對IG的參照，此IG將這些特殊規則與其他profiles、value sets等一起定義為其敘述的一部分。
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Observation.language
Definition | 編寫此resource的語言
Short | 用以表述Observation Resource內容的語言。
Comments | 提供語言是為了支援索引和可存取性（通常，文字表述轉語音等服務使用此語言標籤）。html lanuage tag適用於此敘述。resource上的語言標籤可用於指定從resource中的資料所產成的其他表述之語言。不是所有的內容都必須使用此語言。不應該假定Resource.language自動適用於敘述。如果指定語言，它也應該被指定在html中的div資料項目（關於xml:lang和html lang屬性之間的關係，見HTML5中的規則）。
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) 人類語言；鼓勵使用CommonLanguages代碼表中的代碼，但不強制一定要使用此代碼表，你也可使用其他代碼表的代碼或單純以文字表示。
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Example | Value: zh-TW
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Observation.text
Definition | 人可讀的敘述，包含resource的摘要，可用於向人表述resource的內容。敘述不需要對所有的結構化資料進行編碼，但需要包含足夠的細節使人在閱讀敘述時理解「臨床安全性」。resource定義有哪些內容應該在敘述中表示，以確保臨床安全。
Short | Observation Resource之內容摘要以供人閱讀
Comments | 內嵌（contained）的resource沒有敘述，非內嵌（contained）的resource則 建議應該（SHOULD） 有敘述。有時resource可能只有文字表述，很少或沒有額外的結構化資料（只要滿足所有minOccurs=1的資料項目）。這可能出現在舊系統的資料，當資訊以 「文字表述區塊（text blob） 」的形式被取得，或者文字表述是原始輸入或說明，而編碼資訊稍後再添加。
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Observation.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Observation.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. Observation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Observation.identifier
Definition | 此檢驗檢查的唯一識別碼
Short | 檢驗檢查的識別碼，通常為業務目的所使用的識別碼，例如：檢驗序號或單號。
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | 允許對檢驗檢查結果進行區分和參照
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. Observation.basedOn
Definition | 依據的計劃、提議或醫令或其部分要求進行檢驗檢查。例如：一個MedicationRequest可能要求給病人藥之前要先進行實驗室檢查。
Short | 依據的照護計畫／提議／醫令
Control | 0..*
Type | Reference(TW Core CarePlan, DeviceRequest, ImmunizationRecommendation, TW Core MedicationRequest, NutritionOrder, TW Core ServiceRequest)
Is Modifier | false
Summary | true
Requirements | 允許授權追踪檢驗檢查事件並追踪提議／建議是否有落實
Alternate Names | Fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. Observation.partOf
Definition | 此特定的檢驗檢查（Observation）是一個更大事件中的一個組成或步驟。例如：一項處置裡的一項檢驗檢查。
Short | 此檢驗檢查是哪個參照事件的一部分
Comments | 使用encounter將一個檢驗檢查（Observation）與一個就醫（Encounter）連結起來。關於參照另一個Observation的作法，請參閱下面的Notes小節。
Control | 0..*
Type | Reference(MedicationAdministration, TW Core MedicationDispense, TW Core MedicationStatement, 中醫-處置或手術(Procedure TWCM), TW Core Immunization, TW Core ImagingStudy)
Is Modifier | false
Summary | true
Alternate Names | Container
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. Observation.status
Definition | 結果值的狀態
Short | registered ｜ preliminary ｜ final ｜ amended +
Comments | 這個資料項目被標記為修飾語／修飾用，因為附加到其他文件上的文件，其本身是不完整的文件。
Control | 1..1
Binding | The codes SHALL be taken from ObservationStatus (required to `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` ) 檢驗檢查的狀態代碼；應填入所綁定值集中的其中一個代碼。
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要追踪單個結果狀態，有些結果在整個報告確定之前就已經確定了。
Pattern Value | `final`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Observation.category
Definition | 可以正式參照一個專門術語或本體論來定義一個概念，或者也可以文字表述此概念。
Short | 概念（concept）－參照一個專門術語或只是純文字。
Comments | 並非所有的專門術語使用都符合這個一般模式。在某些情況下，資料模型不應該使用CodeableConcept而應直接使用Coding，並提供他們自己的結構來管理text、codings、translation、資料項目之間的關係、以及先組合配對／前組合式（pre-coordination）和後組合配對／後組合式（post-coordination）。
Control | 1..*
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to `http://hl7.org/fhir/ValueSet/observation-category` ) 高層次的檢驗檢查分類；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Requirements | 用於篩選取得及顯示之檢驗檢查
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
28. Observation.category:twcore
Slice Name | twcore
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 1..1
Binding | The codes SHALL be taken from 臺灣衛福部資訊處Observation Clinical Result類型值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/observation-clinical-result-category` ) 此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", "code" : "laboratory" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. Observation.code
