Partage de Documents de Santé en mobilité (PDSm)
3.1.0 - trial-use

Partage de Documents de Santé en mobilité (PDSm) - Local Development build (v3.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: PDSm_SimplifiedPublish - Detailed Descriptions

Active as of 2025-10-22

Definitions for the pdsm-simplified-publish resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. DocumentReference
Définition | A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text.
Short | A reference to a document
Commentaires | Usually, this is used for documents other than those defined by FHIR.
Control | 0..*
Is Modifier | false
Résumé | false
Invariants | dom-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. DocumentReference.meta
Définition | 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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. DocumentReference.meta.versionId
Définition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Numéro de version de la fiche d’un document attribué par le système cible. La valeur de la métadonnée version est égale à 1 pour la première version de la fiche. Cet élément est requis lorsque le flux envoyé correspond à une mise à jour des données d’une fiche.Version specific identifier
Commentaires | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. DocumentReference.implicitRules
Définition | 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.
Short | A set of rules under which this content was created
Commentaires | 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. DocumentReference.modifierExtension
Définition | An Extension 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).
Short | ExtensionExtensions that cannot be ignored
Commentaires | 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.
Control | 0..0*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Résumé | false
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 Names | extensions, user content
Invariants | ele-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())
10. DocumentReference.masterIdentifier
Définition | Document identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document.
Short | Représente l’identifiant unique global affecté au document par son créateur. Il est utilisable comme référence externe dans d’autres documents.Master Version Specific Identifier
Commentaires | CDA Document Id extension and root.
Control | 10..1
Type | Identifier
Is Modifier | false
Must Support | true
Résumé | true
Requirements | The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.).
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. DocumentReference.identifier
Définition | Other identifiers associated with the document, including version independent identifiers.
Short | Other identifiers for the document
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..0*
Type | Identifier
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. DocumentReference.status
Définition | The status of this document reference.
Short | current | superseded | entered-in-error
Commentaires | This is the status of the DocumentReference object, which might be independent from the docStatus element. This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1` ) The status of the document reference.
Type | code
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Pattern Value | `current`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. DocumentReference.docStatus
Définition | The status of the underlying document.
Short | preliminary | final | amended | entered-in-error
Commentaires | The document that is pointed to might be in various lifecycle states.
Control | 0..01
Binding | The codes SHALL be taken from CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/composition-status|4.0.1` ) Status of the underlying document.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. DocumentReference.type
Définition | Représente le type du document. Specifies the particular kind of document referenced (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced.
Short | Kind of document (LOINC if possible)
Commentaires | Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents.
Control | 0..1
Binding | The codes SHOULD be taken from JDV_J07_XdsTypeCode_CISIS http://hl7.org/fhir/ValueSet/c80-doc-typecodes|4.0.1 (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J07-XdsTypeCode-CISIS/FHIR/JDV-J07-XdsTypeCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) constr-bind-type: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : TRE_A05-TypeDocComplementaireCISIS, OID : 1.2.250.1.213.1.1.4.12 LOINC, OID : 2.16.840.1.113883.6.1 TRE_A12-NomenclatureASTM, OID : ASTM Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J66-TypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J07-XdsTypeCode-CISIS peut être utilisé. ()
20. DocumentReference.category
Définition | A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type.
Short | Représente la classe du document (compte rendu, imagerie médicale, traitement, certificat,...).Categorization of document
Commentaires | Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching.
Control | 0..1*
Binding | The codes SHOULD be taken from For example codes, see JDV_J06_XdsClassCode_CISIS http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1 (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J06-XdsClassCode-CISIS/FHIR/JDV-J06-XdsClassCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | true
Alternate Names | claxs
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) constr-bind-category: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : - TRE_A03-ClasseDocument-CISIS, OID : 1.2.250.1.213.1.1.4.1 - TRE_A10-NomenclatureURN, OID : URN Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J57-ClassCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J06-XdsClassCode-CISIS peut être utilisé. ()
22. DocumentReference.subject
Définition | Who or what the document is about. The document 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 farm animals, or a set of patients that share a common exposure).
Short | Patient concerné par ce document. La ressource référencée peut être présente sous l’élément DocumentReference.contained ou via le champ identifier.Who/what is the subject of the document
Control | 10..1
Type | Reference(FR Core Patient Profile, Patient, Practitioner, Group, Device)
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. DocumentReference.date
Définition | When the document reference was created.
Short | Représente la date de création de la ressource DocumentReference dans FHIRWhen this document reference was created
Commentaires | Referencing/indexing time is used for tracking, organizing versions and searching.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Alternate Names | indexed
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. DocumentReference.author
Définition | Identifies who is responsible for adding the information to the document.
Short | Personnes physiques ou morales et/ou les dispositifs auteurs d'un document.Who and/or what authored the document
Commentaires | Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).
