Fiche de Conciliation des Traitements médicamenteux (FCT) : Liste des traitements médicamenteux conciliés à partir du Bilan Médicamenteux (traitements avant l'hospitalisation) et du Traitement Médicamenteux Courant, conforme aux recommandations du guide de la HAS.

• référence le Bilan Médicamenteux ;
• référence le Traitement Médicamenteux Courant ;
• liste des lignes de traitement conciliées avec, pour chacune,
  • la référence à la ligne de traitement médicamenteux du Bilan Médicamenteux si elle existe,
  • la référence à la ligne de traitement médicamenteux du Traitement Médicamenteux Courant si elle existe,
  • au moins une de ces deux lignes doit exister et être référencée,
  • ses propriétés de conciliation.

Cette Composition comporte 3 <section> et 3 seulement :

1. La référence au Bilan Médicamenteux, une ressource Composition profilée fr-medication-history-composition
2. La référence au Traitement Médicamenteux Courant, une ressource Composition profilée fr-current-medication-composition
3. La liste des traitements médicamenteux conciliés avec chacune ses propriétés de conciliation, une <entry> (de cette 3ème section) par ligne de traitement référençant une ressource MedicationStatement profilée fr-medication-reconciliation-medication-statement

1. Une FCT ne peut être au statut final que si elle est complète, à la fois du point de vue de la documentation des lignes de traitement médicamenteux conciliées (cf. les propriétés de conciliation de chacune de ses lignes de traitement) et du point de vue des auteurs qui assument ces contenus (cf. élément <author> de cette Composition).
2. Une FCT peut être produite en plusieurs étapes pouvant mettre à disposition des versions intermédiaires, préliminaires, précédant la version finale. Cet élément <status> de la Composition permet alors de rendre compte de ces contenus intermédiaires préliminaires.
3. Le projet d'établissement et ses choix d'intégration inter applications peut légitimement se limiter à ne partager que la FCT à l'état final, les éventuelles versions intermédiaires préliminaires ne sortant pas du module qui en a la charge.

Le patient auquel se rapporte ce document FCT (Fiche de Conciliation des Traitements médicamenteux).

Une FCT (Fiche de Conciliation des Traitements médicamenteux) se rapporte obligatoirement à un patient, référencé en tant que ressource Patient profilée fr-patient.

Identifier le patient auquel se rapporte obligatoirement une FCT (Fiche de Conciliation des Traitements médicamenteux), patient référencé en tant que ressource Patient profilée fr-patient.

Le ou les auteurs de cette FCT (Fiche de Conciliation des Traitements médicamenteux), défini ès qualités (ressource PractitionerRole profilée fr-practitioner-role-profession) ET, de préférence, aussi nominativement (la ressource PractionerRole profilée fr-practitioner-role instanciée réfère une instance de ressource Practioner profilée fr-practitioner).

1. Il est vivement recommandé d'identifier nominativement les auteurs : la ressource PractitionerRole profilée fr-practitioner-role-profession instanciée (ex: Médecin) réfère une instance de ressource Practitioner profilée fr-practitioner (ex: Dr UNTEL).
2. En l'absence de signature électronique, la fiche est réputée signée par ses co-auteurs (voir élement <author> de cardinalité [1..*].
3. Les règles de gestion de ce co-authoring peuvent être limitée au seul pharmacien (1 seul auteur) qui assumerait la seule version finale de cette Fiche qui serait communiquée.
4. Un projet plus ambitieux pourrait produire une version préliminaire de la Fiche avec comme seul auteur le pharmacien qui établit la liste des traitements à concilier avec leurs propriétés de conciliation partiellement documentées, puis, une version finale avec comme co-auteurs le phamacien et le prescripteur des lignes de traitement qui ont alors toutes leurs propriétés de conciliation documentées.

Identifier les co-auteurs de la FCT (Fiche de Conciliation des Traitements médicamenteux).

3 sections, prédéfinies et ces 3 sections seulement

Structure de la FCT française conforme au du guide de la HAS.

Le Bilan Médicamenteux auquel se réfère la FCT (Fiche de Conciliation des Traitements médicamenteux).

