{
  "openapi": "3.0.3",
  "info": {
    "title": "ICU EMR FHIR API（越南兒童醫院 Phase 1）",
    "version": "0.1.0",
    "description": "ICU 臨床工作站的 FHIR R4 (4.0.1) 介面。本文件用於與院方及 HIS 廠商溝通介面範圍與約束。\n\n### 三個必須先講清楚的前提\n\n1. **這是 EMR 的介面，不是 HIS 的介面。** HIS 仍是病人、就醫、檢驗結果、處方號的權威來源。\n   EMR 透過整合層與 HIS 往來（`PrescriptionCreated` / `ServiceRequest*` / `MedicationChangeStatus`），\n   臨床端不直接觸碰那些契約。\n2. **醫囑有三個獨立狀態軸**：臨床狀態（`status`）、本地簽署（`Provenance.signature`）、\n   HIS 傳輸（`extension[hisTransmissionStatus]`）。不可合併成單一 `status`。\n   HIS 的 `MedicationChangeStatus` 1–5（新開立／審核／匯總領取／發放／急救車補充）**都不代表已給藥**。\n3. **缺值不補。** 沒有來源就用 `dataAbsentReason` 或省略元素，不送 0、不預設正常、不推定未執行。\n\n### 資料權威（決定哪些欄位可寫）\n\n29 份 S／N 規格的 1,209 個欄位都標了「取得方式」，直接對映到 API 可寫性：\n\n| 取得 | 意義 | 欄位數 | API |\n| --- | --- | --- | --- |\n| M | 手動輸入 | 431 | 可寫 |\n| H | HIS 來源 | 425 | 唯讀，僅整合服務帳號可寫 |\n| P | 引用其他資源 | 264 | 唯讀，以 Reference 表達 |\n| C | 系統計算 | 88 | 唯讀，伺服器產生 |\n| D | 設備來源 | 1 | 唯讀 |\n\n### 通則\n\n- 所有可寫互動要求 `If-Match`（樂觀鎖）。缺少時回 `412`。\n- **不提供 `DELETE`。** 誤建資料以 `status = entered-in-error` 標記。\n- 業務規則編號 `BR-*` 對應規格文件《04 業務規則與狀態機》，可直接作為測試案例編號。\n- 錯誤碼見 `OperationOutcome` schema 的 `ApiErrorCode` 列舉。\n\n### Schema 範圍說明\n\n本文件的資源 schema **只列出本專案實際約束的元素**（必填、唯讀、本地擴充、值域限制），\n其餘元素依 FHIR R4 base 定義，未在此重複。因此所有資源 schema 皆為 `additionalProperties: true`。\n",
    "contact": {
      "name": "ICU Phase 1 專案"
    },
    "license": {
      "name": "院內文件，未對外授權"
    }
  },
  "externalDocs": {
    "description": "完整規格（設計原則、資源對照、業務規則、HIS 整合）",
    "url": "../index.html"
  },
  "servers": [
    {
      "url": "https://{host}/fhir/r4",
      "description": "EMR FHIR Server",
      "variables": {
        "host": {
          "default": "emr.icu.local"
        }
      }
    }
  ],
  "security": [
    {
      "smartOnFhir": []
    }
  ],
  "tags": [
    {
      "name": "系統",
      "description": "能力宣告與 transaction"
    },
    {
      "name": "病人與就醫",
      "description": "HIS 唯讀資源，以及本班照護名單"
    },
    {
      "name": "醫囑",
      "description": "藥物醫囑與醫令（檢驗／檢查／照護）"
    },
    {
      "name": "實際執行",
      "description": "給藥執行、處置執行、醫師核對"
    },
    {
      "name": "檢驗與量測",
      "description": "報告、檢驗指標、生命徵象"
    },
    {
      "name": "病歷文件",
      "description": "Admission／Progress／Discharge Note、會診回覆、SBAR 交班、同意書"
    },
    {
      "name": "工作與交班",
      "description": "臨床工作待辦與交班承接"
    },
    {
      "name": "溯源與稽核",
      "description": "Provenance（臨床溯源）與 AuditEvent（安全稽核）"
    },
    {
      "name": "目錄",
      "description": "B 目錄品項查詢"
    }
  ],
  "paths": {
    "/metadata": {
      "get": {
        "tags": [
          "系統"
        ],
        "summary": "能力宣告",
        "operationId": "getCapabilityStatement",
        "description": "回傳 CapabilityStatement，列出本伺服器支援的資源、互動與搜尋參數。",
        "security": [],
        "responses": {
          "200": {
            "description": "能力宣告",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "type": "object",
                  "additionalProperties": true
                }
              }
            }
          }
        }
      }
    },
    "/": {
      "post": {
        "tags": [
          "系統"
        ],
        "summary": "提交 Bundle（transaction / batch）",
        "operationId": "submitBundle",
        "description": "**transaction**（原子，全成功或全失敗）用於以下情境：\n\n| 情境 | 內容 |\n| --- | --- |\n| 一次開立多項醫囑 | N × MedicationRequest／ServiceRequest，共用 `orderSet` |\n| 簽署文件 | Composition 更新 ＋ Provenance 建立 |\n| 接收交班 | Provenance 建立 ＋ N × Task.owner 更新 |\n| 病歷更正 | 新 Composition 建立 ＋ 舊版 status 更新 |\n| HIS 檢驗結果落地 | Specimen ＋ N × Observation ＋ DiagnosticReport |\n\n**batch** 僅限唯讀批次載入，含寫入時回 `422`。\n\n一次批次建立的醫囑只保證「建立」原子；後續簽署、送出、執行、回報各自獨立（BR-ORD-009）。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Bundle"
              }
            }
          }
        },
        "responses": {
          "200": {
            "description": "每個 entry 的個別結果（`Bundle.type = transaction-response`）",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/Bundle"
                }
              }
            }
          },
          "400": {
            "$ref": "#/components/responses/BadRequest"
          },
          "401": {
            "$ref": "#/components/responses/Unauthorized"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/Patient": {
      "get": {
        "tags": [
          "病人與就醫"
        ],
        "summary": "搜尋病人（HIS 唯讀）",
        "operationId": "searchPatient",
        "description": "結果一律隱含加上病人範圍過濾（只回操作者照護中的病人）。\n**不會因為無權而回 403，而是回較少的結果**——避免透過錯誤碼探測病人是否存在。\n",
        "parameters": [
          {
            "name": "identifier",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "病歷號或身分識別碼"
          },
          {
            "name": "name",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "birthdate",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "FHIR date 前綴語法，例：ge2020-01-01"
          },
          {
            "$ref": "#/components/parameters/count"
          },
          {
            "$ref": "#/components/parameters/sort"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          },
          "401": {
            "$ref": "#/components/responses/Unauthorized"
          }
        }
      }
    },
    "/Patient/{id}": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "get": {
        "tags": [
          "病人與就醫"
        ],
        "summary": "讀取病人",
        "operationId": "readPatient",
        "responses": {
          "200": {
            "description": "病人",
            "headers": {
              "ETag": {
                "$ref": "#/components/headers/ETag"
              }
            },
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/Patient"
                }
              }
            }
          },
          "304": {
            "description": "未變更（`If-None-Match` 命中）"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "404": {
            "$ref": "#/components/responses/NotFound"
          }
        }
      }
    },
    "/Patient/$roster": {
      "get": {
        "tags": [
          "病人與就醫"
        ],
        "summary": "本班照護名單",
        "operationId": "getRoster",
        "description": "回傳目前登入者的照護名單（Patient ＋ CareTeam ＋ 作用中醫囑計數）。\n\n- 主責醫師／護理師：取其 `CareTeam` 參與關係。\n- 照會醫師：只回**已指派給他且尚未完成**的照會病人。\n- 作用中醫囑計數只計 `status=active` 且 `hisTransmissionStatus=accepted` 者。\n",
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          },
          "401": {
            "$ref": "#/components/responses/Unauthorized"
          }
        }
      }
    },
    "/Encounter": {
      "get": {
        "tags": [
          "病人與就醫"
        ],
        "summary": "搜尋就醫事件（HIS 唯讀）",
        "operationId": "searchEncounter",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "date",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "identifier",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      }
    },
    "/CareTeam": {
      "get": {
        "tags": [
          "病人與就醫"
        ],
        "summary": "搜尋照護團隊",
        "operationId": "searchCareTeam",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "participant",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string"
            }
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "病人與就醫"
        ],
        "summary": "建立照護團隊",
        "operationId": "createCareTeam",
        "description": "「確認照護名單」這個動作**不是** CareTeam 上的一個時間欄位，而是另建一筆\n`Provenance`（`activity = roster-confirm`，`target = CareTeam/…`）。\n理由：同一份名單可被不同班別、不同人各自確認一次，每次都要留人與時間。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/CareTeam"
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/MedicationRequest": {
      "get": {
        "tags": [
          "醫囑"
        ],
        "summary": "搜尋藥物醫囑",
        "operationId": "searchMedicationRequest",
        "description": "建議搭配 `_revinclude=MedicationAdministration:request` 一次帶回執行紀錄，\n這正好是 eMAR 工作表的資料需求。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "$ref": "#/components/parameters/encounter"
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "draft",
                "active",
                "on-hold",
                "cancelled",
                "completed",
                "stopped",
                "entered-in-error",
                "unknown"
              ]
            }
          },
          {
            "name": "intent",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "authoredon",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "requester",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "identifier",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "HIS 處方號或每行藥品碼"
          },
          {
            "name": "code",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "$ref": "#/components/parameters/revinclude"
          },
          {
            "$ref": "#/components/parameters/include"
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "醫囑"
        ],
        "summary": "開立藥物醫囑（草稿）",
        "operationId": "createMedicationRequest",
        "description": "建立後為 `status=draft`、未簽署、`hisTransmissionStatus=notSent`。\n\n**必須通過的規則**\n\n| 規則 | 內容 |\n| --- | --- |\n| BR-AUTH-002 | 限主責醫師（照會醫師不可開立） |\n| BR-CTX-002 | 病人必須在操作者照護範圍內 |\n| BR-CTX-004 | 必須已確認本班照護名單 |\n| BR-ORD-001 | 必須指定病程來源（同病人、同作者、已存在的 Composition） |\n| BR-MED-001 | 藥品碼與給藥途徑必須帶 `coding.system` ＋ `code`，只給 `text` 拒絕 |\n| BR-CAT-001 | 停用品項不可用於新開立 |\n\n`requester` 一律取自存取權杖，客戶端送的值被忽略（BR-AUTH-006）。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/MedicationRequest"
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/MedicationRequest/{id}": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "get": {
        "tags": [
          "醫囑"
        ],
        "summary": "讀取藥物醫囑",
        "operationId": "readMedicationRequest",
        "responses": {
          "200": {
            "description": "藥物醫囑",
            "headers": {
              "ETag": {
                "$ref": "#/components/headers/ETag"
              }
            },
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/MedicationRequest"
                },
                "examples": {
                  "active": {
                    "$ref": "#/components/examples/MedicationRequestActive"
                  }
                }
              }
            }
          },
          "404": {
            "$ref": "#/components/responses/NotFound"
          }
        }
      },
      "put": {
        "tags": [
          "醫囑"
        ],
        "summary": "更新藥物醫囑",
        "operationId": "updateMedicationRequest",
        "description": "**可寫範圍取決於狀態（BR-ORD-006）**\n\n| 狀態 | 可改 | 不可改 |\n| --- | --- | --- |\n| `draft` 未簽 | 全部欄位 | — |\n| 已簽、未送出 | `status`（→ `cancelled`） | 藥品、劑量、途徑、頻次 |\n| 已送出 HIS | 無 | 全部 |\n| `active`（HIS 已接受） | `status`（→ `stopped`） | 其餘 |\n\n已送出的醫囑要改內容**必須取消再重開**——HIS 端 `hisPrescriptionNumber` 已產生，\n就地改會讓兩端不一致。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/MedicationRequest"
              }
            }
          }
        },
        "responses": {
          "200": {
            "$ref": "#/components/responses/Updated"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "412": {
            "$ref": "#/components/responses/PreconditionFailed"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      },
      "patch": {
        "tags": [
          "醫囑"
        ],
        "summary": "部分更新（JSON Patch）",
        "operationId": "patchMedicationRequest",
        "description": "主要用途是標記 `entered-in-error`，或在允許的狀態下改 `status`。",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "requestBody": {
          "required": true,
          "content": {
            "application/json-patch+json": {
              "schema": {
                "$ref": "#/components/schemas/JsonPatch"
