This page is part of the Guide d'implémentation cahier de liaison (v3.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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Resource Profile: DocumentReference Cahier de Liaison

Profil de la ressource DocumentReference pour le cahier de liaison. Il regroupe les informations relatives à la note.

Usage:

• Use this Resource Profile: Bundle de création d'une note, Bundle de mise à jour d'une note and Bundle résultat recherche notes

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
isEmergency	S	0..*	boolean	L’urgence de la note qui permettra d’identifier la façon avec laquelle elle devra être prise en compte URL: https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
masterIdentifier	SΣ	0..1	Identifier	Identifiant de la note attribué par le système initiateur à l’origine de la création de la note ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	Le statut de la note. Les gestionnaires de cahiers de liaison ne supportant pas la suppression de notes peuvent proposer leur désactivation par mise à jour de leurs statuts Binding: DocumentReferenceStatus (required): The status of the document reference. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: JDV_J23-TypeNoteCahierLiaison-CISIS (required) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(FR Core Patient Profile)	Who/what is the subject of the document ele-1: All FHIR elements must have a @value or children
date	SΣ	0..1	instant	When this document reference was created ele-1: All FHIR elements must have a @value or children
author	SΣ	1..*	Reference(Device | FR Core Related Person Profile | FR Core Patient Profile | AS Practitioner Profile | AS PractitionerRole Profile | AS Organization Profile)	Auteur de la note. Il est préférable de privilégier la situation d'exercice (PractitionerRole) dans le cas où l'auteur est un professionnel. ele-1: All FHIR elements must have a @value or children
relatesTo	Σ	0..*	BackboneElement	Cet élément peut être utilisé pour lier des notes entre elles (note en réponse à une autre par exemple). Pour ce faire le code « appends » doit être utilisé dans relatesTo.code et relatesTo.reference doit pointer vers la note mère. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. ele-1: All FHIR elements must have a @value or children
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship ele-1: All FHIR elements must have a @value or children
description	SΣ	0..1	string	Human-readable description ele-1: All FHIR elements must have a @value or children
securityLabel	SΣ	0..1	CodeableConcept	Statut de visibilité de la note Binding: JDV_J110-StatutVisibiliteDocument-CISIS (required) ele-1: All FHIR elements must have a @value or children
content	SΣ	1..*	BackboneElement	Contenu de la note. Cet élément qui représente le contenu de la note est répétable. Pour une note avec du texte et une photo par exemple, deux instances de l’élément « content » peuvent être présentes : une pour représenter le texte et une pour représenter la photo. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
attachment	Σ	1..1	Attachment	Where to access the document ele-1: All FHIR elements must have a @value or children
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. ele-1: All FHIR elements must have a @value or children Example General: text/plain; charset=UTF-8, image/png
data	S	0..1	base64Binary	Data inline, base64ed ele-1: All FHIR elements must have a @value or children
url	SΣ	0..1	url	Uri where the data can be found ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/logo-small.png
title	SΣ	0..1	string	Label to display in place of the data ele-1: All FHIR elements must have a @value or children Example General: Official Corporate Logo
creation	SΣ	0..1	dateTime	Date attachment was first created ele-1: All FHIR elements must have a @value or children
context	SΣ	0..1	BackboneElement	Clinical context of document ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 from the FHIR Standard
DocumentReference.type	required	JDV_J23-TypeNoteCahierLiaison-CISIS https://mos.esante.gouv.fr/NOS/JDV_J23-TypeNoteCahierLiaison-CISIS/FHIR/JDV-J23-TypeNoteCahierLiaison-CISIS
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
DocumentReference.securityLabel	required	JDV_J110-StatutVisibiliteDocument-CISIS https://mos.esante.gouv.fr/NOS/JDV_J110-StatutVisibiliteDocument-CISIS/FHIR/JDV-J110-StatutVisibiliteDocument-CISIS
DocumentReference.content.attachment.contentType	required	Mime Types (a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	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	error	DocumentReference	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	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DocumentReference