Definition | 可以透過正式參照一個專門術語或本體論來定義一個概念，或者也可以文字表述此概念。
Short | 概念(concept)－參照一個專門術語或只是純文字。[應填入門診病摘健保檢驗檢查代碼Test NHICode(code)及檢驗檢查名稱Test Name(text)。若為非健保署規範的院內碼，可另加一組coding表示，system請填入醫事機構自訂的代碼系統]
Comments | 並非所有的專門術語使用都符合這個一般模式。在某些情況下，資料模型不應該使用CodeableConcept而應直接使用Coding，並提供他們自己的結構來管理text、codings、translation、資料項目之間的關係、以及先組合配對／前組合式（pre-coordination）和後組合配對／後組合式（post-coordination）。
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from LOINCCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-codes` ) 鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 知道正在進行的是哪種檢驗檢查是理解檢驗檢查的關鍵
Alternate Names | Name
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. Observation.code.id
Definition | resource中資料項目的唯一ID（用於內部參照）。這可以是任何不含空格的字串。
Short | 唯一可識別ID，以供資料項目間相互參照。
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
34. Observation.code.extension
Definition | 擴充的資料項目
Short | 擴充的資料項目
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.code.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
36. Observation.code.coding
Definition | 由專門術語系統（terminology system）所定義之代碼的參照。
Short | 由專門術語系統（terminology system）定義的代碼
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，如SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。
Control | 1..2 This element is affected by the following invariants: ele-1
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許使用者在不知道識別碼系統的情況下利用識別碼
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.code.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ system
38. Observation.code.coding:LOINCObservationCode
Slice Name | LOINCObservationCode
Definition | 由專門術語系統（terminology system）所定義之代碼的參照。
Short | LOINC®為Regenstrief Institute, Inc.維護的檢驗事件描述代碼，可免費使用，可優先選用此代碼。
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，如SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from LOINC實驗室檢驗檢查值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-observation-code` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許使用者在不知道識別碼系統的情況下利用識別碼
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. Observation.code.coding:LOINCObservationCode.id
Definition | resource中資料項目的唯一ID（用於內部參照），這可以是任何不含空格的字串。
Short | 唯一可識別ID，以供資料項目間相互參照。
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
42. Observation.code.coding:LOINCObservationCode.extension
Definition | 可用於表示不屬於此資料項目基本定義的附加資訊。為了擴充的使用安全和可管理，對擴充的定義和使用有一套嚴格的管理。儘管任何實作者都可以定義一個擴充，但作為擴充定義的一部分，有一套要求 必須（SHALL） 滿足。
Short | 擴充的資料項目
Comments | 無論使用或定義擴充的機構或管轄區，任何應用程式、專案或標準使用擴充都不背負任何污名（stigma）。使用擴充是允許FHIR規範為每個人保留一個核心的簡易性。
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.code.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
44. Observation.code.coding:LOINCObservationCode.system
Definition | 定義代碼中符號意義的代碼系統識別。
Short | 專門術語系統（terminology system）的識別
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源
Pattern Value | `http://loinc.org`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Observation.code.coding:LOINCObservationCode.version
Definition | 選擇此代碼時使用的代碼系統版本；請注意，一個維護良好的代碼系統不需要版本報告，因為代碼的意義在不同系統版本中是一致的；然而，不能始終保證這點，當不能保證意義一致時， 必須（SHALL） 將版本資訊也一併作交換。
Short | 系統的版本—如果相關的話
Comments | 如果專門術語沒有明確定義應該使用什麼字串來識別代碼系統的版本，建議使用版本正式發布的日期（用FHIR日期格式表示）作為版本日期。
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. Observation.code.coding:LOINCObservationCode.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。
Short | 系統定義的語法之符號
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Observation.code.coding:LOINCObservationCode.display
Definition | 遵循系統的規則以呈現代碼含義的表示法
Short | 由系統定義的表示法
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Observation.code.coding:LOINCObservationCode.userSelected
Definition | 表明此編碼是由使用者直接選擇，例如：從可用項目（代碼或顯示名稱）的清單中選擇。
Short | 此編碼是否由使用者直接選擇？
Comments | 在一系列備選方案中，直接選擇的代碼是新翻譯最合適的起點；關於「直接選擇」的確切意義，存在模糊不清之處，可能需要貿易夥伴的同意，以更完整澄清此資料項目的使用及其後果。