Une FCT (Fiche de Conciliation des Traitements médicamenteux) doit se référer à un Bilan Médicamenteux. Cette section n'a qu'une seule <entry> qui référence une ressource Composition profilée fr-medication-history-Composition portant le Bilan Médicamenteux attaché à la FCT.

Référencer le Bilan Médicamenteux de cette conciliation des traitements médicamenteux.

L'auteur du Bilan Médicamenteux est celui du Bilan référencé par l'élément <entry>. L'auteur de l'inclusion de ce bilan dans la fiche de conciliation est celui de la Composition.

L'auteur du Bilan Médicamenteux est celui du Bilan référencé par l'élément <entry>. L'auteur de l'inclusion de ce bilan dans cette fiche de conciliation est celui de la Composition.

Le Bilan Médicamenteux ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

Le Bilan Médicamenteux ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

This element is labeled as a modifier because a change list must not be misunderstood as a complete list. Dans ce profil, sa valeur est fixée à working.

Contraindre une gestion univoque de cette liste représentant le Bilan Médicamenteux.

Non concerné car il n'y a qu'une seule <entry> dans cette <section>. L'ordre des lignes du Bilan Médicamenteux attaché, sera porté par l'élément orderedBy de la seule <section> de la Composition référencée.

Un Bilan Médicamenteux, même vide si la patient ne prenait pas de médicament avant son hospitalisation, doit être attaché à la FCT (Fiche de Concimaition des Traitements médicamenteux).

pas de sous-section dans le bilan médicamenteux (toutes les lignes de traitement sont au même niveau)

La liste des traitements médicamenteux courants du patient hospitalisé, confrontée au Bilan Médicamenteux et qui l'objet de la conciliation des traitements.

Formellement, cette liste peut être vide.

Référencer le Traitement Médicamenteux Courant qui fait l'objet de cette conciliation des traitements.

L'auteur du Traitement Médicamenteux Courant est celui du document référencé par l'élément <entry>. L'auteur de l'inclusion de ce document dans cette fiche de conciliation est celui de la Composition.

Le Traitement Médicamenteux Courant ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

Le Traitement Médicamenteux Courant ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

This element is labeled as a modifier because a change list must not be misunderstood as a complete list. Dans ce profil, sa valeur est fixée à working.

Contraindre une gestion univoque de cette liste représentant le Traitement Médicamenteux Courant.

Non concerné car il n'y a qu'une seule <entry> dans cette <section>. L'ordre des lignes du Traitement Médicamenteux Courant attaché, sera porté par l'élément orderedBy de la seule <section> de la Composition référencée.

Un Traitement Médicamenteux Courant, même vide si la patient ne prend aucun médicament lors de son hospitalisation, doit être attaché à la FCT (Fiche de Concimaition des Traitements médicamenteux).

pas de sous-section dans le traitement médicamenteux courant (toutes les lignes de traitement sont au même niveau)

Conciliation proprement dite : synthèse des médicaments du Bilan Médicamenteux et du Traitement médicamenteux courant avec documentation des écarts

décrire la conciliation proprement dite, à ses différentes étapes de réalisation

L'auteur du contenu de cette section conciliation proprement-dite est celui de la composition.

La fiche de conciliation ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir élement <subject> de cette Composition).

This element is labeled as a modifier because a change list must not be misunderstood as a complete list. Dans ce profil, sa valeur est fixée à working.

Contraindre une gestion univoque de cette liste de traitements médicamenteux à concilier.

Chaque ligne est associée à une ligne du Bilan Médicamenteux et/ou une ligne du Traitement Médicamenteux courant et est documentée par étape par le pharmacien et par le prescripteur.

Décrire chaque ligne de traitement médicamenteux à concilier, avec ses propriétés de conciliation

pas de sous-section dans la fiche de conciliation (toutes les lignes de traitement conciliées sont au même niveau)

Fiche de Conciliation des Traitements médicamenteux (FCT) : Liste des traitements médicamenteux conciliés à partir du Bilan Médicamenteux (traitements avant l'hospitalisation) et du Traitement Médicamenteux Courant, conforme aux recommandations du guide de la HAS.

