Médicosocial - Suivi Décisions Orientation
4.0.1 - STU1

This page is part of the Médicosocial - Suivi Décisions Orientation (v4.0.1: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: ESMSDocumentReference

Official URL: https://interop.esante.gouv.fr/ig/fhir/sdo/StructureDefinition/esms-document-reference Version: 4.0.1
Active as of 2023-06-27 Computable Name: ESMSDocumentReference

Profil pour définir le dossier ESMS

Usage:

Formal Views of Profile Content

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

This structure is derived from SDODocumentReference

Summary

Mandatory: 1 element

This structure is derived from SDODocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
​.. DocumentReference 0..*SDODocumentReferenceA reference to a document
​... identifier 2..*IdentifierOther identifiers for the document
​... type 1..1CodeableConceptKind of document (LOINC if possible)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..*SDODocumentReferenceA reference to a document
... id Σ0..1idLogical id of this artifact
... meta ΣN0..1MetaMetadata about the resource
... implicitRules ?!ΣN0..1uriA set of rules under which this content was created
... text N0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
... modifierExtension ?!N0..*ExtensionExtensions that cannot be ignored
Slice: Unordered, Open by value:url
... masterIdentifier ΣN0..1IdentifierMaster Version Specific Identifier
... identifier Σ2..*IdentifierOther identifiers for the document
... status ?!ΣN1..1codecurrent | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.

... docStatus ΣN0..1codepreliminary | final | amended | entered-in-error
Binding: CompositionStatus (required): Status of the underlying document.

... type Σ1..1CodeableConceptKind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category ΣN0..*CodeableConceptCategorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject ΣCN0..1Reference(Patient | Practitioner | Group | Device)Who/what is the subject of the document
... date ΣN0..1instantWhen this document reference was created
... author ΣCN0..*Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson)Who and/or what authored the document
... authenticator CN0..1Reference(Practitioner | PractitionerRole | Organization)Who/what authenticated the document
... custodian CN0..1Reference(Organization)Organization which maintains the document
... relatesTo ΣN0..*BackboneElementRelationships to other documents
.... id 0..1stringUnique id for inter-element referencing
.... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!ΣN0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣN1..1codereplaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target ΣCN1..1Reference(DocumentReference)Target of the relationship
... description ΣN0..1stringHuman-readable description
... securityLabel ΣN0..*CodeableConceptDocument security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ1..1BackboneElementDocument referenced
.... id 0..1stringUnique id for inter-element referencing
.... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!ΣN0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... attachment ΣCN1..1AttachmentWhere to access the document
.... format ΣN0..1CodingFormat/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context ΣN0..1BackboneElementClinical context of document
.... id 0..1stringUnique id for inter-element referencing
.... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!ΣN0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... encounter CN0..*Reference(Encounter | EpisodeOfCare)Context of the document content
.... event N0..*CodeableConceptMain clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period ΣCN0..1PeriodTime of service that is being documented
.... facilityType N0..1CodeableConceptKind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.

.... practiceSetting N0..1CodeableConceptAdditional 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 CN0..1Reference(Patient)Patient demographics from source
.... related CN0..*Reference(Resource)Related identifiers or resources

doco Documentation for this format

This structure is derived from SDODocumentReference

Summary

Mandatory: 1 element

Differential View

This structure is derived from SDODocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
​.. DocumentReference 0..*SDODocumentReferenceA reference to a document
​... identifier 2..*IdentifierOther identifiers for the document
​... type 1..1CodeableConceptKind of document (LOINC if possible)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..*SDODocumentReferenceA reference to a document
... id Σ0..1idLogical id of this artifact
... meta ΣN0..1MetaMetadata about the resource
... implicitRules ?!ΣN0..1uriA set of rules under which this content was created
... text N0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
... modifierExtension ?!N0..*ExtensionExtensions that cannot be ignored
Slice: Unordered, Open by value:url
... masterIdentifier ΣN0..1IdentifierMaster Version Specific Identifier
... identifier Σ2..*IdentifierOther identifiers for the document
... status ?!ΣN1..1codecurrent | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.

... docStatus ΣN0..1codepreliminary | final | amended | entered-in-error
Binding: CompositionStatus (required): Status of the underlying document.

... type Σ1..1CodeableConceptKind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category ΣN0..*CodeableConceptCategorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject ΣCN0..1Reference(Patient | Practitioner | Group | Device)Who/what is the subject of the document
... date ΣN0..1instantWhen this document reference was created
... author ΣCN0..*Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson)Who and/or what authored the document
... authenticator CN0..1Reference(Practitioner | PractitionerRole | Organization)Who/what authenticated the document
... custodian CN0..1Reference(Organization)Organization which maintains the document
... relatesTo ΣN0..*BackboneElementRelationships to other documents
.... id 0..1stringUnique id for inter-element referencing
.... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!ΣN0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣN1..1codereplaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target ΣCN1..1Reference(DocumentReference)Target of the relationship
... description ΣN0..1stringHuman-readable description
... securityLabel ΣN0..*CodeableConceptDocument security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ1..1BackboneElementDocument referenced
.... id 0..1stringUnique id for inter-element referencing
.... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!ΣN0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... attachment ΣCN1..1AttachmentWhere to access the document
.... format ΣN0..1CodingFormat/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context ΣN0..1BackboneElementClinical context of document
.... id 0..1stringUnique id for inter-element referencing
.... extension N0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!ΣN0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... encounter CN0..*Reference(Encounter | EpisodeOfCare)Context of the document content
.... event N0..*CodeableConceptMain clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period ΣCN0..1PeriodTime of service that is being documented
.... facilityType N0..1CodeableConceptKind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.

.... practiceSetting N0..1CodeableConceptAdditional 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 CN0..1Reference(Patient)Patient demographics from source
.... related CN0..*Reference(Resource)Related identifiers or resources

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
DocumentReference.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.statusrequiredDocumentReferenceStatus
DocumentReference.docStatusrequiredCompositionStatus
DocumentReference.typepreferredDocumentTypeValueSet
DocumentReference.categoryexampleDocumentClassValueSet
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
DocumentReference.securityLabelextensibleAll Security Labels
DocumentReference.content.formatpreferredDocumentReferenceFormatCodeSet (a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem)
DocumentReference.context.eventexampleActCode
DocumentReference.context.facilityTypeexampleFacilityTypeCodeValueSet
DocumentReference.context.practiceSettingexamplePracticeSettingCodeValueSet

Constraints

IdGradePath(s)DetailsRequirements
att-1errorDocumentReference.content.attachmentIf the Attachment has data, it SHALL have a contentType
: data.empty() or contentType.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** elementsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
per-1errorDocumentReference.context.periodIf present, start SHALL have a lower value than end
: start.hasValue().not() or end.hasValue().not() or (start <= end)
ref-1errorDocumentReference.subject, DocumentReference.author, DocumentReference.authenticator, DocumentReference.custodian, DocumentReference.relatesTo.target, DocumentReference.context.encounter, DocumentReference.context.sourcePatientInfo, DocumentReference.context.relatedSHALL have a contained resource if a local reference is provided
: reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))