日本版CCDA 退院時サマリ・各種レポート等

日本版CCDA
退院時サマリ・各種レポート等
CDA WG1 リーダ
平井 正明
2015年3月9日
1
 CDAの概要
 統合CDA(Consolidated CDA)
 実例・デモ
2
CDA (Clinical Document Architecture)とは
診療文書アーキテクチャ（Clinical Document Architecture：CDA）リリース2
（R2)は、診療文書の交換するために、「診療文書」の構造とセマンティックを
定めた標準である。CDAは以下のことを特徴とする。
•
永続性（保存性）Persistence： CDAはそれぞれの組織が定めた期間、
不変状態で存続し続けなければならない。
•
維持管理Stewardship： CDAはその組織により維持管理される。
•
真正性Potential for authentication： CDAは法的に認証されることを意
図した情報の集まりである。
•
文脈Context： CDAはその内容に応じた文脈がある。
•
完全性Wholeness： CDAはその文書全体を認証し、文書の一部には適
用しない。
•
見読性Human readability： CDAは可読(Human readable)である。
CDA(Clinical Document Architecture)
 1997 PRA(Patient Record Architecture)としてHL7 SGML SIGとして活動
を開始
 1998 PRAドラフト完








1999 CDA R1(リリース 1) HL7規格として承認
2000 CDA R1 ANSI標準承認
2000 XML SIGがStructure Document TCとなる
2005 CDA R2承認
2006 Care Record Summary 実装ガイド
2007 CCD(Continuity of Care Document)実装ガイド
2008 HHS承認
2009 ISO/TC215 ISO規格として承認(ISO/HL7 27932:2009 Data
Exchange Standards, HL7 Clinical Document Architecture, Release 2)
 2010 ANSI規格として再確認
 2011 CCDA (Consolidated CDA) Health Story Projectとして開発
CDAは
XML(eXtensible Markup Language)で記述される
<要素名>テキスト</要素名>
テキストが無いときは<要素名/>と記述できる
【例】 <名前>平井正明< /名前>
一般型
<要素名 属性名=“属性値” 属性名=“属性値” ・・・・ >テキスト</要素名>
※参考：要素名：Element 属性名：Attribute
CDAでは
<name use="IDE">
<family>平井</family>
<given>正明</given>
</name>
RIM (Reference Information Model)
参照モデル、基本モデル
RIM (Reference Information Model)
参照モデル、基本モデル
7
CDA R2 R-MIM
entryRelationship
Organization
classCode*: <= ORG
determinerCode*: <= INSTANCE
id: SET<II> [0..*]
name: SET<ON> [0..*]
telecom: SET<TEL> [0..*]
addr: SET<AD> [0..*]
standardIndustryClassCode: CE CWE [0..1]
<= OrganizationIndustryClass
0..1 asOrganizationPartOf
classCode*: <= PART
id*: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
statusCode: CS CNE [0..1] <=
RoleStatus
effectiveTime: IVL<TS> [0..1]
Constraint: ParentDocument.text
ParentDocument.text can be used to indicate
the MIME type of the related document. It is
not to be used to embed the related document,
and thus ParentDocument.text.BIN is precluded
from use.
ParentDocument
0..1 representedOrganization
0..* assignedEntity
AssignedEntity
authenticator
classCode*: <= ASSIGNED
id*: SET<II> [1..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
typeCode*: <= AUTHEN
time*: TS [1..1]
signatureCode*: CS CNE [1..1] <= ParticipationSignature
0..1 assignedEntity
legalAuthenticator
typeCode*: <= LA
contextControlCode*: CS CNE [1..1] <= "OP"
time*: TS [1..1]
signatureCode*: CS CNE [1..1] <= ParticipationSignature
0..1 assignedPerson
0..1 receivedOrganization
ClinicalDocument
relatedDocument
classCode*: <= DOCCLIN
moodCode*: <= EVN
id*: II [1..1]
code*: CE CWE [1..1] <= DocumentType
title: ST [0..1]
effectiveTime*: TS [1..1]
confidentialityCode*: CE CWE [1..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <= HumanLanguage
setId: II [0..1]
versionNumber: INT [0..1]
copyTime: TS [0..1] (Deprecated)
typeCode*: <= x_ActRelationshipDocument
classCode*: <= DOCCLIN
moodCode*: <= EVN
id*: SET<II> [1..*]
code: CD CWE [0..1] <= DocumentType
text: ED [0..1]
setId: II [0..1]
versionNumber: INT [0..1]
0..* clinicalStatement
0..*
author
0..* assignedEntity
ServiceEvent
0..* serviceEvent
documentationOf
typeCode*: <= DOC
0..1 representedOrganization
AssignedEntity
performer
classCode*: <= ACT
moodCode*: <= EVN
id: SET<II> [0..*]
code: CE CWE [0..1]
effectiveTime: IVL<TS> [0..1]
typeCode*: <= x_ServiceEventPerformer
functionCode: CE CWE [0..1] <= ParticipationFunction
time: IVL<TS> [0..1]
0..*
informant
0..1 assignedPerson
IntendedRecipient
classCode*: <=
x_InformationRecipientRole
id*: SET<II> [0..*]
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
0..1 informationRecipient
informationRecipient
typeCode*: <= x_InformationRecipient
0..1 representedOrganization
AssignedAuthor
classCode*: <= ASSIGNED
id*: SET<II> [1..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
AuthorChoice
1..* assignedAuthor
authorization
author
typeCode*: <= AUTH
1..1 assignedCustodian
0..1 assignedAuthorChoice
custodian
AssignedCustodian
typeCode*: <= CST
classCode*: <= ASSIGNED
AuthoringDevice
1..1 representedCustodianOrganization
0..* asMaintainedEntity
MaintainedEntity
classCode*: <= MNT
effectiveTime: IVL<TS> [0..1]
1..1 maintainingPerson
Person
typeCode*: <= LOC
CustodianOrganization
classCode*: <= ORG
determinerCode*: <= INSTANCE
id*: SET<II> [1..*]
name: ON [0..1]
telecom: TEL [0..1]
addr: AD [0..1]
0..* assignedEntity
1..1 manufacturedDrugOrOtherMaterial
product
bodyChoice
classCode*: <= DOCBODY
moodCode*: <= EVN
text: ED [1..1]
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
Organization
0..1 providerOrganization
classCode*: <= DOCBODY
moodCode*: <= EVN
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
1..* patientRole
recordTarget
PatientRole
typeCode*: <= RCT
contextControlCode*: CS CNE [1..1] <= "OP"
classCode*: <= PAT
id: SET<II> [1..*]
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
languageCode: CS CNE [0..1] <= HumanLanguage
modeCode: CE CWE [0..1] <= LanguageAbilityMode
proficiencyLevelCode: CE CWE [0..1] <= LanguageAbilityProficiency
preferenceInd: BL [0..1]
CDA R-MIM
component
1..* section
0..*
author
0..* guardian
Guardian
0..*
classCode*: <= GUARD
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
Organization
informant
RelatedSubject
0..1
classCode*: <= x_DocumentSubject
code: CE CWE [0..1] <= PersonalRelationshipRoleType
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
informantChoice
1..1 guardianChoice
0..1 representedOrganization
AssignedEntity
0..1 assignedPerson
Person
RelatedEntity
0..1 relatedPerson
Organization
classCode*: <= ROL
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
(POCD_RM000040)
This RMIM is used to generate
the CDA specification.
