身體活動量測(Physical Activity Measure)
0.1.0 - ci-build

身體活動量測(Physical Activity Measure) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Official URL: https://hapi.fhir.tw/fhir/ImplementationGuide/fhir.SportsData | Version: 0.1.0
Active as of 2024-08-01 | Computable Name: PhysicalActivityMeasure

# Physical Activity Measure

### 專案介紹

身體活動量測實作指引(Physical Activity Measure Implementation Guide)採用HL7® FHIR® standard（Fast Healthcare Interoperability Resources）IG建置方法，在FHIR R4.0.1之標準基礎上，繼承TW Core IG V 0.2.2 (2024-06-28)，進一步定義適用於身體活動量測「(以下簡稱本專案)」資料需求的Resources、其中的資料項目（意即欄位）、基數（意即0..1、0..*、1..1或1..*）及資料類型（文字、日期時間、代碼等）等。

### 運動處方箋

- 保持良好的健康狀態和積極的生活方式可以幫助個人降低罹病率以達到事前預防之效益，同時減少醫療成本，創造三贏的外溢效果。然而，目前民眾就診後，醫師開立的運動處方箋皆為紙本開立，民眾需自行保管，並到合作之運動場域執行。而紙本開立之處方箋容易遺失，或是在需要使用時找不到。另外，由於紙本處方箋無法追蹤，有些民眾可能會在遺失後便不再執行運動，錯失了改善健康的機會。更為重要的是，紙本處方箋因不具備追蹤和記錄運動數據的功能，這使得醫師難以追蹤民眾的運動情況以進行適當的調整和建議。
- 以美國 Physical Activity Implementation Guide 為例，此專案主要目的是採用 FHIR 標準提高病患身體活動健康水準的護理計畫和目標。此專案透過 FHIR 標準化有關身體測量、報告和介入以提高病患身體活動水平的可互操作性，進而改善病患的身體活動水準。在此實作指南定義了病患使用之應用程式、病患身體活動測量設備、臨床電子健康記錄、支付者、品質測量系統以及健身專業人員、個人訓練師和社區健身中心使用的應用程式相關界面。通過提高資料交換和互通性期望能改善病患的整體健康，並降低醫療保健的成本。
- 為了促進醫療資訊系統中運動處方箋的使用和互操作性，本計畫參考 Physical Activity Implementation Guide 的概念，提出一個適用於台灣電子運動處方箋的技術規格，讓病患能將運動處方箋及運動數據以電子化的方式儲存於專用 APP。透過醫院、運動場域與保險公司三方合作，在病患同意的情況下，將醫院開立之運動處方箋數位化，根據本計畫設計的 FHIR實作指引產生國際標準 FHIR 格式文件後，以 FHIR RESTful API 方式作為個人健康管理系統的整合。透過發展各種應用APP，讓個人能夠更好的自主健康管理。

### 針對運動數據收集與分析，結合數位產業署提倡運動數據公益平台計畫。

- 目數位部產業署基於行政院科技會報辦公室舉辦之「運動X科技SRB產業策略會議」的共識下，成立「運動數據公益平台」，透過民眾對政府的信任， 將數據貢獻出來，以利公共利他的研究，協助國內運動科技產業賦能，以社會創新帶動產業創新。目前運動數據公益平台已有超過300萬筆數據，包含: 運動數據、體適能數據以及生理數據。透過數據公益和運動的結合，將民眾日常的生活收集的生體活動資訊，例如透過智慧型手錶和手環收集走路步數、心率等做為資料二次使用以及用於公益。此外，數據公益強調民眾資料的自主決定權，因此針對收集之數據在無個人資料洩漏的疑慮下，開放各界使用，以產生更多創新應用與公益價值。