              },
              "example": [
                {
                  "op": "replace",
                  "path": "/status",
                  "value": "entered-in-error"
                }
              ]
            }
          }
        },
        "responses": {
          "200": {
            "$ref": "#/components/responses/Updated"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "412": {
            "$ref": "#/components/responses/PreconditionFailed"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/MedicationRequest/{id}/$sign": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "post": {
        "tags": [
          "醫囑"
        ],
        "summary": "簽署醫囑（模擬電子簽章）",
        "operationId": "signMedicationRequest",
        "description": "原子完成三件事：\n\n1. 驗證病程來源存在且屬於同病人、同作者（BR-ORD-001）。\n2. 把病程來源的**當下版本**快照寫入 `supportingInformation`（帶版本 Reference，BR-ORD-003）。\n3. 建立 `Provenance.signature`。\n\n只能簽自己建立且尚未簽署的醫囑（BR-ORD-002）。\n簽署前重新驗證品項仍有效；已停用則回 `409 CATALOG-CHANGED`（BR-CAT-003）。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "responses": {
          "200": {
            "description": "已簽署，回傳更新後的醫囑與新建的 Provenance",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/Bundle"
                }
              }
            }
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/MedicationRequest/{id}/$submit": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "post": {
        "tags": [
          "醫囑"
        ],
        "summary": "送出至 HIS",
        "operationId": "submitMedicationRequest",
        "description": "產生 `PrescriptionCreated` 事件並設 `hisTransmissionStatus=sent`。**冪等**：\n同一資源同一版本重送會回傳首次結果，不重打 HIS。\n\n**僅接受「已簽署且 `notSent`」**（BR-ORD-004）。\n\n### 送出前阻擋條件（回 422，醫囑維持已簽未送）\n\n| 編號 | 條件 | 錯誤碼 |\n| --- | --- | --- |\n| BR-INT-001 | 病程來源為空 | `PROGRESS-NOTE-REQUIRED` |\n| BR-INT-002 | 缺 `dispenseStockCode` 對照 | `DISPENSE-STOCK-UNMAPPED` |\n| BR-INT-003 | `medicationConsultationRequest` 為 null（三態未解析） | `TRISTATE-NOT-RESOLVED` |\n| BR-INT-005 | 四時段單位不一致 | `DOSE-UNIT-INCONSISTENT` |\n| BR-INT-006 | `archiveId` 非本次就醫的當前值 | `ARCHIVE-ID-STALE` |\n\n### `hisTransmissionStatus = unknown` 時禁止重送\n\n回 `409 RESEND-BLOCKED-UNKNOWN`。必須由人確認 HIS 端的實際結果，\n自動重送可能造成重複處方（BR-ORD-007）。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "responses": {
          "200": {
            "description": "已送出並取得 HIS 回應",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/MedicationRequest"
                }
              }
            }
          },
          "409": {
            "description": "狀態不允許送出，或 `unknown` 狀態禁止重送",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/OperationOutcome"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "business-rule",
                      "details": {
                        "coding": [
                          {
                            "system": "http://icu.emr.local/CodeSystem/api-error",
                            "code": "RESEND-BLOCKED-UNKNOWN"
                          }
                        ]
                      },
                      "diagnostics": "介接回應未知，結果無法確認。請先查明原送出請求，不可重送。"
                    }
                  ]
                }
              }
            }
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          },
          "502": {
            "$ref": "#/components/responses/HisUnavailable"
          },
          "504": {
            "$ref": "#/components/responses/HisTimeout"
          }
        }
      }
    },
    "/ServiceRequest": {
      "get": {
        "tags": [
          "醫囑"
        ],
        "summary": "搜尋醫令（檢驗／檢查／照護／跨科照會）",
        "operationId": "searchServiceRequest",
        "description": "跨科照會也是 ServiceRequest，以 `category=consultation` 區分。",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "$ref": "#/components/parameters/encounter"
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "category",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "code",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "priority",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "routine",
                "urgent",
                "asap",
                "stat"
              ]
            }
          },
          {
            "name": "performer",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "identifier",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "HIS 需求單號或詳細行碼"
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "醫囑"
        ],
        "summary": "開立醫令",
        "operationId": "createServiceRequest",
        "description": "規則同藥物醫囑（BR-AUTH-002、BR-CTX-002/004、BR-ORD-001、BR-CAT-001）。\n\n**`priority` 值域衝突（未決事項 Q-05）**：HIS 建立用 `severity` 1 正常／2 急／3 特急，\n修改介面則無值域，兩者不能直接互換。EMR 內部一律用 FHIR `priority`，\n由整合層對映；**修改時不送 priority**。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/ServiceRequest"
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/ServiceRequest/{id}": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "get": {
        "tags": [
          "醫囑"
        ],
        "summary": "讀取醫令",
        "operationId": "readServiceRequest",
        "responses": {
          "200": {
            "description": "醫令",
            "headers": {
              "ETag": {
                "$ref": "#/components/headers/ETag"
              }
            },
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/ServiceRequest"
                }
              }
            }
          },
          "404": {
            "$ref": "#/components/responses/NotFound"
          }
        }
      },
      "put": {
        "tags": [
          "醫囑"
        ],
        "summary": "更新醫令",
        "operationId": "updateServiceRequest",
        "description": "送 HIS 的 `ServiceRequestUpdated` 有兩種語義，取決於是否帶舊詳細行碼：\n\n| 帶不帶 `serviceRequestNumber` | HIS 行為 | FHIR 表達 |\n| --- | --- | --- |\n| 帶舊詳細行碼 | HIS 取消舊服務並新增新服務 | 舊筆 `status=revoked`，新建一筆 `replaces` 舊的 |\n| 不帶 | 純新增 | 新建 ServiceRequest |\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/ServiceRequest"
              }
            }
          }
        },
        "responses": {
          "200": {
            "$ref": "#/components/responses/Updated"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "412": {
            "$ref": "#/components/responses/PreconditionFailed"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/MedicationAdministration": {
      "get": {
        "tags": [
          "實際執行"
        ],
        "summary": "搜尋給藥執行紀錄",
        "operationId": "searchMedicationAdministration",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "request",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "來源醫囑"
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "in-progress",
                "not-done",
                "on-hold",
                "completed",
                "entered-in-error",
                "stopped",
                "unknown"
              ]
            }
          },
          {
            "name": "effective-time",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "performer",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "identifier",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "劑次識別碼"
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "實際執行"
        ],
        "summary": "記錄給藥執行",
        "operationId": "createMedicationAdministration",
        "description": "**建立後不可修改。** 誤建以 `entered-in-error` 標記後重建。\n\n### 必須通過的規則\n\n| 規則 | 內容 |\n| --- | --- |\n| BR-AUTH-004 | 限護理師 |\n| BR-MED-002 | 來源醫囑必須 `status=active` **且** `hisTransmissionStatus=accepted` |\n| BR-MED-003 | `completed` 時五對核對必須**全部** `true`，不可由單次掃碼推定 |\n| BR-MED-004 | 實際值與醫囑不同、或狀態非 `completed` 時，原因必填 |\n| BR-MED-005 | 同一劑次至多一筆 `completed` |\n| BR-MED-006 | 實際時間必須落在該醫囑版本有效期間 `[start, end)` |\n| BR-MED-007 | `completed` 時實際劑量與途徑必填，不得以醫囑預定值當事實 |\n\n### 劑次唯一性用條件式建立\n\n帶 `If-None-Exist`；已存在同劑次完成紀錄時回 **`200`**（回傳既有資源）而非 `201`。\n比「先查再寫」安全：不會有兩個護理師同時通過檢查的競態。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifNoneExist"
          }
        ],
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/MedicationAdministration"
              },
              "examples": {
                "completed": {
                  "$ref": "#/components/examples/MedicationAdministrationCompleted"
                }
              }
            }
          }
        },
        "responses": {
          "200": {
            "description": "本劑次已有完成紀錄，回傳既有資源（`DOSE-ALREADY-ADMINISTERED`）",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/MedicationAdministration"
                }
              }
            }
          },
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "description": "來源醫囑不在可執行狀態",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/OperationOutcome"
                }
              }
            }
          },
          "422": {
            "description": "違反業務規則（五對未完成、缺實際值、時間超出有效期間…）",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/OperationOutcome"
                },
                "examples": {
                  "fiveRights": {
                    "$ref": "#/components/examples/FiveRightsIncomplete"
                  }
                }
              }
            }
          }
        }
      }
    },
    "/Procedure": {
      "post": {
        "tags": [
          "實際執行"
        ],
        "summary": "記錄照護／處置執行",
        "operationId": "createProcedure",
        "description": "照護醫令以 ServiceRequest 開立、以 Procedure 記錄執行。建立後不可修改。\n\n手術紀錄在 Phase 1 為**唯讀接收**，EMR 不提供編修或代簽。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Procedure"
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      },
      "get": {
        "tags": [
          "實際執行"
        ],
        "summary": "搜尋處置執行",
        "operationId": "searchProcedure",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "based-on",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "date",
            "in": "query",
            "schema": {
              "type": "string"
            }
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      }
    },
    "/DiagnosticReport": {
      "get": {
        "tags": [
          "檢驗與量測"
        ],
        "summary": "搜尋檢驗／檢查報告（HIS 唯讀）",
        "operationId": "searchDiagnosticReport",
        "description": "一次載入 S13 檢驗結果頁所需的完整資料：\n\n```\nGET /DiagnosticReport?patient=Patient/abc&issued=ge2026-08-30\n    &_include=DiagnosticReport:result\n    &_include=DiagnosticReport:specimen\n    &_revinclude=Provenance:target\n```\n\n帶回報告、逐項數值、檢體，以及已閱／判讀的 Provenance。\n\n**無 `interpretation` 的結果不得歸類為正常**（BR-RPT-005）。\n要查正常值必須明寫 `interpretation=N`。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "registered",
                "partial",
                "preliminary",
                "final",
                "amended",
                "corrected",
                "appended",
                "cancelled",
                "entered-in-error",
                "unknown"
              ]
            }
          },
          {
            "name": "category",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "code",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "issued",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "based-on",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "$ref": "#/components/parameters/include"
          },
          {
            "$ref": "#/components/parameters/revinclude"
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      }
    },
    "/DiagnosticReport/{id}": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "get": {
        "tags": [
          "檢驗與量測"
        ],
        "summary": "讀取報告",
        "operationId": "readDiagnosticReport",
