FR Document Core (FHIR)
0.1.0 - ci-build

FR Document Core (FHIR), published by Agence du Numérique en Santé (ANS) - 2-10 Rue d'Oradour-sur-Glane, 75015 Paris. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ansforge/interop-IG-fhir-document-core/ and changes regularly. See the Directory of published versions

## Accueil

Official URL: https://interop.esante.gouv.fr/ig/fhir/document-core/ImplementationGuide/ans.fhir.fr.document-core | Version: 0.1.0 | Highlight text changes?
Draft as of 2026-08-07 | Computable Name: FHIRFRDocumentCore

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Guide de mise en œuvre FHIR des documents dématérialisés produits en France dans le domaine sanitaire et le domaine médico-social.
FHIR implementation guide of dematerialized health and medico-social documents produced in France.

> Attention ! Cet Implementation Guide n'est pas en version courante. La version courante sera accessible via l'URL canonique suite à la première release : https://interop.esante.gouv.fr/ig/fhir/document-core

⚠️ Version de test
Cette publication est une version de test. Elle ne doit pas être utilisée en production.

### Introduction

Le partage dans Mon espace santé et l'échange par messagerie sécurisée de santé des documents médicaux et médico-sociaux permet d'améliorer la continuité et la coordination des soins.

Le Cadre d'interopérabilité des Systèmes d'Information de Santé (CI-SIS) fixe les règles syntaxiques et sémantiques spécifiques à la France et permettant de produire ces documents afin qu'ils soient :

- compréhensibles par les professionnels des secteurs sanitaire et médico-social et les patients/usagers,
- exploitables par les SI pour permettre la mise en œuvre de services à valeurs ajoutées à partir des données structurées contenues dans ces documents.

Ce guide présente l'implémentation FHIR du modèle logique générique des documents médicaux et médico-sociaux, dont le modèle métier est défini dans le guide FR Document Core (Modèle métier).

Il fait partie du CI-SIS.

### Gouvernance

Ce guide d'implémentation FR Document Core (FHIR) est géré par l'Agence du Numérique en Santé (ANS).

### Droits de propriété intellectuelle

Pour les ressources syntaxiques :

Certaines ressources syntaxiques de ce guide sont protégées par des droits de propriété intellectuelle. L'utilisation de ces ressources est soumise à l'acceptation et au respect des conditions précisées dans la licence d'utilisation de chacune d'entre elle.

Les principales ressources syntaxiques utilisées dans le CI-SIS sont :

- HL7® FHIR® standard: FHIR is copyright© Health Level Seven International (HL7®). Pour plus d'information, voir : https://hl7.org/fhir/license.html.
- IHE Integration Profile Specification: IHE is copyright© 2025 IHE International. Pour plus d'information, voir : https://www.ihe.net/about_ihe/governance/#Intellectual_Property

Pour les ressources sémantiques :

Certaines ressources sémantiques de ce guide sont protégées par des droits de propriété intellectuelle couverte par les déclarations ci-dessous. L’utilisation de ces ressources est soumise à l’acceptation et au respect des conditions précisées dans la licence d’utilisation de chacune d’entre elle.