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
isEmergency	S	0..*	boolean	L’urgence de la note qui permettra d’identifier la façon avec laquelle elle devra être prise en compte URL: https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency
masterIdentifier	S	0..1	Identifier	Identifiant de la note attribué par le système initiateur à l’origine de la création de la note
status	S	1..1	code	Le statut de la note. Les gestionnaires de cahiers de liaison ne supportant pas la suppression de notes peuvent proposer leur désactivation par mise à jour de leurs statuts
docStatus		0..0
type	S	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: JDV_J23-TypeNoteCahierLiaison-CISIS (required)
subject	S	1..1	Reference(FR Core Patient Profile)	Who/what is the subject of the document
date	S	0..1	instant	When this document reference was created
author	S	1..*	Reference(Device | FR Core Related Person Profile | FR Core Patient Profile | AS Practitioner Profile | AS PractitionerRole Profile | AS Organization Profile)	Auteur de la note. Il est préférable de privilégier la situation d'exercice (PractitionerRole) dans le cas où l'auteur est un professionnel.
authenticator		0..0
custodian		0..0
relatesTo		0..*	BackboneElement	Cet élément peut être utilisé pour lier des notes entre elles (note en réponse à une autre par exemple). Pour ce faire le code « appends » doit être utilisé dans relatesTo.code et relatesTo.reference doit pointer vers la note mère.
description	S	0..1	string	Human-readable description
securityLabel	S	0..1	CodeableConcept	Statut de visibilité de la note Binding: JDV_J110-StatutVisibiliteDocument-CISIS (required)
content	S	1..*	BackboneElement	Contenu de la note. Cet élément qui représente le contenu de la note est répétable. Pour une note avec du texte et une photo par exemple, deux instances de l’élément « content » peuvent être présentes : une pour représenter le texte et une pour représenter la photo.
attachment		1..1	Attachment	Where to access the document
contentType	S	0..1	code	Mime type of the content, with charset etc.
data	S	0..1	base64Binary	Data inline, base64ed
url	S	0..1	url	Uri where the data can be found
title	S	0..1	string	Label to display in place of the data
creation	S	0..1	dateTime	Date attachment was first created
context	S	0..1	BackboneElement	Clinical context of document
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.type	required	JDV_J23-TypeNoteCahierLiaison-CISIS https://mos.esante.gouv.fr/NOS/JDV_J23-TypeNoteCahierLiaison-CISIS/FHIR/JDV-J23-TypeNoteCahierLiaison-CISIS
DocumentReference.securityLabel	required	JDV_J110-StatutVisibiliteDocument-CISIS https://mos.esante.gouv.fr/NOS/JDV_J110-StatutVisibiliteDocument-CISIS/FHIR/JDV-J110-StatutVisibiliteDocument-CISIS

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
isEmergency	S	0..*	boolean	L’urgence de la note qui permettra d’identifier la façon avec laquelle elle devra être prise en compte URL: https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	SΣ	0..1	Identifier	Identifiant de la note attribué par le système initiateur à l’origine de la création de la note
identifier	Σ	0..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	Le statut de la note. Les gestionnaires de cahiers de liaison ne supportant pas la suppression de notes peuvent proposer leur désactivation par mise à jour de leurs statuts Binding: DocumentReferenceStatus (required): The status of the document reference.
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: JDV_J23-TypeNoteCahierLiaison-CISIS (required)
category	Σ	0..*	CodeableConcept	Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	SΣ	1..1	Reference(FR Core Patient Profile)	Who/what is the subject of the document
date	SΣ	0..1	instant	When this document reference was created
author	SΣ	1..*	Reference(Device | FR Core Related Person Profile | FR Core Patient Profile | AS Practitioner Profile | AS PractitionerRole Profile | AS Organization Profile)	Auteur de la note. Il est préférable de privilégier la situation d'exercice (PractitionerRole) dans le cas où l'auteur est un professionnel.
relatesTo	Σ	0..*	BackboneElement	Cet élément peut être utilisé pour lier des notes entre elles (note en réponse à une autre par exemple). Pour ce faire le code « appends » doit être utilisé dans relatesTo.code et relatesTo.reference doit pointer vers la note mère.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	SΣ	0..1	string	Human-readable description
securityLabel	SΣ	0..1	CodeableConcept	Statut de visibilité de la note Binding: JDV_J110-StatutVisibiliteDocument-CISIS (required)
content	SΣ	1..*	BackboneElement	Contenu de la note. Cet élément qui représente le contenu de la note est répétable. Pour une note avec du texte et une photo par exemple, deux instances de l’élément « content » peuvent être présentes : une pour représenter le texte et une pour représenter la photo.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Data inline, base64ed
url	SΣ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SΣ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	0..1	dateTime	Date attachment was first created
format	Σ	0..1	Coding	Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context	SΣ	0..1	BackboneElement	Clinical context of document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter		0..*	Reference(Encounter | EpisodeOfCare)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	Time of service that is being documented
facilityType		0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 from the FHIR Standard
DocumentReference.type	required	JDV_J23-TypeNoteCahierLiaison-CISIS https://mos.esante.gouv.fr/NOS/JDV_J23-TypeNoteCahierLiaison-CISIS/FHIR/JDV-J23-TypeNoteCahierLiaison-CISIS
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
DocumentReference.securityLabel	required	JDV_J110-StatutVisibiliteDocument-CISIS https://mos.esante.gouv.fr/NOS/JDV_J110-StatutVisibiliteDocument-CISIS/FHIR/JDV-J110-StatutVisibiliteDocument-CISIS
DocumentReference.content.attachment.contentType	required	Mime Types (a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard
DocumentReference.content.attachment.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.content.format	preferred	DocumentReferenceFormatCodeSet (a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem) http://hl7.org/fhir/ValueSet/formatcodes from the FHIR Standard
DocumentReference.context.event	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityType	example	FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodes from the FHIR Standard
DocumentReference.context.practiceSetting	example	PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	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	error	DocumentReference	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	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DocumentReference