classCode*: <= RoleClassMutualRelationship
code: CE CWE [0..1] <=
PersonalRelationshipRoleType
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
effectiveTime: IVL<TS> [0..1]
0..* informantChoice
informant
typeCode*: <= INF
contextControlCode*: CS CNE [1..1] <= "OP"
0..* associatedEntity
0..1 associatedPerson
classCode*: <= DOCSECT
moodCode*: <= EVN
id: II [0..1]
code: CE CWE [0..1] <= DocumentSectionType
title: ST [0..1]
text*: ED [0..1]
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
AssociatedEntity
participant
classCode*: <= RoleClassAssociative
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
typeCode*: <= ParticipationType
functionCode: CE CWE [0..1] <= ParticipationFunction
contextControlCode*: CS CNE [1..1] <= "OP"
time: IVL<TS> [0..1]
0..* participantRole
participant
typeCode*: <= ParticipationType
contextControlCode*: CS CNE [1..1] <= "OP"
time: IVL<TS> [0..1]
awarenessCode: CE CWE [0..1] <= TargetAwareness
0..1 scopingEntity
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
Section
Entity
classCode*: <= ENT
determinerCode*: <= INSTANCE
id: SET<II> [0..*]
code: CE CWE [0..1] <= EntityCode
desc: ED [0..1]
0..* externalActChoice
reference
ExternalObservation
typeCode*: <= x_ActRelationshipExternalReference
seperatableInd: BL [0..1]
classCode*: <= OBS
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
Encounter
ExternalProcedure
classCode*: <= PROC
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
ExternalDocument
0..* clinicalStatement
Organizer
0..* clinicalStatement
component
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
sequenceNumber: INT [0..1]
seperatableInd: BL [0..1]
entry
0..1 subject
SubjectPerson
classCode*: <= PSN
determinerCode*: <= INSTANCE
name: SET<PN> [0..*]
administrativeGenderCode: CE CWE [0..1] <= AdministrativeGender
birthTime: TS [0..1]
ExternalAct
classCode*: <= ACT
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
classCode*: <= ENC
moodCode*: <= x_DocumentEncounterMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActEncounterCode
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
classCode*: <= x_ActClassDocumentEntryOrganizer
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
statusCode*: CS CNE [1..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
subject
typeCode*: <= SBJ
contextControlCode*: CS CNE [1..1] <= "OP"
awarenessCode: CE CWE [0..1] <= TargetAwareness
classCode*: <= PROC
moodCode*: <= x_DocumentProcedureMood
id: SET<II> [0..*]
code: CD CWE [0..1]
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
languageCode: CS CNE [0..1] <= HumanLanguage
methodCode: SET<CE> CWE [0..*]
approachSiteCode: SET<CD> CWE [0..*]
targetSiteCode: SET<CD> CWE [0..*]
0..* section
typeCode*: <= x_ActRelationshipEntry
contextConductionInd*: BL [1..1] "true"
0..1 scopingOrganization
Person
0..1 relatedSubject
Procedure
0..1 specimenPlayingEntity
ParticipantRole
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
LanguageCommunication
(LanguageCommunication)
typeCode*: <= SPC
classCode*: <= SPEC
id: SET<II> [0..*]
0..1 playingEntityChoice
component
GuardianChoice
SpecimenRole
specimen
externalActChoice
classCode*: <= ENT
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
quantity: SET<PQ> [0..*]
name: SET<PN> [0..*]
desc: ED [0..1]
StructuredBody
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
0..1 birthplace
Person
classCode*: <= SPLY
moodCode*: <= x_DocumentSubstanceMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: GTS [0..1]
priorityCode: SET<CE> CWE [0..*] <= ActPriority
repeatNumber: IVL<INT> [0..1]
independentInd: BL [0..1]
quantity: PQ [0..1]
expectedUseTime: IVL<TS> [0..1]
0..* specimenRole
PlayingEntity
1..1 bodyChoice
component
Birthplace
classCode*: <= BIRTHPL
0..*
languageCommunication
Supply
typeCode*: <= PRD
classCode*: <= DEV
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
manufacturerModelName: SC CWE [0..1]
<= ManufacturerModelName
softwareName: SC CWE [0..1]
<= SoftwareName
NonXMLBody
typeCode*: <= ENT (Transcriptionist)
contextControlCode*: CS CNE [1..1] <= "OP"
time: TS [0..1]
0..1 assignedPerson
classCode*: <= OBS
moodCode*: <= EVN.CRT
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
value: ANY [0..1]
0..1 manufacturedProduct *
Device
0..1 location
classCode*: <= PLC
determinerCode*: <= INSTANCE
name: EN [0..1]
addr: AD [0..1]
0..1 patient
consumable
classCode*: <= MMAT
determinerCode*: <= KIND
code: CE CWE [0..1]
<= MaterialEntityClassType
name: EN [0..1]
lotNumberText: ST [0..1]
0..1 healthCareFacility
1..1 place
classCode*: <= PSN
determinerCode*: <= INSTANCE
id: II [0..1] (Deprecated)
name: SET<PN> [0..*]
administrativeGenderCode: CE CWE [0..1] <= AdministrativeGender
birthTime: TS [0..1]
maritalStatusCode: CE CWE [0..1] <= MaritalStatus
religiousAffiliationCode: CE CWE [0..1] <= ReligiousAffiliation
raceCode: CE CWE [0..1] <= Race
ethnicGroupCode: CE CWE [0..1] <= Ethnicity
1..1 manufacturedProduct
Material
0..1 assignedPerson
Place
dataEnterer
Criterion
0..* criterion
precondition
typeCode*: <= PRCN
SubstanceAdministration
classCode*: <= MANU
id: SET<II> [0..*]
typeCode*: <= CSM
encounterParticipant
typeCode*: <= x_EncounterParticipant
time: IVL<TS> [0..1]
classCode*: <= SDLOC
id: SET<II> [0..*]
code: CE CWE [0..1] <= ServiceDeliveryLocationRoleType
Organization
Note:
Observation.value has cardinality
[0..*], which doesn't show up in the
Visio representation.
classCode*: <= SBADM
moodCode*: <= x_DocumentSubstanceMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= SubstanceAdministrationActCode
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: GTS [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
repeatNumber: IVL<INT> [0..1]
routeCode: CE CWE [0..1] <= RouteOfAdministration
approachSiteCode: SET<CD> CWE [0..*] <= ActSite
doseQuantity: IVL<PQ> [0..1]
rateQuantity: IVL<PQ> [0..1]
maxDoseQuantity: RTO<PQ,PQ> [0..1]
administrationUnitCode: CE CWE [0..1] <=
AdministrableDrugForm
ManufacturedProduct
EntityChoice
0..1 assignedEntity
0..1 representedOrganization
AssignedEntity
Patient
classCode*: <= OBS
moodCode*: <= EVN
id: SET<II> [0..*]
languageCode: CS CNE [0..1] <= HumanLanguage
value*: ED [1..1]
DrugOrOtherMaterial
classCode*: <= MMAT
determinerCode*: <= KIND
code: CE CWE [0..1] <=
DrugEntity
name: EN [0..1]
0..1 representedOrganization
typeCode*: <= RESP
HealthCareFacility
0..1 serviceProviderOrganization
Place
ObservationMedia
performer
LabeledDrug
AssignedEntity
responsibleParty
classCode*: <= ENC
moodCode*: <= EVN
componentOf
id: SET<II> [0..*]
typeCode*: <= COMP
0..1 encompassingEncounter code: CE CWE [0..1] <= ActEncounterCode
effectiveTime*: IVL<TS> [1..1]
dischargeDispositionCode: CE CWE [0..1]
<= EncounterDischargeDisposition
location
classCode*: <= DEV
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
manufacturerModelName: SC CWE [0..1] <= ManufacturerModelName
softwareName: SC CWE [0..1] <= SoftwareName
classCode*: <= OBS
moodCode*: <= EVN.CRT
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
value: ANY [0..1]
interpretationCode: CE CNE [0..1] <= ObservationInterpretation
0..* observationRange
referenceRange
typeCode*: <= REFV
0..1 manufacturerOrganization
0..1 assignedEntity
EncompassingEncounter
0..* assignedEntity
typeCode*: <= PRF
time: IVL<TS> [0..1]
modeCode: CE CWE [0..1] <= ParticipationMode
Consent
classCode*: <= CONS
moodCode*: <= EVN
id: SET<II> [0..*]
code: CE CWE [0..1] <= ActCode
statusCode*: CS CNE [1..1] <= completed
typeCode*: <= AUT
functionCode: CE CWE [0..1] <= ParticipationFunction
contextControlCode*: CS CNE [1..1] <= "OP"
time*: TS [1..1]
Person
classCode*: <= PSN
determinerCode*: <= INSTANCE
name: SET<PN> [0..*]
AssignedEntity
0..1 representedOrganization
Organization
0..1 assignedPerson
0..* consent
Organization
subject
classCode*: <= ACT
moodCode*: <= RQO
id*: SET<II> [1..*]
code: CE CWE [0..1] <= ActCode
priorityCode: CE CWE [0..1] <= ActPriority
0..* intendedRecipient
classCode*: <= ROIOVL
moodCode*: <= EVN
id*: SET<II> [1..*]
code*: CS CNE [1..1] <= ROIOverlayShape
value*: LIST<INT> [1..*]
0..1
Order
typeCode*: <= FLFS
classCode*: <= OBS
moodCode*: <= x_ActMoodDocumentObservation
id: SET<II> [0..*]
code*: CD CWE [1..1] <= ObservationType
negationInd: BL [0..1]
derivationExpr: ST [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
repeatNumber: IVL<INT> [0..1]
languageCode: CS CNE [0..1] <= HumanLanguage
value: ANY [0..1]
interpretationCode: SET<CE> CNE [0..*]
methodCode: SET<CE> CWE [0..*]
targetSiteCode: SET<CD> CWE [0..*]
RegionOfInterest
0..* order
inFulfillmentOf
Person
ObservationRange
clinicalStatement
Observation
0..* parentDocument
Person
Organization
typeCode*: <= x_ActRelationshipEntryRelationship
inversionInd: BL [0..1]
contextConductionInd*: BL [1..1] "true"
sequenceNumber: INT [0..1]
negationInd: BL [0..1]
seperatableInd: BL [0..1]
Constraint: relatedDocument.typeCode
A conformant CDA document can have a single
relatedDocument with typeCode "APND"; a single
relatedDocument with typeCode "RPLC"; a single
relatedDocument with typeCode "XFRM"; two
relatedDocuments with typeCodes "XFRM" and
"RPLC"; or two relatedDocuments with typeCodes
"XFRM" and "APND".