Control | 10..*
Type | Reference(AS PractitionerRole Profile, AS Practitioner Profile, AS Organization Profile, Device, FR Core Patient Profile, FR Core Related Person Profile, Practitioner, PractitionerRole, Organization, Device, Patient, RelatedPerson)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. DocumentReference.authenticator
Définition | Which person or organization authenticates that this document is valid.
Short | Cet attribut représente l’acteur validant le document et prenant la responsabilité du contenu médical de celui-ci. Il peut s’agir de l’auteur du document si celui-ci est une personne et s’il endosse la responsabilité du contenu médical de ses documents. Si l’auteur est un dispositif, cet attribut doit représenter la personne responsable de l’action effectuée par le dispositif.Who/what authenticated the document
Commentaires | Represents a participant within the author institution who has legally authenticated or attested the document. Legal authentication implies that a document has been signed manually or electronically by the legal Authenticator.
Control | 0..1
Type | Reference(AS PractitionerRole Profile, AS Organization Profile, Practitioner, PractitionerRole, Organization)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. DocumentReference.relatesTo
Définition | Relationships that this document has with other document references that already exist.
Short | Relationships to other documents
Commentaires | This element is labeled as a modifier because documents that append to other documents are incomplete on their own.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. DocumentReference.relatesTo.modifierExtension
Définition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Résumé | true
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 Names | extensions, user content, modifiers
Invariants | ele-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())
34. DocumentReference.relatesTo.code
Définition | The type of relationship that this document has with anther document.
Short | replaces | transforms | signs | appends
Commentaires | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Control | 1..1
Binding | The codes SHALL be taken from DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1` ) The type of relationship between documents.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. DocumentReference.relatesTo.target
Définition | The target document of this relationship.
Short | Target of the relationship
Control | 1..1
Type | Reference(DocumentReference, DocumentReference)
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. DocumentReference.description
Définition | Human-readable description of the source document.
Short | Commentaire associé au document.Human-readable description
Commentaires | What the document is about, a terse summary of the document.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Requirements | Helps humans to assess whether the document is of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. DocumentReference.securityLabel
Définition | A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to.
Short | Contient les informations définissant le niveau de confidentialité d'un document.Document security-tags
Commentaires | The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce. In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels http://hl7.org/fhir/ValueSet/security-labels|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/security-labels` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | true
Requirements | Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) constr-bind-securityLabel: Les codes pour cet élément doivent provenir du ValueSet spécifié par le standard. Lorsqu’aucun code ne correspond au concept recherché, un code provenant de la terminologie de référence TRE_A07-StatusVisibiliteDocument, OID : 1.2.250.1.213.1.1.4.13 peut être utilisé. ()
42. DocumentReference.content
Définition | The document and format referenced. The document and format referenced. There may be multiple content element repetitions, each with a different format.
Short | Document contenu.Document referenced
Control | 1..1*
Type | BackboneElement
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. DocumentReference.content.modifierExtension
Définition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Résumé | true
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 Names | extensions, user content, modifiers
Invariants | ele-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())
46. DocumentReference.content.attachment
Définition | The document or URL of the document along with critical metadata to prove content has integrity.
Short | Where to access the document
Control | 1..1
Type | Attachment
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. DocumentReference.content.attachment.contentType
Définition | Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.
Short | Mime type of the content, with charset etc.
Control | 10..1
Binding | The codes SHALL be taken from Mime Types http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 (required to `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` ) The mime type of an attachment. Any valid mime type is allowed.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Processors of the data need to be able to know how to interpret the data.
Exemple | General: text/plain; charset=UTF-8, image/png
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. DocumentReference.content.attachment.language
Définition | The human language of the content. The value can be any valid value according to BCP 47.
Short | Pour tous les documents produits par les systèmes initiateurs français, le code est "fr-FR'.Human language of the content (BCP-47)
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Bindings Additionnels | But
AllLanguages | Binding Max
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Requirements | Users need to be able to choose between the languages in a set of attachments.
Exemple | General: en-AU
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. DocumentReference.content.attachment.data
Définition | The actual data of the attachment - a sequence of bytes, base64 encoded.
Short | Le document est contenu dans l'élément .data au format base64.Data inline, base64ed
Commentaires | The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.
Control | 10..1
Type | base64Binary
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | false
Requirements | The data needs to able to be transmitted inline.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. DocumentReference.content.attachment.url
Définition | A location where the data can be accessed.
Short | Uri where the data can be found
Commentaires | If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.
Control | 0..01
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | The data needs to be transmitted by reference.
Exemple | General: http://www.acme.com/logo-small.png
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. DocumentReference.content.attachment.size
Définition | The number of bytes of data that make up this attachment (before base64 encoding, if that is done).
Short | Représente la taille du document.Number of bytes of content (if url provided)
Commentaires | The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. DocumentReference.content.attachment.hash
Définition | The calculated hash of the data using SHA-1. Represented using base64.