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | 已被確定為一個臨床安全準則—此確切的系統／代碼對(code pair)是被明確選擇的，而不是由系統根據一些規則或是程式語言處理判斷。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Observation.code.coding:TWLaboratoryCategory
Slice Name | TWLaboratoryCategory
Definition | 由專門術語系統（terminology system）所定義之代碼的參照。
Short | 此為中央健康保險署(NHI)維護之醫療服務給付項目-檢驗相關代碼，主要針對申報使用，更新頻率相對頻繁，可免費使用，可依情境選用此代碼。
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，如SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from 臺灣健保署醫療服務給付項目-檢驗值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/laboratory-category-tw` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許使用者在不知道識別碼系統的情況下利用識別碼
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Observation.code.coding:TWLaboratoryCategory.id
Definition | resource中資料項目的唯一ID（用於內部參照），這可以是任何不含空格的字串。
Short | 唯一可識別ID，以供資料項目間相互參照。
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
58. Observation.code.coding:TWLaboratoryCategory.extension
Definition | 可用於表示不屬於此資料項目基本定義的附加資訊。為了擴充的使用安全和可管理，對擴充的定義和使用有一套嚴格的管理。儘管任何實作者都可以定義一個擴充，但作為擴充定義的一部分，有一套要求 必須（SHALL） 滿足。
Short | 擴充的資料項目
Comments | 無論使用或定義擴充的機構或管轄區，任何應用程式、專案或標準使用擴充都不背負任何污名（stigma）。使用擴充是允許FHIR規範為每個人保留一個核心的簡易性。
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.code.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
60. Observation.code.coding:TWLaboratoryCategory.system
Definition | 定義代碼中符號意義的代碼系統識別。
Short | 專門術語系統（terminology system）的識別
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Observation.code.coding:TWLaboratoryCategory.version
Definition | 選擇此代碼時使用的代碼系統版本；請注意，一個維護良好的代碼系統不需要版本報告，因為代碼的意義在不同系統版本中是一致的；然而，不能始終保證這點，當不能保證意義一致時， 必須（SHALL） 將版本資訊也一併作交換。
Short | 系統的版本—如果相關的話
Comments | 如果專門術語沒有明確定義應該使用什麼字串來識別代碼系統的版本，建議使用版本正式發布的日期（用FHIR日期格式表示）作為版本日期。
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Observation.code.coding:TWLaboratoryCategory.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。
Short | 系統定義的語法之符號
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Observation.code.coding:TWLaboratoryCategory.display
Definition | 遵循系統的規則以呈現代碼含義的表示法
Short | 由系統定義的表示法
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Observation.code.coding:TWLaboratoryCategory.userSelected
Definition | 表明此編碼是由使用者直接選擇，例如：從可用項目（代碼或顯示名稱）的清單中選擇。
Short | 此編碼是否由使用者直接選擇？
Comments | 在一系列備選方案中，直接選擇的代碼是新翻譯最合適的起點；關於「直接選擇」的確切意義，存在模糊不清之處，可能需要貿易夥伴的同意，以更完整澄清此資料項目的使用及其後果。
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | 已被確定為一個臨床安全準則—此確切的系統／代碼對(code pair)是被明確選擇的，而不是由系統根據一些規則或是程式語言處理判斷。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. Observation.code.text
Definition | 輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。
Short | 概念的文字表示法
Comments | 很多時候，此文字表述與其中一個代碼的顯示名稱相同。
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Observation.subject
Definition | 此檢驗檢查是關於一位病人、一群病人、地點、或設備。如果檢驗檢查的實際焦點與對象（或其樣本、其部分或其區域）不同，則焦點資料項目或代碼本身會具體說明檢驗檢查的實際焦點。
Short | 檢驗檢查有關的對象及（或）事物
Comments | 人們期望這個資料項目的cardinality為1...1。唯一可能缺少對象的情況是當檢驗檢查是由一個不認識病人的設備進行的。在這種情況下，應透過一些情境／通道對應（context／channel matching）技術將檢驗檢查與病人對應，此時，應更新檢驗檢查資訊。
Control | 1..1
Type | Reference(病人資料(Patient TWCM))
Is Modifier | false
Must Support | true
Summary | true
Requirements | 如果你不知道他們是誰或關於什麼，檢驗檢查不會有值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Observation.focus
Definition | 檢驗檢查的實際焦點，當它不是記錄病人時，代表是與病人有關的事物或人，如配偶、父母、胎兒或捐贈者。例如：母親的記錄中有關胎兒檢驗檢查。檢驗檢查的焦點也可以是現有的狀況、疾病或問題（condition）、介入（intervention）、此對象的飲食、對此對象的另一項檢驗檢查，或身體結構像是腫瘤或植入裝置。有一個案例是使用Observation Resource來取得母親是否已接受更換她的小孩的氣管插管訓練之資訊，在這個例子中，孩子是此記錄的病人，而母親是focus。
Short | 當檢驗檢查並非有關於與病人本身，檢驗檢查是關於什麼。
Comments | 通常檢驗檢查的對象是一位病人或一群病人、地點或設備，檢驗檢查對象與直接測量內容之間的區別在observation.code已具體說明（例如： 「血糖」），不需要使用這個資料項目（focus）單獨表示。如果需要參照檢體，則使用specimen，如果需要一個代碼而不是一個resource，則使用bodysite來表示bodysites或標準擴充focusCode。
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Observation.encounter
Definition | 執行檢驗檢查的健康照護事件（例如：病人及健康照護提供人員的互動）
Short | 檢驗檢查是哪一次就醫時執行的
Comments | 這通常指檢驗檢查發生於哪次就醫，但有些檢驗檢查可能是在就醫前或就醫後發生，但仍與就醫的情境有關（如入院前的實驗室檢驗檢查）。
Control | 0..1
Type | Reference(就醫事件(Encounter TWCM))
