臺灣長期照顧實作指引(TW LTC IG)
1.1.0 - STU 1.1.0

臺灣長期照顧實作指引(TW LTC IG) - Local Development build (v1.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Example Bundle: 在宅急症結案文件範例

Document Subject

王測試 Male, DoB: 1945-03-15 ( Provider number)

Other Id:National Person Identifier where the xxx is the ISO table 3166 3-character (alphabetic) country code/A123456789
Contact Detail
  • ph: 02-00000000
  • 臺北市中正區測試路1號(home)
Emergency Contact:
  • 王家屬
  • ph: 02-00000001
Links:

Document Content

療程經過

本次在宅照護完成；包含實地與視訊訪視。

診斷與問題

呼吸道感染，療程結束時已解除。

過敏資訊

已記錄青黴素過敏及皮疹反應。

藥物與給藥

示範輸注與取消給藥；不是臨床處方建議。

檢查結果

附體溫與血糖檢驗。

照護計畫與措施

附照護目標、計畫、衛教、同意及設備。

後續照護與交班

已完成本次會診與檢驗工作；後續回診資訊尚未提供。

Additional Resources Included in Document

Entry 2 - fullUrl = https://example.org/fhir/Patient/hah-patient

Resource Patient:

王測試 Male, DoB: 1945-03-15 ( Provider number)

Other Id:National Person Identifier where the xxx is the ISO table 3166 3-character (alphabetic) country code/A123456789
Contact Detail
  • ph: 02-00000000
  • 臺北市中正區測試路1號(home)
Emergency Contact:
  • 王家屬
  • ph: 02-00000001
Links:

Entry 3 - fullUrl = https://example.org/fhir/EpisodeOfCare/hah-episode

Resource EpisodeOfCare:

在宅急症－療程結束原因: 完成治療

identifier: https://example.org/hah/episodes/HAH-20260901-001

status: Finished

type: 在宅急症照護

Diagnoses

-Condition
*No display for EpisodeOfCare.diagnosis.condition (reference: ->Condition )

patient: 王測試 Male, DoB: 1945-03-15 ( Provider number)

managingOrganization: Organization 在宅急症示範醫療機構

period: 2026-09-01 08:00:00+0800 --> 2026-09-05 12:00:00+0800

Entry 4 - fullUrl = https://example.org/fhir/Encounter/hah-admission

Resource Encounter:

status: completed

class: inpatient encounter

type: 在宅急症照護

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

episodeOfCare: EpisodeOfCare: extension = 完成治療; identifier = https://example.org/hah/episodes#HAH-20260901-001; status = finished; type = 在宅急症照護; period = 2026-09-01 08:00:00+0800 --> 2026-09-05 12:00:00+0800

serviceProvider: Organization 在宅急症示範醫療機構

participant

Diagnoses

-Condition
*No display for Encounter.diagnosis.condition (reference: ->Condition )

Locations

-Location
*Location 王測試居住地

Entry 5 - fullUrl = https://example.org/fhir/Organization/hah-organization

Resource Organization:

identifier: https://example.org/organizations/HAH-ORG-1

type: Healthcare Provider

name: 在宅急症示範醫療機構

Entry 6 - fullUrl = https://example.org/fhir/Practitioner/hah-practitioner

Resource Practitioner:

identifier: https://example.org/practitioners/HAH-STAFF-1

name: 李示範

Entry 7 - fullUrl = https://example.org/fhir/Location/hah-location

Resource Location:

status: Active

name: 王測試居住地

type: Patient's Residence

address: 臺北市中正區測試路1號

Entry 8 - fullUrl = https://example.org/fhir/Encounter/hah-visit

Resource Encounter:

在宅急症－訪視方式: in-person

status: completed

class: home health

type: 訪視

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

episodeOfCare: EpisodeOfCare: extension = 完成治療; identifier = https://example.org/hah/episodes#HAH-20260901-001; status = finished; type = 在宅急症照護; period = 2026-09-01 08:00:00+0800 --> 2026-09-05 12:00:00+0800

partOf: Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = 在宅急症照護; period = 2026-09-01 09:00:00+0800 --> 2026-09-05 12:00:00+0800

serviceProvider: Organization 在宅急症示範醫療機構

participant

Locations

-Location
*Location 王測試居住地

Entry 9 - fullUrl = https://example.org/fhir/Encounter/hah-video-visit

Resource Encounter:

在宅急症－訪視方式: video

status: completed

class: virtual

type: 訪視

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

episodeOfCare: EpisodeOfCare: extension = 完成治療; identifier = https://example.org/hah/episodes#HAH-20260901-001; status = finished; type = 在宅急症照護; period = 2026-09-01 08:00:00+0800 --> 2026-09-05 12:00:00+0800

partOf: Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = 在宅急症照護; period = 2026-09-01 09:00:00+0800 --> 2026-09-05 12:00:00+0800

serviceProvider: Organization 在宅急症示範醫療機構

participant

Entry 10 - fullUrl = https://example.org/fhir/Condition/hah-condition

Resource Condition:

clinicalStatus: Resolved

verificationStatus: Confirmed

category: Encounter Diagnosis

code: 呼吸道感染

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = 在宅急症照護; period = 2026-09-01 09:00:00+0800 --> 2026-09-05 12:00:00+0800

recordedDate: 2026-09-01 09:00:00+0800

Entry 11 - fullUrl = https://example.org/fhir/CareTeam/hah-team

Resource CareTeam:

status: Inactive

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

participant

role: 主責醫療人員

member: Practitioner 李示範

participant

role: 共照機構

member: Organization 在宅急症示範醫療機構

Entry 12 - fullUrl = https://example.org/fhir/Goal/hah-goal

Resource Goal:

在宅急症－療程關聯: EpisodeOfCare: extension = 完成治療; identifier = https://example.org/hah/episodes#HAH-20260901-001; status = finished; type = 在宅急症照護; period = 2026-09-01 08:00:00+0800 --> 2026-09-05 12:00:00+0800

lifecycleStatus: Completed

description: 本次照護期間能由照顧者協助完成居家量測並回報不適情形

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

Targets

-Due[x]
*2026-09-05

Entry 13 - fullUrl = https://example.org/fhir/CarePlan/hah-plan

Resource CarePlan:

王測試的在宅急症照護計畫，所屬療程 HAH-20260901-001，期間為 2026 年 9 月 1 日至 9 月 5 日，狀態為已完成。處理呼吸道感染問題，目標為協助完成每日量測紀錄；包含血糖檢驗醫囑。

Entry 14 - fullUrl = https://example.org/fhir/ServiceRequest/hah-lab-request

Resource ServiceRequest:

status: Completed

intent: Order

category: 檢驗

code: No display for ServiceRequest.code (concept: )

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

authoredOn: 2026-09-01 09:05:00+0800

requester: Practitioner 李示範

Entry 15 - fullUrl = https://example.org/fhir/ServiceRequest/hah-consult-request

Resource ServiceRequest:

status: Completed

intent: Order

category: 專科照會

code: No display for ServiceRequest.code (concept: 專科照會)

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

authoredOn: 2026-09-01 09:05:00+0800

requester: Practitioner 李示範

performer: Practitioner 李示範

Entry 16 - fullUrl = https://example.org/fhir/Task/hah-task

Resource Task:

status: Completed

intent: Order

code: 檢驗

focus: ServiceRequest

for: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

executionPeriod: 2026-09-01 09:10:00+0800 --> 2026-09-01 09:20:00+0800

authoredOn: 2026-09-01 09:05:00+0800

requester: Practitioner 李示範

owner: CareTeam: status = inactive

location: Location 王測試居住地

Restrictions

-Period
*2026-09-01 09:05:00+0800 --> 2026-09-01 10:00:00+0800

Outputs

-TypeValue[x]
*檢驗報告Diagnostic Report for '' for '->王測試 Male, DoB: 1945-03-15 ( Provider number)'

Entry 17 - fullUrl = https://example.org/fhir/Specimen/hah-specimen

Resource Specimen:

identifier: https://example.org/specimens/HAH-SPECIMEN-1

type: 血液

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

Collections

-CollectorCollected[x]
*Practitioner 李示範2026-09-01 09:10:00+0800

Entry 18 - fullUrl = https://example.org/fhir/Observation/hah-glucose

Resource Observation:

basedOn: ServiceRequest

status: Final

category: Laboratory

code: Glucose [Mass/volume] in Blood

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

effective: 2026-09-01 09:10:00+0800

performer: Practitioner 李示範

value: 110 mg/dL (Details: UCUM codemg/dL = 'mg/dL')

specimen: Specimen: identifier = https://example.org/specimens#HAH-SPECIMEN-1; type =

Entry 19 - fullUrl = https://example.org/fhir/DiagnosticReport/hah-report

Resource DiagnosticReport:

血糖檢驗報告

Subject王測試 Male, DoB: 1945-03-15 ( Provider number)
Relevant Time2026-09-01 09:10:00+0800
Reported2026-09-01 09:20:00+0800
Performer Organization 在宅急症示範醫療機構

Report Details

CodeValueFlags
Glucose [Mass/volume] in Blood110 mg/dL (Details: UCUM codemg/dL = 'mg/dL')Final

Entry 20 - fullUrl = https://example.org/fhir/Observation/hah-temperature

Resource Observation:

status: Final

category: Vital Signs

code: Body temperature

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

effective: 2026-09-01 09:10:00+0800

performer: Practitioner 李示範

value: 37.2 Cel (Details: UCUM codeCel = 'Cel')

device: Device: identifier = https://example.org/devices#THERMOMETER-001; status = active; type =