Short | Représente le résultat de hachage du document (SHA 1).Hash of the data (sha-1, base64ed)
Commentaires | The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature. The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.
Control | 0..1
Type | base64Binary
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. DocumentReference.content.attachment.title
Définition | A label or set of text to display in place of the data.
Short | Label to display in place of the data
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.
Exemple | General: Official Corporate Logo
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. DocumentReference.content.attachment.creation
Définition | The date that the attachment was first created.
Short | Représente la date et l’heure de création du document.Date attachment was first created
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Requirements | This is often tracked as an integrity issue for use of the attachment.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. DocumentReference.content.format
Définition | An identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType.
Short | Format technique détaillé du document.Format/content rules for the document
Commentaires | Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI.
Control | 0..1
Binding | The codes SHOULD be taken from JDV_J10_XdsFormatCode_CISIS http://hl7.org/fhir/ValueSet/formatcodes|4.0.1 (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J10-XdsFormatCode-CISIS/FHIR/JDV-J10-XdsFormatCode-CISIS` )
Type | Coding
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) constr-bind-format: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : - TRE_A06-FormatCodeComplementaire, OID : 1.2.250.1.213.1.1.4.2.282 - TRE_A11-IheFormatCode, OID : 1.3.6.1.4.1.19376.1.2.3 - TRE_A09-DICOMuidRegistry, OID : 1.2.840.10008.2.6.1 - TRE_A10-NomenclatureURN, OID : URN Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J60-FormatCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J10-XdsFormatCode-CISIS peut être utilisé. ()
66. DocumentReference.context
Définition | The clinical context in which the document was prepared.
Short | Clinical context of document
Commentaires | These values are primarily added to help with searching for interesting/relevant documents.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. DocumentReference.context.modifierExtension
Définition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Résumé | true
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 Names | extensions, user content, modifiers
Invariants | ele-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. DocumentReference.context.event
Définition | 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 type Code, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Short | Représente les actes et les pathologies en rapport avec le document.Main clinical acts documented
Commentaires | An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.
Control | 0..1*
Binding | For example codes, see v3 Code System ActCode http://terminology.hl7.org/ValueSet/v3-ActCode (example to `http://terminology.hl7.org/ValueSet/v3-ActCode` ) This list of codes represents the main clinical acts being documented.
Type | CodeableConcept
Is Modifier | false
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) constr-bind-context-event: Nomenclatures utilisées : 1) CCAM pour les actes médicaux (OID="1.2.250.1.213.2.5"); 2) CIM-10 pour les diagnostics de pathologie (OID="2.16.840.1.113883.6.3"), 3) TRE_A00-ProducteurDocNonPS pour les documents d'expression personnelle du patient, 4) autre ()
72. DocumentReference.context.period
Définition | The time period over which the service that is described by the document was provided.
Short | Time of service that is being documented
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. DocumentReference.context.facilityType
Définition | The kind of facility where the patient was seen.
Short | Secteur d'activité lié à la prise en charge de la personne, en lien avec le document produit.Kind of facility where patient was seen
Control | 0..1
Binding | The codes SHOULD be taken from For example codes, see JDV_J02_XdsHealthcareFacilityTypeCode_CISIS http://hl7.org/fhir/ValueSet/c80-facilitycodes|4.0.1 (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J02-XdsHealthcareFacilityTypeCode-CISIS/FHIR/JDV-J02-XdsHealthcareFacilityTypeCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) constr-bind-ProducteurDoc-simplified: L’utilisation de cette nomenclature est recommandée mais non obligatoire (prefered) : - TRE_R02-SecteurActivite, OID : 1.2.250.1.71.4.2.4 (lorsque l’auteur du document est un professionnel ou un équipement sous sa responsabilité) Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J61-HealthcareFacilityTypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J02-XdsHealthcareFacilityTypeCode-CISIS peut être utilisé. ()
76. DocumentReference.context.practiceSetting
Définition | This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty.
Short | Cadre d’exercice de l’acte qui a engendré la création du document.Additional details about where the content was created (e.g. clinical specialty)
Commentaires | This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.
Control | 0..1
Binding | The codes SHOULD be taken from For example codes, see JDV_J04_XdsPracticeSettingCode_CISIS http://hl7.org/fhir/ValueSet/c80-practice-codes|4.0.1 (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J04-XdsPracticeSettingCode-CISIS/FHIR/JDV-J04-XdsPracticeSettingCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | false
Requirements | This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) constr-bind-ProducteurDoc-simplified: L’utilisation de cette nomenclature est recommandée mais non obligatoire (prefered) : - TRE_R02-SecteurActivite, OID : 1.2.250.1.71.4.2.4 (lorsque l’auteur du document est un professionnel ou un équipement sous sa responsabilité) Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J61-HealthcareFacilityTypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J02-XdsHealthcareFacilityTypeCode-CISIS peut être utilisé. ()
78. DocumentReference.context.sourcePatientInfo
Définition | The Patient Information as known when the document was published. May be a reference to a version specific, or contained.
