HL7 FHIR Costa Rica - Core
0.0.1-ballot - ci-build Costa Rica flag

HL7 FHIR Costa Rica - Core, published by Iniciativa HL7 Costa Rica. This guide is not an authorized publication; it is the continuous build for version 0.0.1-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cr/core/ and changes regularly. See the Directory of published versions

Resource Profile: CRCoreBundleDoc - Detailed Descriptions

Page standards status: Draft Maturity Level: 0

Definitions for the cr-core-bundle-doc resource profile.

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

0. Bundle
Definition

A container for a collection of resources.

ShortContains a collection of resources
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsbdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
bdl-2: entry.search only when a search ((type = 'searchset') or entry.search.empty())
bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) ((type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct())
bdl-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource (type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus))
bdl-14: entry.request.method PATCH not allowed for history (type = 'history' implies entry.request.method != 'PATCH')
bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated (type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST'))
bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. (issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning'))
bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. (type = 'document' implies issues.empty())
bdl-18: Self link is required for searchsets. (type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists())
bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements (type in ('document' | 'message' | 'searchset' | 'collection') implies entry.all(resource.exists() and request.empty() and response.empty()))
bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH (type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' | 'PATCH' | 'PUT')) = resource.exists())))
bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH (type in ('transaction' | 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' | 'PATCH' | 'PUT')) = resource.exists())))
bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements (type in ('transaction-response' | 'batch-response') implies entry.all(response.exists()))
bdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
bdl-2: entry.search only when a search ((type = 'searchset') or entry.search.empty())
bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) ((type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct())
bdl-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource (type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus))
bdl-14: entry.request.method PATCH not allowed for history (type = 'history' implies entry.request.method != 'PATCH')
bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated (type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST'))
bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. (issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning'))
bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. (type = 'document' implies issues.empty())
bdl-18: Self link is required for searchsets. (type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists())
bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements (type in ('document' | 'message' | 'searchset' | 'collection') implies entry.all(resource.exists() and request.empty() and response.empty()))
bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH (type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' | 'PATCH' | 'PUT')) = resource.exists())))
bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH (type in ('transaction' | 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' | 'PATCH' | 'PUT')) = resource.exists())))
bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements (type in ('transaction-response' | 'batch-response') implies entry.all(response.exists()))
2. Bundle.implicitRules
Definition

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.

ShortA set of rules under which this content was created
Comments

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 its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Bundle.identifier
Definition

Identificador único del documento clínico, como un número de informe o código asignado por el sistema de gestión de documentos.


A persistent identifier for the bundle that won't change as a bundle is copied from server to server.

ShortIdentificador único del documento clínico.Persistent identifier for the bundle
Comments

Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..1
This element is affected by the following invariants: bdl-9
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Bundle.type
Definition

Tipo de documento clínico representado en el Bundle, como informe médico, nota de evolución, etc.


Indicates the purpose of this bundle - how it is intended to be used.

ShortTipo de documento clínico.document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection | subscription-notification
Comments

It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.

Control1..1
This element is affected by the following invariants: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
BindingThe codes SHALL be taken from BundleTypehttp://hl7.org/fhir/ValueSet/bundle-type|5.0.0
(required to http://hl7.org/fhir/ValueSet/bundle-type|5.0.0)

ValueSet de tipos de Bundle definidos en FHIR.


Indicates the purpose of a bundle - how it is intended to be used.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Bundle.timestamp
Definition

Fecha y hora en que se creó el documento clínico.


The date/time that the bundle was assembled - i.e. when the resources were placed in the bundle.

ShortFecha y hora de creación del documento clínico.When the bundle was assembled
Comments

For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated.

Usage:

  • document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time
  • message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message
  • history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates
  • searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query
  • transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning

The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.

Control10..1
This element is affected by the following invariants: bdl-10
Typeinstant
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Bundle.entry
Definition

Lista de recursos FHIR que componen el documento clínico, como Patient, Practitioner, Observation, etc.


An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).

ShortEntradas del documento clínico.Entry in the bundle - will have a resource or information
Control10..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
bdl-8: fullUrl cannot be a version specific reference (fullUrl.exists() implies fullUrl.contains('/_history/').not())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
bdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
bdl-8: fullUrl cannot be a version specific reference (fullUrl.exists() implies fullUrl.contains('/_history/').not())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Bundle.entry.modifierExtension
Definition

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 managable, 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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
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 Namesextensions, user content, modifiers
Invariantsele-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())
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())
14. Bundle.entry.fullUrl
Definition

The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when:

  • invoking a create
  • invoking or responding to an operation where the body is not a single identified resource
  • invoking or returning the results of a search or history operation.
ShortURI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
Comments

fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id.

Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).


fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id.

Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).

Control0..1
This element is affected by the following invariants: bdl-7, bdl-15, bdl-8
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Bundle.entry.resource
Definition

The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.

ShortA resource in the bundle
Control0..1
This element is affected by the following invariants: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summarytrue
18. Bundle.entry.request
Definition

Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

ShortAdditional execution information (transaction/batch/history)
Control0..1
This element is affected by the following invariants: bdl-3a, bdl-3b, bdl-5
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Bundle.entry.request.modifierExtension
Definition

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 managable, 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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
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 Namesextensions, user content, modifiers
Invariantsele-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())
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())
22. Bundle.entry.request.method
Definition

In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred.

ShortGET | HEAD | POST | PUT | DELETE | PATCH
Control1..1
This element is affected by the following invariants: bdl-3b, bdl-3c, bdl-14, bdl-15
BindingThe codes SHALL be taken from HTTPVerbhttp://hl7.org/fhir/ValueSet/http-verb|5.0.0
(required to http://hl7.org/fhir/ValueSet/http-verb|5.0.0)

HTTP verbs (in the HTTP command line). See HTTP rfc for details.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Bundle.entry.request.url
Definition

The URL for this entry, relative to the root (the address to which the request is posted).

ShortURL for HTTP equivalent of this entry
Comments

E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]".

Control1..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Bundle.entry.response
Definition

Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

ShortResults of execution (transaction/batch/history)
Control0..1
This element is affected by the following invariants: bdl-3a, bdl-3b, bdl-3d, bdl-5
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Bundle.entry.response.modifierExtension
Definition

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 managable, 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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
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 Namesextensions, user content, modifiers
Invariantsele-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())
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())
30. Bundle.entry.response.status
Definition

The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code.

ShortStatus response code (text optional)
Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Bundle.signature
Definition

Firma digital que autentica el documento clínico, asegurando su integridad y origen.


Digital Signature - base64 encoded. XML-DSig or a JWS.

ShortFirma digital del documento clínico.Digital Signature
Comments

Se recomienda incluir una firma digital para garantizar la autenticidad del documento clínico. Para Costa Rica se debe soportar el formato de firma digital JAdES.


The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.

Control10..1
TypeSignature
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Bundle.signature.type
Definition

Tipo de firma digital utilizada en el documento clínico.


An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

ShortTipo de firma digital.Indication of the reason the entity signed the object(s)
Comments

Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

Control10..*
BindingThe codes SHALL be taken from The codes SHOULD be taken from SignatureTypeCodeshttp://hl7.org/fhir/ValueSet/signature-type|5.0.0
(required to http://hl7.org/fhir/ValueSet/signature-type|5.0.0)

ValueSet de tipos de firma definidos en FHIR.


An indication of the reason that an entity signed the object.

TypeCoding
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Bundle.signature.when
Definition

Fecha y hora en que se realizó la firma digital del documento clínico.


When the digital signature was signed.

ShortFecha y hora de la firma digital.When the signature was created
Comments

This should agree with the information in the signature.

Control10..1
Typeinstant
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Bundle.signature.who
Definition

Referencia a la entidad (persona u organización) que realizó la firma digital del documento clínico.


A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).

ShortEntidad que realizó la firma digital.Who signed
Comments

This should agree with the information in the signature.

Control10..1
TypeReference(Profesional de la Salud, Organización, Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Bundle.signature.onBehalfOf
Definition

Referencia a la entidad en cuyo nombre se realizó la firma digital del documento clínico.


A reference to an application-usable description of the identity that is represented by the signature.

ShortFirma en representación de otra entidad.The party represented
Comments

The party that can't sign. For example a child.

Control0..1
TypeReference(Organización, Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

used when the signature is on behalf of a non-signer.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Bundle.signature.targetFormat
Definition

Formato en el que se desea representar el documento clínico al exportarlo o compartirlo.


A mime type that indicates the technical format of the target resources signed by the signature.

ShortFormato de destino del documento clínico.The technical format of the signed resources
Comments

"xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.

Control0..1
BindingThe codes SHALL be taken from MimeTypeshttp://hl7.org/fhir/ValueSet/mimetypes|5.0.0
(required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Pattern Valuejson
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Bundle.signature.sigFormat
Definition

Formato utilizado para la firma digital del documento clínico.


A mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc.

ShortFormato de la firma digital.The technical format of the signature
Control0..1
BindingThe codes SHALL be taken from MimeTypeshttp://hl7.org/fhir/ValueSet/mimetypes|5.0.0
(required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Pattern Valuejades
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Bundle.issues
Definition

Captures issues and warnings that relate to the construction of the Bundle and the content within it.

ShortIssues with the Bundle
Comments

Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.

Control0..01
This element is affected by the following invariants: bdl-16, bdl-17
TypeResource(OperationOutcome)
Is Modifierfalse
Must Supportfalse
Summarytrue

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

0. Bundle
2. Bundle.meta
4. Bundle.meta.security
Definition

Las etiquetas de seguridad se pueden utilizar para proteger información sensible del paciente, como nombre y dirección. Se recomienda usar la etiqueta 'R' (Restricted) del vocabulario HL7 v3 ActCode cuando sea necesario proteger datos de pacientes.

ShortEtiqueta de seguridad
BindingThe codes SHALL be taken from Confidentiality (3.0.0)
(required to http://terminology.hl7.org/ValueSet/v3-Confidentiality|3.0.0)
6. Bundle.identifier
Definition

Identificador único del documento clínico, como un número de informe o código asignado por el sistema de gestión de documentos.

ShortIdentificador único del documento clínico.
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
Must Supporttrue
8. Bundle.type
Definition

Tipo de documento clínico representado en el Bundle, como informe médico, nota de evolución, etc.

ShortTipo de documento clínico.
BindingThe codes SHALL be taken from BundleType
(required to http://hl7.org/fhir/ValueSet/bundle-type|5.0.0)

ValueSet de tipos de Bundle definidos en FHIR.

Must Supporttrue
10. Bundle.timestamp
Definition

Fecha y hora en que se creó el documento clínico.

ShortFecha y hora de creación del documento clínico.
Control1..?
Must Supporttrue
12. Bundle.entry
Definition

Lista de recursos FHIR que componen el documento clínico, como Patient, Practitioner, Observation, etc.

ShortEntradas del documento clínico.
Control1..?
Must Supporttrue
14. Bundle.signature
Definition

Firma digital que autentica el documento clínico, asegurando su integridad y origen.

ShortFirma digital del documento clínico.
Comments

Se recomienda incluir una firma digital para garantizar la autenticidad del documento clínico. Para Costa Rica se debe soportar el formato de firma digital JAdES.

Control1..?
Must Supporttrue
16. Bundle.signature.type
Definition

Tipo de firma digital utilizada en el documento clínico.

ShortTipo de firma digital.
Control1..?
BindingThe codes SHALL be taken from SignatureTypeCodes
(required to http://hl7.org/fhir/ValueSet/signature-type|5.0.0)

ValueSet de tipos de firma definidos en FHIR.

Must Supporttrue
18. Bundle.signature.when
Definition

Fecha y hora en que se realizó la firma digital del documento clínico.

ShortFecha y hora de la firma digital.
Control1..?
Must Supporttrue
20. Bundle.signature.who
Definition

Referencia a la entidad (persona u organización) que realizó la firma digital del documento clínico.

ShortEntidad que realizó la firma digital.
Control1..?
TypeReference(Profesional de la Salud, Organización)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
22. Bundle.signature.onBehalfOf
Definition

Referencia a la entidad en cuyo nombre se realizó la firma digital del documento clínico.

ShortFirma en representación de otra entidad.
TypeReference(Organización)
Must Supporttrue
24. Bundle.signature.targetFormat
Definition

Formato en el que se desea representar el documento clínico al exportarlo o compartirlo.

ShortFormato de destino del documento clínico.
Must Supporttrue
Pattern Valuejson
26. Bundle.signature.sigFormat
Definition

Formato utilizado para la firma digital del documento clínico.

ShortFormato de la firma digital.
Must Supporttrue
Pattern Valuejades
28. Bundle.issues
Control0..0

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

0. Bundle
Definition

A container for a collection of resources.