        "description": "**EMR 不可寫入報告。** 臨床端的「已閱」「判讀」一律另建 `Provenance`，\n不去改報告本身（BR-RPT-001）。\n",
        "responses": {
          "200": {
            "description": "報告",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/DiagnosticReport"
                }
              }
            }
          },
          "404": {
            "$ref": "#/components/responses/NotFound"
          }
        }
      },
      "put": {
        "tags": [
          "檢驗與量測"
        ],
        "summary": "更新報告（僅整合服務帳號）",
        "operationId": "updateDiagnosticReport",
        "description": "臨床使用者帳號呼叫一律回 `422 READ-ONLY-SOURCE`。\n僅具 `system/DiagnosticReport.u` scope 的整合服務可寫。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/DiagnosticReport"
              }
            }
          }
        },
        "responses": {
          "200": {
            "$ref": "#/components/responses/Updated"
          },
          "422": {
            "description": "臨床帳號嘗試寫入 HIS 來源",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/OperationOutcome"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "business-rule",
                      "details": {
                        "coding": [
                          {
                            "system": "http://icu.emr.local/CodeSystem/api-error",
                            "code": "READ-ONLY-SOURCE"
                          }
                        ]
                      },
                      "diagnostics": "DiagnosticReport 由 HIS 提供，EMR 不接受寫入。已閱與判讀請建立 Provenance。",
                      "expression": [
                        "DiagnosticReport.issued"
                      ]
                    }
                  ]
                }
              }
            }
          }
        }
      }
    },
    "/Observation": {
      "get": {
        "tags": [
          "檢驗與量測"
        ],
        "summary": "搜尋量測與檢驗指標",
        "operationId": "searchObservation",
        "description": "**時間窗查詢**（對應工作站的三種時間窗）：\n\n| 時間窗 | 查詢 |\n| --- | --- |\n| 24 小時 | `date=ge2026-08-30T19:00:00+07:00&date=le2026-08-31T19:00:00+07:00` |\n| 本班起訖 | 由客戶端依班別起訖換算後帶入相同格式 |\n| 全部 | 不帶 `date` |\n\n伺服器**不提供** `window=shift` 這種語意參數——班別起訖屬排班資料，\n換算責任在客戶端，避免伺服器對「本班」有隱含定義。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "code",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "component-code",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "血壓子項用，例：收縮壓 8480-6"
          },
          {
            "name": "date",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "category",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "vital-signs",
                "laboratory",
                "procedure"
              ]
            }
          },
          {
            "name": "part-of",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "$ref": "#/components/parameters/sort"
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "檢驗與量測"
        ],
        "summary": "記錄生理量測",
        "operationId": "createObservation",
        "description": "建立後不可修改。\n\n| 規則 | 內容 |\n| --- | --- |\n| BR-AUTH-004 | 限護理師 |\n| BR-OBS-001 | 項目須在支援清單內，數值須為非負有限數 |\n| BR-OBS-002 | **血壓必須以單一 Observation 的兩個 component 表達，且兩子項同時提供** |\n| BR-OBS-003 | 缺值一律 `dataAbsentReason`，**禁止送 0 代替** |\n| BR-OBS-004 | 輸注速率觀察須 `partOf` 一筆執行紀錄，且 `notCountedAsIntake=true` |\n\n血壓拆成兩筆獨立 Observation 會讓收縮／舒張壓在時間軸上失去配對，因此明文禁止。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Observation"
              },
              "examples": {
                "bloodPressure": {
                  "$ref": "#/components/examples/ObservationBloodPressure"
                }
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/Composition": {
      "get": {
        "tags": [
          "病歷文件"
        ],
        "summary": "搜尋病歷文件",
        "operationId": "searchComposition",
        "description": "| 文件 | `type` |\n| --- | --- |\n| Admission Note | LOINC `34117-2` |\n| Progress Note（SOAP） | LOINC `11506-3` |\n| Discharge Summary | LOINC `18842-5` |\n| 會診／照會回覆 | LOINC `11488-4` |\n| 護理紀錄 | 本地碼【待確認】 |\n| SBAR 交班 | 本地碼【未決事項 Q-04】 |\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "$ref": "#/components/parameters/encounter"
          },
          {
            "name": "type",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "preliminary",
                "final",
                "amended",
                "entered-in-error"
              ]
            }
          },
          {
            "name": "date",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "author",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "related-id",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "依 relatesTo 目標查更正鏈"
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "病歷文件"
        ],
        "summary": "建立病歷文件（草稿）",
        "operationId": "createComposition",
        "description": "建立為 `status=preliminary`（草稿）。\n\n### 各類型必填段落\n\n| 類型 | 必填 | 規則 |\n| --- | --- | --- |\n| Progress Note | S／O／A／P 四段 | BR-DOC-001 |\n| Admission Note | CC／PI／PH／入院生命徵象／初步評估 | BR-DOC-002 |\n| Discharge Summary | 入出院日期與診斷、檢驗檢查、手術處置、已執行醫囑、住院經過、追蹤計畫、轉診建議 | BR-DOC-003 |\n\n### 自動帶入的約束\n\n- 自動帶入的內容一律保留來源編號（`section.entry` 用**帶版本**的 Reference，BR-DOC-008），\n  這樣「引用當時看到的數值」不會被後來的更正改掉。\n- 複製前一日病程須帶 `copyTrace`，記錄複製來源與**哪些 SOAP 段落被改過**。\n  **複製不視為已核對**（BR-DOC-007）。\n- 草稿依作者、病人、文件類型分開儲存，切換類型不互相覆寫（BR-DOC-010）。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Composition"
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/Composition/{id}": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "get": {
        "tags": [
          "病歷文件"
        ],
        "summary": "讀取病歷文件",
        "operationId": "readComposition",
        "responses": {
          "200": {
            "description": "病歷文件",
            "headers": {
              "ETag": {
                "$ref": "#/components/headers/ETag"
              }
            },
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/Composition"
                }
              }
            }
          },
          "404": {
            "$ref": "#/components/responses/NotFound"
          }
        }
      },
      "put": {
        "tags": [
          "病歷文件"
        ],
        "summary": "更新病歷文件",
        "operationId": "updateComposition",
        "description": "| 狀態 | 可改 |\n| --- | --- |\n| `preliminary`（草稿） | 全部欄位 |\n| `final`（已簽） | **無**。更正一律新建 Composition ＋ `relatesTo[replaces]` ＋ 更正原因必填 |\n| `amended` | 無 |\n\n更正是**新增**不是修改：舊版轉 `amended`，內容完整保留（BR-DOC-005）。\n理由：`_history` 是技術稽核軌跡，臨床閱讀者需要在當前資源集合裡就看到「這份有更正版」。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Composition"
              }
            }
          }
        },
        "responses": {
          "200": {
            "$ref": "#/components/responses/Updated"
          },
          "409": {
            "description": "已簽文件不可修改",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/OperationOutcome"
                },
                "example": {
                  "resourceType": "OperationOutcome",
                  "issue": [
                    {
                      "severity": "error",
                      "code": "conflict",
                      "details": {
                        "coding": [
                          {
                            "system": "http://icu.emr.local/CodeSystem/api-error",
                            "code": "SIGNED-IMMUTABLE"
                          }
                        ]
                      },
                      "diagnostics": "已簽署的文件不可修改。請建立更正版本並填寫更正原因，原文會完整保留。"
                    }
                  ]
                }
              }
            }
          },
          "412": {
            "$ref": "#/components/responses/PreconditionFailed"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/Composition/{id}/$sign": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "post": {
        "tags": [
          "病歷文件"
        ],
        "summary": "簽署文件",
        "operationId": "signComposition",
        "description": "只能簽自己的 `preliminary` 文件（BR-DOC-004）。\n簽署後 `status` 轉 `final` 並建立 `Provenance.signature`。\n\n簽章驗證結果由伺服器產生，透過 `extension[signatureValidation]` 回傳：\n`valid` / `invalid` / `unverified`。憑證服務不可用時用 `unverified`，**不預設 valid**。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "responses": {
          "200": {
            "description": "已簽署，回傳更新後的文件與 Provenance",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/Bundle"
                }
              }
            }
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          }
        }
      }
    },
    "/Composition/{id}/$receive": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "post": {
        "tags": [
          "工作與交班"
        ],
        "summary": "接收交班",
        "operationId": "receiveHandover",
        "description": "交班版本是 `Composition`（SBAR），接收是 `Provenance`。本操作原子完成：\n\n1. 建立 `Provenance`（`activity = handover-receive`）。\n2. 把交出者名下**未完成**的 Task `owner` 轉移給接收者（已完成的不動，BR-HO-004）。\n\n### 拒絕條件\n\n| 規則 | 條件 | 錯誤碼 |\n| --- | --- | --- |\n| BR-HO-003 | 接收者角色與交班角色不符 | `HANDOVER-ROLE-MISMATCH` |\n| BR-HO-005 | 該版本已被更正 | `HANDOVER-SUPERSEDED` |\n| BR-HO-006 | 同一版本重複接收 | `HANDOVER-ALREADY-RECEIVED` |\n\n交班內容含交出當下未結工作的**快照**，快照不隨後續變動而改（BR-HO-007）。\n",
        "responses": {
          "200": {
            "description": "已接收，回傳 Provenance 與被轉移的 Task",
            "content": {
              "application/fhir+json": {
                "schema": {
                  "$ref": "#/components/schemas/Bundle"
                }
              }
            }
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          }
        }
      }
    },
    "/Task": {
      "get": {
        "tags": [
          "工作與交班"
        ],
        "summary": "搜尋臨床工作",
        "operationId": "searchTask",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "status",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "draft",
                "requested",
                "received",
                "accepted",
                "rejected",
                "ready",
                "cancelled",
                "in-progress",
                "on-hold",
                "failed",
                "completed",
                "entered-in-error"
              ]
            }
          },
          {
            "name": "owner",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "focus",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "來源單據（報告、醫令、文件）"
          },
          {
            "name": "business-status",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "工作與交班"
        ],
        "summary": "建立臨床工作",
        "operationId": "createTask",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Task"
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/Task/{id}": {
      "parameters": [
        {
          "$ref": "#/components/parameters/id"
        }
      ],
      "put": {
        "tags": [
          "工作與交班"
        ],
        "summary": "更新工作狀態",
        "operationId": "updateTask",
        "description": "| 規則 | 內容 |\n| --- | --- |\n| BR-TASK-001 | 只有目前 `owner` 可更新 |\n| BR-TASK-002 | 結案必填完成證據（`output`）；若 `focus` 是檢驗報告，該報告必須**已回報且已有判讀紀錄** |\n| BR-TASK-003 | 狀態異動一律追加歷程，不覆寫 |\n\nBR-TASK-002 的用意：待回結果尚未完成處理就不能結案，避免工作被形式上關掉。\n\n原型狀態對映：`open`→`requested`、`accepted`→`accepted`、`waiting`→`on-hold`、`done`→`completed`。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/ifMatch"
          }
        ],
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Task"
              }
            }
          }
        },
        "responses": {
          "200": {
            "$ref": "#/components/responses/Updated"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "412": {