Summary

Mandatory: 3 elements
Must-Support: 16 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

• FR Core Patient Profile (https://hl7.fr/ig/fhir/core/StructureDefinition/fr-core-patient)
• FR Core Related Person Profile (https://hl7.fr/ig/fhir/core/StructureDefinition/fr-core-related-person)
• AS Practitioner Profile (https://interop.esante.gouv.fr/ig/fhir/annuaire/StructureDefinition/as-practitioner)
• AS PractitionerRole Profile (https://interop.esante.gouv.fr/ig/fhir/annuaire/StructureDefinition/as-practitionerrole)
• AS Organization Profile (https://interop.esante.gouv.fr/ig/fhir/annuaire/StructureDefinition/as-organization)

Extensions

This structure refers to these extensions:

• https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
isEmergency	S	0..*	boolean	L’urgence de la note qui permettra d’identifier la façon avec laquelle elle devra être prise en compte URL: https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
masterIdentifier	SΣ	0..1	Identifier	Identifiant de la note attribué par le système initiateur à l’origine de la création de la note ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	Le statut de la note. Les gestionnaires de cahiers de liaison ne supportant pas la suppression de notes peuvent proposer leur désactivation par mise à jour de leurs statuts Binding: DocumentReferenceStatus (required): The status of the document reference. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: JDV_J23-TypeNoteCahierLiaison-CISIS (required) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(FR Core Patient Profile)	Who/what is the subject of the document ele-1: All FHIR elements must have a @value or children
date	SΣ	0..1	instant	When this document reference was created ele-1: All FHIR elements must have a @value or children
author	SΣ	1..*	Reference(Device | FR Core Related Person Profile | FR Core Patient Profile | AS Practitioner Profile | AS PractitionerRole Profile | AS Organization Profile)	Auteur de la note. Il est préférable de privilégier la situation d'exercice (PractitionerRole) dans le cas où l'auteur est un professionnel. ele-1: All FHIR elements must have a @value or children
relatesTo	Σ	0..*	BackboneElement	Cet élément peut être utilisé pour lier des notes entre elles (note en réponse à une autre par exemple). Pour ce faire le code « appends » doit être utilisé dans relatesTo.code et relatesTo.reference doit pointer vers la note mère. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. ele-1: All FHIR elements must have a @value or children
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship ele-1: All FHIR elements must have a @value or children
description	SΣ	0..1	string	Human-readable description ele-1: All FHIR elements must have a @value or children
securityLabel	SΣ	0..1	CodeableConcept	Statut de visibilité de la note Binding: JDV_J110-StatutVisibiliteDocument-CISIS (required) ele-1: All FHIR elements must have a @value or children
content	SΣ	1..*	BackboneElement	Contenu de la note. Cet élément qui représente le contenu de la note est répétable. Pour une note avec du texte et une photo par exemple, deux instances de l’élément « content » peuvent être présentes : une pour représenter le texte et une pour représenter la photo. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
attachment	Σ	1..1	Attachment	Where to access the document ele-1: All FHIR elements must have a @value or children
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. ele-1: All FHIR elements must have a @value or children Example General: text/plain; charset=UTF-8, image/png
data	S	0..1	base64Binary	Data inline, base64ed ele-1: All FHIR elements must have a @value or children
url	SΣ	0..1	url	Uri where the data can be found ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/logo-small.png
title	SΣ	0..1	string	Label to display in place of the data ele-1: All FHIR elements must have a @value or children Example General: Official Corporate Logo
creation	SΣ	0..1	dateTime	Date attachment was first created ele-1: All FHIR elements must have a @value or children
context	SΣ	0..1	BackboneElement	Clinical context of document ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 from the FHIR Standard
DocumentReference.type	required	JDV_J23-TypeNoteCahierLiaison-CISIS https://mos.esante.gouv.fr/NOS/JDV_J23-TypeNoteCahierLiaison-CISIS/FHIR/JDV-J23-TypeNoteCahierLiaison-CISIS
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
DocumentReference.securityLabel	required	JDV_J110-StatutVisibiliteDocument-CISIS https://mos.esante.gouv.fr/NOS/JDV_J110-StatutVisibiliteDocument-CISIS/FHIR/JDV-J110-StatutVisibiliteDocument-CISIS
DocumentReference.content.attachment.contentType	required	Mime Types (a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	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	error	DocumentReference	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	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from DocumentReference