OrganizationPartOf
0..1 wholeOrganization
Constraint: Section.text
Section.text.mediaType
fixed as "text/x-hl7-text+xml".
See section "Section Narrative
Block" for details.
Constraint: Organizer
Act
classCode*: <= x_ActClassDocumentEntryAct
moodCode*: <= x_DocumentActMood
id: SET<II> [0..*]
code*: CD CWE [1..1] <= ActCode
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
languageCode: CS CNE [0..1] <= HumanLanguage
The Organizer clone can be the source
of the component relationship or
the reference relationship, but not
the entryRelationship relationship.
classCode*: <= DOC
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= DocumentType
text: ED [0..1]
setId: II [0..1]
versionNumber: INT [0..1]
クロン化(患者属性 RIMR-MIMXML)
<patient>
<name use="IDE">
<family>日本</family>
<given>花子</given>
</name>
<name use="SYL">
<family>ニホン</family>
<given>ハナコ</given>
</name>
<administrativeGenderCode code=“F" codeSystem="2.16.840.1.113883.5.1" />
<birthTime value="19590707" />
</patient>
9
CDA R2 R-MIM
Organization
0..1 providerOrganization
classCode*: <= PSN
determinerCode*: <= INSTANCE
id: II [0..1] (Deprecated)
name: SET<PN> [0..*]OrganizationPartOf
Organization
desc: ED [0..1]
administrativeGenderCode: CE CWE [0..1] <= AdministrativeGender
birthTime: TS [0..1]
ClinicalDocument
maritalStatusCode: CEAssignedEntity
CWE [0..1] <=
MaritalStatus
authenticator
religiousAffiliationCode:
CE CWE [0..1] <= ReligiousAffiliation
Person
raceCode: CE CWE [0..1] <= Race legalAuthenticator
ethnicGroupCode: CE CWE [0..1] <= Ethnicity
0..1 wholeOrganization
classCode*: <= ORG
determinerCode*: <= INSTANCE
id: SET<II> [0..*]
name: SET<ON> [0..*]
telecom: SET<TEL> [0..*]
addr: SET<AD> [0..*]
standardIndustryClassCode: CE CWE [0..1]
<= OrganizationIndustryClass
0..1 asOrganizationPartOf
0..* assignedEntity
classCode*: <= ASSIGNED
id*: SET<II> [1..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
typeCode*: <= LA
contextControlCode*: CS CNE [1..1] <= "OP"
time*: TS [1..1]
signatureCode*: CS CNE [1..1] <= ParticipationSignature
0..1 assignedPerson
Organization
typeCode*: <= AUTHEN
time*: TS [1..1]
signatureCode*: CS CNE [1..1] <= ParticipationSignature
0..1 assignedEntity
0..1 receivedOrganization
classCode*: <= DOCCLIN
moodCode*: <= EVN
id*: II [1..1]
code*: CE CWE [1..1] <= DocumentType
title: ST [0..1]
effectiveTime*: TS [1..1]
confidentialityCode*: CE CWE [1..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <= HumanLanguage
setId: II [0..1]
versionNumber: INT [0..1]
copyTime: TS [0..1] (Deprecated)
recordTarget
typeCode*: <= RCT
contextControlCode*: CS CNE [1..1] <= "OP"
classCode*: <= PAT
id: SET<II> [1..*]
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
entryRelationship
typeCode*: <= x_ActRelationshipEntryRelationship
inversionInd: BL [0..1]
contextConductionInd*: BL [1..1] "true"
sequenceNumber: INT [0..1]
negationInd: BL [0..1]
seperatableInd: BL [0..1]
Constraint: relatedDocument.typeCode
A conformant CDA document can have a single
relatedDocument with typeCode "APND"; a single
relatedDocument with typeCode "RPLC"; a single
relatedDocument with typeCode "XFRM"; two
relatedDocuments with typeCodes "XFRM" and
"RPLC"; or two relatedDocuments with typeCodes
"XFRM" and "APND".
classCode*: <= PART
id*: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
statusCode: CS CNE [0..1] <=
RoleStatus
effectiveTime: IVL<TS> [0..1]
0..1 representedOrganization
1..* patientRole
PatientRole
0..1 patient
Patient
ParentDocument
0..* parentDocument
relatedDocument
typeCode*: <= x_ActRelationshipDocument
classCode*: <= DOCCLIN
moodCode*: <= EVN
id*: SET<II> [1..*]
code: CD CWE [0..1] <= DocumentType
text: ED [0..1]
setId: II [0..1]
versionNumber: INT [0..1]
0..* clinicalStatement
0..*
author
0..* assignedEntity
ServiceEvent
0..* serviceEvent
documentationOf
typeCode*: <= DOC
0..1 representedOrganization
AssignedEntity
performer
classCode*: <= ACT
moodCode*: <= EVN
id: SET<II> [0..*]
code: CE CWE [0..1]
effectiveTime: IVL<TS> [0..1]
typeCode*: <= x_ServiceEventPerformer
functionCode: CE CWE [0..1] <= ParticipationFunction
time: IVL<TS> [0..1]
0..*
informant
0..1 assignedPerson
IntendedRecipient
classCode*: <=
x_InformationRecipientRole
id*: SET<II> [0..*]
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
0..1 informationRecipient
informationRecipient
typeCode*: <= x_InformationRecipient
0..1 representedOrganization
AssignedAuthor
classCode*: <= ASSIGNED
id*: SET<II> [1..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
AuthorChoice
1..* assignedAuthor
authorization
author
typeCode*: <= AUTH
1..1 assignedCustodian
0..1 assignedAuthorChoice
custodian
AssignedCustodian
typeCode*: <= CST
classCode*: <= ASSIGNED
AuthoringDevice
1..1 representedCustodianOrganization
0..* asMaintainedEntity
MaintainedEntity
classCode*: <= MNT
effectiveTime: IVL<TS> [0..1]
1..1 maintainingPerson
Person
typeCode*: <= LOC
CustodianOrganization
classCode*: <= ORG
determinerCode*: <= INSTANCE
id*: SET<II> [1..*]
name: ON [0..1]
telecom: TEL [0..1]
addr: AD [0..1]
0..* assignedEntity
1..1 manufacturedDrugOrOtherMaterial
product
bodyChoice
classCode*: <= DOCBODY
moodCode*: <= EVN
text: ED [1..1]
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
Organization
0..1 providerOrganization
classCode*: <= DOCBODY
moodCode*: <= EVN
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
1..* patientRole
recordTarget
PatientRole
typeCode*: <= RCT
contextControlCode*: CS CNE [1..1] <= "OP"
classCode*: <= PAT
id: SET<II> [1..*]
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
languageCode: CS CNE [0..1] <= HumanLanguage
modeCode: CE CWE [0..1] <= LanguageAbilityMode
proficiencyLevelCode: CE CWE [0..1] <= LanguageAbilityProficiency
preferenceInd: BL [0..1]
CDA R-MIM
component
1..* section
0..*
author
0..* guardian
Guardian
0..*
classCode*: <= GUARD
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
Organization
informant
RelatedSubject
0..1
classCode*: <= x_DocumentSubject
code: CE CWE [0..1] <= PersonalRelationshipRoleType
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
informantChoice
1..1 guardianChoice
0..1 representedOrganization
AssignedEntity
0..1 assignedPerson
Person
RelatedEntity
classCode*: <= RoleClassMutualRelationship
code: CE CWE [0..1] <=
PersonalRelationshipRoleType
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
effectiveTime: IVL<TS> [0..1]
0..1 relatedPerson
Organization
classCode*: <= ROL
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
(POCD_RM000040)
This RMIM is used to generate
the CDA specification.
