This page is part of the FHIR eMedication exchange formats for the implementation effort of CARA within its EPR community (v1.0.0: STU1) 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

Guidance Compositions

Definitions

The documents defined in this guide (MTP, DIS, PADV, PML, PMLc, PRE) are all FHIR documents. As such they all have the same structure, which is well described in the FHIR documentation.

This page outlines some important aspects of the document’s structure and give several pointers towards useful documentations.

FHIR documents are a special type of FHIR Bundles, with type = "document". The first entry of the document bundle is always a composition, that is a structure containing references towards resources.

Example

The example below shows the skeletton of the FHIR’s discharge summary document.

• The resource is of Bundle of type "document"
• It contains a series of entries
• The first entry is a ressource of type "composition", that references other entries by "fullUrl"

  {
  "resourceType": "Bundle",
    ...
  "type": "document",
  "entry": [
    {
      "resource": {
        "resourceType": "Composition",
        ...
        "section": [
          {
            "title": "Reason for admission",
            ...
            "entry": [
              {
                "reference": "urn:uuid:541a72a8-df75-4484-ac89-ac4923f03b81"
              }
            ]
          },
          {
            "title": "Medications on Discharge",
            ...
            "entry": [
              {
                "reference": "urn:uuid:124a6916-5d84-4b8c-b250-10cefb8e6e86"
              },
              {
                "reference": "urn:uuid:673f8db5-0ffd-4395-9657-6da00420bbc1"
              }
            ]
          },
          {
            "title": "Known allergies",
           ...
            "entry": [
              {
                "reference": "urn:uuid:47600e0f-b6b5-4308-84b5-5dec157f7637"
              }
            ]
          }
        ]
      }
    },
    ...
    {
      "fullUrl": "urn:uuid:541a72a8-df75-4484-ac89-ac4923f03b81",
      "resource": {
        "resourceType": "Observation",
        ...
      }
    },
    {
      "fullUrl": "urn:uuid:124a6916-5d84-4b8c-b250-10cefb8e6e86",
      "resource": {
        "resourceType": "MedicationRequest",
        ...
      }
    },
    {
      "fullUrl": "urn:uuid:673f8db5-0ffd-4395-9657-6da00420bbc1",
      "resource": {
        "resourceType": "MedicationStatement",
        ...
      }
    },
    {
      "fullUrl": "urn:uuid:47600e0f-b6b5-4308-84b5-5dec157f7637",
      "resource": {
        "resourceType": "AllergyIntolerance",
        ...
      }
    }
  ],
   ...
  }
  

Processing documents

When processing a FHIR document, one should always start by reading the composition and then follow the references instead of listing every entry first.

Contained resources

In some cases, resources must be contained instead of referenced. This happens when a resource has no independant existance, that is it is only meaningful in the context of the containing resource.

In the eMedication context, this is the case for the medication resource, that must always be contained in a medication statement resource : medication only exists within the context of a medication statement.