ShortContains a collection of resources
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsbdl-1: total only when a search or history (total.empty() or (type = 'searchset') or (type = 'history'))
bdl-2: entry.search only when a search ((type = 'searchset') or entry.search.empty())
bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles) ((type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&iif(resource.meta.versionId.exists(), resource.meta.versionId, '')).isDistinct())
bdl-9: A document must have an identifier with a system and a value (type = 'document' implies (identifier.system.exists() and identifier.value.exists()))
bdl-10: A document must have a date (type = 'document' implies (timestamp.hasValue()))
bdl-11: A document must have a Composition as the first resource (type = 'document' implies entry.first().resource.is(Composition))
bdl-12: A message must have a MessageHeader as the first resource (type = 'message' implies entry.first().resource.is(MessageHeader))
bdl-13: A subscription-notification must have a SubscriptionStatus as the first resource (type = 'subscription-notification' implies entry.first().resource.is(SubscriptionStatus))
bdl-14: entry.request.method PATCH not allowed for history (type = 'history' implies entry.request.method != 'PATCH')
bdl-15: Bundle resources where type is not transaction, transaction-response, batch, or batch-response or when the request is a POST SHALL have Bundle.entry.fullUrl populated (type='transaction' or type='transaction-response' or type='batch' or type='batch-response' or entry.all(fullUrl.exists() or request.method='POST'))
bdl-16: Issue.severity for all issues within the OperationOutcome must be either 'information' or 'warning'. (issues.exists() implies (issues.issue.severity = 'information' or issues.issue.severity = 'warning'))
bdl-17: Use and meaning of issues for documents has not been validated because the content will not be rendered in the document. (type = 'document' implies issues.empty())
bdl-18: Self link is required for searchsets. (type = 'searchset' implies link.where(relation = 'self' and url.exists()).exists())
bdl-3a: For collections of type document, message, searchset or collection, all entries must contain resources, and not have request or response elements (type in ('document' | 'message' | 'searchset' | 'collection') implies entry.all(resource.exists() and request.empty() and response.empty()))
bdl-3b: For collections of type history, all entries must contain request or response elements, and resources if the method is POST, PUT or PATCH (type = 'history' implies entry.all(request.exists() and response.exists() and ((request.method in ('POST' | 'PATCH' | 'PUT')) = resource.exists())))
bdl-3c: For collections of type transaction or batch, all entries must contain request elements, and resources if the method is POST, PUT or PATCH (type in ('transaction' | 'batch') implies entry.all(request.method.exists() and ((request.method in ('POST' | 'PATCH' | 'PUT')) = resource.exists())))
bdl-3d: For collections of type transaction-response or batch-response, all entries must contain response elements (type in ('transaction-response' | 'batch-response') implies entry.all(response.exists()))
2. Bundle.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

Control0..1
Typeid
Is Modifierfalse
Must Supportfalse
Summarytrue
4. Bundle.meta
Definition

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.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Bundle.meta.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
This element is affected by the following invariants: ele-1
Typeid
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
8. Bundle.meta.extension
Definition

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 managable, 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.

ShortAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-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())
SlicingThis element introduces a set of slices on Bundle.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. Bundle.meta.versionId
    Definition

    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.

    ShortVersion specific identifier
    Comments

    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.

    Control0..1
    Typeid
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Bundle.meta.lastUpdated
    Definition

    When the resource last changed - e.g. when the version changed.

    ShortWhen the resource version last changed
    Comments

    This element is generally omitted in instances submitted in a PUT or POST. Instead, it is populated in the response instance and when retrieving information using a GET. 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.

    Control0..1
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Bundle.meta.source
    Definition

    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.

    ShortIdentifies where the resource comes from
    Comments

    The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference.

    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.

    Control0..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Bundle.meta.profile
    Definition

    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

    ShortProfiles this resource claims to conform to
    Comments

    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.

    Control0..*
    Typecanonical(StructureDefinition)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Bundle.meta.security
    Definition

    Las etiquetas de seguridad se pueden utilizar para proteger información sensible del paciente, como nombre y dirección. Se recomienda usar la etiqueta 'R' (Restricted) del vocabulario HL7 v3 ActCode cuando sea necesario proteger datos de pacientes.

    ShortEtiqueta de seguridad
    Comments

    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.

    Control0..*
    BindingThe codes SHALL be taken from Confidentiality (3.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-Confidentiality|3.0.0)
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Bundle.meta.tag
    Definition

    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.

    ShortTags applied to this resource
    Comments

    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.

    Control0..*
    BindingFor example codes, see CommonTags
    (example to http://hl7.org/fhir/ValueSet/common-tags|5.0.0)

    Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

    TypeCoding
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Bundle.implicitRules
    Definition

    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.

    ShortA set of rules under which this content was created
    Comments

    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 its narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Bundle.language
    Definition

    The base language in which the resource is written.

    ShortLanguage of the resource content
    Comments

    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).

