臺灣長期照顧實作指引 (Taiwan Long-Term Care Implementation Guide) - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: 長期照顧－照顧團隊

此 Profile 說明本 IG 如何進一步定義 FHIR 的 CareTeam Resource，以呈現長期照顧情境中涉及之照顧團隊資訊。

Usage:

• Refer to this Resource Profile: 長期照顧－照顧計畫 and 運動處方－運動計畫

Formal Views of Profile Content

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

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

This structure is derived from TWCoreCareTeam

Name	Flags	Card.	Type	Description & Constraints
CareTeam			TWCoreCareTeam
status		1..1	code	照顧團隊的狀態。[應填入 proposed / active / suspended / inactive / entered-in-error] Binding: CareTeamStatus (required)
subject		1..1	Reference(長期照顧－住民基本資料)	照顧團隊的適用主體，即這個照顧團隊的適用對象是誰？
reference	S	1..1	string	照顧團隊的適用主體。[應輸入 Patient Resource ID]
participant		1..*	BackboneElement	照顧團隊的參與者，即這個照顧團隊是由哪些人參與的？
role		1..1	CodeableConcept	照顧團隊參與者的角色 Binding: ParticipantRoles (required)
member		1..1	Reference(長期照顧－照顧服務提供者 | 長期照顧－關係人 | 長期照顧－服務人員角色)	照顧團隊的成員
reference	S	1..1	string	照顧團隊的成員。[應輸入 Practitioner / RelatedPerson / PractitionerRole Resource ID]
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	required	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	TWCoreCareTeam	Planned participants in the coordination and delivery of care for a patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	照顧團隊的狀態。[應填入 proposed / active / suspended / inactive / entered-in-error] Binding: CareTeamStatus (required)
subject	SΣ	1..1	Reference(長期照顧－住民基本資料)	照顧團隊的適用主體，即這個照顧團隊的適用對象是誰？
reference	SΣC	1..1	string	照顧團隊的適用主體。[應輸入 Patient Resource ID]
participant	SC	1..*	BackboneElement	照顧團隊的參與者，即這個照顧團隊是由哪些人參與的？ ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	照顧團隊參與者的角色 Binding: ParticipantRoles (required)
member	SΣ	1..1	Reference(長期照顧－照顧服務提供者 | 長期照顧－關係人 | 長期照顧－服務人員角色)	照顧團隊的成員
reference	SΣC	1..1	string	照顧團隊的成員。[應輸入 Practitioner / RelatedPerson / PractitionerRole Resource ID]
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	required	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ctm-1	error	CareTeam.participant	CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner : onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2	error	CareTeam	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CareTeam	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CareTeam	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	TWCoreCareTeam	Planned participants in the coordination and delivery of care for a patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this team
status	?!SΣ	1..1	code	照顧團隊的狀態。[應填入 proposed / active / suspended / inactive / entered-in-error] Binding: CareTeamStatus (required)
category	Σ	0..*	CodeableConcept	Type of team Binding: CareTeamCategory (example): Indicates the type of care team.
name	Σ	0..1	string	Name of the team, such as crisis assessment team
subject	SΣ	1..1	Reference(長期照顧－住民基本資料)	照顧團隊的適用主體，即這個照顧團隊的適用對象是誰？
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	照顧團隊的適用主體。[應輸入 Patient Resource ID]
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	Σ	0..1	Reference(TW Core Encounter)	Encounter created as part of
period	Σ	0..1	Period	Time period team covers
participant	SC	1..*	BackboneElement	照顧團隊的參與者，即這個照顧團隊是由哪些人參與的？ ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	照顧團隊參與者的角色 Binding: ParticipantRoles (required)
member	SΣ	1..1	Reference(長期照顧－照顧服務提供者 | 長期照顧－關係人 | 長期照顧－服務人員角色)	照顧團隊的成員
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	照顧團隊的成員。[應輸入 Practitioner / RelatedPerson / PractitionerRole Resource ID]
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
onBehalfOf	Σ	0..1	Reference(TW Core Organization)	Organization of the practitioner
period		0..1	Period	Time period of participant
reasonCode		0..*	CodeableConcept	Why the care team exists Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.
reasonReference		0..*	Reference(TW Core Condition)	Why the care team exists
managingOrganization	Σ	0..*	Reference(TW Core Organization)	Organization responsible for the care team
telecom		0..*	ContactPoint	A contact detail for the care team (that applies to all members)
note		0..*	Annotation	Comments made about the CareTeam
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.category	example	CareTeamCategory http://hl7.org/fhir/ValueSet/care-team-category from the FHIR Standard
CareTeam.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CareTeam.participant.role	required	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
CareTeam.participant.member.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CareTeam.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ctm-1	error	CareTeam.participant	CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner : onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2	error	CareTeam	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CareTeam	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CareTeam	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from TWCoreCareTeam

Summary

Mandatory: 3 elements
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• 長期照顧－住民基本資料 (http://ltc-ig.fhir.tw/StructureDefinition/LTCPatient)
• 長期照顧－照顧服務提供者 (http://ltc-ig.fhir.tw/StructureDefinition/LTCPractitioner)
• 長期照顧－關係人 (http://ltc-ig.fhir.tw/StructureDefinition/LTCRelatedPerson)
• 長期照顧－服務人員角色 (http://ltc-ig.fhir.tw/StructureDefinition/LTCPractitionerRole)

