Guide d'implémentation du médicament
0.1.0 - ci-build

Guide d'implémentation du médicament - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: FrOnAdmissionRetroactiveMedicationReconciliationComposition - Detailed Descriptions

Draft as of 2021-06-24

Definitions for the FrOnAdmissionRetroactiveMedicationReconciliationComposition resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Composition
Definition

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

  • référence le Bilan Médicamenteux ;
  • référence l'Ordonnance médicale d'Admission (OMA) ;
  • 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 de l'OMA si elle existe,
    • au moins une de ces deux lignes doit exister et être référencée,
    • ses propriétés de conciliation.
ShortFiche de Conciliation des Traitements médicamenteux (FCT) rétroactive d'admission
Comments

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 à l'OMA, une ressource Composition profilée fr-on-adsmission-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
2. Composition.type
Fixed Value{
  "coding" : [{
    "system" : "http://interopsante.org/fhir/CodeSystem/fr-document-type",
    "code" : "10000002",
    "display" : "FCT rétroactive d'admission"
  }]
}
4. Composition.section:CurrentMedication
Slice NameCurrentMedication
Definition

La liste des traitements médicamenteux prescrit à l'admission (Ordonnance Médicale d'admission - OMA), confrontée au Bilan Médicamenteux et qui l'objet de la conciliation des traitements.

ShortOrdonnance Médicale d'admission (OMA)
Requirements

Référencer l'Ordonnance Médicale d'Admission qui fait l'objet de cette conciliation des traitements.

6. Composition.section:CurrentMedication.entry
Definition

La référence à la ressource Composition de l'Ordonnance Médicale d'Admission (OMA). Cette Ordonnance peut, formellement, être vide si le patient n'a aucun médicament prescrit à son admission.

ShortLa composition de l'Ordonnance Médicale d'Admission (OMA) attachée
Comments

Une Ordonnance Médicale d'Admission (OMA), même vide si la patient n'a aucun médicament prescrit lors de son admission, doit être attachée à la FCT (Fiche de Concimaition des Traitements médicamenteux).

TypeReference(FrOnAdmissionMedicationComposition)

Guidance on how to interpret the contents of this table can be found here

0. Composition
Definition

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

  • référence le Bilan Médicamenteux ;
  • référence l'Ordonnance médicale d'Admission (OMA) ;
  • 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 de l'OMA si elle existe,
    • au moins une de ces deux lignes doit exister et être référencée,
    • ses propriétés de conciliation.

A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

ShortFiche de Conciliation des Traitements médicamenteux (FCT) rétroactive d'admissionA set of resources composed into a single coherent clinical statement with clinical attestation
Comments

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 à l'OMA, une ressource Composition profilée fr-on-adsmission-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

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

Control0..*
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Composition.implicitRules
Definition

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.

ShortA set of rules under which this content was created
Comments

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.

Control0..01
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Composition.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Composition.status
Definition

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

Shortpreliminary | final | amended | entered-in-error
Comments
  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.

If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

Control1..1
BindingThe codes SHALL be taken from CompositionStatushttp://hl7.org/fhir/ValueSet/composition-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

The workflow/clinical status of the composition.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Composition.type
Definition

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.

ShortKind of composition (LOINC if possible)
Comments

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.

Control1..1
BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from value set InterOp'Santé - type de document de la ressource Composition d'une FCThttp://hl7.org/fhir/ValueSet/doc-typecodes
(extensible to http://interopsante.org/fhir/ValueSet/fr-medication-reconciliation-document-type)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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

Fixed Value{
  "coding" : [{
    "system" : "http://interopsante.org/fhir/CodeSystem/fr-document-type",
    "code" : "10000002",
    "display" : "FCT rétroactive d'admission"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Composition.subject
Definition

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


Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

ShortLe patientWho and/or what the composition is about
Comments

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


For clinical documents, this is usually the patient.

Control10..1
TypeReference(FR Core Patient Profile, Resource)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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.


Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Composition.date
Definition

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

ShortComposition editing time
Comments

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

Control1..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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.


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.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Composition.author
Definition

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).


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

ShortLe ou les auteursWho and/or what authored the composition
Comments
  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.
Control1..*
TypeReference(FR Core Practitioner Role Profession, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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


Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Composition.title
Definition

Official human-readable label for the composition.