0..1 relatedSubject
classCode*: <= DOCSECT
moodCode*: <= EVN
id: II [0..1]
code: CE CWE [0..1] <= DocumentSectionType
title: ST [0..1]
text*: ED [0..1]
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
informant
typeCode*: <= INF
contextControlCode*: CS CNE [1..1] <= "OP"
typeCode*: <= SBJ
contextControlCode*: CS CNE [1..1] <= "OP"
awarenessCode: CE CWE [0..1] <= TargetAwareness
participant
classCode*: <= RoleClassAssociative
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
typeCode*: <= ParticipationType
functionCode: CE CWE [0..1] <= ParticipationFunction
contextControlCode*: CS CNE [1..1] <= "OP"
time: IVL<TS> [0..1]
Entity
classCode*: <= ENT
determinerCode*: <= INSTANCE
id: SET<II> [0..*]
code: CE CWE [0..1] <= EntityCode
desc: ED [0..1]
ExternalAct
classCode*: <= ACT
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
0..* externalActChoice
reference
ExternalObservation
typeCode*: <= x_ActRelationshipExternalReference
seperatableInd: BL [0..1]
classCode*: <= OBS
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
Encounter
ExternalProcedure
classCode*: <= ENC
moodCode*: <= x_DocumentEncounterMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActEncounterCode
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
classCode*: <= PROC
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
ExternalDocument
classCode*: <= DOC
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= DocumentType
text: ED [0..1]
setId: II [0..1]
versionNumber: INT [0..1]
0..* clinicalStatement
Organizer
classCode*: <= x_ActClassDocumentEntryOrganizer
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
statusCode*: CS CNE [1..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
0..* clinicalStatement
component
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
sequenceNumber: INT [0..1]
seperatableInd: BL [0..1]
entry
SubjectPerson
classCode*: <= PSN
determinerCode*: <= INSTANCE
name: SET<PN> [0..*]
administrativeGenderCode: CE CWE [0..1] <= AdministrativeGender
birthTime: TS [0..1]
classCode*: <= PROC
moodCode*: <= x_DocumentProcedureMood
id: SET<II> [0..*]
code: CD CWE [0..1]
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
languageCode: CS CNE [0..1] <= HumanLanguage
methodCode: SET<CE> CWE [0..*]
approachSiteCode: SET<CD> CWE [0..*]
targetSiteCode: SET<CD> CWE [0..*]
0..* section
0..1 subject
Constraint: Section.text
Section.text.mediaType
fixed as "text/x-hl7-text+xml".
See section "Section Narrative
Block" for details.
0..* associatedEntity
AssociatedEntity
participant
typeCode*: <= ParticipationType
contextControlCode*: CS CNE [1..1] <= "OP"
time: IVL<TS> [0..1]
awarenessCode: CE CWE [0..1] <= TargetAwareness
subject
0..1 scopingOrganization
Person
0..* participantRole
0..1 scopingEntity
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
Section
typeCode*: <= x_ActRelationshipEntry
contextConductionInd*: BL [1..1] "true"
0..* informantChoice
Procedure
0..1 specimenPlayingEntity
ParticipantRole
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
LanguageCommunication
(LanguageCommunication)
typeCode*: <= SPC
classCode*: <= SPEC
id: SET<II> [0..*]
0..1 playingEntityChoice
component
GuardianChoice
SpecimenRole
specimen
externalActChoice
classCode*: <= ENT
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
quantity: SET<PQ> [0..*]
name: SET<PN> [0..*]
desc: ED [0..1]
StructuredBody
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
0..1 birthplace
Person
classCode*: <= SPLY
moodCode*: <= x_DocumentSubstanceMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: GTS [0..1]
priorityCode: SET<CE> CWE [0..*] <= ActPriority
repeatNumber: IVL<INT> [0..1]
independentInd: BL [0..1]
quantity: PQ [0..1]
expectedUseTime: IVL<TS> [0..1]
0..* specimenRole
PlayingEntity
1..1 bodyChoice
component
Birthplace
classCode*: <= BIRTHPL
0..*
languageCommunication
Supply
typeCode*: <= PRD
classCode*: <= DEV
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
manufacturerModelName: SC CWE [0..1]
<= ManufacturerModelName
softwareName: SC CWE [0..1]
<= SoftwareName
NonXMLBody
typeCode*: <= ENT (Transcriptionist)
contextControlCode*: CS CNE [1..1] <= "OP"
time: TS [0..1]
0..1 assignedPerson
classCode*: <= OBS
moodCode*: <= EVN.CRT
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
value: ANY [0..1]
0..1 manufacturedProduct *
Device
0..1 location
classCode*: <= PLC
determinerCode*: <= INSTANCE
name: EN [0..1]
addr: AD [0..1]
0..1 patient
consumable
classCode*: <= MMAT
determinerCode*: <= KIND
code: CE CWE [0..1]
<= MaterialEntityClassType
name: EN [0..1]
lotNumberText: ST [0..1]
0..1 healthCareFacility
1..1 place
classCode*: <= PSN
determinerCode*: <= INSTANCE
id: II [0..1] (Deprecated)
name: SET<PN> [0..*]
administrativeGenderCode: CE CWE [0..1] <= AdministrativeGender
birthTime: TS [0..1]
maritalStatusCode: CE CWE [0..1] <= MaritalStatus
religiousAffiliationCode: CE CWE [0..1] <= ReligiousAffiliation
raceCode: CE CWE [0..1] <= Race
ethnicGroupCode: CE CWE [0..1] <= Ethnicity
1..1 manufacturedProduct
Material
0..1 assignedPerson
Place
dataEnterer
Criterion
0..* criterion
precondition
typeCode*: <= PRCN
SubstanceAdministration
classCode*: <= MANU
id: SET<II> [0..*]
typeCode*: <= CSM
encounterParticipant
typeCode*: <= x_EncounterParticipant
time: IVL<TS> [0..1]
classCode*: <= SDLOC
id: SET<II> [0..*]
code: CE CWE [0..1] <= ServiceDeliveryLocationRoleType
Organization
Note:
Observation.value has cardinality
[0..*], which doesn't show up in the
Visio representation.