Short | Référence vers la ressource Patient titulaire du dossier.Patient demographics from source
Control | 0..1
Type | Reference(FR Core Patient Profile, Patient)
Is Modifier | false
Must Support | true
Résumé | false
Invariants | ele-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 foundhere

0. DocumentReference
2. DocumentReference.meta
4. DocumentReference.meta.versionId
Short | Numéro de version de la fiche d’un document attribué par le système cible. La valeur de la métadonnée version est égale à 1 pour la première version de la fiche. Cet élément est requis lorsque le flux envoyé correspond à une mise à jour des données d’une fiche.
Must Support | true
6. DocumentReference.masterIdentifier
Short | Représente l’identifiant unique global affecté au document par son créateur. Il est utilisable comme référence externe dans d’autres documents.
Must Support | true
8. DocumentReference.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Must Support | true
10. DocumentReference.status
Must Support | true
12. DocumentReference.type
Définition | Représente le type du document.
Binding | The codes SHOULD be taken from JDV_J07_XdsTypeCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J07-XdsTypeCode-CISIS/FHIR/JDV-J07-XdsTypeCode-CISIS` )
Invariants | constr-bind-type: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : TRE_A05-TypeDocComplementaireCISIS, OID : 1.2.250.1.213.1.1.4.12 LOINC, OID : 2.16.840.1.113883.6.1 TRE_A12-NomenclatureASTM, OID : ASTM Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J66-TypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J07-XdsTypeCode-CISIS peut être utilisé. ()
14. DocumentReference.category
Short | Représente la classe du document (compte rendu, imagerie médicale, traitement, certificat,...).
Binding | The codes SHOULD be taken from JDV_J06_XdsClassCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J06-XdsClassCode-CISIS/FHIR/JDV-J06-XdsClassCode-CISIS` )
Invariants | constr-bind-category: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : - TRE_A03-ClasseDocument-CISIS, OID : 1.2.250.1.213.1.1.4.1 - TRE_A10-NomenclatureURN, OID : URN Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J57-ClassCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J06-XdsClassCode-CISIS peut être utilisé. ()
16. DocumentReference.subject
Short | Patient concerné par ce document. La ressource référencée peut être présente sous l’élément DocumentReference.contained ou via le champ identifier.
Type | Reference(FR Core Patient Profile)
18. DocumentReference.date
Short | Représente la date de création de la ressource DocumentReference dans FHIR
20. DocumentReference.author
Short | Personnes physiques ou morales et/ou les dispositifs auteurs d'un document.
Control | 1..?
Type | Reference(AS PractitionerRole Profile, AS Practitioner Profile, AS Organization Profile, Device, FR Core Patient Profile, FR Core Related Person Profile)
22. DocumentReference.authenticator
Short | Cet attribut représente l’acteur validant le document et prenant la responsabilité du contenu médical de celui-ci. Il peut s’agir de l’auteur du document si celui-ci est une personne et s’il endosse la responsabilité du contenu médical de ses documents. Si l’auteur est un dispositif, cet attribut doit représenter la personne responsable de l’action effectuée par le dispositif.
Type | Reference(AS PractitionerRole Profile, AS Organization Profile)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
24. DocumentReference.description
Short | Commentaire associé au document.
Must Support | true
26. DocumentReference.securityLabel
Short | Contient les informations définissant le niveau de confidentialité d'un document.
Invariants | constr-bind-securityLabel: Les codes pour cet élément doivent provenir du ValueSet spécifié par le standard. Lorsqu’aucun code ne correspond au concept recherché, un code provenant de la terminologie de référence TRE_A07-StatusVisibiliteDocument, OID : 1.2.250.1.213.1.1.4.13 peut être utilisé. ()
28. DocumentReference.content
Short | Document contenu.
Must Support | true
30. DocumentReference.content.attachment
32. DocumentReference.content.attachment.language
Short | Pour tous les documents produits par les systèmes initiateurs français, le code est "fr-FR'.
34. DocumentReference.content.attachment.data
Short | Le document est contenu dans l'élément .data au format base64.
36. DocumentReference.content.attachment.size
Short | Représente la taille du document.
38. DocumentReference.content.attachment.hash
Short | Représente le résultat de hachage du document (SHA 1).
40. DocumentReference.content.attachment.title
Control | 1..?
42. DocumentReference.content.attachment.creation
Short | Représente la date et l’heure de création du document.
44. DocumentReference.content.format
Short | Format technique détaillé du document.