            "$ref": "#/components/responses/PreconditionFailed"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/Provenance": {
      "get": {
        "tags": [
          "溯源與稽核"
        ],
        "summary": "搜尋溯源紀錄",
        "operationId": "searchProvenance",
        "parameters": [
          {
            "name": "target",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "被溯源的資源"
          },
          {
            "name": "agent",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "recorded",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "activity",
            "in": "query",
            "schema": {
              "type": "string"
            }
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          }
        }
      },
      "post": {
        "tags": [
          "溯源與稽核"
        ],
        "summary": "建立溯源紀錄",
        "operationId": "createProvenance",
        "description": "**僅新增，永不修改。**\n\n### activity 值域\n\n| code | 用途 | 系統 |\n| --- | --- | --- |\n| `READ` | 記錄已閱（真正的讀取動作） | `v3-DataOperation` |\n| `clinical-review` | 判讀結果／核對護理執行 | 本地 |\n| `handover-receive` | 交班接收 | 本地 |\n| `roster-confirm` | 照護名單確認 | 本地 |\n| `sign` | 簽署 | 本地 |\n\n「判讀」「核對」「交班接收」「名單確認」是**臨床業務動作，不是資料操作**，\n`v3-DataOperation` 沒有對應碼（該系統只有 OPERATE／CREATE／READ／UPDATE／DELETE／APPEND／MODIFYSTATUS 等），\n因此改用本地 CodeSystem，不硬套語義不符的標準碼。\n\n### 相關規則\n\n- BR-MED-008／BR-RPT-003：`clinical-review` 的 `reviewNote` 必填，前次核對結論全部保留。\n- BR-RPT-002：記錄已閱／判讀時，報告必須已回報且來源未缺漏。\n- BR-RPT-004：**已閱、判讀、工作結案彼此獨立**；任一項完成不影響其他待回項目。\n",
        "requestBody": {
          "required": true,
          "content": {
            "application/fhir+json": {
              "schema": {
                "$ref": "#/components/schemas/Provenance"
              },
              "examples": {
                "executionReview": {
                  "$ref": "#/components/examples/ProvenanceExecutionReview"
                }
              }
            }
          }
        },
        "responses": {
          "201": {
            "$ref": "#/components/responses/Created"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          },
          "409": {
            "$ref": "#/components/responses/Conflict"
          },
          "422": {
            "$ref": "#/components/responses/BusinessRuleViolation"
          }
        }
      }
    },
    "/AuditEvent": {
      "get": {
        "tags": [
          "溯源與稽核"
        ],
        "summary": "查詢稽核軌跡（限稽核角色）",
        "operationId": "searchAuditEvent",
        "description": "伺服器自動產生，每個請求一筆，**包含讀取**（`action=R`）。失敗的請求同樣記錄（尤其 403）。\n\n`agent.network.address` 由伺服器從連線取得，客戶端送的值忽略——\n對應規格中 `ipAddress`／`computerName`「不可手打冒充」的要求。\n\n臨床帳號不可查詢此端點。\n",
        "parameters": [
          {
            "$ref": "#/components/parameters/patient"
          },
          {
            "name": "agent",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "date",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "name": "action",
            "in": "query",
            "schema": {
              "type": "string",
              "enum": [
                "C",
                "R",
                "U",
                "D",
                "E"
              ]
            }
          },
          {
            "name": "outcome",
            "in": "query",
            "schema": {
              "type": "string"
            }
          },
          {
            "$ref": "#/components/parameters/count"
          }
        ],
        "responses": {
          "200": {
            "$ref": "#/components/responses/SearchSet"
          },
          "403": {
            "$ref": "#/components/responses/Forbidden"
          }
        }
      }
    },
    "/ValueSet/{valueSetId}/$expand": {
      "parameters": [
        {
          "name": "valueSetId",
          "in": "path",
          "required": true,
          "schema": {
            "type": "string",
            "enum": [
              "his-medication",
              "his-service",
              "his-route",
              "his-unit",
              "icd-10",
              "diet",
              "supply"
            ]
          }
        }
      ],
      "get": {
        "tags": [
          "目錄"
        ],
        "summary": "展開 B 目錄品項",
        "operationId": "expandValueSet",
        "description": "B 目錄共 31,146 筆（藥品 2,935／服務 7,892／ICD-10 15,994／途徑 62／單位 216／飲食 285／耗材 3,752）。\n品項查詢走 `$expand`，**不走資源搜尋**。\n\n- `ValueSet.version` 帶目錄版本（例：`20260831-b1`）。\n- 回應帶 `Cache-Control: max-age=3600`。\n- **中文譯名未核定**：`display` 一律填來源原文（越文／英文），\n  譯名放 `extension[reviewTranslation]`，避免未核定譯名被當正式名稱往下游傳。\n- 停用品項（`active=false`）會回傳但標記為 inactive，不得用於新開立（BR-CAT-001）。\n",
        "parameters": [
          {
            "name": "filter",
            "in": "query",
            "schema": {
              "type": "string"
            },
            "description": "關鍵字，支援代碼、越文、英文模糊比對"
          },
          {
            "name": "count",
            "in": "query",
            "schema": {
              "type": "integer",
              "default": 20,
              "maximum": 200
            }
          },
          {
            "name": "offset",
            "in": "query",
            "schema": {
              "type": "integer",
              "default": 0
            }
          }
        ],
        "responses": {
          "200": {
            "description": "展開結果",
            "headers": {
              "Cache-Control": {
                "schema": {
                  "type": "string"
                },
                "example": "max-age=3600"
              }
            },
            "content": {
              "application/fhir+json": {
                "schema": {
                  "type": "object",
                  "additionalProperties": true
                }
              }
            }
          }
        }
      }
    }
  },
  "components": {
    "securitySchemes": {
      "smartOnFhir": {
        "type": "oauth2",
        "description": "OAuth 2.0 ＋ SMART on FHIR。存取權杖必須帶：\n\n| Claim | 內容 |\n| --- | --- |\n| `sub` | 使用者識別 |\n| `fhirUser` | `PractitionerRole/{id}`，決定角色與科別 |\n| `shift` | 班別代碼，決定「本班」時間窗與交班對象 |\n\n**Scope 是必要條件，不是充分條件。** 通過 scope 後仍要跑全部業務規則——\n例如護理師有 `MedicationAdministration.c`，但 BR-MED-002／BR-MED-003 仍可能擋下。\n\n除 scope 外，伺服器對每個請求另做病人範圍（compartment）檢查。\n",
        "flows": {
          "authorizationCode": {
            "authorizationUrl": "https://auth.icu.local/authorize",
            "tokenUrl": "https://auth.icu.local/token",
            "scopes": {
              "user/Patient.rs": "讀取與搜尋病人",
              "user/Encounter.rs": "讀取與搜尋就醫事件",
              "user/MedicationRequest.cru": "開立與維護藥物醫囑（主責醫師）",
              "user/MedicationRequest.rs": "讀取藥物醫囑（護理師）",
              "user/MedicationAdministration.cs": "記錄給藥執行（護理師）",
              "user/ServiceRequest.cru": "開立與維護醫令（主責醫師）",
              "user/Observation.crs": "記錄與讀取量測（護理師）",
              "user/Observation.rs": "讀取量測（醫師）",
              "user/DiagnosticReport.rs": "讀取檢驗報告",
              "user/Composition.cru": "撰寫與維護病歷文件",
              "user/Composition.rs": "唯讀病歷（照會醫師）",
              "user/Task.cru": "臨床工作",
              "user/Provenance.cs": "建立溯源紀錄",
              "user/Communication.cs": "必要溝通",
              "user/Condition.cru": "診斷管理（主責醫師）",
              "user/Goal.cru": "查房問題與目標（主責醫師）",
              "user/CarePlan.cs": "照顧重點",
              "system/DiagnosticReport.cu": "整合服務落地檢驗結果",
              "system/Patient.cu": "整合服務同步病人",
              "system/Encounter.cu": "整合服務同步就醫事件"
            }
          }
        }
      }
    },
    "parameters": {
      "id": {
        "name": "id",
        "in": "path",
        "required": true,
        "description": "資源的 EMR 內部主鍵。**絕不等於任何 HIS 號碼。**",
        "schema": {
          "type": "string"
        }
      },
      "patient": {
        "name": "patient",
        "in": "query",
        "description": "病人 Reference，例 `Patient/abc`",
        "schema": {
          "type": "string"
        }
      },
      "encounter": {
        "name": "encounter",
        "in": "query",
        "schema": {
          "type": "string"
        }
      },
      "count": {
        "name": "_count",
        "in": "query",
        "description": "每頁筆數。分頁一律跟隨 `Bundle.link[next]` 的 URL，不得自行拼 offset。",
        "schema": {
          "type": "integer",
          "default": 20,
          "maximum": 200
        }
      },
      "sort": {
        "name": "_sort",
        "in": "query",
        "schema": {
          "type": "string"
        }
      },
      "include": {
        "name": "_include",
        "in": "query",
        "description": "一併帶回被引用的資源，減少往返",
        "schema": {
          "type": "string"
        }
      },
      "revinclude": {
        "name": "_revinclude",
        "in": "query",
        "description": "一併帶回反向引用本資源的資源",
        "schema": {
          "type": "string"
        }
      },
      "ifMatch": {
        "name": "If-Match",
        "in": "header",
        "required": true,
        "description": "樂觀鎖，值為讀取時取得的 `ETag`（例 `W/\"4\"`）。\n**缺少時直接回 `412`**，不允許盲目覆寫。\n",
        "schema": {
          "type": "string"
        },
        "example": "W/\"4\""
      },
      "ifNoneExist": {
        "name": "If-None-Exist",
        "in": "header",
        "description": "條件式建立。符合條件的資源已存在時回 `200`（回傳既有資源）而非 `201`。\n\n給藥劑次唯一性用：\n`identifier=http://icu.emr.local/CodeSystem/occurrence-id|M1-V1-D1&status=completed`\n",
        "schema": {
          "type": "string"
        }
      }
    },
    "headers": {
      "ETag": {
        "description": "資源版本，用於後續 `If-Match`",
        "schema": {
          "type": "string"
        },
        "example": "W/\"4\""
      },
      "Location": {
        "description": "新建資源的 URL",
        "schema": {
          "type": "string"
        }
      }
    },
    "responses": {
      "SearchSet": {
        "description": "搜尋結果（`Bundle.type = searchset`）",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/Bundle"
            }
          }
        }
      },
      "Created": {
        "description": "已建立",
        "headers": {
          "Location": {
            "$ref": "#/components/headers/Location"
          },
          "ETag": {
            "$ref": "#/components/headers/ETag"
          }
        },
        "content": {
          "application/fhir+json": {
            "schema": {
              "type": "object",
              "additionalProperties": true
            }
          }
        }
      },
      "Updated": {
        "description": "已更新",
        "headers": {
          "ETag": {
            "$ref": "#/components/headers/ETag"
          }
        },
        "content": {
          "application/fhir+json": {
            "schema": {
              "type": "object",
              "additionalProperties": true
            }
          }
        }
      },
      "BadRequest": {
        "description": "語法錯誤（JSON 壞掉、參數不合法）",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      },
      "Unauthorized": {
        "description": "未認證或權杖失效",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      },
      "Forbidden": {
        "description": "已認證但無權（角色限制、病人不在照護範圍）。\n\n**不因無權而回 404**——權限問題一律 403，資源不存在才 404。\n但搜尋是例外：一律回較少的結果而非 403，避免探測病人是否存在。\n",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      },
      "NotFound": {
        "description": "資源不存在",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      },
      "Conflict": {
        "description": "版本衝突，或目前狀態不允許此操作。\n\n版本衝突時必須帶目前版本，讓客戶端就地合併——**內容不會被覆寫**。\n",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            },
            "example": {