classCode*: <= SBADM
moodCode*: <= x_DocumentSubstanceMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= SubstanceAdministrationActCode
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: GTS [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
repeatNumber: IVL<INT> [0..1]
routeCode: CE CWE [0..1] <= RouteOfAdministration
approachSiteCode: SET<CD> CWE [0..*] <= ActSite
doseQuantity: IVL<PQ> [0..1]
rateQuantity: IVL<PQ> [0..1]
maxDoseQuantity: RTO<PQ,PQ> [0..1]
administrationUnitCode: CE CWE [0..1] <=
AdministrableDrugForm
ManufacturedProduct
EntityChoice
0..1 assignedEntity
0..1 representedOrganization
AssignedEntity
Patient
classCode*: <= OBS
moodCode*: <= EVN
id: SET<II> [0..*]
languageCode: CS CNE [0..1] <= HumanLanguage
value*: ED [1..1]
DrugOrOtherMaterial
classCode*: <= MMAT
determinerCode*: <= KIND
code: CE CWE [0..1] <=
DrugEntity
name: EN [0..1]
0..1 representedOrganization
typeCode*: <= RESP
HealthCareFacility
0..1 serviceProviderOrganization
Place
ObservationMedia
performer
LabeledDrug
AssignedEntity
responsibleParty
classCode*: <= ENC
moodCode*: <= EVN
componentOf
id: SET<II> [0..*]
typeCode*: <= COMP
0..1 encompassingEncounter code: CE CWE [0..1] <= ActEncounterCode
effectiveTime*: IVL<TS> [1..1]
dischargeDispositionCode: CE CWE [0..1]
<= EncounterDischargeDisposition
location
classCode*: <= DEV
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
manufacturerModelName: SC CWE [0..1] <= ManufacturerModelName
softwareName: SC CWE [0..1] <= SoftwareName
classCode*: <= OBS
moodCode*: <= EVN.CRT
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
value: ANY [0..1]
interpretationCode: CE CNE [0..1] <= ObservationInterpretation
0..* observationRange
referenceRange
typeCode*: <= REFV
0..1 manufacturerOrganization
0..1 assignedEntity
EncompassingEncounter
0..* assignedEntity
typeCode*: <= PRF
time: IVL<TS> [0..1]
modeCode: CE CWE [0..1] <= ParticipationMode
Consent
classCode*: <= CONS
moodCode*: <= EVN
id: SET<II> [0..*]
code: CE CWE [0..1] <= ActCode
statusCode*: CS CNE [1..1] <= completed
typeCode*: <= AUT
functionCode: CE CWE [0..1] <= ParticipationFunction
contextControlCode*: CS CNE [1..1] <= "OP"
time*: TS [1..1]
Person
classCode*: <= PSN
determinerCode*: <= INSTANCE
name: SET<PN> [0..*]
AssignedEntity
0..1 representedOrganization
Organization
0..1 assignedPerson
0..* consent
Organization
subject
classCode*: <= ACT
moodCode*: <= RQO
id*: SET<II> [1..*]
code: CE CWE [0..1] <= ActCode
priorityCode: CE CWE [0..1] <= ActPriority
0..* intendedRecipient
classCode*: <= ROIOVL
moodCode*: <= EVN
id*: SET<II> [1..*]
code*: CS CNE [1..1] <= ROIOverlayShape
value*: LIST<INT> [1..*]
0..1
Order
typeCode*: <= FLFS
classCode*: <= OBS
moodCode*: <= x_ActMoodDocumentObservation
id: SET<II> [0..*]
code*: CD CWE [1..1] <= ObservationType
negationInd: BL [0..1]
derivationExpr: ST [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
repeatNumber: IVL<INT> [0..1]
languageCode: CS CNE [0..1] <= HumanLanguage
value: ANY [0..1]
interpretationCode: SET<CE> CNE [0..*]
methodCode: SET<CE> CWE [0..*]
targetSiteCode: SET<CD> CWE [0..*]
RegionOfInterest
0..* order
inFulfillmentOf
Person
ObservationRange
clinicalStatement
Observation
Constraint: ParentDocument.text
ParentDocument.text can be used to indicate
the MIME type of the related document. It is
not to be used to embed the related document,
and thus ParentDocument.text.BIN is precluded
from use.
Constraint: Organizer
Act
classCode*: <= x_ActClassDocumentEntryAct
moodCode*: <= x_DocumentActMood
id: SET<II> [0..*]
code*: CD CWE [1..1] <= ActCode
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
languageCode: CS CNE [0..1] <= HumanLanguage
The Organizer clone can be the source
of the component relationship or
the reference relationship, but not
the entryRelationship relationship.
0..1 associatedPerson
ヘッダ部
叙述部
エントリー部
外部
参照部
CDA ヘッダ
OrganizationPartOf
0..1 wholeOrganization
Organization
classCode*: <= ORG
determinerCode*: <= INSTANCE
id: SET<II> [0..*]
name: SET<ON> [0..*]
telecom: SET<TEL> [0..*]
addr: SET<AD> [0..*]
standardIndustryClassCode: CE CWE [0..1]
<= OrganizationIndustryClass
0..1 asOrganizationPartOf
classCode*: <= PART
id*: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
statusCode: CS CNE [0..1] <=
RoleStatus
effectiveTime: IVL<TS> [0..1]
ParentDocument
0..* assignedEntity
Person
AssignedEntity
authenticator
classCode*: <= ASSIGNED
id*: SET<II> [1..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
typeCode*: <= AUTHEN
time*: TS [1..1]
signatureCode*: CS CNE [1..1] <= ParticipationSignature
認証者
0..1 assignedEntity
legalAuthenticator
typeCode*: <= LA
contextControlCode*: CS CNE [1..1] <= "OP"
time*: TS [1..1]
signatureCode*: CS CNE [1..1] <= ParticipationSignature
0..1 assignedPerson
Organization
親文書
0..* parentDocument
0..1 representedOrganization
0..1 receivedOrganization
ClinicalDocument
relatedDocument
classCode*: <= DOCCLIN
moodCode*: <= EVN
id*: II [1..1]
code*: CE CWE [1..1] <= DocumentType
title: ST [0..1]
effectiveTime*: TS [1..1]
confidentialityCode*: CE CWE [1..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <= HumanLanguage
setId: II [0..1]
versionNumber: INT [0..1]
copyTime: TS [0..1] (Deprecated)
typeCode*: <= x_ActRelationshipDocument
classCode*: <= DOCCLIN
moodCode*: <= EVN
id*: SET<II> [1..*]
code: CD CWE [0..1] <= DocumentType
text: ED [0..1]
setId: II [0..1]
versionNumber: INT [0..1]
0..* assignedEntity
ServiceEvent
行為者
0..* serviceEvent
documentationOf
typeCode*: <= DOC
0..1 representedOrganization
AssignedEntity
performer
classCode*: <= ACT
moodCode*: <= EVN
id: SET<II> [0..*]
code: CE CWE [0..1]
effectiveTime: IVL<TS> [0..1]
typeCode*: <= x_ServiceEventPerformer