Is Modifier | false
Must Support | true
Summary | true
Requirements | 對於某些檢驗檢查來說，知道某個檢驗檢查和某個特定的就醫事件之間的連結可能很重要。
Alternate Names | Context
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Observation.effective[x]
Definition | 宣告檢驗檢查值的產出時間或時間區段是真的。對於生物學研究對象—例如病人—這通常被稱為「生理相關時間」。這通常是處置的時間或採樣的時間，但很多時候不知道日期或時間的來源，只知道日期或時間本身。
Short | 檢驗檢查執行日期或時間區間
Comments | 除非這是一份檢驗檢查的歷史報告，否則至少應該有一個日期。為了記錄不精確或「模煳」的時間（例如：測量「早餐後 」血糖），使用Timing datatype以允許測量能與常規生活事件連結。
Control | 1..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | dateTime
Summary | true
Requirements | 知道一項檢驗檢查何時被認為是真的，對其相關性和確定趨勢都很重要。
Alternate Names | Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) tw-core-3: Datetime must be at least to day. (`$this is dateTime implies $this.toString().length() >= 10`)
Slicing | This element introduces a set of slices on `Observation.effective[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
80. Observation.effective[x]:effectiveDateTime
Slice Name | effectiveDateTime
Definition | 宣告檢驗檢查值的產出時間或時間區段是真的。對於生物學研究對象—例如病人—這通常被稱為「生理相關時間」。這通常是處置的時間或採樣的時間，但很多時候不知道日期或時間的來源，只知道日期或時間本身。
Short | 檢驗檢查執行日期或時間區間。[應填入門診病摘之檢查日期Exam Date]
Comments | 除非這是一份檢驗檢查的歷史報告，否則至少應該有一個日期。為了記錄不精確或「模煳」的時間（例如：測量「早餐後 」血糖），使用Timing datatype以允許測量能與常規生活事件連結。
Control | 1..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | dateTime
Summary | true
Requirements | 知道一項檢驗檢查何時被認為是真的，對其相關性和確定趨勢都很重要。
Alternate Names | Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) tw-core-3: Datetime must be at least to day. (`$this is dateTime implies $this.toString().length() >= 10`)
82. Observation.issued
Definition | 此版本的檢驗檢查資訊可供健康照護提供人員取得的日期和時間，通常是在結果被審查與核實之後。
Short | [應填入檢驗檢查完成的日期或時間]
Comments | 對於不需要審查和核實的檢驗檢查值，發佈日期時間可能與resource本身的最後更新日期時間相同。對於需要對某些更新進行審查和核實的檢驗檢查，若為非臨床上的重要更新則不需要對新版本進行再次審查和驗證，所以發佈日期時間可能與resource本身的最後更新日期時間不一樣。
Control | 1..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Observation.performer
Definition | 誰負責宣告檢驗檢查結果值為「真的」
Short | [應填入檢驗檢查執行醫事機構代碼Exam Hospital ID與檢驗檢查執行醫事機構名稱Exam Hospital Name]
Control | 1..1
Type | Reference(檢驗檢查機構(OrganizationInspection TWCM))
Is Modifier | false
Must Support | true
Summary | true
Requirements | 可以對此檢驗檢查有一定程度的信任，並指出後續問題的方向。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Observation.value[x]
Definition | 如果此資訊有一個簡單的值，則將其作為此項檢驗檢查的結果。
Short | [應填入門診病摘檢驗檢查結果值Test Result及檢驗檢查結果單位Result Unit]。
Comments | 一項檢驗檢查可能有：（1）單一值、（2）一個值及一組相關或組成之檢驗檢查的多個值、或者（3）只有一組相關或組成之檢驗檢查的多個值。如果有一個值，這個資料項目的datatype應該由Observation.code決定。如果這個資料項目是編碼或者如果與Observation.code相關的type定義一個編碼值，那麼將使用只有文字表述的CodeableConcept來代替字串。若需要更多的說明，請參閱下面Notes小節。
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | Choice of: Quantity, CodeableConcept, string
Summary | true
Requirements | 通常一項檢驗檢查就會有一個值，雖然若它有錯誤或者它代表一組檢驗檢查可能不會有值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) tw-core-5: SHALL use UCUM for coded quantity units. (`ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'`)
88. Observation.dataAbsentReason
Definition | 提供資料項目Observation.value[x]中的預期值缺少的原因
Short | 缺少檢驗檢查結果的原因
Comments | 空值（Null）或例外值可以在FHIR Observations中以兩種方式表示，一種方法是簡單地將它們含括在值集中，並在值中表示例外。例如：血清檢測的測量值可以是「檢測到」、「未檢測到」、「不確定」或「檢測未完成」。 另一種方法是使用資料項目value呈現實際檢驗檢查值，並使用資料項目dataAbsentReason來明確記錄例外值。例如：當測量沒有完成，可使用dataAbsentReason代碼「error」。請注意，只有在有值的情況下，才可以報告檢驗檢查。例如：只有在>0的情況下才可能報告細胞計數的差值。由於有這些選項，所以需要有使用案例協議（use-case agreements）來解釋一般檢驗檢查的例外值。
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason` ) 代碼具體說明檢驗檢查結果缺少的原因；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。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 對於許多結果，必須處理測量中的異常值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. Observation.interpretation
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | 高、低、正常等。[應填入門診病摘檢驗檢查結果判斷註記Result Flag]
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation` ) 代碼指明檢驗檢查結果的解釋；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。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 對於某些結果，特別是數值結果，需有一個解釋以便完全理解結果之意義。