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
isEmergency	S	0..*	boolean	L’urgence de la note qui permettra d’identifier la façon avec laquelle elle devra être prise en compte URL: https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency
masterIdentifier	S	0..1	Identifier	Identifiant de la note attribué par le système initiateur à l’origine de la création de la note
status	S	1..1	code	Le statut de la note. Les gestionnaires de cahiers de liaison ne supportant pas la suppression de notes peuvent proposer leur désactivation par mise à jour de leurs statuts
docStatus		0..0
type	S	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: JDV_J23-TypeNoteCahierLiaison-CISIS (required)
subject	S	1..1	Reference(FR Core Patient Profile)	Who/what is the subject of the document
date	S	0..1	instant	When this document reference was created
author	S	1..*	Reference(Device | FR Core Related Person Profile | FR Core Patient Profile | AS Practitioner Profile | AS PractitionerRole Profile | AS Organization Profile)	Auteur de la note. Il est préférable de privilégier la situation d'exercice (PractitionerRole) dans le cas où l'auteur est un professionnel.
authenticator		0..0
custodian		0..0
relatesTo		0..*	BackboneElement	Cet élément peut être utilisé pour lier des notes entre elles (note en réponse à une autre par exemple). Pour ce faire le code « appends » doit être utilisé dans relatesTo.code et relatesTo.reference doit pointer vers la note mère.
description	S	0..1	string	Human-readable description
securityLabel	S	0..1	CodeableConcept	Statut de visibilité de la note Binding: JDV_J110-StatutVisibiliteDocument-CISIS (required)
content	S	1..*	BackboneElement	Contenu de la note. Cet élément qui représente le contenu de la note est répétable. Pour une note avec du texte et une photo par exemple, deux instances de l’élément « content » peuvent être présentes : une pour représenter le texte et une pour représenter la photo.
attachment		1..1	Attachment	Where to access the document
contentType	S	0..1	code	Mime type of the content, with charset etc.
data	S	0..1	base64Binary	Data inline, base64ed
url	S	0..1	url	Uri where the data can be found
title	S	0..1	string	Label to display in place of the data
creation	S	0..1	dateTime	Date attachment was first created
context	S	0..1	BackboneElement	Clinical context of document
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.type	required	JDV_J23-TypeNoteCahierLiaison-CISIS https://mos.esante.gouv.fr/NOS/JDV_J23-TypeNoteCahierLiaison-CISIS/FHIR/JDV-J23-TypeNoteCahierLiaison-CISIS
DocumentReference.securityLabel	required	JDV_J110-StatutVisibiliteDocument-CISIS https://mos.esante.gouv.fr/NOS/JDV_J110-StatutVisibiliteDocument-CISIS/FHIR/JDV-J110-StatutVisibiliteDocument-CISIS