              "resourceType": "OperationOutcome",
              "issue": [
                {
                  "severity": "error",
                  "code": "conflict",
                  "details": {
                    "text": "currentVersionId=6"
                  },
                  "diagnostics": "資源已被其他工作階段更新至 versionId=6。請重新讀取後合併，內容未被覆寫。"
                }
              ]
            }
          }
        }
      },
      "PreconditionFailed": {
        "description": "缺少 `If-Match` 標頭",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      },
      "BusinessRuleViolation": {
        "description": "資源結構合法但違反業務規則。`issue.details.coding.code` 是本院錯誤碼，\n`issue.diagnostics` 是**可直接顯示給臨床使用者的繁中訊息**。\n",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      },
      "HisUnavailable": {
        "description": "HIS 不可用",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      },
      "HisTimeout": {
        "description": "HIS 逾時。本地醫囑仍持久化為已送出，`hisTransmissionStatus=unknown`，\n並產生人工查明 Task。**之後禁止自動重送。**\n",
        "content": {
          "application/fhir+json": {
            "schema": {
              "$ref": "#/components/schemas/OperationOutcome"
            }
          }
        }
      }
    },
    "schemas": {
      "Coding": {
        "type": "object",
        "additionalProperties": true,
        "properties": {
          "system": {
            "type": "string"
          },
          "code": {
            "type": "string"
          },
          "display": {
            "type": "string",
            "description": "B 目錄品項一律填來源原文；中文譯名未核定，放 extension"
          }
        }
      },
      "CodeableConcept": {
        "type": "object",
        "additionalProperties": true,
        "properties": {
          "coding": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Coding"
            }
          },
          "text": {
            "type": "string"
          }
        }
      },
      "Identifier": {
        "type": "object",
        "additionalProperties": true,
        "properties": {
          "use": {
            "type": "string"
          },
          "system": {
            "type": "string"
          },
          "value": {
            "type": "string"
          }
        }
      },
      "Reference": {
        "type": "object",
        "additionalProperties": true,
        "properties": {
          "reference": {
            "type": "string",
            "description": "資源參照。引用臨床來源時**必須帶版本**（例 `Composition/abc/_history/2`），\n這樣引用當時看到的內容不會被後來的更正改掉。\n",
            "example": "MedicationRequest/8f3a/_history/3"
          },
          "display": {
            "type": "string"
          }
        }
      },
      "Quantity": {
        "type": "object",
        "additionalProperties": true,
        "properties": {
          "value": {
            "type": "number"
          },
          "unit": {
            "type": "string"
          },
          "system": {
            "type": "string"
          },
          "code": {
            "type": "string"
          }
        }
      },
      "Meta": {
        "type": "object",
        "additionalProperties": true,
        "properties": {
          "versionId": {
            "type": "string"
          },
          "lastUpdated": {
            "type": "string",
            "format": "date-time"
          }
        }
      },
      "Extension": {
        "type": "object",
        "additionalProperties": true,
        "properties": {
          "url": {
            "type": "string"
          }
        }
      },
      "ApiErrorCode": {
        "type": "string",
        "description": "本院錯誤碼（`system = http://icu.emr.local/CodeSystem/api-error`）",
        "enum": [
          "UNKNOWN-ACTOR",
          "ROLE-DOCTOR-ONLY",
          "ROLE-NURSE-ONLY",
          "CONSULT-READ-ONLY",
          "ACTOR-NOT-ASSIGNABLE",
          "PATIENT-REQUIRED",
          "PATIENT-OUT-OF-SCOPE",
          "ENCOUNTER-MISMATCH",
          "ROSTER-NOT-CONFIRMED",
          "SOURCE-PATIENT-MISMATCH",
          "READ-ONLY-SOURCE",
          "PROGRESS-NOTE-REQUIRED",
          "SIGN-OWN-DRAFT-ONLY",
          "SUBMIT-STATE-INVALID",
          "HIS-RESPONSE-INVALID",
          "ORDER-IMMUTABLE-AFTER-SUBMIT",
          "RESEND-BLOCKED-UNKNOWN",
          "CODE-REQUIRED",
          "ORDER-NOT-EXECUTABLE",
          "FIVE-RIGHTS-INCOMPLETE",
          "VARIANCE-REASON-REQUIRED",
          "DOSE-ALREADY-ADMINISTERED",
          "TIME-OUT-OF-ORDER-PERIOD",
          "ACTUAL-VALUE-REQUIRED",
          "REVIEW-NOTE-REQUIRED",
          "VALUE-INVALID",
          "BP-COMPONENTS-REQUIRED",
          "ZERO-AS-MISSING",
          "INFUSION-SOURCE-REQUIRED",
          "REPORT-NOT-AVAILABLE",
          "SECTION-REQUIRED",
          "SIGNED-IMMUTABLE",
          "AMEND-REASON-REQUIRED",
          "NO-COPYABLE-PROGRESS",
          "CATALOG-INACTIVE",
          "CATALOG-CHANGED",
          "TASK-NOT-OWNER",
          "EVIDENCE-REQUIRED",
          "SOURCE-NOT-PROCESSED",
          "SUMMARY-REQUIRED",
          "HANDOVER-SUPERSEDED",
          "HANDOVER-ROLE-MISMATCH",
          "HANDOVER-ALREADY-RECEIVED",
          "ASSIGNEE-INVALID",
          "CONSULT-NOT-ASSIGNEE",
          "CONSULT-ALREADY-ANSWERED",
          "RECOMMENDATION-REQUIRED",
          "TIMEZONE-REQUIRED",
          "TIME-INVALID",
          "DISPENSE-STOCK-UNMAPPED",
          "TRISTATE-NOT-RESOLVED",
          "DOSE-UNIT-INCONSISTENT",
          "ARCHIVE-ID-STALE",
          "PERFORMING-PLACE-UNMAPPED",
          "PRICE-TYPE-MISSING",
          "SPECIMEN-CODE-UNMAPPED",
          "PATIENT-TYPE-INVALID",
          "HIS-UNAVAILABLE",
          "HIS-TIMEOUT"
        ]
      },
      "OperationOutcome": {
        "type": "object",
        "required": [
          "resourceType",
          "issue"
        ],
        "additionalProperties": true,
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "OperationOutcome"
            ]
          },
          "issue": {
            "type": "array",
            "minItems": 1,
            "items": {
              "type": "object",
              "required": [
                "severity",
                "code",
                "details",
                "diagnostics"
              ],
              "properties": {
                "severity": {
                  "type": "string",
                  "enum": [
                    "fatal",
                    "error",
                    "warning",
                    "information"
                  ]
                },
                "code": {
                  "type": "string",
                  "description": "FHIR R4 標準 issue-type",
                  "enum": [
                    "invalid",
                    "structure",
                    "required",
                    "value",
                    "invariant",
                    "security",
                    "login",
                    "forbidden",
                    "processing",
                    "not-supported",
                    "duplicate",
                    "not-found",
                    "conflict",
                    "transient",
                    "timeout",
                    "business-rule",
                    "exception",
                    "throttled",
                    "informational"
                  ]
                },
                "details": {
                  "type": "object",
                  "properties": {
                    "coding": {
                      "type": "array",
                      "items": {
                        "type": "object",
                        "properties": {
                          "system": {
                            "type": "string",
                            "example": "http://icu.emr.local/CodeSystem/api-error"
                          },
                          "code": {
                            "$ref": "#/components/schemas/ApiErrorCode"
                          }
                        }
                      }
                    },
                    "text": {
                      "type": "string"
                    }
                  }
                },
                "diagnostics": {
                  "type": "string",
                  "description": "**給臨床使用者看的繁中訊息**，可直接顯示在畫面。不是給工程師的堆疊訊息。"
                },
                "expression": {
                  "type": "array",
                  "description": "欄位層級錯誤時必填，FHIRPath 路徑",
                  "items": {
                    "type": "string"
                  }
                }
              }
            }
          }
        }
      },
      "JsonPatch": {
        "type": "array",
        "items": {
          "type": "object",
          "required": [
            "op",
            "path"
          ],
          "properties": {
            "op": {
              "type": "string",
              "enum": [
                "add",
                "remove",
                "replace",
                "move",
                "copy",
                "test"
              ]
            },
            "path": {
              "type": "string"
            },
            "value": {}
          }
        }
      },
      "Bundle": {
        "type": "object",
        "required": [
          "resourceType",
          "type"
        ],
        "additionalProperties": true,
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "Bundle"
            ]
          },
          "type": {
            "type": "string",
            "enum": [
              "searchset",
              "transaction",
              "transaction-response",
              "batch",
              "batch-response",
              "history",
              "collection"
            ]
          },
          "total": {
            "type": "integer"
          },
          "link": {
            "type": "array",
            "description": "分頁連結。客戶端一律跟隨 `next`，不得自行拼 offset。",
            "items": {
              "type": "object",
              "properties": {
                "relation": {
                  "type": "string",
                  "enum": [
                    "self",
                    "next",
                    "previous",
                    "first",
                    "last"
                  ]
                },
                "url": {
                  "type": "string"
                }
              }
            }
          },
          "entry": {
            "type": "array",
            "items": {
              "type": "object",
              "properties": {
                "fullUrl": {
                  "type": "string"
                },
                "resource": {
                  "type": "object",
                  "additionalProperties": true
                },
                "search": {
                  "type": "object",
                  "properties": {
                    "mode": {
                      "type": "string",
                      "enum": [
                        "match",
                        "include",
                        "outcome"
                      ]
                    }
                  }
                },
                "request": {
                  "type": "object",
                  "description": "transaction／batch 必填",
                  "properties": {
                    "method": {
                      "type": "string",
                      "enum": [
                        "GET",
                        "POST",
                        "PUT",
                        "PATCH",
                        "DELETE"
                      ]