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. Observation.note
Definition | 關於檢驗檢查或結果的解說
Short | 關於此檢驗檢查之解說[應填入門診病摘檢驗檢查結果備註說明Result Comment]
Comments | 可包括關於檢驗檢查的一般陳述，或關於重要的、非預期的或不可靠的結果值的陳述，或與資料項目interpretation有關的來源資訊。
Control | 0..*
Type | Annotation
Is Modifier | false
Must Support | true
Summary | false
Requirements | 需能提供純文字表述的附加資訊
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Observation.bodySite
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | 概念（Concept）— 參照一個專門術語或只是文字表述
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from SNOMEDCTBodyStructures (extensible to `http://hl7.org/fhir/ValueSet/body-site` )
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Observation.method
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | 概念（Concept）— 參照一個專門術語或只是文字表述
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ObservationMethods (extensible to `http://hl7.org/fhir/ValueSet/observation-methods` )
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Requirements | 在某些情況下，方法會影響結果，因此用於確認結果是否可以比較或確認結果的顯著性（significance）。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Observation.specimen
Definition | 進行這項檢驗檢查時使用的檢體
Short | 此檢驗檢查的檢體
Comments | 只有在Observation.code中的代碼未隱含此資料項目概念時才會使用。 檢驗檢查不是針對檢體本身進行，而是針對對象，但在很多情況下是透過檢體的方式進行檢驗檢查。請注意，雖然經常涉及到檢體，但並不總是明確地對其進行追踪和報告。還要注意的是Observation resources可在明確追踪檢體的情境下使用（例如：Diagnostic Report）。
Control | 0..1
Type | Reference(TW Core Specimen)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Observation.device
Definition | 用於產生檢驗檢查資料的設備
Short | （測量）設備
Comments | 請注意，這不是用來表示結果傳輸的設備，例如：閘道器（gateway）等可在相關情況下使用 Provenance resource進行記錄。
Control | 0..1
Type | Reference(Device, DeviceMetric)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Observation.referenceRange
Definition | 指導如何透過與正常或建議範圍值的比較來解釋此值。多個參考範圍值以「OR」解釋。換句話說，為了代表兩個不同的目標人群，將使用兩個referenceRange資料項目。
Short | 解釋結果值的指引。 obs-3：必須至少有低、高或文字表述。
Comments | 大多數檢驗檢查只有一個通用的參考範圍值。系統 可能可以（MAY） 選擇限制只提供病人的相關參考範圍值（例如：具體的病人年齡、性別、體重和其他因素），但這可能是不可能的或也不合適。只要提供了一個以上的參考範圍值，就 建議應該（SHOULD） 提供不同年齡的參考範圍值差異。
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | 知道什麼值被認為是「正常的」，可以幫助評估某一特定結果的意義。需要能夠為不同的情境提供多個參考範圍值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) obs-3: Must have at least a low or a high or text (`low.exists() or high.exists() or text.exists()`)
104. Observation.referenceRange.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
106. Observation.referenceRange.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
108. Observation.referenceRange.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
110. Observation.referenceRange.low
Definition | 參考範圍值的下限值。參考範圍值endpoint的下限值包含在此值中（例如：參考範圍值是>=5 - <=9）。如果省略下限值，則被認為是沒有意義的（例如：參考範圍值是<=2.3）。
Short | 參考範圍值的下限值，如果相關。
Control | 0..1 This element is affected by the following invariants: obs-3
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. Observation.referenceRange.high
Definition | 參考範圍值的下限值。參考範圍值endpoint的下限值包含在此值中（例如：參考範圍值是>=5 - <=9）。如果省略下限值，則被認為是沒有意義的（例如：參考範圍值是<=2.3）。
Short | 參考範圍值的上限值，如果相關。
Control | 0..1 This element is affected by the following invariants: obs-3
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. Observation.referenceRange.type
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | 概念（Concept）— 參照一個專門術語或只是文字表述
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from ObservationReferenceRangeMeaningCodes (preferred to `http://hl7.org/fhir/ValueSet/referencerange-meaning` ) 用以表述參考範圍值之含意的代碼；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Requirements | 需要能夠說出這是什麼樣的參考範圍值：正常的、建議的、治療的等，以便正確解釋。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. Observation.referenceRange.appliesTo
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | 概念（Concept）— 參照一個專門術語或只是文字表述