Binding | The codes SHOULD be taken from JDV_J10_XdsFormatCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J10-XdsFormatCode-CISIS/FHIR/JDV-J10-XdsFormatCode-CISIS` )
Invariants | constr-bind-format: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : - TRE_A06-FormatCodeComplementaire, OID : 1.2.250.1.213.1.1.4.2.282 - TRE_A11-IheFormatCode, OID : 1.3.6.1.4.1.19376.1.2.3 - TRE_A09-DICOMuidRegistry, OID : 1.2.840.10008.2.6.1 - TRE_A10-NomenclatureURN, OID : URN Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J60-FormatCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J10-XdsFormatCode-CISIS peut être utilisé. ()
46. DocumentReference.context
Must Support | true
48. DocumentReference.context.event
Short | Représente les actes et les pathologies en rapport avec le document.
Control | 0..1
Invariants | constr-bind-context-event: Nomenclatures utilisées : 1) CCAM pour les actes médicaux (OID="1.2.250.1.213.2.5"); 2) CIM-10 pour les diagnostics de pathologie (OID="2.16.840.1.113883.6.3"), 3) TRE_A00-ProducteurDocNonPS pour les documents d'expression personnelle du patient, 4) autre ()
50. DocumentReference.context.facilityType
Short | Secteur d'activité lié à la prise en charge de la personne, en lien avec le document produit.
Binding | The codes SHOULD be taken from JDV_J02_XdsHealthcareFacilityTypeCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J02-XdsHealthcareFacilityTypeCode-CISIS/FHIR/JDV-J02-XdsHealthcareFacilityTypeCode-CISIS` )
Invariants | constr-bind-ProducteurDoc-simplified: L’utilisation de cette nomenclature est recommandée mais non obligatoire (prefered) : - TRE_R02-SecteurActivite, OID : 1.2.250.1.71.4.2.4 (lorsque l’auteur du document est un professionnel ou un équipement sous sa responsabilité) Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J61-HealthcareFacilityTypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J02-XdsHealthcareFacilityTypeCode-CISIS peut être utilisé. ()
52. DocumentReference.context.practiceSetting
Short | Cadre d’exercice de l’acte qui a engendré la création du document.
Binding | The codes SHOULD be taken from JDV_J04_XdsPracticeSettingCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J04-XdsPracticeSettingCode-CISIS/FHIR/JDV-J04-XdsPracticeSettingCode-CISIS` )
Invariants | constr-bind-ProducteurDoc-simplified: L’utilisation de cette nomenclature est recommandée mais non obligatoire (prefered) : - TRE_R02-SecteurActivite, OID : 1.2.250.1.71.4.2.4 (lorsque l’auteur du document est un professionnel ou un équipement sous sa responsabilité) Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J61-HealthcareFacilityTypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J02-XdsHealthcareFacilityTypeCode-CISIS peut être utilisé. ()
54. DocumentReference.context.sourcePatientInfo
Short | Référence vers la ressource Patient titulaire du dossier.
Type | Reference(FR Core Patient Profile)

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

0. DocumentReference
Définition | A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text.
Short | A reference to a document
Commentaires | Usually, this is used for documents other than those defined by FHIR.
Control | 0..*
Is Modifier | false
Résumé | false
Invariants | dom-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. DocumentReference.id
Définition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Commentaires | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Résumé | true
4. DocumentReference.meta
Définition | 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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. DocumentReference.meta.id
Définition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Résumé | false
8. DocumentReference.meta.extension
Définition | 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.
Short | Additional content defined by implementations
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Résumé | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `DocumentReference.meta.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. DocumentReference.meta.versionId
Définition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Numéro de version de la fiche d’un document attribué par le système cible. La valeur de la métadonnée version est égale à 1 pour la première version de la fiche. Cet élément est requis lorsque le flux envoyé correspond à une mise à jour des données d’une fiche.
Commentaires | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. DocumentReference.meta.lastUpdated
Définition | When the resource last changed - e.g. when the version changed.
Short | When the resource version last changed
Commentaires | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
14. DocumentReference.meta.source
Définition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Short | Identifies where the resource comes from
Commentaires | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. DocumentReference.meta.profile
Définition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Short | Profiles this resource claims to conform to
Commentaires | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Control | 0..*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. DocumentReference.meta.security
Définition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Short | Security Labels applied to this resource
Commentaires | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. DocumentReference.meta.tag
Définition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Short | Tags applied to this resource
Commentaires | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | For example codes, see CommonTags (example to `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` ) Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
Type | Coding
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. DocumentReference.implicitRules
Définition | 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.
Short | A set of rules under which this content was created
Commentaires | 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. DocumentReference.language
Définition | The base language in which the resource is written.
Short | Language of the resource content
Commentaires | 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Bindings Additionnels | But
AllLanguages | Binding Max
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. DocumentReference.text
Définition | 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.
Short | Text summary of the resource, for human interpretation
Commentaires | 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.