- CC BY-ND 3.0 IGO
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  - Classification anatomique, thérapeutique et chimique: FRImmunizationDocument, FRImmunizationRecommendationDocument, FRMedicationDocument and FRValueSetMedicationTranslationDocument
- CC BY 4.0
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  - Dictionnaire européen multilingue des substances entrant dans la composition de médicaments: FRAllergyIntoleranceDocument, FRMedicationDocument, FRValueSetAllergyCodeDocument and FRValueSetAllergySubstanceDocument
  - Standard Terms Data Base Dictionnaire européen multilingue de termes normalisés descripteurs de médicaments: FRImmunizationDocument, FRMedicationAdministrationDocument... Show 6 more, FRMedicationDispenseDocument, FRMedicationDocument, FRMedicationRequestDocument, FRMedicationStatementDocument, FRValueSetEDQMDocument and FRValueSetEDQMFormDocument
- LOv2
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  - Base de données publique du médicament: FRAllergyIntoleranceDocument, FRImmunizationDocument... Show 5 more, FRImmunizationRecommendationDocument, FRMedicationDocument, FRValueSetAllergyCodeDocument, FRValueSetMedicationTranslationDocument and FRValueSetVaccineCodeCISDocument
  - Classification Commune des Actes Médicaux: FRProcedureDocument and FRValueSetProcedureCodeDocument
- ISO maintains the copyright on the country codes, and controls its use carefully. For further details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
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  - ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: FHIRFRDocumentCore, FRAccessionNumberIdentifierDocument... Show 91 more, FRActorExtension, FRAdvanceDirectiveDocument, FRAdverseEventDocument, FRAllergyIntoleranceDocument, FRAuthorTimeExtension, FRBodyStructureDocument, FRBundleDocument, FRCSNoteType, FRCarePlanDocument, FRComparisonStudiesExtension, FRCompositionDocument, FRConditionDocument, FRDeviceAuteurDocument, FRDeviceRequestDocument, FRDeviceUseStatementDocument, FRDiagnosticReportBIOChapterDocument, FRDiagnosticReportDocument, FRDiagnosticReportImagingDocument, FRDocumentReferenceDocument, FREncounterCareDocument, FREncounterDocument, FREndpointWadoDocument, FRFamilyMemberHistoryBodySiteExtension, FRFamilyMemberHistoryDocument, FRHumanNameDocument, FRImagingProcedureExtension, FRImagingStudyDocument, FRImmunizationDocument, FRImmunizationRecommendationDocument, FRImmunizationTypeExtension, FRInterpretationExtension, FRLocationDocument, FRMediaDocument, FRMedicationAdministrationDocument, FRMedicationAdministrationSequenceExtension, FRMedicationDispenseDocument, FRMedicationDocument, FRMedicationRequestDocument, FRMedicationStatementDocument, FRMethodExtension, FRNotCoveredExtension, FRNoteTypeExtension, FRNumberOfFramesExtension, FRObservationALDDocument, FRObservationAssessmentDocument, FRObservationContraIndicationsImagingDocument, FRObservationLaboratoryReportResultsDocument, FRObservationMicroorganismDetectionDocument, FRObservationMultiresistantMicroorganismsIdentificationDocument, FRObservationPainScoreDocument, FRObservationPregnancyDocument, FRObservationPregnancyHistoryDocument, FRObservationPreventionDocument, FRObservationRadiationExposureDocument, FRObservationResultDocument, FRObservationSocialHistoryDocument, FRObservationVitalSignsDocument, FRObservationVitalSignsPanelDocument, FRObservationWorkRelatedAccidentDocument, FROrganizationDocument, FRPatientDocument, FRPatientHistoryExtension, FRPatientINSDocument, FRPerformerEventExtension, FRPractitionerDocument, FRPractitionerRoleDocument, FRProcedureDifficultyExtension, FRProcedureDocument, FRProcedureImagingDocument, FRProcedurePriorityExtension, FRRelatedPersonDocument, FRServiceRequestDocument, FRServiceRequestImagingDocument, FRSpecimenDocument, FRStatusReasonExtension, FRStudyInstanceUidIdentifierDocument, FRTaskPatientTransportDocument, FRValueSetActorTypeDocument, FRValueSetAllergyCodeDocument, FRValueSetAllergyInoleranceTypeDocument, FRValueSetAllergySubstanceDocument, FRValueSetEDQMDocument, FRValueSetEDQMFormDocument, FRValueSetEvaluationTypeDocument, FRValueSetLocationBodyStructureDocument, FRValueSetMedicationTranslationDocument, FRValueSetNoteType, FRValueSetParticipationType, FRValueSetProcedureCodeDocument, FRValueSetRolePriseCharge and FRValueSetVaccineCodeCISDocument
- Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved.
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  - International Classification of Functioning, Disability and Health: FRObservationAssessmentDocument and FRValueSetEvaluationTypeDocument
- The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
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  - Unified Code for Units of Measure (UCUM): FRObservationVitalSignsDocument
- The WHO grants a license for "commercial and non-commercial use" of ICD-11CC BY-ND 3.0 IGODetailed information can be found here: https://icd.who.int/en/docs/icd11-license.pdf Contact licensing@who.int to obtain further information.
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  - International Classification of Diseases, 11th Revision Mortality and Morbidity Statistics (MMS): FRAllergyIntoleranceDocument and FRValueSetAllergyCodeDocument
- These codes are excerpted from Digital Imaging and Communications in Medicine (DICOM) Standard, Part 16: Content Mapping Resource, Copyright © 2011 by the National Electrical Manufacturers Association.
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  - DICOM Controlled Terminology Definitions: FRCompositionDocument, FRImagingStudyDocument and FRObservationRadiationExposureDocument
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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  - LOINC: FRAdvanceDirectiveDocument, FRCompositionDocument... Show 10 more, FRDiagnosticReportBIOChapterDocument, FRDiagnosticReportDocument, FRDiagnosticReportImagingDocument, FRObservationAssessmentDocument, FRObservationPregnancyDocument, FRObservationRadiationExposureDocument, FRObservationSocialHistoryDocument, FRObservationVitalSignsDocument, FRProcedureImagingDocument and FRValueSetEvaluationTypeDocument
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  - SNOMED Clinical Terms&reg; (SNOMED CT&reg;): FRAdvanceDirectiveDocument, FRAdverseEventDocument... Show 20 more, FRAllergyIntoleranceDocument, FRBodyStructureDocument, FRConditionDocument, FREncounterDocument, FRFamilyMemberHistoryBodySiteExtension, FRFamilyMemberHistoryDocument, FRImagingStudyDocument, FRImmunizationDocument, FRMedicationAdministrationDocument, FRMedicationRequestDocument, FRMedicationStatementDocument, FRObservationContraIndicationsImagingDocument, FRObservationPainScoreDocument, FRObservationVitalSignsDocument, FRProcedureDifficultyExtension, FRProcedureDocument, FRProcedureImagingDocument, FRServiceRequestDocument, FRSpecimenDocument and FRValueSetAllergyInoleranceTypeDocument
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
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  - AllergyIntolerance Clinical Status Codes: AllergyIntolerance/example-allergy-intolerance-data-absent-reason
  - AllergyIntolerance Verification Status: AllergyIntolerance/example-allergy-intolerance-data-absent-reason
  - Consent Scope Codes: FRAdvanceDirectiveDocument
  - Observation Category Codes: FRObservationAssessmentDocument and FRObservationSocialHistoryDocument
  - identifierType: FRAccessionNumberIdentifierDocument, FRPatientDocument and FRPatientINSDocument
  - providerRole: FRImmunizationDocument
  - specimenType: FRSpecimenDocument
  - ActCode: FRImmunizationDocument, FRImmunizationTypeExtension and FRMedicationDispenseDocument
  - ActPriority: FRProcedurePriorityExtension
  - ObservationInterpretation: FRInterpretationExtension, FRObservationContraIndicationsImagingDocument... Show 7 more, FRObservationLaboratoryReportResultsDocument, FRObservationMicroorganismDetectionDocument, FRObservationMultiresistantMicroorganismsIdentificationDocument, FRObservationPregnancyDocument, FRObservationResultDocument, FRObservationVitalSignsDocument and FRObservationWorkRelatedAccidentDocument
  - ObservationMethod: FRMethodExtension, FRObservationContraIndicationsImagingDocument... Show 5 more, FRObservationMicroorganismDetectionDocument, FRObservationMultiresistantMicroorganismsIdentificationDocument, FRObservationPregnancyDocument, FRObservationResultDocument and FRObservationWorkRelatedAccidentDocument
  - ParticipationType: FRActorExtension, FRCompositionDocument, FRObservationLaboratoryReportResultsDocument, FRValueSetActorTypeDocument and FRValueSetParticipationType
  - RoleClass: FRPatientINSDocument
  - RoleCode: FRFamilyMemberHistoryDocument
  - SpecimenType: FRSpecimenDocument
  - Substance Admin Substitution: FRMedicationRequestDocument