ShortHuman Readable name/title
Comments

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.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Composition.section
Definition

The root of the sections that make up the composition.

ShortComposition is broken into sections
Comments

3 sections, prédéfinies et ces 3 sections seulement

Control30..3*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Closed, and defines no disciminators to differentiate the slices
20. Composition.section.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. Composition.section:MedicationHistory
Slice NameMedicationHistory
Definition

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


The root of the sections that make up the composition.

ShortBilan MédicamenteuxComposition is broken into sections
Comments

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.

Control10..1*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

Référencer le Bilan Médicamenteux de cette conciliation des traitements médicamenteux.

Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
24. Composition.section:MedicationHistory.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. Composition.section:MedicationHistory.title
Definition

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.

ShortLabel for section (e.g. for ToC)
Comments

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.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

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

Alternate Namesheader, label, caption
Pattern ValueBilan Médicamenteux
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Composition.section:MedicationHistory.author
Definition

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

ShortWho and/or what authored the section
Comments

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.

Control0..0*
TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Requirements

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.


Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Composition.section:MedicationHistory.focus
Definition

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).

ShortWho/what the section is about, when it is not about the subject of composition
Comments

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


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.

Control0..01
TypeReference(Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Composition.section:MedicationHistory.mode
Definition

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.

ShortListe courante exhaustive à sa date de réalisation (cf. element *date*\) par son auteur (cf. element *author*\).working | snapshot | changes
Comments

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.


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

Control10..1
BindingThe codes SHALL be taken from ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
(required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

The processing mode that applies to this section.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Requirements

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


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

Pattern Valueworking
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Composition.section:MedicationHistory.entry
Definition

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

ShortLa référence à la ressource *Composition* du Bilan Médicamenteux. Ce Bilan peut être vide si le patient ne prend pas de médicament en dehors de l'hospitalisation au titre de laquelle la Conciliation est réalisée.A reference to data that supports this section
Comments

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).


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

Control10..1*
This element is affected by the following invariants: cmp-2
TypeReference(FrMedicationHistoryComposition, Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Composition.section:MedicationHistory.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

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

Control0..0*
This element is affected by the following invariants: cmp-1
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Composition.section:CurrentMedication
Slice NameCurrentMedication
Definition

La liste des traitements médicamenteux prescrit à l'admission (Ordonnance Médicale d'admission - OMA), confrontée au Bilan Médicamenteux et qui l'objet de la conciliation des traitements.


The root of the sections that make up the composition.

ShortOrdonnance Médicale d'admission (OMA)Composition is broken into sections
Comments

Formellement, cette liste peut être vide.

Control10..1*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

Référencer l'Ordonnance Médicale d'Admission qui fait l'objet de cette conciliation des traitements.

Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
40. Composition.section:CurrentMedication.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. Composition.section:CurrentMedication.title
Definition

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.

ShortLabel for section (e.g. for ToC)
Comments

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.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

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

Alternate Namesheader, label, caption
Fixed ValueTraitement Médicamenteux Courant
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Composition.section:CurrentMedication.author
Definition

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

ShortWho and/or what authored the section
Control0..0*
TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Requirements

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.


Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Composition.section:CurrentMedication.focus
Definition

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).

ShortWho/what the section is about, when it is not about the subject of composition
Comments

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


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.

Control0..01
TypeReference(Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Composition.section:CurrentMedication.mode
Definition

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.

ShortListe courante exhaustive à sa date de réalisation (cf. element *date*\) par son auteur (cf. element *author*\).working | snapshot | changes
Comments

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.


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

Control10..1
BindingThe codes SHALL be taken from ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
(required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

The processing mode that applies to this section.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Requirements

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


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

Fixed Valueworking
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Composition.section:CurrentMedication.entry
Definition

La référence à la ressource Composition de l'Ordonnance Médicale d'Admission (OMA). Cette Ordonnance peut, formellement, être vide si le patient n'a aucun médicament prescrit à son admission.


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

ShortLa composition de l'Ordonnance Médicale d'Admission (OMA) attachéeA reference to data that supports this section
Comments

Une Ordonnance Médicale d'Admission (OMA), même vide si la patient n'a aucun médicament prescrit lors de son admission, doit être attachée à la FCT (Fiche de Concimaition des Traitements médicamenteux).