### 效益(Benefits)

- 促進使用運動處方箋可提供民眾一個明確的目標，透過「運動處方箋」可讓病患明確地知道需要從事那些運動。如何正確地運動來提供各種健康狀態的改善，例如，制定運動處方的目標為達成心跳目標，透過明確的指引引導民眾達問運動目的，用來改善減少藥物的服用量，幫助患者穩定控制病情。常見的有糖尿病患者的糖化血色素、失智症患者延緩延緩認知功能障礙、以及改善代謝症候群患者等諸多好處。
- 現在臺灣實際上開立的運動處方箋絕大多數為紙本，造成實務上醫師開立運動處方後，在運動指導以及執行之結構與內容尚無一個通用的指引可依循，透過本賽道預期針對符合FHIR架構的結構化架構，能夠讓提高資料交換和互通性期望能改現有情況，進而促進運動產業的數位轉型。
- 針對運動數據收集與分析，本賽道透過公私協力合作模式，結合數位產業署提倡運動數據公益平台計畫。目前訂定欄位多達65項，92種設備類型，串接業者達50家。隨著資料與設備越來越多，為了達到資料治理FAIR準則讓來自不同設備以及系統能滿足資料操作性，提供一個技術框架做為未來收載來自不同資料與設備提供的PA數據。

### 詳細資訊(Details)

運動處方箋

- 情境1-1：運動處方箋交換
- 產生: 醫院端 (Provider/EHR)開立運動處方箋，經過病患授權後，將文件傳送至儲存庫 (Repository)。</p>

- 查詢與調閱:教練端(PHI Professional)接籤，查看醫師開立之運動處方箋、運動目標與病患病史。</P>

- 情境1-2：運動計畫交換
- 產生: 教練端 (PHI Professional) 制定運動計畫，上傳至儲存庫 (Repository)。</p>
- 查詢與調閱** 民眾端 (PHI Patient)查看教練(場館、物理治療師)制定之運動計畫。</p>

運動數據平台

- 情境 2-1：基本生理量測數據交換
- 產生: 儀器端（Device）上傳生理量測數據至傳送至儲存庫 (Repository)。</p>

- 查詢與調閱: 個人健康管理系統(個人使用)或分析軟體(分析軟體)查看或調閱生理量測數據。</p>

- 情境 2-2：靜態活動: 身體組成分析儀 (Inbody)數據交換
- 產生: 儀器端（Device）上傳Inbody數據至數據儲存庫 (Repository)。</p>

- 查詢與調閱: 個人健康管理系統(個人使用)或分析軟體(分析軟體)查看或調閱Inbody數據。</p>

- 情境 2-3：運動分析: 步態分析數據交換
- 產生: 儀器 (跑步機、IoT量測設備)上傳步態分析數據至數據儲存庫 (Repository)。</p>
- 查詢與調閱: 個人健康管理系統(個人使用)或分析軟體(分析軟體)查看步態分析數據或是原始資料。</p>

### 如何閱讀此IG

- 應用說明：IG介紹及背景說明。
- 規範文件
  - 能力聲明 ：應用IG於建置業務目的使用的FHIR Server時，該FHIR Server必須及建議應該支援的操作功能。
  - 查詢參數 ：查詢FHIR Server的Profiles時，針對各Profiles可使用的查詢參數及操作定義。
  - 邏輯模型 ：IG的所有邏輯模型（Logical Models），各邏輯模型會定義相應情境下使用的所有資料欄位。為了便於實作者快速理解，資料欄位會使用易於理解的命名，實作者再透過邏輯模型中的功能頁籤「Mappings」瞭解各資料欄位實際使用本IG的哪個Profiles的哪個資料項目（element）。
  - FHIR Profiles：
    - IG的所有Profiles之定義。
    - 各資料項目不同實作強制程度的Terminology。
    - 各資料項目的限制（Constraints）。
    - 查詢依據IG實作之FHIR Server的特定Profiles時，可使用的查詢參數。
    - 有哪些Profiles具有查詢參數以及Server必須支援哪些必要的查詢參數功能。
  - 專門術語 ：IG網站所使用的專門術語，包括代碼系統（Code Systems）及值集（Value Sets）。
- 範例：遵從TW Core IG所定義Profiles之範例。
- 結構定義與範例檔下載：實作者若不偏好使用FHIR RESTful API驗證資料是否遵從Profiles，可直接下載所需的格式驗證檔，包括XML、JSON及Turtle三種格式，亦可於此下載完整範例。
- 安全性：主要說明採用IG網站進行實作時，有關資料存取授權的作法。

#### Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (fhir.SportsData.r4) and R4B (fhir.SportsData.r4b) are available.