Control | 0..1
Type | Narrative
Is Modifier | false
Résumé | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. DocumentReference.contained
Définition | 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.
Short | Contained, inline Resources
Commentaires | 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.
Control | 0..*
Type | Resource
Is Modifier | false
Résumé | false
Alternate Names | inline resources, anonymous resources, contained resources
30. DocumentReference.extension
Définition | 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.
Short | Additional content defined by implementations
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Résumé | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
32. DocumentReference.modifierExtension
Définition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Résumé | false
Invariants | ele-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()`)
34. DocumentReference.masterIdentifier
Définition | Document identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document.
Short | Représente l’identifiant unique global affecté au document par son créateur. Il est utilisable comme référence externe dans d’autres documents.
Commentaires | CDA Document Id extension and root.
Control | 1..1
Type | Identifier
Is Modifier | false
Must Support | true
Résumé | true
Requirements | The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. DocumentReference.identifier
Définition | Other identifiers associated with the document, including version independent identifiers.
Short | Other identifiers for the document
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..0
Type | Identifier
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. DocumentReference.status
Définition | The status of this document reference.
Short | current | superseded | entered-in-error
Commentaires | This is the status of the DocumentReference object, which might be independent from the docStatus element. This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from DocumentReferenceStatus (required to `http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1` ) The status of the document reference.
Type | code
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Pattern Value | `current`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. DocumentReference.docStatus
Définition | The status of the underlying document.
Short | preliminary | final | amended | entered-in-error
Commentaires | The document that is pointed to might be in various lifecycle states.
Control | 0..0
Binding | The codes SHALL be taken from CompositionStatus (required to `http://hl7.org/fhir/ValueSet/composition-status|4.0.1` ) Status of the underlying document.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. DocumentReference.type
Définition | Représente le type du document.
Short | Kind of document (LOINC if possible)
Commentaires | Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents.
Control | 0..1
Binding | The codes SHOULD be taken from JDV_J07_XdsTypeCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J07-XdsTypeCode-CISIS/FHIR/JDV-J07-XdsTypeCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) constr-bind-type: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : TRE_A05-TypeDocComplementaireCISIS, OID : 1.2.250.1.213.1.1.4.12 LOINC, OID : 2.16.840.1.113883.6.1 TRE_A12-NomenclatureASTM, OID : ASTM Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J66-TypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J07-XdsTypeCode-CISIS peut être utilisé. ()
44. DocumentReference.category
Définition | A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type.
Short | Représente la classe du document (compte rendu, imagerie médicale, traitement, certificat,...).
Commentaires | Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching.
Control | 0..1
Binding | The codes SHOULD be taken from JDV_J06_XdsClassCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J06-XdsClassCode-CISIS/FHIR/JDV-J06-XdsClassCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | true
Alternate Names | claxs
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) constr-bind-category: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : - TRE_A03-ClasseDocument-CISIS, OID : 1.2.250.1.213.1.1.4.1 - TRE_A10-NomenclatureURN, OID : URN Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J57-ClassCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J06-XdsClassCode-CISIS peut être utilisé. ()
46. DocumentReference.subject
Définition | Who or what the document is about. The document 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 farm animals, or a set of patients that share a common exposure).
Short | Patient concerné par ce document. La ressource référencée peut être présente sous l’élément DocumentReference.contained ou via le champ identifier.
Control | 1..1
Type | Reference(FR Core Patient Profile)
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. DocumentReference.date
Définition | When the document reference was created.
Short | Représente la date de création de la ressource DocumentReference dans FHIR
Commentaires | Referencing/indexing time is used for tracking, organizing versions and searching.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Alternate Names | indexed
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. DocumentReference.author
Définition | Identifies who is responsible for adding the information to the document.
Short | Personnes physiques ou morales et/ou les dispositifs auteurs d'un document.
Commentaires | Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).
Control | 1..*
Type | Reference(AS PractitionerRole Profile, AS Practitioner Profile, AS Organization Profile, Device, FR Core Patient Profile, FR Core Related Person Profile)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. DocumentReference.authenticator
Définition | Which person or organization authenticates that this document is valid.
Short | Cet attribut représente l’acteur validant le document et prenant la responsabilité du contenu médical de celui-ci. Il peut s’agir de l’auteur du document si celui-ci est une personne et s’il endosse la responsabilité du contenu médical de ses documents. Si l’auteur est un dispositif, cet attribut doit représenter la personne responsable de l’action effectuée par le dispositif.
Commentaires | Represents a participant within the author institution who has legally authenticated or attested the document. Legal authentication implies that a document has been signed manually or electronically by the legal Authenticator.
Control | 0..1
Type | Reference(AS PractitionerRole Profile, AS Organization Profile)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. DocumentReference.custodian
Définition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the document.
Short | Organization which maintains the document
Commentaires | Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. DocumentReference.relatesTo
Définition | Relationships that this document has with other document references that already exist.