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

Control10..1*
This element is affected by the following invariants: cmp-2
TypeReference(FrOnAdmissionMedicationComposition, Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Composition.section:CurrentMedication.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

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

Control0..0*
This element is affected by the following invariants: cmp-1
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Composition.section:Reconciliation
Slice NameReconciliation
Definition

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


The root of the sections that make up the composition.

ShortConciliation proprement diteComposition is broken into sections
Control10..1*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
56. Composition.section:Reconciliation.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
58. Composition.section:Reconciliation.title
Definition

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.

ShortLabel for section (e.g. for ToC)
Comments

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.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

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

Alternate Namesheader, label, caption
Pattern ValueFiche de Conciliation des Traitements médicamenteux
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Composition.section:Reconciliation.author
Definition

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

ShortWho authored the sectionWho and/or what authored the section
Control0..0*
TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Summaryfalse
Requirements

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


Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Composition.section:Reconciliation.focus
Definition

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).

ShortWho/what the section is about, when it is not about the subject of composition
Comments

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.

Control0..01
TypeReference(Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Composition.section:Reconciliation.mode
Definition

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.

ShortListe courante exhaustive à sa date de réalisation (cf. element *date*\) par son auteur (cf. element *author*\).working | snapshot | changes
Comments

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.


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

Control10..1
BindingThe codes SHALL be taken from ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
(required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

The processing mode that applies to this section.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Requirements

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


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

Pattern Valueworking
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Composition.section:Reconciliation.entry
Definition

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

ShortLigne de traitement médicamenteux de la FCT (Fiche de Concilitaion des Traitements médicamenteux)A reference to data that supports this section
Comments

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.


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

Control0..*
This element is affected by the following invariants: cmp-2
TypeReference(FrMedicationReconciliationMedicationStatement, Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Composition.section:Reconciliation.section
Definition

A nested sub-section within this section.

ShortNested Section
Comments

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

Control0..0*
This element is affected by the following invariants: cmp-1
TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. Composition
Definition

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

  • référence le Bilan Médicamenteux ;
  • référence l'Ordonnance médicale d'Admission (OMA) ;
  • 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 de l'OMA si elle existe,
    • au moins une de ces deux lignes doit exister et être référencée,
    • ses propriétés de conciliation.
ShortFiche de Conciliation des Traitements médicamenteux (FCT) rétroactive d'admission
Comments

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 à l'OMA, une ressource Composition profilée fr-on-adsmission-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
Control0..*
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Composition.id
Definition

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

ShortLogical id of this artifact
Comments

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

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. Composition.meta
Definition

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.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Composition.implicitRules
Definition

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.

ShortA set of rules under which this content was created
Comments

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.

Control0..0
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Composition.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

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).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Composition.text
Definition

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.

ShortText summary of the resource, for human interpretation
Comments

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.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Composition.contained
Definition

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.

ShortContained, inline Resources
Comments

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.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. Composition.extension
Definition

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.

ShortAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Composition.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Composition.identifier
Definition

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

ShortVersion-independent identifier for the Composition
Comments

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

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Composition.status
Definition

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

Shortpreliminary | final | amended | entered-in-error
Comments
  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.
Control1..1
BindingThe codes SHALL be taken from CompositionStatus
(required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

The workflow/clinical status of the composition.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Composition.type
Definition

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.

ShortKind of composition (LOINC if possible)
Comments

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.

Control1..1
BindingUnless not suitable, these codes SHALL be taken from value set InterOp'Santé - type de document de la ressource Composition d'une FCT
(extensible to http://interopsante.org/fhir/ValueSet/fr-medication-reconciliation-document-type)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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

Fixed Value{
  "coding" : [{
    "system" : "http://interopsante.org/fhir/CodeSystem/fr-document-type",
    "code" : "10000002",
    "display" : "FCT rétroactive d'admission"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.category
Definition

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.

ShortCategorization of Composition
Comments

This is a metadata field from XDS/MHD.

Control0..*
BindingFor example codes, see DocumentClassValueSet
(example to http://hl7.org/fhir/ValueSet/document-classcodes)

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

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Composition.subject
Definition

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

ShortLe patient
Comments

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

Control1..1
TypeReference(FR Core Patient Profile)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Composition.subject.id
Definition

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

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
30. Composition.subject.extension
Definition

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.

ShortAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Composition.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 32. Composition.subject.reference
    Definition

    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.

    ShortLiteral reference, Relative, internal or absolute URL
    Comments

    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.

    Control0..1
    This element is affected by the following invariants: ref-1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Composition.subject.type
    Definition

    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).

    ShortType the reference refers to (e.g. "Patient")
    Comments

    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.

    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from ResourceType
    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Pattern ValuePatient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Composition.subject.identifier
    Definition

    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.

    ShortLogical reference, when literal reference is not known
    Comments

    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).

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Composition.subject.display
    Definition

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

    ShortText alternative for the resource
    Comments

    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.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Composition.encounter
    Definition

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

    ShortContext of the Composition
    Control0..1
    TypeReference(Encounter)
    Is Modifierfalse
    Summarytrue
    Requirements

    Provides context for the composition and supports searching.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Composition.date
    Definition

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

    ShortComposition editing time
    Comments

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

    Control1..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    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.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Composition.author
    Definition

    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).

    ShortLe ou les auteurs
    Comments
    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.
    Control1..*
    TypeReference(FR Core Practitioner Role Profession)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Composition.author.id
    Definition

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

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    48. Composition.author.extension
    Definition

    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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Composition.author.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 50. Composition.author.reference
      Definition

      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.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      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.

      Control0..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. Composition.author.type
      Definition

      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).

      ShortType the reference refers to (e.g. "Patient")
      Comments

      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.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from ResourceType
      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Pattern ValuePractitionerRole
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. Composition.author.identifier
      Definition

      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.

      ShortLogical reference, when literal reference is not known
      Comments

      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).

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. Composition.author.display
      Definition

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

      ShortText alternative for the resource
      Comments

      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.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. Composition.title
      Definition

      Official human-readable label for the composition.

      ShortHuman Readable name/title
      Comments

      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.

      Control1..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. Composition.confidentiality
      Definition

      The code specifying the level of confidentiality of the Composition.

      ShortAs defined by affinity domain
      Comments

      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.

      Control0..1
      BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
      (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

      Codes specifying the level of confidentiality of the composition.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. Composition.attester
      Definition

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

      ShortAttests to accuracy of composition
      Comments

      Only list each attester once.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Requirements

      Identifies responsibility for the accuracy of the composition content.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. Composition.attester.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      66. Composition.attester.extension
      Definition

      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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      68. Composition.attester.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      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.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      70. Composition.attester.mode
      Definition

      The type of attestation the authenticator offers.

      Shortpersonal | professional | legal | official
      Control1..1
      BindingThe codes SHALL be taken from CompositionAttestationMode
      (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

      The way in which a person authenticated a composition.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Requirements

      Indicates the level of authority of the attestation.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. Composition.attester.time
      Definition

      When the composition was attested by the party.

      ShortWhen the composition was attested
      Control0..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. Composition.attester.party
      Definition

      Who attested the composition in the specified way.

      ShortWho attested the composition
      Control1..1
      TypeReference(FR Core Practitioner Role Profession)
      Is Modifierfalse
      Summaryfalse
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      76. Composition.attester.party.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      78. Composition.attester.party.extension
      Definition

      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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Composition.attester.party.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 80. Composition.attester.party.reference
        Definition

        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.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        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.

        Control1..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Composition.attester.party.type
        Definition

        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).

        ShortType the reference refers to (e.g. "Patient")
        Comments

        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.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from ResourceType
        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Pattern ValuePractitioner
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. Composition.attester.party.identifier
        Definition

        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.

        ShortLogical reference, when literal reference is not known
        Comments

        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).

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..0
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. Composition.attester.party.display
        Definition

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

        ShortText alternative for the resource
        Comments

        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.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Composition.custodian
        Definition

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

        ShortOrganization which maintains the composition
        Comments

        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.

        Control0..1
        TypeReference(Organization)
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. Composition.relatesTo
        Definition

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

        ShortRelationships to other compositions/documents
        Comments

        A document is a version specific composition.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        92. Composition.relatesTo.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        94. Composition.relatesTo.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        96. Composition.relatesTo.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        98. Composition.relatesTo.code
        Definition

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

        Shortreplaces | transforms | signs | appends
        Comments

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

        Control1..1
        BindingThe codes SHALL be taken from DocumentRelationshipType
        (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

        The type of relationship between documents.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        100. Composition.relatesTo.target[x]
        Definition

        The target composition/document of this relationship.