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | For example codes, see ObservationReferenceRangeAppliesToCodes (example to `http://hl7.org/fhir/ValueSet/referencerange-appliesto` ) 用以指明參考範圍值適用的對象或人口群之代碼；可參考所綁定代碼表，但此代碼表只是針對這個欄位的一個可能值的示例，不預期也不鼓勵使用者一定要使用此代碼表的代碼代碼表中的代碼。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Requirements | 需要能夠指明目標人群以進行適當的解釋。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. Observation.referenceRange.age
Definition | 此參考範圍值適用的年齡，如果意思是說足月時的週數，這就是指新生兒年齡。
Short | 適用的年齡範圍值，如果相關。
Control | 0..1
Type | Range
Is Modifier | false
Summary | false
Requirements | 有些分析隨著年齡的增長變化很大
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. Observation.referenceRange.text
Definition | 檢驗檢查中以文字表述的參考範圍值，可在不適合以定量範圍值呈現某項檢驗檢查時使用。例如：「陰性」的參照值或 「正常」的清單／列表。
Short | 檢驗檢查中以文字表述的參考範圍值
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Observation.hasMember
Definition | 這項檢驗檢查是一組檢驗檢查，例如：一個套組（battery）、一個檢驗套組（panel）或一組生命徵象測量，其組成的檢驗檢查為此資料項目的目標resource。
Short | 屬於此組檢驗檢查的相關Resource
Comments | 使用這個資料項目時，一項檢驗檢查通常會有一個值或者一組相關的resources，儘管在某些情況下兩者都可能存在。有關討論如何將Observations組合在一起的方法，請參閱下面的Notes小節。請注意，系統可能針對問卷調查的結果（ QuestionnaireResponse）計算成一個最終的分數，並將這個分數表示為一個Observation。
Control | 0..*
Type | Reference(檢驗檢查(Observation TWCM), TW Core QuestionnaireResponse, MolecularSequence)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Observation.derivedFrom
Definition | 目標resource為一種測量，此檢驗檢查就是從那個測量中得出。例如：陰離子間隙（an anion gap）或胎兒的測量值是從超音波影像計算而得。
Short | 檢驗檢查源自哪些相關測量
Comments | 在這個資料項目中列出可以代表臨床檢檢查和其他測量的所有參照選項，可能是衍生值的來源。最常見參照另一個Observation，關於Observations如何組合在一起的討論，請參閱下面的Notes小節。
Control | 0..*
Type | Reference(文件參照(DocumentReference TWCM), TW Core ImagingStudy, TW Core Media, TW Core QuestionnaireResponse, 檢驗檢查(Observation TWCM), MolecularSequence)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. Observation.component
Definition | 有有些檢驗檢查有多個組成之檢驗檢查，這些組成之檢驗檢查被表達為具有相同屬性的獨立的代碼值對（code value pair）。例子包括血壓測量的收縮壓和舒張壓即為組成之檢驗檢查（component observations），以及遺傳學檢驗檢查的多個組成之檢驗檢查。
Short | 組成之（部分）檢驗檢查的檢驗結果。若為檢驗套組此項目為必填。
Comments | 有關如何組合Observations的方法討論，請參閱下面的Notes小節。
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | true
Requirements | 組成之檢驗檢查在Obsrvation resource中與主要檢驗檢查共享相同的屬性，並且總是被視為單個檢驗檢查的一部分（它們是不可分離的）。然而，主要檢驗檢查的參考範圍值並不被組成之檢驗檢查所繼承，在適當的時候需給予每項組成之檢驗檢查參考範圍值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. Observation.component.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
130. Observation.component.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
132. Observation.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
134. Observation.component.code
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | [應填入健保檢驗檢查代碼Test NHICode(Code)與檢驗檢查名稱Test Name(text)]
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | For example codes, see LOINC實驗室檢驗檢查值集 (example to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-observation-code` )
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 知道正在進行的是哪種檢驗檢查是理解檢驗檢查的關鍵
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. Observation.component.code.id
Definition | resource中資料項目的唯一ID（用於內部參照）。這可以是任何不含空格的字串。
Short | 唯一可識別ID，以供資料項目間相互參照。
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
138. Observation.component.code.extension
Definition | 擴充的資料項目
Short | 擴充的資料項目
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.code.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
140. Observation.component.code.coding
Definition | 由專門術語系統（terminology system）所定義之代碼的參照
Short | 由專門術語系統（terminology system）定義的代碼
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。
Control | 0..* This element is affected by the following invariants: ele-1
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.component.code.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ system
142. Observation.component.code.coding:LOINCObservationCode
Slice Name | LOINCObservationCode
Definition | 由專門術語系統（terminology system）所定義之代碼的參照
Short | LOINC®為Regenstrief Institute, Inc.維護的檢驗事件描述代碼，可免費使用，可優先選用此代碼。