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
DocumentReference		0..*	DocumentReference	A reference to a document
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
isEmergency	S	0..*	boolean	L’urgence de la note qui permettra d’identifier la façon avec laquelle elle devra être prise en compte URL: https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	SΣ	0..1	Identifier	Identifiant de la note attribué par le système initiateur à l’origine de la création de la note
identifier	Σ	0..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	Le statut de la note. Les gestionnaires de cahiers de liaison ne supportant pas la suppression de notes peuvent proposer leur désactivation par mise à jour de leurs statuts Binding: DocumentReferenceStatus (required): The status of the document reference.
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: JDV_J23-TypeNoteCahierLiaison-CISIS (required)
category	Σ	0..*	CodeableConcept	Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	SΣ	1..1	Reference(FR Core Patient Profile)	Who/what is the subject of the document
date	SΣ	0..1	instant	When this document reference was created
author	SΣ	1..*	Reference(Device | FR Core Related Person Profile | FR Core Patient Profile | AS Practitioner Profile | AS PractitionerRole Profile | AS Organization Profile)	Auteur de la note. Il est préférable de privilégier la situation d'exercice (PractitionerRole) dans le cas où l'auteur est un professionnel.
relatesTo	Σ	0..*	BackboneElement	Cet élément peut être utilisé pour lier des notes entre elles (note en réponse à une autre par exemple). Pour ce faire le code « appends » doit être utilisé dans relatesTo.code et relatesTo.reference doit pointer vers la note mère.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	SΣ	0..1	string	Human-readable description
securityLabel	SΣ	0..1	CodeableConcept	Statut de visibilité de la note Binding: JDV_J110-StatutVisibiliteDocument-CISIS (required)
content	SΣ	1..*	BackboneElement	Contenu de la note. Cet élément qui représente le contenu de la note est répétable. Pour une note avec du texte et une photo par exemple, deux instances de l’élément « content » peuvent être présentes : une pour représenter le texte et une pour représenter la photo.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Data inline, base64ed
url	SΣ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SΣ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	0..1	dateTime	Date attachment was first created
format	Σ	0..1	Coding	Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context	SΣ	0..1	BackboneElement	Clinical context of document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter		0..*	Reference(Encounter | EpisodeOfCare)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	Time of service that is being documented
facilityType		0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 from the FHIR Standard
DocumentReference.type	required	JDV_J23-TypeNoteCahierLiaison-CISIS https://mos.esante.gouv.fr/NOS/JDV_J23-TypeNoteCahierLiaison-CISIS/FHIR/JDV-J23-TypeNoteCahierLiaison-CISIS
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
DocumentReference.securityLabel	required	JDV_J110-StatutVisibiliteDocument-CISIS https://mos.esante.gouv.fr/NOS/JDV_J110-StatutVisibiliteDocument-CISIS/FHIR/JDV-J110-StatutVisibiliteDocument-CISIS
DocumentReference.content.attachment.contentType	required	Mime Types (a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 from the FHIR Standard
DocumentReference.content.attachment.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.content.format	preferred	DocumentReferenceFormatCodeSet (a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem) http://hl7.org/fhir/ValueSet/formatcodes from the FHIR Standard
DocumentReference.context.event	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityType	example	FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodes from the FHIR Standard
DocumentReference.context.practiceSetting	example	PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	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	error	DocumentReference	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	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DocumentReference

Summary

Mandatory: 3 elements
Must-Support: 16 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

• FR Core Patient Profile (https://hl7.fr/ig/fhir/core/StructureDefinition/fr-core-patient)
• FR Core Related Person Profile (https://hl7.fr/ig/fhir/core/StructureDefinition/fr-core-related-person)
• AS Practitioner Profile (https://interop.esante.gouv.fr/ig/fhir/annuaire/StructureDefinition/as-practitioner)
• AS PractitionerRole Profile (https://interop.esante.gouv.fr/ig/fhir/annuaire/StructureDefinition/as-practitionerrole)
• AS Organization Profile (https://interop.esante.gouv.fr/ig/fhir/annuaire/StructureDefinition/as-organization)

Extensions

This structure refers to these extensions:

• https://interop.esante.gouv.fr/ig/fhir/cdl/StructureDefinition/cdl-ext-is-emergency

Other representations of profile: CSV, Excel, Schematron