#### Dependency Table

IG | Package | FHIR | Comment
--- | --- | --- | ---
身體活動量測(Physical Activity Measure) | fhir.SportsData#0.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.0.2 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.1.0 | R4 | Automatically added as a dependency - all IGs depend on the HL7 Extension Pack
臺灣核心實作指引(TW Core IG) | tw.gov.mohw.twcore#0.2.2 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.5.0 | R4 |
International Patient Summary Implementation Guide | hl7.fhir.uv.ips#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.0.0 | R4 |
| fhir.dicom#2022.4.20221006 | R4 |

Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.uv.ips#1.1.0 International Patient Summary (IPS) FHIR Implementation Guide (built Tue, Nov 22, 2022 03:24+0000+00:00)

Package tw.gov.mohw.twcore#0.2.2 臺灣核心實作指引(TW Core IG) (built Tue, May 28, 2024 21:46+0800+08:00)

#### Globals Table

There are no Global profiles defined

#### IP Statements

This publication includes IP covered under the following statements.

- ISO Maintains the copyright on the country codes, and controls it's use carefully. For futher details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
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  - ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: Patient/patient-ex-example and Patient/patient-tw-example
- The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
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  - Unified Code for Units of Measure (UCUM): Goal/goal-example, Observation/BMI-example... Show 34 more, Observation/BMR-example, Observation/BPF-example, Observation/ECW-example, Observation/FFM-example, Observation/ICW-example, Observation/SLM-example, Observation/SMI-example, Observation/SMM-example, Observation/SpO2-example, Observation/TBW-example, Observation/VFA-example, Observation/bloodpressure-example, Observation/bodycellmass-example, Observation/bodyfatmass-example, Observation/bonemass-example, Observation/gaitcycle-l-example, Observation/gaitcycle-r-example, Observation/gaittype-l-example, Observation/gaittype-r-example, Observation/glucose-example, Observation/heartrate-example, Observation/heartratevariability-example, Observation/height-example, Observation/meanheartrate-example, Observation/mineral-example, Observation/obseitydegree-example, Observation/protein-example, Observation/respiratoryrate-example, Observation/restingheartrate-example, Observation/temperature-example, Observation/treadmill-example, Observation/waist-example, Observation/weight-example and Observation/weighttraining-example
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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  - LOINC: Condition/condition-m-example, Goal/goal-example... Show 42 more, Observation/BMI-example, Observation/BPF-example, Observation/FFM-example, Observation/SpO2-example, Observation/TBW-example, Observation/VFA-example, Observation/bloodpressure-example, Observation/bodyfatmass-example, Observation/bonemass-example, Observation/glucose-example, Observation/heartrate-example, Observation/heartratevariability-example, Observation/height-example, Observation/meanheartrate-example, Observation/respiratoryrate-example, Observation/restingheartrate-example, Observation/temperature-example, Observation/treadmill-example, Observation/waist-example, Observation/weight-example, Observation/weighttraining-example, ObservationBMI, ObservationBloodPressure, ObservationBodyBoneMass, ObservationBodyFatMass, ObservationBodyFatPercentage, ObservationBodyTemperature, ObservationFatFreeMass, ObservationGlucose, ObservationHeartRate, ObservationHeartRateVariability, ObservationHeight, ObservationMeanHeartRate, ObservationRespiratoryRate, ObservationRestingHeartRate, ObservationSpO2, ObservationTotalBodyWater, ObservationTreadmill, ObservationVFA, ObservationWaist, ObservationWeight and ObservationWeightTraining