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from LOINC實驗室檢驗檢查值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/loinc-observation-code` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. Observation.component.code.coding:LOINCObservationCode.id
Definition | resource中資料項目的唯一ID（用於內部參照），這可以是任何不含空格的字串。
Short | 唯一可識別ID，以供資料項目間相互參照。
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
146. Observation.component.code.coding:LOINCObservationCode.extension
Definition | 可用於表示不屬於此資料項目基本定義的附加資訊。為了擴充的使用安全和可管理，對擴充的定義和使用有一套嚴格的管理。儘管任何實作者都可以定義一個擴充，但作為擴充定義的一部分，有一套要求 必須（SHALL） 滿足。
Short | 擴充的資料項目
Comments | 無論使用或定義擴充的機構或管轄區，任何應用程式、專案或標準使用擴充都不背負任何污名（stigma）。使用擴充是允許FHIR規範為每個人保留一個核心的簡易性。
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.code.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
148. Observation.component.code.coding:LOINCObservationCode.system
Definition | 定義代碼中符號意義的代碼系統識別
Short | 專門術語系統（terminology system）的識別
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源
Pattern Value | `http://loinc.org`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. Observation.component.code.coding:LOINCObservationCode.version
Definition | 選擇此代碼時使用的代碼系統版本；請注意，一個維護良好的代碼系統不需要版本報告，因為代碼的意義在不同系統版本中是一致的；然而，不能始終保證這點，當不能保證意義一致時， 必須（SHALL） 將版本資訊也一併作交換。
Short | 系統的版本—如果相關的話
Comments | 如果專門術語沒有明確定義應該使用什麼字串來識別代碼系統的版本，建議使用版本正式發布的日期（用FHIR日期格式表示）作為版本日期。
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. Observation.component.code.coding:LOINCObservationCode.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。
Short | 系統定義的語法之符號
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Observation.component.code.coding:LOINCObservationCode.display
Definition | 遵循系統的規則以呈現代碼含義的表示法
Short | 由系統定義的表示法
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Observation.component.code.coding:LOINCObservationCode.userSelected
Definition | 表明此編碼是由使用者直接選擇，例如：從可用項目（代碼或顯示名稱）的清單中選擇。
Short | 此編碼是否由使用者直接選擇？
Comments | 在一系列備選方案中，直接選擇的代碼是新翻譯最合適的起點；關於「直接選擇」的確切意義，存在模糊不清之處，可能需要貿易夥伴的同意，以更完整澄清此資料項目的使用及其後果。
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | 已被確定為一個臨床安全準則—此確切的系統／代碼對(code pair)是被明確選擇的，而不是由系統根據一些規則或是程式語言處理判斷。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Observation.component.code.coding:TWLaboratoryCategory
Slice Name | TWLaboratoryCategory
Definition | 由專門術語系統（terminology system）所定義之代碼的參照
Short | 此為中央健康保險署(NHI)維護之醫療服務給付項目相關代碼，主要針對申報使用，更新頻率相對頻繁，可免費使用，可依情境選用此代碼。
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from 臺灣健保署醫療服務給付項目-檢驗值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/laboratory-category-tw` ) 應填入所綁定值集中的其中一個代碼。
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Observation.component.code.coding:TWLaboratoryCategory.id
Definition | resource中資料項目的唯一ID（用於內部參照），這可以是任何不含空格的字串。
Short | 唯一可識別ID，以供資料項目間相互參照。
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
162. Observation.component.code.coding:TWLaboratoryCategory.extension
Definition | 可用於表示不屬於此資料項目基本定義的附加資訊。為了擴充的使用安全和可管理，對擴充的定義和使用有一套嚴格的管理。儘管任何實作者都可以定義一個擴充，但作為擴充定義的一部分，有一套要求 必須（SHALL） 滿足。
Short | 擴充的資料項目
Comments | 無論使用或定義擴充的機構或管轄區，任何應用程式、專案或標準使用擴充都不背負任何污名（stigma）。使用擴充是允許FHIR規範為每個人保留一個核心的簡易性。
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.code.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
164. Observation.component.code.coding:TWLaboratoryCategory.system
Definition | 定義代碼中符號意義的代碼系統識別
Short | 專門術語系統（terminology system）的識別
Comments | URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要明確說明符號定義的來源
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. Observation.component.code.coding:TWLaboratoryCategory.version
Definition | 選擇此代碼時使用的代碼系統版本；請注意，一個維護良好的代碼系統不需要版本報告，因為代碼的意義在不同系統版本中是一致的；然而，不能始終保證這點，當不能保證意義一致時， 必須（SHALL） 將版本資訊也一併作交換。
Short | 系統的版本—如果相關的話
Comments | 如果專門術語沒有明確定義應該使用什麼字串來識別代碼系統的版本，建議使用版本正式發布的日期（用FHIR日期格式表示）作為版本日期。
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. Observation.component.code.coding:TWLaboratoryCategory.code
Definition | 系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。
Short | 系統定義的語法之符號
