臺灣牙醫實作指引 (Taiwan Dental Implementation Guide)
0.0.1 - ballot

臺灣牙醫實作指引 (Taiwan Dental Implementation Guide) - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Example Binary: 牙醫－牙周病統合治療確認書範例

This content is an example of the 病人基本資料暨接受牙周病統合治療確認書 (TW Periodontal Consent) 之邏輯模型 Logical Model and is not a FHIR Resource

    
{
  "resourceType": "http://dental-ig.fhir.tw/StructureDefinition/TWDentalPeriodontalConsent",
  "patientName": {
    "text": "王小明",
    "family": "王",
    "given": [
      "小明"
    ]
  },
  "medicalRecordNumber": {
    "system": "https://dental-ig.fhir.tw/identifier/medical-record",
    "value": "MR-001"
  },
  "medicalHistory": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "38341003"
        }
      ],
      "text": "高血壓"
    },
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "73211009"
        }
      ],
      "text": "糖尿病"
    }
  ],
  "medicalHistoryOther": "輕微心律不整",
  "smoking": {
    "present": true,
    "packPerDay": 1,
    "years": 10
  },
  "alcohol": true,
  "betelNut": {
    "present": false,
    "countPerDay": 0,
    "years": 0
  },
  "allergy": {
    "none": false,
    "drug": "青黴素過敏",
    "food": "海鮮過敏",
    "other": "花粉過敏"
  },
  "familyHistory": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "363346000"
        }
      ],
      "text": "家族心臟病史"
    },
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "372087000"
        }
      ],
      "text": "家族癌症病史"
    }
  ],
  "familyHistoryCancerType": "肺癌",
  "familyHistoryOther": "家族高血壓史",
  "doctorStatements": [
    "1. 醫師已詳細說明牙周病治療的目的、方法、風險及可能併發症",
    "2. 醫師已告知治療過程中可能出現疼痛、腫脹等不適症狀",
    "3. 醫師已說明治療後的注意事項及維護方法"
  ],
  "patientStatements": [
    "1. 本人已充分了解牙周病治療的相關資訊",
    "2. 本人同意接受所建議的牙周病統合治療",
    "3. 本人了解治療過程中應配合醫師指示"
  ],
  "dentistSignature": {
    "type": [
      {
        "system": "urn:iso-astm:E1762-95:2013",
        "code": "1.2.840.10065.1.12.1.1",
        "display": "Author's Signature"
      }
    ],
    "who": {
      "reference": "Practitioner/Dental-practitioner-example"
    },
    "when": "2024-01-01T10:00:00+08:00"
  },
  "consentSignature": {
    "type": [
      {
        "system": "urn:iso-astm:E1762-95:2013",
        "code": "1.2.840.10065.1.12.1.1",
        "display": "Author's Signature"
      }
    ],
    "who": {
      "reference": "Patient/Dental-patient-example"
    },
    "when": "2024-01-01T10:05:00+08:00"
  },
  "consentRelation": "本人",
  "consentDate": "2024-01-01"
}