functionCode: CE CWE [0..1] <= ParticipationFunction
time: IVL<TS> [0..1]
0..1 assignedPerson
0..* order
受取者
IntendedRecipient
classCode*: <=
x_InformationRecipientRole
id*: SET<II> [0..*]
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
Person
0..1 informationRecipient
Organization
オーダ情報
informationRecipient
author
AssignedAuthor
classCode*: <= ASSIGNED
id*: SET<II> [1..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
作成者
typeCode*: <= CST
classCode*: <= ASSIGNED
Consent
classCode*: <= CONS
moodCode*: <= EVN
id: SET<II> [0..*]
code: CE CWE [0..1] <= ActCode
statusCode*: CS CNE [1..1] <= completed
typeCode*: <= AUTH
承諾書
0..1 assignedEntity
custodian
AssignedCustodian
0..* consent
authorization
EncompassingEncounter
保管組織
1..1 assignedCustodian
0..1 assignedAuthorChoice
文書情報
typeCode*: <= AUT
functionCode: CE CWE [0..1] <= ParticipationFunction
contextControlCode*: CS CNE [1..1] <= "OP"
time*: TS [1..1]
Person
AuthoringDevice
1..1 representedCustodianOrganization
0..* asMaintainedEntity
MaintainedEntity
classCode*: <= MNT
effectiveTime: IVL<TS> [0..1]
1..1 maintainingPerson
受診情報
typeCode*: <= LOC
CustodianOrganization
classCode*: <= ORG
determinerCode*: <= INSTANCE
id*: SET<II> [1..*]
name: ON [0..1]
telecom: TEL [0..1]
addr: AD [0..1]
転記者
0..1 assignedEntity
AssignedEntity
0..1 representedOrganization
Place
0..* assignedEntity
encounterParticipant
typeCode*: <= x_EncounterParticipant
time: IVL<TS> [0..1]
0..1 healthCareFacility
classCode*: <= SDLOC
id: SET<II> [0..*]
code: CE CWE [0..1] <= ServiceDeliveryLocationRoleType
0..1 serviceProviderOrganization
Organization
0..1 location
Place
typeCode*: <= ENT (Transcriptionist)
contextControlCode*: CS CNE [1..1] <= "OP"
time: TS [0..1]
classCode*: <= PLC
determinerCode*: <= INSTANCE
name: EN [0..1]
addr: AD [0..1]
1..1 place
Organization
Birthplace
classCode*: <= BIRTHPL
0..1 birthplace
患者情報
0..1 providerOrganization
1..* patientRole
recordTarget
PatientRole
0..1 patient
Patient
typeCode*: <= RCT
contextControlCode*: CS CNE [1..1] <= "OP"
classCode*: <= PAT
id: SET<II> [1..*]
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
classCode*: <= PSN
determinerCode*: <= INSTANCE
id: II [0..1] (Deprecated)
name: SET<PN> [0..*]
administrativeGenderCode: CE CWE [0..1] <= AdministrativeGender
birthTime: TS [0..1]
maritalStatusCode: CE CWE [0..1] <= MaritalStatus
religiousAffiliationCode: CE CWE [0..1] <= ReligiousAffiliation
raceCode: CE CWE [0..1] <= Race
ethnicGroupCode: CE CWE [0..1] <= Ethnicity
LanguageCommunication
(LanguageCommunication)
0..*
languageCommunication
languageCode: CS CNE [0..1] <= HumanLanguage
modeCode: CE CWE [0..1] <= LanguageAbilityMode
proficiencyLevelCode: CE CWE [0..1] <= LanguageAbilityProficiency
preferenceInd: BL [0..1]
GuardianChoice
Person
0..* guardian
Guardian
classCode*: <= GUARD
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
Organization
informantChoice
1..1 guardianChoice
0..1 representedOrganization
AssignedEntity
0..1 assignedPerson
Person
RelatedEntity
0..1 relatedPerson
Organization
classCode*: <= RoleClassMutualRelationship
code: CE CWE [0..1] <=
PersonalRelationshipRoleType
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
effectiveTime: IVL<TS> [0..1]
情報提供者
0..* informantChoice
informant
typeCode*: <= INF
contextControlCode*: CS CNE [1..1] <= "OP"
0..1 scopingOrganization
0..* associatedEntity
Person
0..1 associatedPerson
関係者
AssociatedEntity
participant
classCode*: <= RoleClassAssociative
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
typeCode*: <= ParticipationType
functionCode: CE CWE [0..1] <= ParticipationFunction
contextControlCode*: CS CNE [1..1] <= "OP"
time: IVL<TS> [0..1]
0..1 representedOrganization
typeCode*: <= RESP
HealthCareFacility
dataEnterer
0..1 assignedPerson
AssignedEntity
responsibleParty
classCode*: <= ENC
moodCode*: <= EVN
id: SET<II> [0..*]
typeCode*: <= COMP
0..1 encompassingEncounter code: CE CWE [0..1] <= ActEncounterCode
effectiveTime*: IVL<TS> [1..1]
dischargeDispositionCode: CE CWE [0..1]
<= EncounterDischargeDisposition
componentOf
location
classCode*: <= DEV
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
manufacturerModelName: SC CWE [0..1] <= ManufacturerModelName
softwareName: SC CWE [0..1] <= SoftwareName
Person
classCode*: <= ACT
moodCode*: <= RQO
id*: SET<II> [1..*]
code: CE CWE [0..1] <= ActCode
priorityCode: CE CWE [0..1] <= ActPriority
typeCode*: <= x_InformationRecipient
1..* assignedAuthor
AuthorChoice
Order
typeCode*: <= FLFS
0..* intendedRecipient
0..1 representedOrganization
classCode*: <= PSN
determinerCode*: <= INSTANCE
name: SET<PN> [0..*]
inFulfillmentOf
CDA R-MIM
(POCD_RM000040)
This RMIM is used to generate
the CDA specification.
開始
0..1 assignedPerson
本文 (Narrative部 + Clinical
statement部 + 外部参照)
entryRelationship
typeCode*: <= x_ActRelationshipEntryRelationship
inversionInd: BL [0..1]
contextConductionInd*: BL [1..1] "true"
sequenceNumber: INT [0..1]
negationInd: BL [0..1]
seperatableInd: BL [0..1]
ObservationRange
clinicalStatement
Observation
classCode*: <= OBS
moodCode*: <= x_ActMoodDocumentObservation
id: SET<II> [0..*]
code*: CD CWE [1..1] <= ObservationType
negationInd: BL [0..1]
derivationExpr: ST [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
repeatNumber: IVL<INT> [0..1]
languageCode: CS CNE [0..1] <= HumanLanguage
value: ANY [0..1]
interpretationCode: SET<CE> CNE [0..*]
methodCode: SET<CE> CWE [0..*]
targetSiteCode: SET<CD> CWE [0..*]
受診・検査
0..* clinicalStatement
0..*
author
0..*
informant
注目領域
0..* observationRange
referenceRange
typeCode*: <= REFV
Note:
Observation.value has cardinality
[0..*], which doesn't show up in the
Visio representation.