Differential View

This structure is derived from TWCoreCareTeam

Name	Flags	Card.	Type	Description & Constraints
CareTeam			TWCoreCareTeam
status		1..1	code	照顧團隊的狀態。[應填入 proposed / active / suspended / inactive / entered-in-error] Binding: CareTeamStatus (required)
subject		1..1	Reference(長期照顧－住民基本資料)	照顧團隊的適用主體，即這個照顧團隊的適用對象是誰？
reference	S	1..1	string	照顧團隊的適用主體。[應輸入 Patient Resource ID]
participant		1..*	BackboneElement	照顧團隊的參與者，即這個照顧團隊是由哪些人參與的？
role		1..1	CodeableConcept	照顧團隊參與者的角色 Binding: ParticipantRoles (required)
member		1..1	Reference(長期照顧－照顧服務提供者 | 長期照顧－關係人 | 長期照顧－服務人員角色)	照顧團隊的成員
reference	S	1..1	string	照顧團隊的成員。[應輸入 Practitioner / RelatedPerson / PractitionerRole Resource ID]
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	required	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	TWCoreCareTeam	Planned participants in the coordination and delivery of care for a patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	照顧團隊的狀態。[應填入 proposed / active / suspended / inactive / entered-in-error] Binding: CareTeamStatus (required)
subject	SΣ	1..1	Reference(長期照顧－住民基本資料)	照顧團隊的適用主體，即這個照顧團隊的適用對象是誰？
reference	SΣC	1..1	string	照顧團隊的適用主體。[應輸入 Patient Resource ID]
participant	SC	1..*	BackboneElement	照顧團隊的參與者，即這個照顧團隊是由哪些人參與的？ ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	照顧團隊參與者的角色 Binding: ParticipantRoles (required)
member	SΣ	1..1	Reference(長期照顧－照顧服務提供者 | 長期照顧－關係人 | 長期照顧－服務人員角色)	照顧團隊的成員
reference	SΣC	1..1	string	照顧團隊的成員。[應輸入 Practitioner / RelatedPerson / PractitionerRole Resource ID]
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	required	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ctm-1	error	CareTeam.participant	CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner : onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2	error	CareTeam	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CareTeam	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CareTeam	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	TWCoreCareTeam	Planned participants in the coordination and delivery of care for a patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this team
status	?!SΣ	1..1	code	照顧團隊的狀態。[應填入 proposed / active / suspended / inactive / entered-in-error] Binding: CareTeamStatus (required)
category	Σ	0..*	CodeableConcept	Type of team Binding: CareTeamCategory (example): Indicates the type of care team.
name	Σ	0..1	string	Name of the team, such as crisis assessment team
subject	SΣ	1..1	Reference(長期照顧－住民基本資料)	照顧團隊的適用主體，即這個照顧團隊的適用對象是誰？
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	照顧團隊的適用主體。[應輸入 Patient Resource ID]
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	Σ	0..1	Reference(TW Core Encounter)	Encounter created as part of
period	Σ	0..1	Period	Time period team covers
participant	SC	1..*	BackboneElement	照顧團隊的參與者，即這個照顧團隊是由哪些人參與的？ ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	照顧團隊參與者的角色 Binding: ParticipantRoles (required)
member	SΣ	1..1	Reference(長期照顧－照顧服務提供者 | 長期照顧－關係人 | 長期照顧－服務人員角色)	照顧團隊的成員
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	照顧團隊的成員。[應輸入 Practitioner / RelatedPerson / PractitionerRole Resource ID]
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
onBehalfOf	Σ	0..1	Reference(TW Core Organization)	Organization of the practitioner
period		0..1	Period	Time period of participant
reasonCode		0..*	CodeableConcept	Why the care team exists Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.
reasonReference		0..*	Reference(TW Core Condition)	Why the care team exists
managingOrganization	Σ	0..*	Reference(TW Core Organization)	Organization responsible for the care team
telecom		0..*	ContactPoint	A contact detail for the care team (that applies to all members)
note		0..*	Annotation	Comments made about the CareTeam
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.category	example	CareTeamCategory http://hl7.org/fhir/ValueSet/care-team-category from the FHIR Standard
CareTeam.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CareTeam.participant.role	required	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
CareTeam.participant.member.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CareTeam.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ctm-1	error	CareTeam.participant	CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner : onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2	error	CareTeam	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CareTeam	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CareTeam	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CareTeam	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from TWCoreCareTeam

Summary

Mandatory: 3 elements
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• 長期照顧－住民基本資料 (http://ltc-ig.fhir.tw/StructureDefinition/LTCPatient)
• 長期照顧－照顧服務提供者 (http://ltc-ig.fhir.tw/StructureDefinition/LTCPractitioner)
• 長期照顧－關係人 (http://ltc-ig.fhir.tw/StructureDefinition/LTCRelatedPerson)
• 長期照顧－服務人員角色 (http://ltc-ig.fhir.tw/StructureDefinition/LTCPractitionerRole)

Other representations of profile: CSV, Excel, Schematron