        ShortTarget of the relationship
        Control1..1
        TypeChoice of: Identifier, Reference(Composition)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. Composition.event
        Definition

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

        ShortThe clinical service(s) being documented
        Comments

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

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. Composition.event.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        106. Composition.event.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        108. Composition.event.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        110. Composition.event.code
        Definition

        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.

        ShortCode(s) that apply to the event being documented
        Comments

        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.

        Control0..*
        BindingFor example codes, see v3 Code System ActCode
        (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

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

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        112. Composition.event.period
        Definition

        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.

        ShortThe period covered by the documentation
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        114. Composition.event.detail
        Definition

        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.

        ShortThe event(s) being documented
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        116. Composition.section
        Definition

        The root of the sections that make up the composition.

        ShortComposition is broken into sections
        Comments

        3 sections, prédéfinies et ces 3 sections seulement

        Control3..3
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Closed, and defines no disciminators to differentiate the slices
        118. Composition.section.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        120. Composition.section.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        122. Composition.section.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        124. Composition.section.title
        Definition

        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.

        ShortLabel for section (e.g. for ToC)
        Comments

        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.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

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

        Alternate Namesheader, label, caption
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        126. Composition.section.code
        Definition

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

        ShortClassification of section (recommended)
        Comments

        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.

        Control0..1
        BindingFor example codes, see DocumentSectionCodes
        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

        Classification of a section of a composition/document.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        128. Composition.section.author
        Definition

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

        ShortWho and/or what authored the section
        Control0..*
        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
        Is Modifierfalse
        Summaryfalse
        Requirements

        Identifies who is responsible for the content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        130. Composition.section.focus
        Definition

        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).

        ShortWho/what the section is about, when it is not about the subject of composition
        Comments

        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.

        Control0..1
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        132. Composition.section.text
        Definition

        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.

        ShortText summary of the section, for human interpretation
        Comments

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

        Control0..1
        This element is affected by the following invariants: cmp-1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        134. Composition.section.mode
        Definition

        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.

        Shortworking | snapshot | changes
        Comments

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

        Control0..1
        BindingThe codes SHALL be taken from ListMode
        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

        The processing mode that applies to this section.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        136. Composition.section.orderedBy
        Definition

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

        ShortOrder of section entries
        Comments

        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.

        Control0..1
        BindingThe codes SHOULD be taken from ListOrderCodes
        (preferred to http://hl7.org/fhir/ValueSet/list-order)

        What order applies to the items in the entry.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        138. Composition.section.entry
        Definition

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

        ShortA reference to data that supports this section
        Comments

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

        Control0..*
        This element is affected by the following invariants: cmp-2
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        140. Composition.section.emptyReason
        Definition

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

        ShortWhy the section is empty
        Comments

        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.

        Control0..1
        This element is affected by the following invariants: cmp-2
        BindingThe codes SHOULD be taken from ListEmptyReasons
        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

        If a section is empty, why it is empty.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        142. Composition.section.section
        Definition

        A nested sub-section within this section.

        ShortNested Section
        Comments

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

        Control0..*
        This element is affected by the following invariants: cmp-1
        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        144. Composition.section:MedicationHistory
        Slice NameMedicationHistory
        Definition

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

        ShortBilan Médicamenteux
        Comments

        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.

        Control1..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Référencer le Bilan Médicamenteux de cette conciliation des traitements médicamenteux.

        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        146. Composition.section:MedicationHistory.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        148. Composition.section:MedicationHistory.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        150. Composition.section:MedicationHistory.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        152. Composition.section:MedicationHistory.title
        Definition

        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.

        ShortLabel for section (e.g. for ToC)
        Comments

        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.

        Control1..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

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

        Alternate Namesheader, label, caption
        Pattern ValueBilan Médicamenteux
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        154. Composition.section:MedicationHistory.code
        Definition

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

        ShortClassification of section (recommended)
        Comments

        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.

        Control0..1
        BindingFor example codes, see DocumentSectionCodes
        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

        Classification of a section of a composition/document.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "10160-0"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        156. Composition.section:MedicationHistory.author
        Definition

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

        ShortWho and/or what authored the section
        Comments

        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.

