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: FrCurrentMedicationComposition - Detailed Descriptions

Draft as of 2025-04-11

Definitions for the fr-current-medication-composition resource profile.

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

0. Composition
Definition

Traitement Médicamenteux Courant : liste des lignes de traitement médicamenteux courant hospitalier.


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.).

ShortTraitement Médicamenteux CourantA set of resources composed into a single coherent clinical statement with clinical attestation
Comments

En général, une ligne par médicament prescrit en cours. Des différences de construction des lignes peuvent exister d'un logiciel à un autre, liées à la structuration de la posologie (nombre de doses unitaires par période, quantité des doses unitaires, horaire des doses unitaires). Le jeu de tests de prescriptions intiales de référence permet l'évaluation de la capacité des logiciels à supporter la structuration de posologies complexes.


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
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.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 CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
(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()))
6. 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())
8. 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

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
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()))
10. Composition.type
Definition

Le contexte de la liste des Traitements Médicamenteux Courants (sans précision, OMA, sortie, transfert) ; jeu de valeurs extensible


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.

ShortType de liste des Traitements Médicamenteux CourantsKind of composition (LOINC if possible)
Comments

Tous les types de liste des Traitements Médicamenteux Courants n'ont pas de code LOINC. Le contexte de la liste des Traitements médicamenteux Courant peut dépasser le périmètre du jeu de valeurs associé, binding extensible.


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 https://hl7.fr/fhir/fr/medication/ValueSet/fr-current-medication-document-type)

Type of a Current Medciation.


Type of a composition.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Préciser le contexte de réalisation de la liste des Traitements Médicamenteux Courants


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

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

Le patient auquel se rapporte ce document Traitement Médicamenteux Courant.


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

Un Traitement Médicamenteux Courant 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 un Traitement Médicamenteux Courant, 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()))
14. 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.

Control10..1
BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
(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()))
16. Composition.encounter
Definition

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

ShortContext of the Composition
Control0..1
TypeReference(FR Core Encounter Profile, 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()))
18. Composition.date
Definition

Date de détermination du Traitementeux Courant par son auteur (cf. element author). //The composition editing time, when the composition was last logically changed by the author.


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

ShortDate de détermination du Traitement Médicamenteux CourantComposition 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()))
20. Composition.author
Definition

Le prescripteur de ce Traitement Médicamenteux Courant, défini ès qualités (ressource PractitionerRole profilée fr-practitioner-role) ET, de préférence, aussi nominativement (la ressource PractionerRole profilée fr-practitioner-role-profession 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 prescripteurWho and/or what authored the composition
Comments

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).

Control1..1*
TypeReference(FR Core Practitioner Role, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Identifier le prescriteur.


Identifies who is responsible for the content.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. 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
Pattern ValueTraitement Médicamenteux Courant
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.section
Definition

La liste des lignes de prescription médicamenteuse en cours.


The root of the sections that make up the composition.

ShortListe des médicaments prescritsComposition is broken into sections
Comments

Une ligne par <entry>, de médicament prescrit, avec sa posologie.

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

Fournir la liste des prescriptions médicamenteuses en cours.

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())
26. 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())
28. 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
Pattern ValueListe des médicaments prescrits en cours
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. 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..0*
TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifierfalse
Summaryfalse
Requirements

L'auteur de la section est celui de l'ensemble du document


Identifies who is responsible for the content.

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

Le sujet sur lequel porte la section, quand ce n'est pas celui sur lequel porte la Composition.


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

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

Le Traitement Médicamenteux Courant ne concerne que le patient courant, sujet de la Composition.

  • La manière de décrire pour le nouveau-né ou le nourisson, les substances prises par sa mère qu'il absorberait par allaitement maternel, n'a pas été explicitement définie. Il s'agirait, de toute façon et sous réserve que cette substance doive figurer dans le Traitement Médicamenteux Courant du bébé, d'une <entry> de cette section, une ressource MedicationStatement profilée fr-current-medication-medication-statement dont il serait précisé qu'elle provient de l'allaitement maternel. Cas d'usage non détaillé.

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
Summaryfalse
Requirements

Le Traitement Médicamenteux Courant ne concerne que le patient auquel se rapporte ce document (voir element subject de la Composition).

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

Liste courante exhaustive à sa date de réalisation (cf. element date) par son auteur (cf. element author).


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 exhaustiveworking | 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()))
36. Composition.section.orderedBy
Definition

L'ordre des lignes de traitement du Traitement Médicamenteux Courant, c'est à dire, l'ordre des <entry> de son unique <section>.


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

ShortOrdre des lignes du Traitement Médicamenteux CourantOrder of section entries
Comments

Il est recommandé d'utiliser la valeur codée user si l'ordre des <entry> provient d'un choix de l'auteur à travers l'IHM de son logiciel qui est conservé dans la génération de la ressource Traitement Médicamenteux Courant. Car, rappel des spécifications HL7-FHIR : If there is no order specified, the order is unknown, though there may still be some order.


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 ListOrderCodeshttp://hl7.org/fhir/ValueSet/list-order
(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()))
38. Composition.section.entry
Definition

Référence à la ligne de traitement médicamenteux courant, ressource MedicationStatement profilée fr-current-medication-medication-statement.


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

ShortLa ligne de traitement médicamenteuxA reference to data that supports this section
Comments

0 à n lignes de traitement médicamenteux dans le Traitement Médicamenteux Courant.


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(FrCurrentMedicationMedicationStatement, Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Requirements

Porter les lignes du traitement médicamenteux courant.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. 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..0*
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()))