• référence le Bilan Médicamenteux ;
• référence le Traitement Médicamenteux Courant ;
• liste des lignes de traitement conciliées avec, pour chacune,
  • la référence à la ligne de traitement médicamenteux du Bilan Médicamenteux si elle existe,
  • la référence à la ligne de traitement médicamenteux du Traitement Médicamenteux Courant si elle existe,
  • au moins une de ces deux lignes doit exister et être référencée,
  • ses propriétés de conciliation.

Cette Composition comporte 3 <section> et 3 seulement :

1. La référence au Bilan Médicamenteux, une ressource Composition profilée fr-medication-history-composition
2. La référence au Traitement Médicamenteux Courant, une ressource Composition profilée fr-current-medication-composition
3. La liste des traitements médicamenteux conciliés avec chacune ses propriétés de conciliation, une <entry> (de cette 3ème section) par ligne de traitement référençant une ressource MedicationStatement profilée fr-medication-reconciliation-medication-statement

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

1. Une FCT ne peut être au statut final que si elle est complète, à la fois du point de vue de la documentation des lignes de traitement médicamenteux conciliées (cf. les propriétés de conciliation de chacune de ses lignes de traitement) et du point de vue des auteurs qui assument ces contenus (cf. élément <author> de cette Composition).
2. Une FCT peut être produite en plusieurs étapes pouvant mettre à disposition des versions intermédiaires, préliminaires, précédant la version finale. Cet élément <status> de la Composition permet alors de rendre compte de ces contenus intermédiaires préliminaires.
3. Le projet d'établissement et ses choix d'intégration inter applications peut légitimement se limiter à ne partager que la FCT à l'état final, les éventuelles versions intermédiaires préliminaires ne sortant pas du module qui en a la charge.

The workflow/clinical status of the composition.

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Key metadata element describing the composition, used in searching/filtering.

Le patient auquel se rapporte ce document FCT (Fiche de Conciliation des Traitements médicamenteux).

Une FCT (Fiche de Conciliation des Traitements médicamenteux) se rapporte obligatoirement à un patient, référencé en tant que ressource Patient profilée fr-patient.

Identifier le patient auquel se rapporte obligatoirement une FCT (Fiche de Conciliation des Traitements médicamenteux), patient référencé en tant que ressource Patient profilée fr-patient.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

The composition editing time, when the composition was last logically changed by the author.

The Last Modified Date on the composition may be after the date of the document was attested without being changed.

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

Le ou les auteurs de cette FCT (Fiche de Conciliation des Traitements médicamenteux), défini ès qualités (ressource PractitionerRole profilée fr-practitioner-role-profession) ET, de préférence, aussi nominativement (la ressource PractionerRole profilée fr-practitioner-role instanciée réfère une instance de ressource Practioner profilée fr-practitioner).

1. Il est vivement recommandé d'identifier nominativement les auteurs : la ressource PractitionerRole profilée fr-practitioner-role-profession instanciée (ex: Médecin) réfère une instance de ressource Practitioner profilée fr-practitioner (ex: Dr UNTEL).
2. En l'absence de signature électronique, la fiche est réputée signée par ses co-auteurs (voir élement <author> de cardinalité [1..*].
3. Les règles de gestion de ce co-authoring peuvent être limitée au seul pharmacien (1 seul auteur) qui assumerait la seule version finale de cette Fiche qui serait communiquée.
4. Un projet plus ambitieux pourrait produire une version préliminaire de la Fiche avec comme seul auteur le pharmacien qui établit la liste des traitements à concilier avec leurs propriétés de conciliation partiellement documentées, puis, une version finale avec comme co-auteurs le phamacien et le prescripteur des lignes de traitement qui ont alors toutes leurs propriétés de conciliation documentées.

Identifier les co-auteurs de la FCT (Fiche de Conciliation des Traitements médicamenteux).

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

Official human-readable label for the composition.

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

The root of the sections that make up the composition.

3 sections, prédéfinies et ces 3 sections seulement

Structure de la FCT française conforme au du guide de la HAS.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Le Bilan Médicamenteux auquel se réfère la FCT (Fiche de Conciliation des Traitements médicamenteux).