                    },
                    "url": {
                      "type": "string"
                    },
                    "ifMatch": {
                      "type": "string"
                    },
                    "ifNoneExist": {
                      "type": "string"
                    }
                  }
                },
                "response": {
                  "type": "object",
                  "properties": {
                    "status": {
                      "type": "string"
                    },
                    "location": {
                      "type": "string"
                    },
                    "etag": {
                      "type": "string"
                    }
                  }
                }
              }
            }
          }
        }
      },
      "Patient": {
        "type": "object",
        "required": [
          "resourceType"
        ],
        "additionalProperties": true,
        "description": "**HIS 唯讀。** 臨床帳號寫入一律回 `422 READ-ONLY-SOURCE`。\n\n年齡不落地——由客戶端從 `birthDate` 於檢視時點計算。\n",
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "Patient"
            ]
          },
          "id": {
            "type": "string"
          },
          "meta": {
            "$ref": "#/components/schemas/Meta"
          },
          "identifier": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Identifier"
            }
          },
          "name": {
            "type": "array",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          },
          "gender": {
            "type": "string",
            "enum": [
              "male",
              "female",
              "other",
              "unknown"
            ]
          },
          "birthDate": {
            "type": "string",
            "format": "date"
          }
        }
      },
      "CareTeam": {
        "type": "object",
        "required": [
          "resourceType",
          "status"
        ],
        "additionalProperties": true,
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "CareTeam"
            ]
          },
          "id": {
            "type": "string"
          },
          "status": {
            "type": "string",
            "enum": [
              "proposed",
              "active",
              "suspended",
              "inactive",
              "entered-in-error"
            ]
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "participant": {
            "type": "array",
            "items": {
              "type": "object",
              "additionalProperties": true,
              "properties": {
                "member": {
                  "$ref": "#/components/schemas/Reference"
                },
                "role": {
                  "type": "array",
                  "items": {
                    "$ref": "#/components/schemas/CodeableConcept"
                  }
                }
              }
            }
          },
          "extension": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Extension"
            }
          }
        }
      },
      "MedicationRequest": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "intent",
          "subject"
        ],
        "additionalProperties": true,
        "description": "### 三軸狀態\n\n| 軸 | 表達 |\n| --- | --- |\n| 臨床狀態 | `status`：`draft` → `active` → `stopped`／`cancelled` |\n| 本地簽署 | 存在指向該版本的 `Provenance.signature` |\n| HIS 傳輸 | `extension[hisTransmissionStatus]` |\n\n**只有 `status=active` ＋ `hisTransmissionStatus=accepted` 才是護理端可執行狀態。**\n",
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "MedicationRequest"
            ]
          },
          "id": {
            "type": "string"
          },
          "meta": {
            "$ref": "#/components/schemas/Meta"
          },
          "extension": {
            "type": "array",
            "description": "本地擴充：\n\n| url 尾段 | 型別 | 用途 |\n| --- | --- | --- |\n| `hisTransmissionStatus` | code | `notSent`／`sent`／`accepted`／`rejected`／`unknown` |\n| `hisTransmissionEvent` | complex | `requestId`、`sentAt`、`respondedAt`、`message` |\n| `catalogSnapshot` | complex | 開立當下的目錄品項快照（`catalogVersion`、`sourceSHA256`） |\n| `orderSet` | Identifier | 套組來源 |\n| `doseSafetyDisplay` | code | 劑量安全**畫面示例**的選擇結果，非臨床判定 |\n",
            "items": {
              "$ref": "#/components/schemas/Extension"
            }
          },
          "identifier": {
            "type": "array",
            "description": "HIS 處方號（`his-prescription-number`）與每行藥品碼（`his-medication-request-id`）。取消處方必須用**處方號**，不是每行碼。",
            "items": {
              "$ref": "#/components/schemas/Identifier"
            }
          },
          "status": {
            "type": "string",
            "enum": [
              "draft",
              "active",
              "on-hold",
              "cancelled",
              "completed",
              "stopped",
              "entered-in-error",
              "unknown"
            ]
          },
          "intent": {
            "type": "string",
            "enum": [
              "proposal",
              "plan",
              "order",
              "original-order"
            ]
          },
          "medicationCodeableConcept": {
            "allOf": [
              {
                "$ref": "#/components/schemas/CodeableConcept"
              }
            ],
            "description": "必須帶 `coding.system` ＋ `code`，且來自已同步目錄。只給 `text` 回 422（BR-MED-001）。"
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "authoredOn": {
            "type": "string",
            "format": "date-time",
            "description": "必須帶時區位移"
          },
          "requester": {
            "allOf": [
              {
                "$ref": "#/components/schemas/Reference"
              }
            ],
            "description": "一律取自存取權杖，客戶端送的值被忽略（BR-AUTH-006）"
          },
          "supportingInformation": {
            "type": "array",
            "description": "病程來源，簽署時寫入**帶版本**的 Reference（BR-ORD-003）",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "dosageInstruction": {
            "type": "array",
            "items": {
              "type": "object",
              "additionalProperties": true,
              "properties": {
                "text": {
                  "type": "string"
                },
                "timing": {
                  "type": "object",
                  "additionalProperties": true
                },
                "route": {
                  "allOf": [
                    {
                      "$ref": "#/components/schemas/CodeableConcept"
                    }
                  ],
                  "description": "須與 HIS 藥品目錄一致，**不能用本地 PO/IV 假定等值**"
                },
                "doseAndRate": {
                  "type": "array",
                  "items": {
                    "type": "object",
                    "additionalProperties": true,
                    "properties": {
                      "doseQuantity": {
                        "$ref": "#/components/schemas/Quantity"
                      },
                      "rateQuantity": {
                        "allOf": [
                          {
                            "$ref": "#/components/schemas/Quantity"
                          }
                        ],
                        "description": "需單位與濃度，**不把 mg/kg/min 直接當 mL/h**"
                      }
                    }
                  }
                }
              }
            }
          }
        }
      },
      "MedicationAdministration": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "subject",
          "effectiveDateTime"
        ],
        "additionalProperties": true,
        "description": "**建立後不可修改。** 沒有紀錄 ≠ `not-done`——沒建立資源就是「尚未記錄」。",
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "MedicationAdministration"
            ]
          },
          "id": {
            "type": "string"
          },
          "meta": {
            "$ref": "#/components/schemas/Meta"
          },
          "extension": {
            "type": "array",
            "description": "`verificationChecklist`（五對人工核對）：\n`rightPatient`／`rightMedication`／`rightDose`／`rightRoute`／`rightTime` 五個 boolean ＋ `checkedBy`。\n`status=completed` 時五項必須全為 `true`（BR-MED-003）。\n",
            "items": {
              "$ref": "#/components/schemas/Extension"
            }
          },
          "identifier": {
            "type": "array",
            "description": "劑次識別碼（`occurrence-id`），用於 `If-None-Exist` 保證同劑次至多一筆完成紀錄",
            "items": {
              "$ref": "#/components/schemas/Identifier"
            }
          },
          "status": {
            "type": "string",
            "enum": [
              "in-progress",
              "not-done",
              "on-hold",
              "completed",
              "entered-in-error",
              "stopped",
              "unknown"
            ],
            "description": "原型對映：`done`→`completed`、`held`→`on-hold`、`notDone`→`not-done`"
          },
          "statusReason": {
            "type": "array",
            "description": "`not-done` 時必填",
            "items": {
              "$ref": "#/components/schemas/CodeableConcept"
            }
          },
          "medicationCodeableConcept": {
            "$ref": "#/components/schemas/CodeableConcept"
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "context": {
            "$ref": "#/components/schemas/Reference"
          },
          "effectiveDateTime": {
            "type": "string",
            "format": "date-time",
            "description": "實際執行時間（護理師填）。與伺服器產生的記錄時間分開儲存（BR-TIME-003）"
          },
          "performer": {
            "type": "array",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          },
          "request": {
            "allOf": [
              {
                "$ref": "#/components/schemas/Reference"
              }
            ],
            "description": "來源醫囑，**帶版本**"
          },
          "dosage": {
            "type": "object",
            "additionalProperties": true,
            "description": "`completed` 時 `dose` 與 `route` 必填，不得以醫囑預定值當事實（BR-MED-007）",
            "properties": {
              "text": {
                "type": "string"
              },
              "route": {
                "$ref": "#/components/schemas/CodeableConcept"
              },
              "dose": {
                "$ref": "#/components/schemas/Quantity"
              },
              "rateQuantity": {
                "$ref": "#/components/schemas/Quantity"
              }
            }
          },
          "note": {
            "type": "array",
            "description": "實際值與醫囑不同、或狀態非 `completed` 時必填（BR-MED-004）",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          }
        }
      },
      "ServiceRequest": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "intent",
          "subject"
        ],
        "additionalProperties": true,
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "ServiceRequest"
            ]
          },
          "id": {
            "type": "string"
          },
          "meta": {
            "$ref": "#/components/schemas/Meta"
          },
          "identifier": {
            "type": "array",
            "description": "`order-number`（整張需求單）與 `service-request-number`（單內一行）。**兩者不可互相代入。**",
            "items": {
              "$ref": "#/components/schemas/Identifier"
            }
          },
          "status": {
            "type": "string",
            "enum": [
              "draft",
              "active",