Entry 21 - fullUrl = https://example.org/fhir/Device/hah-device

Resource Device:

identifier: https://example.org/devices/THERMOMETER-001

status: Active

type: 體溫計

owner: Organization 在宅急症示範醫療機構

Entry 22 - fullUrl = https://example.org/fhir/QuestionnaireResponse/hah-assessment

Resource QuestionnaireResponse:

LinkIDTextDefinitionAnswerdoco
.. hah-assessmentQuestionnaire:在宅急症收案評估
... criteria示範機構收案程序 1.0；本例不作給付判定
... home-safety已確認照護空間及聯絡設備
... caregiver-support照顧者可協助量測並聯繫團隊
... decision在宅急症－收案評估結果代碼: eligible (建議收案)

doco Documentation for this format

Entry 23 - fullUrl = https://example.org/fhir/ClinicalImpression/hah-impression

Resource ClinicalImpression:

status: Completed

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

effective: 2026-09-01 09:30:00+0800

date: 2026-09-01 09:35:00+0800

problem: Condition

summary: 已完成本次病情與居家照護需求評估，後續依照護計畫追蹤。

supportingInfo:

Entry 24 - fullUrl = https://example.org/fhir/Procedure/hah-procedure

Resource Procedure:

status: Completed

code: 照護者衛教

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

Performers

-Actor
*Practitioner 李示範

note:

已向照顧者說明量測紀錄與聯繫方式。

Entry 25 - fullUrl = https://example.org/fhir/MedicationRequest/hah-medication-order

Resource MedicationRequest:

status: Completed

intent: Order

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

authoredOn: 2026-09-01 09:10:00+0800

requester: Practitioner 李示範

DosageInstructions

-Text
*本例僅示範輸注期間及速率欄位。

Entry 26 - fullUrl = https://example.org/fhir/MedicationAdministration/hah-infusion

Resource MedicationAdministration:

status: completed

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

Performers

-Actor
*No display for MedicationAdministration.performer.actor (reference: ->Practitioner 李示範)

request: MedicationRequest: status = completed; intent = order; medication[x] = ; authoredOn = 2026-09-01 09:10:00+0800

Dosages

-RouteRate[x]
*靜脈100 mL/h (Details: UCUM codemL/h = 'mL/h')

Entry 27 - fullUrl = https://example.org/fhir/MedicationAdministration/hah-medication-not-done

Resource MedicationAdministration:

status: not-done

statusReason: 本次給藥經評估取消

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

Performers

-Actor
*No display for MedicationAdministration.performer.actor (reference: ->Practitioner 李示範)

request: MedicationRequest: status = completed; intent = order; medication[x] = ; authoredOn = 2026-09-01 09:10:00+0800

Entry 28 - fullUrl = https://example.org/fhir/AllergyIntolerance/hah-allergy

Resource AllergyIntolerance:

clinicalStatus: Active

verificationStatus: Confirmed

code: 青黴素

patient: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

recordedDate: 2026-09-01 09:00:00+0800

Reactions

-Manifestation
*No display for AllergyIntolerance.reaction.manifestation (concept: )

Entry 29 - fullUrl = https://example.org/fhir/DocumentReference/hah-attachment

Resource DocumentReference:

status: Current

type: 在宅照護同意文件

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

context

Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = 在宅急症照護; period = 2026-09-01 09:00:00+0800 --> 2026-09-05 12:00:00+0800

date: 2026-09-01 08:30:00+0800

author: Practitioner 李示範

content

Attachments

-ContentTypeDataTitle
*text/plainRXhhbXBsZSBvbmx5合成同意文件

Entry 30 - fullUrl = https://example.org/fhir/Consent/hah-consent

Resource Consent:

Participants

RoleDetails
Patient王測試 Male, DoB: 1945-03-15 ( Provider number)
Grantee王測試 Male, DoB: 1945-03-15 ( Provider number)
ManagerOrganization 在宅急症示範醫療機構

Entry 31 - fullUrl = https://example.org/fhir/Communication/hah-communication

Resource Communication:

basedOn: ServiceRequest 專科照會

status: Completed

category: 專科照會

subject: 王測試 Male, DoB: 1945-03-15 ( Provider number)

encounter: Encounter: extension = in-person; status = finished; class = home health (ActCode#HH); type = 訪視; period = 2026-09-01 09:00:00+0800 --> 2026-09-01 10:00:00+0800

sent: 2026-09-01 10:00:00+0800

recipient: CareTeam: status = inactive

sender: Practitioner 李示範

Payloads

-Content[x]
*已回覆本次照會，請依照護計畫持續追蹤。