Une FCT (Fiche de Conciliation des Traitements médicamenteux) doit se référer à un Bilan Médicamenteux. Cette section n'a qu'une seule <entry> qui référence une ressource Composition profilée fr-medication-history-Composition portant le Bilan Médicamenteux attaché à la FCT.

Référencer le Bilan Médicamenteux de cette conciliation des traitements médicamenteux.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

A code identifying the kind of content contained within the section. This must be consistent with the section title.

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Classification of a section of a composition/document.

Provides computable standardized labels to topics within the document.

Identifies who is responsible for the information in this section, not necessarily who typed it in.

L'auteur du Bilan Médicamenteux est celui du Bilan référencé par l'élément <entry>. L'auteur de l'inclusion de ce bilan dans la fiche de conciliation est celui de la Composition.

L'auteur du Bilan Médicamenteux est celui du Bilan référencé par l'élément <entry>. L'auteur de l'inclusion de ce bilan dans cette fiche de conciliation est celui de la Composition.

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Le Bilan Médicamenteux ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

Le Bilan Médicamenteux ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

This element is labeled as a modifier because a change list must not be misunderstood as a complete list. Dans ce profil, sa valeur est fixée à working.

The processing mode that applies to this section.

Contraindre une gestion univoque de cette liste représentant le Bilan Médicamenteux.

Specifies the order applied to the items in the section entries.

Non concerné car il n'y a qu'une seule <entry> dans cette <section>. L'ordre des lignes du Bilan Médicamenteux attaché, sera porté par l'élément orderedBy de la seule <section> de la Composition référencée.

What order applies to the items in the entry.

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

A reference to the actual resource from which the narrative in the section is derived.

Un Bilan Médicamenteux, même vide si la patient ne prenait pas de médicament avant son hospitalisation, doit être attaché à la FCT (Fiche de Concimaition des Traitements médicamenteux).

A nested sub-section within this section.

Nested sections are primarily used to help human readers navigate to particular portions of the document.

pas de sous-section dans le bilan médicamenteux (toutes les lignes de traitement sont au même niveau)

La liste des traitements médicamenteux courants du patient hospitalisé, confrontée au Bilan Médicamenteux et qui l'objet de la conciliation des traitements.

Formellement, cette liste peut être vide.

Référencer le Traitement Médicamenteux Courant qui fait l'objet de cette conciliation des traitements.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Identifies who is responsible for the information in this section, not necessarily who typed it in.

L'auteur du Traitement Médicamenteux Courant est celui du document référencé par l'élément <entry>. L'auteur de l'inclusion de ce document dans cette fiche de conciliation est celui de la Composition.

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Le Traitement Médicamenteux Courant ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

Le Traitement Médicamenteux Courant ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

This element is labeled as a modifier because a change list must not be misunderstood as a complete list. Dans ce profil, sa valeur est fixée à working.

The processing mode that applies to this section.

Contraindre une gestion univoque de cette liste représentant le Traitement Médicamenteux Courant.

Specifies the order applied to the items in the section entries.

Non concerné car il n'y a qu'une seule <entry> dans cette <section>. L'ordre des lignes du Traitement Médicamenteux Courant attaché, sera porté par l'élément orderedBy de la seule <section> de la Composition référencée.

What order applies to the items in the entry.

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

A reference to the actual resource from which the narrative in the section is derived.

Un Traitement Médicamenteux Courant, même vide si la patient ne prend aucun médicament lors de son hospitalisation, doit être attaché à la FCT (Fiche de Concimaition des Traitements médicamenteux).

A nested sub-section within this section.

Nested sections are primarily used to help human readers navigate to particular portions of the document.

pas de sous-section dans le traitement médicamenteux courant (toutes les lignes de traitement sont au même niveau)

Conciliation proprement dite : synthèse des médicaments du Bilan Médicamenteux et du Traitement médicamenteux courant avec documentation des écarts

décrire la conciliation proprement dite, à ses différentes étapes de réalisation

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Identifies who is responsible for the information in this section, not necessarily who typed it in.

L'auteur du contenu de cette section conciliation proprement-dite est celui de la composition.

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

La fiche de conciliation ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir élement <subject> de cette Composition).