Short | Relationships to other documents
Commentaires | This element is labeled as a modifier because documents that append to other documents are incomplete on their own.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. DocumentReference.relatesTo.id
Définition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Résumé | false
60. DocumentReference.relatesTo.extension
Définition | 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.
Short | Additional content defined by implementations
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Résumé | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
62. DocumentReference.relatesTo.modifierExtension
Définition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Résumé | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
64. DocumentReference.relatesTo.code
Définition | The type of relationship that this document has with anther document.
Short | replaces | transforms | signs | appends
Commentaires | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Control | 1..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. DocumentReference.relatesTo.target
Définition | The target document of this relationship.
Short | Target of the relationship
Control | 1..1
Type | Reference(DocumentReference)
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. DocumentReference.description
Définition | Human-readable description of the source document.
Short | Commentaire associé au document.
Commentaires | What the document is about, a terse summary of the document.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Requirements | Helps humans to assess whether the document is of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. DocumentReference.securityLabel
Définition | A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to.
Short | Contient les informations définissant le niveau de confidentialité d'un document.
Commentaires | The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce. In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | true
Requirements | Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) constr-bind-securityLabel: Les codes pour cet élément doivent provenir du ValueSet spécifié par le standard. Lorsqu’aucun code ne correspond au concept recherché, un code provenant de la terminologie de référence TRE_A07-StatusVisibiliteDocument, OID : 1.2.250.1.213.1.1.4.13 peut être utilisé. ()
72. DocumentReference.content
Définition | The document and format referenced.
Short | Document contenu.
Control | 1..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. DocumentReference.content.id
Définition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Résumé | false
76. DocumentReference.content.extension
Définition | 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.
Short | Additional content defined by implementations
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Résumé | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
78. DocumentReference.content.modifierExtension
Définition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Résumé | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
80. DocumentReference.content.attachment
Définition | The document or URL of the document along with critical metadata to prove content has integrity.
Short | Where to access the document
Control | 1..1
Type | Attachment
Is Modifier | false
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. DocumentReference.content.attachment.id
Définition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Résumé | false
84. DocumentReference.content.attachment.extension
Définition | 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.
Short | Additional content defined by implementations
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Résumé | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `DocumentReference.content.attachment.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
86. DocumentReference.content.attachment.contentType
Définition | Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.
Short | Mime type of the content, with charset etc.
Control | 1..1
Binding | The codes SHALL be taken from Mime Types (required to `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` ) The mime type of an attachment. Any valid mime type is allowed.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Processors of the data need to be able to know how to interpret the data.
Exemple | General: text/plain; charset=UTF-8, image/png
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. DocumentReference.content.attachment.language
Définition | The human language of the content. The value can be any valid value according to BCP 47.
Short | Pour tous les documents produits par les systèmes initiateurs français, le code est "fr-FR'.
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Bindings Additionnels | But
AllLanguages | Binding Max
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Requirements | Users need to be able to choose between the languages in a set of attachments.
Exemple | General: en-AU
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. DocumentReference.content.attachment.data
Définition | The actual data of the attachment - a sequence of bytes, base64 encoded.
Short | Le document est contenu dans l'élément .data au format base64.
Commentaires | The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.
Control | 1..1
Type | base64Binary
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | false
Requirements | The data needs to able to be transmitted inline.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. DocumentReference.content.attachment.url
Définition | A location where the data can be accessed.
Short | Uri where the data can be found
Commentaires | If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.
Control | 0..0
Type | url
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | The data needs to be transmitted by reference.
Exemple | General: http://www.acme.com/logo-small.png
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. DocumentReference.content.attachment.size
Définition | The number of bytes of data that make up this attachment (before base64 encoding, if that is done).
Short | Représente la taille du document.
Commentaires | The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.
Control | 0..1
Type | unsignedInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. DocumentReference.content.attachment.hash
Définition | The calculated hash of the data using SHA-1. Represented using base64.
Short | Représente le résultat de hachage du document (SHA 1).
Commentaires | The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.
Control | 0..1
Type | base64Binary
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. DocumentReference.content.attachment.title
Définition | A label or set of text to display in place of the data.
Short | Label to display in place of the data
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Résumé | true
Requirements | Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.
Exemple | General: Official Corporate Logo
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. DocumentReference.content.attachment.creation
Définition | The date that the attachment was first created.
Short | Représente la date et l’heure de création du document.
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Résumé | true
Requirements | This is often tracked as an integrity issue for use of the attachment.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. DocumentReference.content.format
Définition | An identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType.
Short | Format technique détaillé du document.
Commentaires | Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI.