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  - SNOMED Clinical Terms® (SNOMED CT®): Condition/condition-e-example, ConditionExcerciseHistory... Show 48 more, ExerciseHistory, GaitType, Observation/BMR-example, Observation/gaitcycle-l-example, Observation/gaitcycle-r-example, Observation/gaittype-l-example, Observation/gaittype-r-example, Observation/treadmill-example, Observation/weighttraining-example, ObservationBasalmetabolicrate, ObservationBodyAge, ObservationBodyBoneMass, ObservationBodyCellMass, ObservationBodyFatMass, ObservationBodyFatPercentage, ObservationBodyTemperature, ObservationECWRatio, ObservationExtracellularWater, ObservationFatFreeMass, ObservationGaitCycle, ObservationGaitType, ObservationGlucose, ObservationHeartRate, ObservationHeartRateVariability, ObservationHeight, ObservationIntracellularWater, ObservationMeanHeartRate, ObservationMineral, ObservationObesityDegree, ObservationProtein, ObservationRespiratoryRate, ObservationRestingHeartRate, ObservationSkeletalMuscleMass, ObservationSkeletalMuscleMassIndex, ObservationSoftLeanMass, ObservationSpO2, ObservationTotalBodyWater, ObservationTreadmill, ObservationVFA, ObservationVFI, ObservationWaist, ObservationWaistHipRate, ObservationWeight, ObservationWeightTraining, ServiceRequest/servicerequest-example, ServiceRequestPA, SportServiceRequest and TreadmillType
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license
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  - Condition Clinical Status Codes: Condition/condition-e-example and Condition/condition-m-example
  - Observation Category Codes: Observation/BMI-example, Observation/BMR-example... Show 66 more, Observation/BPF-example, Observation/ECW-example, Observation/ECWRatio-example, Observation/FFM-example, Observation/ICW-example, Observation/SLM-example, Observation/SMI-example, Observation/SMM-example, Observation/SpO2-example, Observation/TBW-example, Observation/VFA-example, Observation/VFI-example, Observation/WHR-example, Observation/bloodpressure-example, Observation/bodyage-example, Observation/bodycellmass-example, Observation/bodyfatmass-example, Observation/bonemass-example, Observation/gaitcycle-l-example, Observation/gaitcycle-r-example, Observation/gaittype-l-example, Observation/gaittype-r-example, Observation/glucose-example, Observation/heartrate-example, Observation/heartratevariability-example, Observation/height-example, Observation/meanheartrate-example, Observation/mineral-example, Observation/obseitydegree-example, Observation/protein-example, Observation/respiratoryrate-example, Observation/restingheartrate-example, Observation/temperature-example, Observation/treadmill-example, Observation/waist-example, Observation/weight-example, Observation/weighttraining-example, ObservationBasalmetabolicrate, ObservationBodyAge, ObservationBodyBoneMass, ObservationBodyCellMass, ObservationBodyFatMass, ObservationBodyFatPercentage, ObservationECWRatio, ObservationExtracellularWater, ObservationFatFreeMass, ObservationGaitCycle, ObservationGaitType, ObservationGlucose, ObservationHeartRateVariability, ObservationIntracellularWater, ObservationMeanHeartRate, ObservationMineral, ObservationObesityDegree, ObservationProtein, ObservationRestingHeartRate, ObservationSkeletalMuscleMass, ObservationSkeletalMuscleMassIndex, ObservationSoftLeanMass, ObservationTotalBodyWater, ObservationTreadmill, ObservationVFA, ObservationVFI, ObservationWaist, ObservationWaistHipRate and ObservationWeightTraining
  - Organization type: morefit and 臺北醫院
  - identifierType: Patient/patient-ex-example, Patient/patient-tw-example... Show 5 more, Practitioner/practitioner-c-example, Practitioner/practitioner-d-example, TWCorePatient, morefit and 臺北醫院
- World Health Organization (WHO)
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  - 臺灣2023年中文版ICD-10-PCS-F-復健及診斷性聽力學: ICD10PCSF and SportServiceRequest
  - 暫時使用的代碼: CarePlan/careplan-example, Condition/condition-e-example... Show 29 more, Goal/goal-example, Observation/ECW-example, Observation/ECWRatio-example, Observation/ICW-example, Observation/SLM-example, Observation/SMI-example, Observation/SMM-example, Observation/VFI-example, Observation/WHR-example, Observation/bodyage-example, Observation/bodycellmass-example, Observation/mineral-example, Observation/obseitydegree-example, Observation/protein-example, ObservationBodyAge, ObservationBodyCellMass, ObservationECWRatio, ObservationExtracellularWater, ObservationIntracellularWater, ObservationMineral, ObservationObesityDegree, ObservationProtein, ObservationSkeletalMuscleMass, ObservationSkeletalMuscleMassIndex, ObservationSoftLeanMass, ObservationVFI, ObservationWaistHipRate, ServiceRequest/servicerequest-example and TempCode
  - 臺灣健保署2021年中文版ICD-10-CM: Condition/condition-m-example
- 衛生福利部資訊處
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  - 臺灣衛福部資訊處識別碼類型: TWCorePatient