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

This element is labeled as a modifier because a change list must not be misunderstood as a complete list. Dans ce profil, sa valeur est fixée à working.

The processing mode that applies to this section.

Contraindre une gestion univoque de cette liste de traitements médicamenteux à concilier.

A reference to the actual resource from which the narrative in the section is derived.

Chaque ligne est associée à une ligne du Bilan Médicamenteux et/ou une ligne du Traitement Médicamenteux courant et est documentée par étape par le pharmacien et par le prescripteur.

Décrire chaque ligne de traitement médicamenteux à concilier, avec ses propriétés de conciliation

A nested sub-section within this section.

Nested sections are primarily used to help human readers navigate to particular portions of the document.

pas de sous-section dans la fiche de conciliation (toutes les lignes de traitement conciliées sont au même niveau)

Fiche de Conciliation des Traitements médicamenteux (FCT) : Liste des traitements médicamenteux conciliés à partir du Bilan Médicamenteux (traitements avant l'hospitalisation) et du Traitement Médicamenteux Courant, conforme aux recommandations du guide de la HAS.

• référence le Bilan Médicamenteux ;
• référence le Traitement Médicamenteux Courant ;
• liste des lignes de traitement conciliées avec, pour chacune,
  • la référence à la ligne de traitement médicamenteux du Bilan Médicamenteux si elle existe,
  • la référence à la ligne de traitement médicamenteux du Traitement Médicamenteux Courant si elle existe,
  • au moins une de ces deux lignes doit exister et être référencée,
  • ses propriétés de conciliation.

Cette Composition comporte 3 <section> et 3 seulement :

1. La référence au Bilan Médicamenteux, une ressource Composition profilée fr-medication-history-composition
2. La référence au Traitement Médicamenteux Courant, une ressource Composition profilée fr-current-medication-composition
3. La liste des traitements médicamenteux conciliés avec chacune ses propriétés de conciliation, une <entry> (de cette 3ème section) par ligne de traitement référençant une ressource MedicationStatement profilée fr-medication-reconciliation-medication-statement

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

1. Une FCT ne peut être au statut final que si elle est complète, à la fois du point de vue de la documentation des lignes de traitement médicamenteux conciliées (cf. les propriétés de conciliation de chacune de ses lignes de traitement) et du point de vue des auteurs qui assument ces contenus (cf. élément <author> de cette Composition).
2. Une FCT peut être produite en plusieurs étapes pouvant mettre à disposition des versions intermédiaires, préliminaires, précédant la version finale. Cet élément <status> de la Composition permet alors de rendre compte de ces contenus intermédiaires préliminaires.
3. Le projet d'établissement et ses choix d'intégration inter applications peut légitimement se limiter à ne partager que la FCT à l'état final, les éventuelles versions intermédiaires préliminaires ne sortant pas du module qui en a la charge.

The workflow/clinical status of the composition.

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Key metadata element describing the composition, used in searching/filtering.

A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

This is a metadata field from XDS/MHD.

High-level kind of a clinical document at a macro level.

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Le patient auquel se rapporte ce document FCT (Fiche de Conciliation des Traitements médicamenteux).

Une FCT (Fiche de Conciliation des Traitements médicamenteux) se rapporte obligatoirement à un patient, référencé en tant que ressource Patient profilée fr-patient.

Identifier le patient auquel se rapporte obligatoirement une FCT (Fiche de Conciliation des Traitements médicamenteux), patient référencé en tant que ressource Patient profilée fr-patient.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Describes the clinical encounter or type of care this documentation is associated with.

Provides context for the composition and supports searching.

The composition editing time, when the composition was last logically changed by the author.

The Last Modified Date on the composition may be after the date of the document was attested without being changed.

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

Le ou les auteurs de cette FCT (Fiche de Conciliation des Traitements médicamenteux), défini ès qualités (ressource PractitionerRole profilée fr-practitioner-role-profession) ET, de préférence, aussi nominativement (la ressource PractionerRole profilée fr-practitioner-role instanciée réfère une instance de ressource Practioner profilée fr-practitioner).