Control | 0..1
Binding | The codes SHOULD be taken from JDV_J10_XdsFormatCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J10-XdsFormatCode-CISIS/FHIR/JDV-J10-XdsFormatCode-CISIS` )
Type | Coding
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) constr-bind-format: Les valeurs possibles pour cet élément doivent provenir d’une des terminologies de référence suivantes : - TRE_A06-FormatCodeComplementaire, OID : 1.2.250.1.213.1.1.4.2.282 - TRE_A11-IheFormatCode, OID : 1.3.6.1.4.1.19376.1.2.3 - TRE_A09-DICOMuidRegistry, OID : 1.2.840.10008.2.6.1 - TRE_A10-NomenclatureURN, OID : URN Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J60-FormatCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J10-XdsFormatCode-CISIS peut être utilisé. ()
104. DocumentReference.context
Définition | The clinical context in which the document was prepared.
Short | Clinical context of document
Commentaires | These values are primarily added to help with searching for interesting/relevant documents.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. DocumentReference.context.id
Définition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Résumé | false
108. DocumentReference.context.extension
Définition | 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.
Short | Additional content defined by implementations
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | false
Résumé | false
Alternate Names | extensions, user content
Invariants | ele-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. DocumentReference.context.modifierExtension
Définition | 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).
Short | Extensions that cannot be ignored even if unrecognized
Commentaires | 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Résumé | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
112. DocumentReference.context.encounter
Définition | Describes the clinical encounter or type of care that the document content is associated with.
Short | Context of the document content
Control | 0..*
Type | Reference(Encounter, EpisodeOfCare)
Is Modifier | false
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. DocumentReference.context.event
Définition | 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 type Code, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
Short | Représente les actes et les pathologies en rapport avec le document.
Commentaires | An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.
Control | 0..1
Binding | For 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.
Type | CodeableConcept
Is Modifier | false
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) constr-bind-context-event: Nomenclatures utilisées : 1) CCAM pour les actes médicaux (OID="1.2.250.1.213.2.5"); 2) CIM-10 pour les diagnostics de pathologie (OID="2.16.840.1.113883.6.3"), 3) TRE_A00-ProducteurDocNonPS pour les documents d'expression personnelle du patient, 4) autre ()
116. DocumentReference.context.period
Définition | The time period over which the service that is described by the document was provided.
Short | Time of service that is being documented
Control | 0..1
Type | Period
Is Modifier | false
Must Support | true
Résumé | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. DocumentReference.context.facilityType
Définition | The kind of facility where the patient was seen.
Short | Secteur d'activité lié à la prise en charge de la personne, en lien avec le document produit.
Control | 0..1
Binding | The codes SHOULD be taken from JDV_J02_XdsHealthcareFacilityTypeCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J02-XdsHealthcareFacilityTypeCode-CISIS/FHIR/JDV-J02-XdsHealthcareFacilityTypeCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) constr-bind-ProducteurDoc-simplified: L’utilisation de cette nomenclature est recommandée mais non obligatoire (prefered) : - TRE_R02-SecteurActivite, OID : 1.2.250.1.71.4.2.4 (lorsque l’auteur du document est un professionnel ou un équipement sous sa responsabilité) Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J61-HealthcareFacilityTypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J02-XdsHealthcareFacilityTypeCode-CISIS peut être utilisé. ()
120. DocumentReference.context.practiceSetting
Définition | This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty.
Short | Cadre d’exercice de l’acte qui a engendré la création du document.
Commentaires | This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.
Control | 0..1
Binding | The codes SHOULD be taken from JDV_J04_XdsPracticeSettingCode_CISIS (preferred to `https://mos.esante.gouv.fr/NOS/JDV_J04-XdsPracticeSettingCode-CISIS/FHIR/JDV-J04-XdsPracticeSettingCode-CISIS` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Résumé | false
Requirements | This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) constr-bind-ProducteurDoc-simplified: L’utilisation de cette nomenclature est recommandée mais non obligatoire (prefered) : - TRE_R02-SecteurActivite, OID : 1.2.250.1.71.4.2.4 (lorsque l’auteur du document est un professionnel ou un équipement sous sa responsabilité) Les valeurs possibles peuvent être restreintes en fonction du jeu de valeurs correspondant mis à disposition par le projet (exemple : JDV_J61-HealthcareFacilityTypeCode-DMP). En l’absence de spécifications complémentaires, le jeu de valeurs JDV_J02-XdsHealthcareFacilityTypeCode-CISIS peut être utilisé. ()
122. DocumentReference.context.sourcePatientInfo
Définition | The Patient Information as known when the document was published. May be a reference to a version specific, or contained.
Short | Référence vers la ressource Patient titulaire du dossier.
Control | 0..1
Type | Reference(FR Core Patient Profile)
Is Modifier | false
Must Support | true
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. DocumentReference.context.related
Définition | Related identifiers or resources associated with the DocumentReference.
Short | Related identifiers or resources
Commentaires | May be identifiers or resources that caused the DocumentReference or referenced Document to be created.
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Résumé | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)