        Control0..0
        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summaryfalse
        Requirements

        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.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        158. Composition.section:MedicationHistory.focus
        Definition

        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).

        ShortWho/what the section is about, when it is not about the subject of composition
        Comments

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

        Control0..0
        TypeReference(Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        160. Composition.section:MedicationHistory.text
        Definition

        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.

        ShortText summary of the section, for human interpretation
        Comments

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

        Control0..1
        This element is affected by the following invariants: cmp-1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        162. Composition.section:MedicationHistory.mode
        Definition

        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.

        ShortListe courante exhaustive à sa date de réalisation (cf. element *date*\) par son auteur (cf. element *author*\).
        Comments

        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.

        Control1..1
        BindingThe codes SHALL be taken from ListMode
        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

        The processing mode that applies to this section.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Pattern Valueworking
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        164. Composition.section:MedicationHistory.orderedBy
        Definition

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

        ShortOrder of section entries
        Comments

        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.

        Control0..1
        BindingThe codes SHOULD be taken from ListOrderCodes
        (preferred to http://hl7.org/fhir/ValueSet/list-order)

        What order applies to the items in the entry.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        166. Composition.section:MedicationHistory.entry
        Definition

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

        ShortLa référence à la ressource *Composition* du Bilan Médicamenteux. Ce Bilan peut être vide si le patient ne prend pas de médicament en dehors de l'hospitalisation au titre de laquelle la Conciliation est réalisée.
        Comments

        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).

        Control1..1
        This element is affected by the following invariants: cmp-2
        TypeReference(FrMedicationHistoryComposition)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        168. Composition.section:MedicationHistory.emptyReason
        Definition

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

        ShortWhy the section is empty
        Comments

        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.

        Control0..1
        This element is affected by the following invariants: cmp-2
        BindingThe codes SHOULD be taken from ListEmptyReasons
        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

        If a section is empty, why it is empty.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        170. Composition.section:MedicationHistory.section
        Definition

        A nested sub-section within this section.

        ShortNested Section
        Comments

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

        Control0..0
        This element is affected by the following invariants: cmp-1
        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        172. Composition.section:CurrentMedication
        Slice NameCurrentMedication
        Definition

        La liste des traitements médicamenteux prescrit à l'admission (Ordonnance Médicale d'admission - OMA), confrontée au Bilan Médicamenteux et qui l'objet de la conciliation des traitements.

        ShortOrdonnance Médicale d'admission (OMA)
        Comments

        Formellement, cette liste peut être vide.

        Control1..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Référencer l'Ordonnance Médicale d'Admission qui fait l'objet de cette conciliation des traitements.

        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        174. Composition.section:CurrentMedication.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        176. Composition.section:CurrentMedication.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        178. Composition.section:CurrentMedication.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        180. Composition.section:CurrentMedication.title
        Definition

        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.

        ShortLabel for section (e.g. for ToC)
        Comments

        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.

        Control1..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

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

        Alternate Namesheader, label, caption
        Fixed ValueTraitement Médicamenteux Courant
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        182. Composition.section:CurrentMedication.code
        Definition

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

        ShortClassification of section (recommended)
        Comments

        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.

        Control0..1
        BindingFor example codes, see DocumentSectionCodes
        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

        Classification of a section of a composition/document.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        184. Composition.section:CurrentMedication.author
        Definition

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

        ShortWho and/or what authored the section
        Control0..0
        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summaryfalse
        Requirements

        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.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        186. Composition.section:CurrentMedication.focus
        Definition

        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).

        ShortWho/what the section is about, when it is not about the subject of composition
        Comments

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

        Control0..0
        TypeReference(Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        188. Composition.section:CurrentMedication.text
        Definition

        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.

        ShortText summary of the section, for human interpretation
        Comments

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

        Control0..1
        This element is affected by the following invariants: cmp-1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        190. Composition.section:CurrentMedication.mode
        Definition

        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.

        ShortListe courante exhaustive à sa date de réalisation (cf. element *date*\) par son auteur (cf. element *author*\).
        Comments

        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.

        Control1..1
        BindingThe codes SHALL be taken from ListMode
        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

        The processing mode that applies to this section.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Fixed Valueworking
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        192. Composition.section:CurrentMedication.orderedBy
        Definition

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

        ShortOrder of section entries
        Comments

        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.