Criterion
RegionOfInterest
classCode*: <= ROIOVL
moodCode*: <= EVN
id*: SET<II> [1..*]
code*: CS CNE [1..1] <= ROIOverlayShape
value*: LIST<INT> [1..*]
0..1
subject
AssignedEntity
0..1 representedOrganization
Organization
0..* assignedEntity
ObservationMedia
performer
classCode*: <= OBS
moodCode*: <= EVN
id: SET<II> [0..*]
languageCode: CS CNE [0..1] <= HumanLanguage
value*: ED [1..1]
0..* criterion
precondition
typeCode*: <= PRCN
classCode*: <= OBS
moodCode*: <= EVN.CRT
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
value: ANY [0..1]
画像情報
typeCode*: <= PRF
time: IVL<TS> [0..1]
modeCode: CE CWE [0..1] <= ParticipationMode
0..1 assignedPerson
classCode*: <= OBS
moodCode*: <= EVN.CRT
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
value: ANY [0..1]
interpretationCode: CE CNE [0..1] <= ObservationInterpretation
0..1 manufacturerOrganization
SubstanceAdministration
DrugOrOtherMaterial
classCode*: <= SBADM
moodCode*: <= x_DocumentSubstanceMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= SubstanceAdministrationActCode
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: GTS [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
repeatNumber: IVL<INT> [0..1]
routeCode: CE CWE [0..1] <= RouteOfAdministration
approachSiteCode: SET<CD> CWE [0..*] <= ActSite
doseQuantity: IVL<PQ> [0..1]
rateQuantity: IVL<PQ> [0..1]
maxDoseQuantity: RTO<PQ,PQ> [0..1]
administrationUnitCode: CE CWE [0..1] <=
AdministrableDrugForm
LabeledDrug
classCode*: <= MMAT
determinerCode*: <= KIND
code: CE CWE [0..1] <=
DrugEntity
name: EN [0..1]
ManufacturedProduct
classCode*: <= MANU
id: SET<II> [0..*]
1..1 manufacturedProduct
consumable
投薬情報
typeCode*: <= CSM
Material
製品情報
classCode*: <= MMAT
determinerCode*: <= KIND
code: CE CWE [0..1]
<= MaterialEntityClassType
name: EN [0..1]
lotNumberText: ST [0..1]
1..1 manufacturedDrugOrOtherMaterial
0..1 manufacturedProduct *
product
Supply
typeCode*: <= PRD
classCode*: <= SPLY
moodCode*: <= x_DocumentSubstanceMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: GTS [0..1]
priorityCode: SET<CE> CWE [0..*] <= ActPriority
repeatNumber: IVL<INT> [0..1]
independentInd: BL [0..1]
quantity: PQ [0..1]
expectedUseTime: IVL<TS> [0..1]
EntityChoice
Device
bodyChoice
NonXMLBody
classCode*: <= DOCBODY
moodCode*: <= EVN
text: ED [1..1]
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
非XMLデータ
StructuredBody
classCode*: <= DOCBODY
moodCode*: <= EVN
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
0..1 relatedSubject
RelatedSubject
0..1
classCode*: <= x_DocumentSubject
code: CE CWE [0..1] <= PersonalRelationshipRoleType
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
Procedure
0..1 specimenPlayingEntity
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
Section
classCode*: <= DOCSECT
moodCode*: <= EVN
id: II [0..1]
code: CE CWE [0..1] <= DocumentSectionType
title: ST [0..1]
text*: ED [0..1]
confidentialityCode: CE CWE [0..1]
<= x_BasicConfidentialityKind
languageCode: CS CNE [0..1] <=
HumanLanguage
本文
participant
typeCode*: <= ParticipationType
contextControlCode*: CS CNE [1..1] <= "OP"
time: IVL<TS> [0..1]
awarenessCode: CE CWE [0..1] <= TargetAwareness
0..1 scopingEntity
Entity
関係者
0..1 subject
SubjectPerson
classCode*: <= PSN
determinerCode*: <= INSTANCE
name: SET<PN> [0..*]
administrativeGenderCode: CE CWE [0..1] <= AdministrativeGender
birthTime: TS [0..1]
ExternalAct
classCode*: <= ACT
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
0..* externalActChoice
reference
ExternalObservation
classCode*: <= OBS
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
Encounter
ExternalProcedure
classCode*: <= ENC
moodCode*: <= x_DocumentEncounterMood
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActEncounterCode
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
classCode*: <= PROC
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
text: ED [0..1]
ExternalDocument
0..* section
0..* clinicalStatement
Organizer
classCode*: <= x_ActClassDocumentEntryOrganizer
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= ActCode
statusCode*: CS CNE [1..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
検体/グループ
0..* clinicalStatement
entry
typeCode*: <= x_ActRelationshipEntry
contextConductionInd*: BL [1..1] "true"
外部参照情報
typeCode*: <= x_ActRelationshipExternalReference
seperatableInd: BL [0..1]
受診情報
classCode*: <= ENT
determinerCode*: <= INSTANCE
id: SET<II> [0..*]
code: CE CWE [0..1] <= EntityCode
desc: ED [0..1]
subject
typeCode*: <= SBJ
contextControlCode*: CS CNE [1..1] <= "OP"
awarenessCode: CE CWE [0..1] <= TargetAwareness
classCode*: <= PROC
moodCode*: <= x_DocumentProcedureMood
id: SET<II> [0..*]
code: CD CWE [0..1]
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
languageCode: CS CNE [0..1] <= HumanLanguage
methodCode: SET<CE> CWE [0..*]
approachSiteCode: SET<CD> CWE [0..*]
targetSiteCode: SET<CD> CWE [0..*]
処置・手術
0..* participantRole
関係者
classCode*: <= ROL
id: SET<II> [0..*]
code: CE CWE [0..1] <= RoleCode
addr: SET<AD> [0..*]
telecom: SET<TEL> [0..*]
component
informant
typeCode*: <= SPC
classCode*: <= SPEC
id: SET<II> [0..*]
ParticipantRole
1..* section
0..*
物品情報
specimen
0..1 playingEntityChoice
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
author
検体情報
SpecimenRole
externalActChoice
component
0..*
0..* specimenRole
PlayingEntity
classCode*: <= ENT
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
quantity: SET<PQ> [0..*]
name: SET<PN> [0..*]
desc: ED [0..1]
1..1 bodyChoice
component
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
classCode*: <= DEV
determinerCode*: <= INSTANCE
code: CE CWE [0..1] <= EntityCode
manufacturerModelName: SC CWE [0..1]
<= ManufacturerModelName
softwareName: SC CWE [0..1]
<= SoftwareName
Act
classCode*: <= x_ActClassDocumentEntryAct
moodCode*: <= x_DocumentActMood
id: SET<II> [0..*]
code*: CD CWE [1..1] <= ActCode
negationInd: BL [0..1]
text: ED [0..1]
statusCode: CS CNE [0..1] <= ActStatus
effectiveTime: IVL<TS> [0..1]
priorityCode: CE CWE [0..1] <= ActPriority
languageCode: CS CNE [0..1] <= HumanLanguage
その他
component
typeCode*: <= COMP
contextConductionInd*: BL [1..1] "true"
sequenceNumber: INT [0..1]
seperatableInd: BL [0..1]
classCode*: <= DOC
moodCode*: <= EVN
id: SET<II> [0..*]
code: CD CWE [0..1] <= DocumentType
text: ED [0..1]
setId: II [0..1]
versionNumber: INT [0..1]
CDAヘッダ
ヘッダ部共通仕様
XPath
ClinicalDocument
realmCode
@code
typeID
@root
@extension
templateId
@root
id
@extension
@root
code
@code
@displayName
@codeSystem
@codeSystemName
title
text()
effectiveTime
@value
confidentialityCode
@code
@codeSystem
languageCode
@code
setID
@extension
@root
version
@value
Card.
1..1
M
1..1
M
M
1..1
M
1..1
M
M
1..1
M
M
M
O
0..1
M
1..1
M
1..1
M
M
0..1
M
1..1
M
M
1..1
M
値
備考
JP
2.16.840.1.113883.1.3
POCD_HD000040
例. 退院時サマリ
例. 2.16.840.1.113883.6.1
例. LOINC
例. 退院時サマリ
N
2.16.840.1.113883.5.25
Ja-JP
患者情報 RecordTarget
患者情報 recordTarget/patientRole/Patient
<recordTarget>
<patientRole>
<id extension="111111" root="2.16.840.1.113883.2.2.3.10.1.2"/>
<addr use="HP">
<streetAddressLine>新橋2丁目5番5号</streetAddressLine>
<city>港区</city>
<state>東京都</state>
<postalCode>105-0004</postalCode>
<county>日本</county>
</addr>
<telecom use="HP" value="tel:03-3506-8010"/>
<patient>
<name use=“ABC">
<family>Tokyo</family>
<given>Hanako</given>
</name>
<name use="SYL">
<family>トウキョウ</family>
<given>ハナコ</given>
</name>
<name use="IDE">
<family>東京</family>
<given>花子</given>
</name>
<administrativeGenderCode code="F"
codeSystem="2.16.840.1.113883.5.1" displayName="女"/>
<birthTime value="19370723"/>
共通ヘッダ部
ヘッダ部情報
recordTarget
患者基本情報
author
作成者および作成システム
dataEnterer
転記者
informant
情報提供者
custodian
保管組織
informationRecipient
受取人
legalAuthenticator
法的本書承認者
authenticator
本書記載内容責任者
participant
関係者
inFulfillmentOf
オーダ情報
documentationOf
検査・診療等行為
relatedDocument
文書関係（元文書、変更、置換）
authorization
承諾
componentOf
受診時情報
一部Sectionで補足
患者以外からの情報提供
オーダ番号
本文(component/structuredBody)
<component>
<structuredBody>
<component>
<section>
<templateId
root="2.16.840.1.113883.2.2.1.