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要參照系統中的一個特定代碼
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
170. Observation.component.code.coding:TWLaboratoryCategory.display
Definition | 遵循系統的規則以呈現代碼含義的表示法
Short | 由系統定義的表示法
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 需要能為不了解此系統的讀者呈現可讀的代碼含義
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
172. Observation.component.code.coding:TWLaboratoryCategory.userSelected
Definition | 表明此編碼是由使用者直接選擇，例如：從可用項目（代碼或顯示名稱）的清單中選擇。
Short | 此編碼是否由使用者直接選擇？
Comments | 在一系列備選方案中，直接選擇的代碼是新翻譯最合適的起點；關於「直接選擇」的確切意義，存在模糊不清之處，可能需要貿易夥伴的同意，以更完整澄清此資料項目的使用及其後果。
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | 已被確定為一個臨床安全準則—此確切的系統／代碼對(code pair)是被明確選擇的，而不是由系統根據一些規則或是程式語言處理判斷。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Observation.component.code.text
Definition | 輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。
Short | 概念的文字表示法
Comments | 很多時候，此文字表述與其中一個代碼的顯示名稱相同。
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
176. Observation.component.value[x]
Definition | 如果資訊中帶有一個值（simple value）則其可作為檢驗檢查的結果。
Short | [應填入門診病摘組成之檢驗檢查結果值Test Result及檢驗檢查結果單位Result Unit]
Comments | 一項檢驗檢查可能有一個值（如Apgar評分）和組成之檢驗檢查值（Apgar評分所來自多項檢驗檢查）。如果有一個值，這個資料項目的datatype應該由Observation.code決定。如果這個資料項目是編碼或者如果與Observation.code相關的type定義一個編碼值，那麼將使用只有文字表述的CodeableConcept來代替字串。若需要更多的說明，請參閱下面Notes小節。
Control | 0..1
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | 通常一項檢驗檢查就會有一個值，雖然若它有錯誤或者它代表一組檢驗檢查可能不會有值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
178. Observation.component.dataAbsentReason
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | 概念（Concept）— 參照一個專門術語或只是文字表述
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason` ) 代碼指明為什麼結果（Observation.value[x]）缺少；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。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Requirements | 對於許多結果，必須處理測量中的異常值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
180. Observation.component.interpretation
Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Short | 高、低、正常等。[應填入門診病摘檢驗檢查結果判斷註記Result Flag]
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation` ) 用以指明檢驗檢查的解釋之代碼。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。
Type | CodeableConcept(TW CodeableConcept)
Is Modifier | false
Must Support | true
Requirements | 對於某些結果，特別是數值結果，需有一個解釋以便完全理解結果之意義。
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
182. Observation.component.interpretation.id
Definition | resource中資料項目的唯一ID（用於內部參照）。這可以是任何不含空格的字串。
Short | 唯一可識別ID，以供資料項目間相互參照。
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
184. Observation.component.interpretation.extension
Definition | 擴充的資料項目
Short | 擴充的資料項目
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.interpretation.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
186. Observation.component.interpretation.coding
Definition | 由專門術語系統（terminology system）所定義之代碼的參照
Short | 由專門術語系統（terminology system）定義的代碼
Comments | 代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。
Control | 0..* This element is affected by the following invariants: ele-1
Type | Coding(TW Coding)
Is Modifier | false
Must Support | true
Requirements | 允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. Observation.component.interpretation.text
Definition | 輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。
Short | [應填入門診病摘檢驗檢查結果備註說明Result Comment]
Comments | 很多時候，此文字表述與其中一個代碼的顯示名稱相同。
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | 專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. Observation.component.referenceRange
Definition | 關於如何透過與正常值或建議範圍值的比較來解釋此值
Short | 解釋此組成之檢驗驗查的結果值之指引
Comments | 大多數檢驗檢查只有一個通用的參考範圍值。系統 可能可以（MAY） 選擇限制只提供病人的相關參考範圍值（例如：具體的病人年齡、性別、體重和其他因素），但這可能是不可能的或也不合適。只要提供了一個以上的參考範圍值，就 建議應該（SHOULD） 提供不同年齡的參考範圍值差異。
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | 知道什麼值被認為是「正常的」，可以幫助評估某一特定結果的意義。需要能夠為不同的情境提供多個參考範圍值。
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)