1. Il est vivement recommandé d'identifier nominativement les auteurs : la ressource PractitionerRole profilée fr-practitioner-role-profession instanciée (ex: Médecin) réfère une instance de ressource Practitioner profilée fr-practitioner (ex: Dr UNTEL).
2. En l'absence de signature électronique, la fiche est réputée signée par ses co-auteurs (voir élement <author> de cardinalité [1..*].
3. Les règles de gestion de ce co-authoring peuvent être limitée au seul pharmacien (1 seul auteur) qui assumerait la seule version finale de cette Fiche qui serait communiquée.
4. Un projet plus ambitieux pourrait produire une version préliminaire de la Fiche avec comme seul auteur le pharmacien qui établit la liste des traitements à concilier avec leurs propriétés de conciliation partiellement documentées, puis, une version finale avec comme co-auteurs le phamacien et le prescripteur des lignes de traitement qui ont alors toutes leurs propriétés de conciliation documentées.

Identifier les co-auteurs de la FCT (Fiche de Conciliation des Traitements médicamenteux).

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Official human-readable label for the composition.

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

The code specifying the level of confidentiality of the Composition.

The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

Codes specifying the level of confidentiality of the composition.

A participant who has attested to the accuracy of the composition/document.

Only list each attester once.

Identifies responsibility for the accuracy of the composition content.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The type of attestation the authenticator offers.

The way in which a person authenticated a composition.

Indicates the level of authority of the attestation.

When the composition was attested by the party.

Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

Who attested the composition in the specified way.

Identifies who has taken on the responsibility for accuracy of the composition content.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

Identifies where to go to find the current version, where to report issues, etc.

Relationships that this composition has with other compositions or documents that already exist.

A document is a version specific composition.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The type of relationship that this composition has with anther composition or document.

If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

The type of relationship between documents.

The target composition/document of this relationship.

The clinical service, such as a colonoscopy or an appendectomy, being documented.

The event needs to be consistent with the type element, though can provide further information if desired.

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

This list of codes represents the main clinical acts being documented.

The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

The root of the sections that make up the composition.

3 sections, prédéfinies et ces 3 sections seulement

Structure de la FCT française conforme au du guide de la HAS.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

A code identifying the kind of content contained within the section. This must be consistent with the section title.

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Classification of a section of a composition/document.

Provides computable standardized labels to topics within the document.

Identifies who is responsible for the information in this section, not necessarily who typed it in.

Identifies who is responsible for the content.

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

The processing mode that applies to this section.

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Specifies the order applied to the items in the section entries.

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

What order applies to the items in the entry.

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

A reference to the actual resource from which the narrative in the section is derived.

If there are no entries in the list, an emptyReason SHOULD be provided.

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

If a section is empty, why it is empty.

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

A nested sub-section within this section.

Nested sections are primarily used to help human readers navigate to particular portions of the document.

Le Bilan Médicamenteux auquel se réfère la FCT (Fiche de Conciliation des Traitements médicamenteux).

Une FCT (Fiche de Conciliation des Traitements médicamenteux) doit se référer à un Bilan Médicamenteux. Cette section n'a qu'une seule <entry> qui référence une ressource Composition profilée fr-medication-history-Composition portant le Bilan Médicamenteux attaché à la FCT.

Référencer le Bilan Médicamenteux de cette conciliation des traitements médicamenteux.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

A code identifying the kind of content contained within the section. This must be consistent with the section title.

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Classification of a section of a composition/document.

Provides computable standardized labels to topics within the document.

Identifies who is responsible for the information in this section, not necessarily who typed it in.

L'auteur du Bilan Médicamenteux est celui du Bilan référencé par l'élément <entry>. L'auteur de l'inclusion de ce bilan dans la fiche de conciliation est celui de la Composition.

L'auteur du Bilan Médicamenteux est celui du Bilan référencé par l'élément <entry>. L'auteur de l'inclusion de ce bilan dans cette fiche de conciliation est celui de la Composition.

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

Le Bilan Médicamenteux ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

Le Bilan Médicamenteux ne peut concerner que le patient déclaré comme sujet de cette Conciliation Médicamenteuse (voir element subject de la Composition).

A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

Document profiles may define what content should be represented in the narrative to ensure clinical safety.