5.3"/>
<code code="52460-3"
codeSystem="2.16.840.1.1138
83.6.1"/>
本文 (フリーテキスト)
<component>
<section>
<templateId root="2.16.840.1.113883.2.2.1.5.8"/>
<code code="48765-2" codeSystem="2.16.840.1.113883.6.1"
displayName="アレルギー"/>
<title>アレルギー</title>
<text>薬物、食物ともに無し</text>
</section>
</component>
共通化(Consolidate:統一、一元管理）
 ヘッダ部の共通化
 ヘッダ部 補完部の共通化
 本体記述の方法論の共通化
 （コンテンツの共通化）
 外部参照等の記述・方法の共通化
 （既存） 保存、署名、暗号化
21
ヘッダ部
XPath
ClinicalDocument
realmCode
@code
typeID
@root
@extension
templateId
@root
id
@extension
@root
code
@code
@displayName
@codeSystem
@codeSystemName
title
text()
effectiveTime
@value
confidentialityCode
@code
@codeSystem
languageCode
@code
setID
@extension
@root
versionNumber
@value
値
Card.
1..1
M
1..1
M
M
1..1
M
1..1
M
M
1..1
R
R
R
O
0..1
R
1..1
R
1..1
R
R
0..1
R
0..1
R
R
0..1
R
備考
JP
2.16.840.1.113883.1.3
POCD_HD000040
例. 退院時サマリ
例. 2.16.840.1.113883.6.1
例. LOINC
例. 退院時サマリ
N
2.16.840.1.113883.5.25
ja-JP
22
患者情報(1)
XPath
値
Card.
備考
recordTarget
patientRole
id
1..*
1..*
@extension
R
患者ID
@root
R
患者IDを管理する組織OID
addr
0..*
telecom
0..*
patient
1..1
住所
電話番号
患者氏名
0..1
性別
administrativeGenderCode
性別コード
@code
R
@codeSystem
R
2.16.840.1.113883.5.1
@codeSystemName
O
AdministrativeGender
@displayName
R
birthTime
1..1
@value
R
maritalStatusCode
性別
生年月日
表0130
0..1
婚姻情報コード
@code
R
@displayName
R
@codeSystem
R
2.16.840.1.113883.5.2
@codeSystemName
O
MaritalStatus
23
患者情報(2)
XPath
guardian
code
@code
@displayName
@codeSystem
@codeSystemName
addr
@use
streetAddressLine
text()
postalCode
text()
telecom
guardianPerson
name
@use
family
text()
Card.
0..*
1..1
R
R
R
O
0..*
O
1..1
R
0..1
R
0..*
0..1
1..1
1..1
1..1
R
値
備考
後見人
2.16.840.1.113883.5.111
RoleCode
roleCode
簡易住所を使用する
住所区分
全住所を記述する
郵便番号を記述する
電話番号
姓名非分離記述せず
IDE
24
患者情報(3)
XPath
birthplace
place
addr
city
text()
state
text()
languageCommunication
languageCode
@code
modeCode
@code
@displayName
@codeSystem
@codeSystemName
proficiencyLevelCode
@code
@displayName
@codeSystem
@codeSystemName
preferenceInd
@value
Card.
0..1
1..1
1..*
0..*
R
1..1
R
0..*
1..1
R
0..1
R
R
R
O
0..1
R
R
R
O
0..1
R
値
備考
生誕地
簡易住所を使用する
市、都
都道府県
2.16.840.1.113883.5.60
LanguageAbilityMode
2.16.840.1.113883.5.61
LanguageAbilityProficiency
25
患者情報(4)
XPath
providerOrganization
id
Card.
値
備考
0..1
0..1
@root
name
R
1..1
text()
R
telecom
0..*
telNumber
addr
0..*
簡易住所を使用する
@use
streetAddressLine
text()
O
1..1
住所区分
全住所を記述する
R
26
人名
XPath
name
@use
family
text()
given
text()
name
@use
family
text()
given
text()
name
@use
family
text()
given
text()
Card.
0..1
R
1..1
値
備考
ABC
英語またはローマ字氏名(患者名では第一要素とする）
(姓名が区別できない場合はFamilyで記載)
IDE
表意文字（漢字氏名）
姓 (姓名が区別できない場合はFamilyで記載)
R
0..*
R
1..1
O
1..1
R
名
0..1
R
0..1
R
1..1
R
SYL
表音文字（カナ氏名）
セイ
(姓名が区別できない場合はFamilyで記載)
0..*
0..1
メイ
27
退院時サマリヘッダ(1)
項目
退院時サマリ
M
recordTarget/patientRole
患者情報
ID
R
id
O
addr
住所
O
tel
電話番号
patient
use="ABC"
O
姓名（英語）
use="SYL"
R
姓名（漢字）
use="IDE"
R
姓名（カナ）
R
administrativeGenderCode
性別
R
birthTime
生年月日
R
maritalStatusCode
婚姻
O
religiousAffiliationCode
宗教
N
人種
N
民族
O
guardian
保護者
O
Birthplace/place
生誕地
O
languageCommunication
対話言語
R
providerOrganization
医療機関
section/template 2.16.840.1.113883.2.2.1.5.3 code="52460-3"
O
Loinc=30525-0
年齢
O
Loinc=882-1
血液型
O
Loinc=21847-9
職業
O
Loinc=3141-9
体重
O
Loinc=8302-2
身長
O
Loinc=8867-4
脈拍
O
Loinc=18684-1
血圧
O
JMIX=MD0010480
本籍地
28
退院時サマリヘッダ(2)
作成
作成者
住所
電話番号
姓名
作成システム
住所
電話番号
医療機器
転記者
ID
住所
電話番号
入力者
情報提供者１
ID
住所
電話番号
姓名
情報提供者2
Code
関係者
M
R
O
O
R
N
N
N
N
author
assignedAuthor/assignedPerson
addr/streetAddressLineにより都道府県から番地まですべて記載
tel
name/familyのみで記載する
O
N
N
N
N
O
informant/
O
relatedEntity
N
N
N
N
O
N
29
退院時サマリヘッダ(3)
M
保管組織
組織名
電話番号
住所
R
R
R
ID
住所
電話番号
受取人
受取組織
O
O
O
O
O
受取者（依頼科）
O
O
(法的)承認者
日時
署名コード
R
R
R
O
記載責任者
日時
署名コード
R
R
R
O
関係者
O
O
オーダ情報
オーダ番号
オーダ目的
検査・診療等行為
N
N
O
O
O
custodian/assignedCustodian/representedCustodianOrganization
id
tel
addr
informationRecipient/intendedRecipient
id
addr/streetAddressLineにより都道府県から番地まですべて記載
tel
person/ name/familyのみで記載する
organization
legalAuthenticator
time
signatureCode
assignedEntity
name/familyのみで記載する
addr/streetAddressLineにより都道府県から番地まですべて記載
authenticator
time
signatureCode
assignedEntity
name/familyのみで記載する
addr/streetAddressLineにより都道府県から番地まですべて記載
participant
name/familyのみで記載する
addr/streetAddressLineにより都道府県から番地まですべて記載
inFulfillmentOf/order
ie
code
documentationOf/serviceEvent
id
code
30
退院時サマリ(1)
Document Type
Preferred LOINC templateId
セクション
退院時サマリ
18842-5
主訴
主訴および来院理由
退院時食餌
家族歴
機能状態
既往歴
現病歴
入院時診断
入院時処方
入院時身体所見
対診
検査結果
退院時指示
退院時身体記録
退院時検査サマリ
予防接種・免疫情報
US Realm
2.16.840.1.113883.10.20.22.1.8
JP Realm
2.16.840.1.113883.2.2.1.7.1
退院時サマリ(2)
Document Type
Preferred LOINC templateId
セクション
退院時サマリ
18842-5
プロブレムリスト
手術・処置記録
手術・処置歴
来院理由
体調
社会歴
バイタルサイン
アレルギー検査情報
アレルギー
入院経過
退院時診断
退院時処方
ケアプラン（治療計画）
診療記録
US Realm
2.16.840.1.113883.10.20.22.1.8
JP Realm
2.16.840.1.113883.2.2.1.7.1
33
外部参照(1)
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<text>
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34
外部参照(2)
<entry>
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35
表示例
36
画像埋めこみ
<section>
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<title>画像情報</title>
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.
.
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37
38
39
40
ご清聴ありがとうございました
41