              "on-hold",
              "revoked",
              "completed",
              "entered-in-error",
              "unknown"
            ]
          },
          "intent": {
            "type": "string",
            "enum": [
              "proposal",
              "plan",
              "order",
              "original-order"
            ]
          },
          "category": {
            "type": "array",
            "description": "跨科照會用 `consultation`",
            "items": {
              "$ref": "#/components/schemas/CodeableConcept"
            }
          },
          "priority": {
            "type": "string",
            "enum": [
              "routine",
              "urgent",
              "asap",
              "stat"
            ],
            "description": "送 HIS 建立時對映為 severity 1／2／3；**修改時不送**（Q-05）"
          },
          "code": {
            "$ref": "#/components/schemas/CodeableConcept"
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "authoredOn": {
            "type": "string",
            "format": "date-time"
          },
          "requester": {
            "$ref": "#/components/schemas/Reference"
          },
          "performer": {
            "type": "array",
            "description": "跨科照會的受照會醫師",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "specimen": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "bodySite": {
            "type": "array",
            "description": "採樣／拍攝部位。**不混用檢體類型。**",
            "items": {
              "$ref": "#/components/schemas/CodeableConcept"
            }
          }
        }
      },
      "Procedure": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "subject"
        ],
        "additionalProperties": true,
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "Procedure"
            ]
          },
          "id": {
            "type": "string"
          },
          "status": {
            "type": "string",
            "enum": [
              "preparation",
              "in-progress",
              "not-done",
              "on-hold",
              "stopped",
              "completed",
              "entered-in-error",
              "unknown"
            ]
          },
          "basedOn": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "performedDateTime": {
            "type": "string",
            "format": "date-time"
          },
          "performer": {
            "type": "array",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          },
          "statusReason": {
            "$ref": "#/components/schemas/CodeableConcept"
          }
        }
      },
      "DiagnosticReport": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "code"
        ],
        "additionalProperties": true,
        "description": "**HIS 唯讀。** 每個檢驗指標必須是獨立的 `Observation`（由 `result` 引用），\n不可塞進 `conclusion` 的文字——趨勢圖需要逐指標時間序列。\n\n無關聯醫囑時 `basedOn` 留空並在 UI 顯示「未提供來源醫囑關聯」，\n**不按名稱猜測配對**（名稱相近就自動綁定會產生錯誤的醫囑－結果對應）。\n",
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "DiagnosticReport"
            ]
          },
          "id": {
            "type": "string"
          },
          "identifier": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Identifier"
            }
          },
          "status": {
            "type": "string",
            "enum": [
              "registered",
              "partial",
              "preliminary",
              "final",
              "amended",
              "corrected",
              "appended",
              "cancelled",
              "entered-in-error",
              "unknown"
            ],
            "description": "`registered` = 待回。醫囑被 HIS 接受時自動建立（BR-ORD-008）。重發用 `corrected`，舊版保留。"
          },
          "code": {
            "$ref": "#/components/schemas/CodeableConcept"
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "basedOn": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "issued": {
            "type": "string",
            "format": "date-time"
          },
          "specimen": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "result": {
            "type": "array",
            "description": "逐項檢驗指標",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "conclusion": {
            "type": "string",
            "description": "待回時**不填**，不可預設「正常」"
          }
        }
      },
      "Observation": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "code"
        ],
        "additionalProperties": true,
        "description": "**建立後不可修改。**\n\n血壓必須用單一 Observation 的兩個 `component`（收縮 8480-6／TDL.0094、\n舒張 8462-4／TDL.0095），拆成兩筆會失去配對。\n\n已確認可用的 LOINC：心率 `8867-4`、體溫 `8310-5`、呼吸頻率 `9279-1`、\nSpO₂ `59408-5`、體重 `29463-7`。\n**檢驗指標字典（Q-02）與出入量項目（Q-03）在來源查不到對照，\n只帶院內／TDL 碼，不自行指派 LOINC。**\n",
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "Observation"
            ]
          },
          "id": {
            "type": "string"
          },
          "extension": {
            "type": "array",
            "description": "`notCountedAsIntake`（boolean）：輸注速率觀察不列入出入量彙總",
            "items": {
              "$ref": "#/components/schemas/Extension"
            }
          },
          "status": {
            "type": "string",
            "enum": [
              "registered",
              "preliminary",
              "final",
              "amended",
              "corrected",
              "cancelled",
              "entered-in-error",
              "unknown"
            ]
          },
          "category": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/CodeableConcept"
            }
          },
          "code": {
            "$ref": "#/components/schemas/CodeableConcept"
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "effectiveDateTime": {
            "type": "string",
            "format": "date-time"
          },
          "valueQuantity": {
            "$ref": "#/components/schemas/Quantity"
          },
          "dataAbsentReason": {
            "allOf": [
              {
                "$ref": "#/components/schemas/CodeableConcept"
              }
            ],
            "description": "缺值時填此欄並**省略** `value[x]`。**禁止送 0 代替缺值**（BR-OBS-003）。\n本專案只用：`unknown`／`not-performed`／`not-asked`／`error`／`masked`。\n"
          },
          "interpretation": {
            "type": "array",
            "description": "**只有來源提供旗標時才填。無旗標 ≠ 正常**（BR-RPT-005）。",
            "items": {
              "$ref": "#/components/schemas/CodeableConcept"
            }
          },
          "device": {
            "allOf": [
              {
                "$ref": "#/components/schemas/Reference"
              }
            ],
            "description": "設備來源（取得＝D）時標示"
          },
          "partOf": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "component": {
            "type": "array",
            "description": "血壓等多子項量測。子項共用同一 `effectiveDateTime`。",
            "items": {
              "type": "object",
              "additionalProperties": true,
              "properties": {
                "code": {
                  "$ref": "#/components/schemas/CodeableConcept"
                },
                "valueQuantity": {
                  "$ref": "#/components/schemas/Quantity"
                },
                "dataAbsentReason": {
                  "$ref": "#/components/schemas/CodeableConcept"
                }
              }
            }
          }
        }
      },
      "Composition": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "type",
          "date",
          "author",
          "title"
        ],
        "additionalProperties": true,
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "Composition"
            ]
          },
          "id": {
            "type": "string"
          },
          "meta": {
            "$ref": "#/components/schemas/Meta"
          },
          "extension": {
            "type": "array",
            "description": "| url 尾段 | 用途 |\n| --- | --- |\n| `copyTrace` | 前一日病程複製軌跡（`from`、`copiedAt`、`changedSections[]`） |\n| `handoverReceiver` | 交班對象 |\n| `educationTemplate` | 衛教組套來源（在 `section` 上） |\n",
            "items": {
              "$ref": "#/components/schemas/Extension"
            }
          },
          "status": {
            "type": "string",
            "enum": [
              "preliminary",
              "final",
              "amended",
              "entered-in-error"
            ],
            "description": "`preliminary`=草稿、`final`=已簽、`amended`=已被更正"
          },
          "type": {
            "$ref": "#/components/schemas/CodeableConcept"
          },
          "subject": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "date": {
            "type": "string",
            "format": "date-time",
            "description": "臨床時間（病程時間），非建立時間"
          },
          "author": {
            "type": "array",
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "title": {
            "type": "string"
          },
          "relatesTo": {
            "type": "array",
            "description": "更正鏈。更正一律新建並以 `replaces` 指向舊版，舊版內容完整保留。",
            "items": {
              "type": "object",
              "additionalProperties": true,
              "properties": {
                "code": {
                  "type": "string",
                  "enum": [
                    "replaces",
                    "transforms",
                    "signs",
                    "appends"
                  ]
                },
                "targetReference": {
                  "$ref": "#/components/schemas/Reference"
                }
              }
            }
          },
          "section": {
            "type": "array",
            "items": {
              "type": "object",
              "additionalProperties": true,
              "properties": {
                "title": {
                  "type": "string"
                },
                "code": {
                  "$ref": "#/components/schemas/CodeableConcept"
                },
                "text": {
                  "type": "object",
                  "additionalProperties": true
                },
                "entry": {
                  "type": "array",
                  "description": "引用來源，**必須帶版本**（BR-DOC-008）",
                  "items": {
                    "$ref": "#/components/schemas/Reference"
                  }
                }
              }
            }
          }
        }
      },
      "Task": {
        "type": "object",
        "required": [
          "resourceType",
          "status",
          "intent"
        ],
        "additionalProperties": true,
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "Task"
            ]
          },
          "id": {
            "type": "string"
          },
          "status": {
            "type": "string",
            "enum": [
              "draft",
              "requested",
              "received",
              "accepted",
              "rejected",
              "ready",
              "cancelled",
              "in-progress",
              "on-hold",
              "failed",
              "completed",
              "entered-in-error"
            ]
          },
          "intent": {
            "type": "string"
          },
          "description": {
            "type": "string"
          },
          "for": {
            "$ref": "#/components/schemas/Reference"
          },
          "encounter": {
            "$ref": "#/components/schemas/Reference"
          },
          "focus": {
            "allOf": [
              {
                "$ref": "#/components/schemas/Reference"