        Control0..1
        BindingThe codes SHOULD be taken from ListOrderCodes
        (preferred to http://hl7.org/fhir/ValueSet/list-order)

        What order applies to the items in the entry.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        194. Composition.section:CurrentMedication.entry
        Definition

        La référence à la ressource Composition de l'Ordonnance Médicale d'Admission (OMA). Cette Ordonnance peut, formellement, être vide si le patient n'a aucun médicament prescrit à son admission.

        ShortLa composition de l'Ordonnance Médicale d'Admission (OMA) attachée
        Comments

        Une Ordonnance Médicale d'Admission (OMA), même vide si la patient n'a aucun médicament prescrit lors de son admission, doit être attachée à la FCT (Fiche de Concimaition des Traitements médicamenteux).

        Control1..1
        This element is affected by the following invariants: cmp-2
        TypeReference(FrOnAdmissionMedicationComposition)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        196. Composition.section:CurrentMedication.emptyReason
        Definition

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

        ShortWhy the section is empty
        Comments

        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.

        Control0..1
        This element is affected by the following invariants: cmp-2
        BindingThe codes SHOULD be taken from ListEmptyReasons
        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

        If a section is empty, why it is empty.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        198. Composition.section:CurrentMedication.section
        Definition

        A nested sub-section within this section.

        ShortNested Section
        Comments

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

        Control0..0
        This element is affected by the following invariants: cmp-1
        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        200. Composition.section:Reconciliation
        Slice NameReconciliation
        Definition

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

        ShortConciliation proprement dite
        Control1..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        202. Composition.section:Reconciliation.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        204. Composition.section:Reconciliation.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        206. Composition.section:Reconciliation.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        208. Composition.section:Reconciliation.title
        Definition

        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.

        ShortLabel for section (e.g. for ToC)
        Comments

        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.

        Control1..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

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

        Alternate Namesheader, label, caption
        Pattern ValueFiche de Conciliation des Traitements médicamenteux
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        210. Composition.section:Reconciliation.code
        Definition

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

        ShortClassification of section (recommended)
        Comments

        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.

        Control0..1
        BindingFor example codes, see DocumentSectionCodes
        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

        Classification of a section of a composition/document.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        Provides computable standardized labels to topics within the document.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        212. Composition.section:Reconciliation.author
        Definition

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

        ShortWho authored the section
        Control0..0
        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        220. Composition.section:Reconciliation.focus
        Definition

        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).

        ShortWho/what the section is about, when it is not about the subject of composition
        Comments

        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.

        Control0..0
        TypeReference(Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        222. Composition.section:Reconciliation.text
        Definition

        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.

        ShortText summary of the section, for human interpretation
        Comments

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

        Control0..1
        This element is affected by the following invariants: cmp-1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        224. Composition.section:Reconciliation.mode
        Definition

        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.

        ShortListe courante exhaustive à sa date de réalisation (cf. element *date*\) par son auteur (cf. element *author*\).
        Comments

        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.

        Control1..1
        BindingThe codes SHALL be taken from ListMode
        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

        The processing mode that applies to this section.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Pattern Valueworking
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        226. Composition.section:Reconciliation.orderedBy
        Definition

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

        ShortOrder of section entries
        Comments

        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.

        Control0..1
        BindingThe codes SHOULD be taken from ListOrderCodes
        (preferred to http://hl7.org/fhir/ValueSet/list-order)

        What order applies to the items in the entry.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        228. Composition.section:Reconciliation.entry
        Definition

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

        ShortLigne de traitement médicamenteux de la FCT (Fiche de Concilitaion des Traitements médicamenteux)
        Comments

        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.

        Control0..*
        This element is affected by the following invariants: cmp-2
        TypeReference(FrMedicationReconciliationMedicationStatement)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        230. Composition.section:Reconciliation.emptyReason
        Definition

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

        ShortWhy the section is empty
        Comments

        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.

        Control0..1
        This element is affected by the following invariants: cmp-2
        BindingThe codes SHOULD be taken from ListEmptyReasons
        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

        If a section is empty, why it is empty.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        232. Composition.section:Reconciliation.section
        Definition

        A nested sub-section within this section.

        ShortNested Section
        Comments

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

        Control0..0
        This element is affected by the following invariants: cmp-1
        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))