Les terminologies publiées sur le Serveur Multi-terminologies (SMT) de l'ANS précisent la licence d'utilisation associée.

Pour les terminologies qui ne sont pas publiées dans le SMT, se renseigner auprès de l'unité de production.

### Dépendances

IG | Package | FHIR | Comment
--- | --- | --- | ---
FR Document Core (FHIR) | ans.fhir.fr.document-core#0.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.3.0 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.3.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.1.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 |
Guide d'implémentation Fr Core | hl7.fhir.fr.core#2.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.0.2 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.1.0 | R4 |
Nomenclatures des objets de santé (NOS) | ans.fr.nos#1.3.0 | R4 |
Extensions for Using Data Elements from FHIR R5 in FHIR R4 | hl7.fhir.uv.xver-r5.r4#0.1.0 | R4 |
Annuaire Santé | ans.fhir.fr.annuaire#1.1.0 | R4 |
Nomenclatures des objets de santé (NOS) | ans.fr.nos#1.5.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.2.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.5.0 | R4 |
FHIR Clinical Documents | hl7.fhir.uv.fhir-clinical-document#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.2.0 | R4 |
Medication Prescription and Dispense (MPD) | ihe.pharm.mpd#1.0.0-comment-2 | R5 |
HL7 Terminology (THO) | hl7.terminology.r5#6.3.0 | R5 |
Terminologies de Santé | ans.fr.terminologies#1.11.1 | R4 |
International Patient Summary Implementation Guide | hl7.fhir.uv.ips#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.0.0 | R4 |
fhir.dicom | fhir.dicom#2022.4.20221006 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#1.1.2 | R4 | for example references

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.extensions.r4#5.3.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, May 16, 2026 18:32+1000+10:00)

Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package ans.fr.nos#1.3.0 Les nomenclatures des objets de Sante (built Thu, Aug 29, 2024 14:54+0000+00:00)

Package hl7.fhir.uv.xver-r5.r4#0.1.0 Extensions for Using Data Elements from FHIR R5 in FHIR R4 (built Fri, Mar 20, 2026 15:40+1100+11:00)

Package ans.fr.nos#1.5.0 Les nomenclatures des objets de Sante (built Tue, Feb 11, 2025 10:50+0000+00:00)

Package ans.fhir.fr.annuaire#1.1.0 Ressources de conformité basées sur le modèle d'exposition de l'Annuaire Santé. (built Mon, Apr 14, 2025 13:04+0000+00:00)

Package ihe.pharm.mpd#1.0.0-comment-2 ImplementationGuide for IHE Pharmacy Medication Prescription and Dispense (MPD) profile (built Tue, May 27, 2025 16:32+0200+02:00)

Package hl7.fhir.uv.ips#1.1.0 International Patient Summary (IPS) FHIR Implementation Guide (built Tue, Nov 22, 2022 03:24+0000+00:00)

Package ans.fr.terminologies#1.11.1 Les nomenclatures des objets de Santé sont mises à disposition du secteur santé-social par l’agence du numérique en santé (built Tue, Jul 7, 2026 20:48+0000+00:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)