              }
            ],
            "description": "來源單據（DiagnosticReport／ServiceRequest／Composition）"
          },
          "owner": {
            "allOf": [
              {
                "$ref": "#/components/schemas/Reference"
              }
            ],
            "description": "交班接收時由伺服器轉移"
          },
          "output": {
            "type": "array",
            "description": "完成證據。結案必填（BR-TASK-002）。",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          },
          "note": {
            "type": "array",
            "description": "承接／變更歷程，一律追加不覆寫",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          }
        }
      },
      "Provenance": {
        "type": "object",
        "required": [
          "resourceType",
          "target",
          "recorded",
          "agent"
        ],
        "additionalProperties": true,
        "description": "**僅新增，永不修改。** 與 `AuditEvent` 分工：Provenance 是臨床溯源（畫面可見），AuditEvent 是安全稽核（僅稽核人員）。",
        "properties": {
          "resourceType": {
            "type": "string",
            "enum": [
              "Provenance"
            ]
          },
          "id": {
            "type": "string"
          },
          "extension": {
            "type": "array",
            "description": "| url 尾段 | 用途 |\n| --- | --- |\n| `reviewOutcome` | `reviewed`／`difference` |\n| `reviewNote` | 核對依據／判讀處理紀錄（必填） |\n| `signatureValidation` | `valid`／`invalid`／`unverified`。**憑證服務不可用時用 `unverified`，不預設 valid** |\n",
            "items": {
              "$ref": "#/components/schemas/Extension"
            }
          },
          "target": {
            "type": "array",
            "minItems": 1,
            "items": {
              "$ref": "#/components/schemas/Reference"
            }
          },
          "recorded": {
            "type": "string",
            "format": "date-time"
          },
          "activity": {
            "$ref": "#/components/schemas/CodeableConcept"
          },
          "agent": {
            "type": "array",
            "minItems": 1,
            "items": {
              "type": "object",
              "additionalProperties": true,
              "properties": {
                "type": {
                  "$ref": "#/components/schemas/CodeableConcept"
                },
                "who": {
                  "$ref": "#/components/schemas/Reference"
                }
              }
            }
          },
          "entity": {
            "type": "array",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          },
          "signature": {
            "type": "array",
            "description": "電子簽章。`signature_hash` 與驗證結果由伺服器產生，客戶端不可送。",
            "items": {
              "type": "object",
              "additionalProperties": true
            }
          }
        }
      }
    },
    "examples": {
      "MedicationRequestActive": {
        "summary": "生效中的藥物醫囑",
        "value": {
          "resourceType": "MedicationRequest",
          "id": "mr-efferalgan-0831",
          "meta": {
            "versionId": "3",
            "lastUpdated": "2026-08-31T08:05:12+07:00"
          },
          "extension": [
            {
              "url": "http://icu.emr.local/StructureDefinition/hisTransmissionStatus",
              "valueCode": "accepted"
            }
          ],
          "identifier": [
            {
              "system": "http://icu.emr.local/CodeSystem/his-prescription-number",
              "value": "HP-2026083100417"
            }
          ],
          "status": "active",
          "intent": "order",
          "medicationCodeableConcept": {
            "coding": [
              {
                "system": "http://icu.emr.local/CodeSystem/his-medication",
                "code": "50631",
                "display": "Efferalgan 300 mg (Paracetamol)"
              }
            ]
          },
          "subject": {
            "reference": "Patient/demo-a"
          },
          "authoredOn": "2026-08-31T08:05:00+07:00",
          "requester": {
            "reference": "PractitionerRole/doctor-d1"
          },
          "supportingInformation": [
            {
              "reference": "Composition/demo-soap-0831/_history/1"
            }
          ],
          "dosageInstruction": [
            {
              "text": "300 mg（1 錠），口服，BID（每日 2 次）",
              "route": {
                "coding": [
                  {
                    "system": "http://icu.emr.local/CodeSystem/his-route",
                    "code": "913",
                    "display": "Uống"
                  }
                ]
              },
              "doseAndRate": [
                {
                  "doseQuantity": {
                    "value": 300,
                    "unit": "mg",
                    "system": "http://unitsofmeasure.org",
                    "code": "mg"
                  }
                }
              ]
            }
          ]
        }
      },
      "MedicationAdministrationCompleted": {
        "summary": "已給藥（五對齊全）",
        "value": {
          "resourceType": "MedicationAdministration",
          "extension": [
            {
              "url": "http://icu.emr.local/StructureDefinition/verificationChecklist",
              "extension": [
                {
                  "url": "rightPatient",
                  "valueBoolean": true
                },
                {
                  "url": "rightMedication",
                  "valueBoolean": true
                },
                {
                  "url": "rightDose",
                  "valueBoolean": true
                },
                {
                  "url": "rightRoute",
                  "valueBoolean": true
                },
                {
                  "url": "rightTime",
                  "valueBoolean": true
                },
                {
                  "url": "checkedBy",
                  "valueReference": {
                    "reference": "PractitionerRole/nurse-n1"
                  }
                }
              ]
            }
          ],
          "identifier": [
            {
              "system": "http://icu.emr.local/CodeSystem/occurrence-id",
              "value": "M3-V1-D1"
            }
          ],
          "status": "completed",
          "medicationCodeableConcept": {
            "coding": [
              {
                "system": "http://icu.emr.local/CodeSystem/his-medication",
                "code": "50631"
              }
            ]
          },
          "subject": {
            "reference": "Patient/demo-a"
          },
          "context": {
            "reference": "Encounter/enc-a"
          },
          "effectiveDateTime": "2026-08-31T09:00:00+07:00",
          "performer": [
            {
              "actor": {
                "reference": "PractitionerRole/nurse-n1"
              }
            }
          ],
          "request": {
            "reference": "MedicationRequest/mr-efferalgan-0831/_history/3"
          },
          "dosage": {
            "text": "300 mg（1 錠）",
            "route": {
              "coding": [
                {
                  "system": "http://icu.emr.local/CodeSystem/his-route",
                  "code": "913"
                }
              ]
            },
            "dose": {
              "value": 300,
              "unit": "mg",
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            }
          }
        }
      },
      "ObservationBloodPressure": {
        "summary": "血壓（單一 Observation ＋ 兩個 component）",
        "value": {
          "resourceType": "Observation",
          "status": "final",
          "category": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                  "code": "vital-signs"
                }
              ]
            }
          ],
          "code": {
            "coding": [
              {
                "system": "http://loinc.org",
                "code": "85354-9",
                "display": "Blood pressure panel"
              }
            ],
            "text": "血壓"
          },
          "subject": {
            "reference": "Patient/demo-a"
          },
          "effectiveDateTime": "2026-08-31T18:00:00+07:00",
          "component": [
            {
              "code": {
                "coding": [
                  {
                    "system": "http://loinc.org",
                    "code": "8480-6"
                  },
                  {
                    "system": "http://icu.emr.local/CodeSystem/tdl",
                    "code": "TDL.0094",
                    "display": "收縮壓"
                  }
                ]
              },
              "valueQuantity": {
                "value": 125,
                "unit": "mmHg",
                "system": "http://unitsofmeasure.org",
                "code": "mm[Hg]"
              }
            },
            {
              "code": {
                "coding": [
                  {
                    "system": "http://loinc.org",
                    "code": "8462-4"
                  },
                  {
                    "system": "http://icu.emr.local/CodeSystem/tdl",
                    "code": "TDL.0095",
                    "display": "舒張壓"
                  }
                ]
              },
              "valueQuantity": {
                "value": 77,
                "unit": "mmHg",
                "system": "http://unitsofmeasure.org",
                "code": "mm[Hg]"
              }
            }
          ]
        }
      },
      "ProvenanceExecutionReview": {
        "summary": "醫師核對護理執行（差異待追蹤）",
        "value": {
          "resourceType": "Provenance",
          "extension": [
            {
              "url": "http://icu.emr.local/StructureDefinition/reviewOutcome",
              "valueCode": "difference"
            },
            {
              "url": "http://icu.emr.local/StructureDefinition/reviewNote",
              "valueString": "實際給藥時間較預定晚 45 分鐘，已與護理端確認原因並列入追蹤。"
            }
          ],
          "target": [
            {
              "reference": "MedicationAdministration/ma-m3-d1"
            }
          ],
          "recorded": "2026-08-31T10:15:03+07:00",
          "activity": {
            "coding": [
              {
                "system": "http://icu.emr.local/CodeSystem/provenance-activity",
                "code": "clinical-review",
                "display": "臨床核對／判讀"
              }
            ]
          },
          "agent": [
            {
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                    "code": "verifier"
                  }
                ]
              },
              "who": {
                "reference": "PractitionerRole/doctor-d1"
              }
            }
          ]
        }
      },
      "FiveRightsIncomplete": {
        "summary": "五對核對未完成",
        "value": {
          "resourceType": "OperationOutcome",
          "issue": [
            {
              "severity": "error",
              "code": "business-rule",
              "details": {
                "coding": [
                  {
                    "system": "http://icu.emr.local/CodeSystem/api-error",
                    "code": "FIVE-RIGHTS-INCOMPLETE"
                  }
                ]
              },
              "diagnostics": "需逐項人工確認五對，不能由單次掃碼推定。",
              "expression": [
                "MedicationAdministration.extension('…/verificationChecklist').extension('rightDose')"
              ]
            }
          ]
        }
      }
    }
  }
}