    Control0..1
    BindingThe codes SHALL be taken from AllLanguages
    (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

    IETF language tag for a human language

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Bundle.identifier
    Definition

    Identificador único del documento clínico, como un número de informe o código asignado por el sistema de gestión de documentos.

    ShortIdentificador único del documento clínico.
    Comments

    Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..1
    This element is affected by the following invariants: bdl-9
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Bundle.type
    Definition

    Tipo de documento clínico representado en el Bundle, como informe médico, nota de evolución, etc.

    ShortTipo de documento clínico.
    Comments

    It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types.

    Control1..1
    This element is affected by the following invariants: bdl-1, bdl-2, bdl-3a, bdl-3b, bdl-3c, bdl-3d, bdl-7, bdl-9, bdl-10, bdl-11, bdl-12, bdl-13, bdl-14, bdl-15, bdl-17, bdl-18
    BindingThe codes SHALL be taken from BundleType
    (required to http://hl7.org/fhir/ValueSet/bundle-type|5.0.0)

    ValueSet de tipos de Bundle definidos en FHIR.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Bundle.timestamp
    Definition

    Fecha y hora en que se creó el documento clínico.

    ShortFecha y hora de creación del documento clínico.
    Comments

    For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated.

    Usage:

    • document : the date the document was created. Note: the composition may predate the document, or be associated with multiple documents. The date of the composition - the authoring time - may be earlier than the document assembly time
    • message : the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message
    • history : the date that the history was assembled. This time would be used as the _since time to ask for subsequent updates
    • searchset : the time that the search set was assembled. Note that different pages MAY have different timestamps but need not. Having different timestamps does not imply that subsequent pages will represent or include changes made since the initial query
    • transaction | transaction-response | batch | batch-response | collection : no particular assigned meaning

    The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.

    Control1..1
    This element is affected by the following invariants: bdl-10
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Bundle.total
    Definition

    If a set of search matches, this is the (potentially estimated) total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle.

    ShortIf search, the total number of matches
    Comments

    Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.

    Control0..1
    This element is affected by the following invariants: bdl-1
    TypeunsignedInt
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Bundle.link
    Definition

    A series of links that provide context to this bundle.

    ShortLinks related to this Bundle
    Comments

    Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS).

    Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly.

    This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific. The behavior of navigation link types (next/prev/first/last) are well defined for searchset and history Bundles but are not currently defined for other types. Implementers who choose to use such link relationships for other bundle types will need to negotiate behavior with their interoperability partners.

    Control0..*
    This element is affected by the following invariants: bdl-18
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Bundle.link.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    38. Bundle.link.extension
    Definition

    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 managable, 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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    40. Bundle.link.modifierExtension
    Definition

    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 managable, 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).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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 Namesextensions, user content, modifiers
    Invariantsele-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())
    42. Bundle.link.relation
    Definition

    A name which details the functional use for this link - see http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1.

    ShortSee http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
    Control1..1
    This element is affected by the following invariants: bdl-18
    BindingThe codes SHALL be taken from LinkRelationTypes
    (required to http://hl7.org/fhir/ValueSet/iana-link-relations|5.0.0)
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Bundle.link.url
    Definition

    The reference details for the link.

    ShortReference details for the link
    Control1..1
    This element is affected by the following invariants: bdl-18
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Bundle.entry
    Definition

    Lista de recursos FHIR que componen el documento clínico, como Patient, Practitioner, Observation, etc.

    ShortEntradas del documento clínico.
    Control1..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsbdl-5: must be a resource unless there's a request or response (resource.exists() or request.exists() or response.exists())
    bdl-8: fullUrl cannot be a version specific reference (fullUrl.exists() implies fullUrl.contains('/_history/').not())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Bundle.entry.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    50. Bundle.entry.extension
    Definition

    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 managable, 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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    52. Bundle.entry.modifierExtension
    Definition

    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 managable, 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).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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 Namesextensions, user content, modifiers
    Invariantsele-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())
    54. Bundle.entry.link
    Definition

    A series of links that provide context to this entry.

    ShortLinks related to this entry
    Control0..*
    TypeSeettp://hl7.org/fhir/StructureDefinition/Bundle#Bundle.link
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. Bundle.entry.fullUrl
    Definition

    The Absolute URL for the resource. Except for transactions and batches, each entry in a Bundle must have a fullUrl. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. Even when not required, fullUrl MAY be set to a urn:uuid to allow referencing entries in a transaction. The fullUrl can be an arbitrary URI and is not limited to urn:uuid, urn:oid, http, and https. The fullUrl element SHALL have a value except when:

    • invoking a create
    • invoking or responding to an operation where the body is not a single identified resource
    • invoking or returning the results of a search or history operation.
    ShortURI for resource (e.g. the absolute URL server address, URI for UUID/OID, etc.)
    Comments

    fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id.

    Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).

    Control0..1
    This element is affected by the following invariants: bdl-7, bdl-15, bdl-8
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. Bundle.entry.resource
    Definition

    The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. This is allowed to be a Parameters resource if and only if it is referenced by something else within the Bundle that provides context/meaning.

    ShortA resource in the bundle
    Control0..1
    This element is affected by the following invariants: bdl-3a, bdl-3b, bdl-3c, bdl-7, bdl-11, bdl-12, bdl-13, bdl-5
    TypeResource
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    60. Bundle.entry.search
    Definition

    Information about the search process that lead to the creation of this entry.

    ShortSearch related information
    Control0..1
    This element is affected by the following invariants: bdl-2
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. Bundle.entry.search.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    64. Bundle.entry.search.extension
    Definition

    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 managable, 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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    66. Bundle.entry.search.modifierExtension
    Definition

    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 managable, 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).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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 Namesextensions, user content, modifiers
    Invariantsele-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())
    68. Bundle.entry.search.mode
    Definition

    Why this entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.

    Shortmatch | include - why this is in the result set
    Comments

    There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, 'match' takes precedence.

    Control0..1
    BindingThe codes SHALL be taken from SearchEntryMode
    (required to http://hl7.org/fhir/ValueSet/search-entry-mode|5.0.0)

    Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. Bundle.entry.search.score
    Definition

    When searching, the server's search ranking score for the entry.

    ShortSearch ranking (between 0 and 1)
    Comments

    Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order.

    See Patient Match for the EMPI search which relates to this element.

    Control0..1
    Typedecimal
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    72. Bundle.entry.request
    Definition

    Additional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.

    ShortAdditional execution information (transaction/batch/history)
    Control0..1
    This element is affected by the following invariants: bdl-3a, bdl-3b, bdl-5
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. Bundle.entry.request.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    76. Bundle.entry.request.extension
    Definition

    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 managable, 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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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. Bundle.entry.request.modifierExtension
    Definition

    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 managable, 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).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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 Namesextensions, user content, modifiers
    Invariantsele-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. Bundle.entry.request.method
    Definition

    In a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred.

    ShortGET | HEAD | POST | PUT | DELETE | PATCH
    Control1..1
    This element is affected by the following invariants: bdl-3b, bdl-3c, bdl-14, bdl-15
    BindingThe codes SHALL be taken from HTTPVerb
    (required to http://hl7.org/fhir/ValueSet/http-verb|5.0.0)

    HTTP verbs (in the HTTP command line). See HTTP rfc for details.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    82. Bundle.entry.request.url
    Definition

    The URL for this entry, relative to the root (the address to which the request is posted).

    ShortURL for HTTP equivalent of this entry
    Comments

    E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]".

    Control1..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    84. Bundle.entry.request.ifNoneMatch
    Definition

    If the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".

    ShortFor managing cache validation
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    86. Bundle.entry.request.ifModifiedSince
    Definition

    Only perform the operation if the last updated date matches. See the API documentation for "Conditional Read".

    ShortFor managing cache currency
    Control0..1
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    88. Bundle.entry.request.ifMatch
    Definition

    Only perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".

    ShortFor managing update contention
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    90. Bundle.entry.request.ifNoneExist
    Definition

    Instruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for "Conditional Create". This is just the query portion of the URL - what follows the "?" (not including the "?").

    ShortFor conditional creates
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    92. Bundle.entry.response
    Definition

    Indicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.

    ShortResults of execution (transaction/batch/history)
    Control0..1
    This element is affected by the following invariants: bdl-3a, bdl-3b, bdl-3d, bdl-5
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    94. Bundle.entry.response.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    96. Bundle.entry.response.extension
    Definition

    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 managable, 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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    98. Bundle.entry.response.modifierExtension
    Definition

    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 managable, 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).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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 Namesextensions, user content, modifiers
    Invariantsele-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())
    100. Bundle.entry.response.status
    Definition

    The status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code.

    ShortStatus response code (text optional)
    Control1..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    102. Bundle.entry.response.location
    Definition

    The location header created by processing this operation, populated if the operation returns a location.

    ShortThe location (if the operation returns a location)
    Control0..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    104. Bundle.entry.response.etag
    Definition

    The Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention).

    ShortThe Etag for the resource (if relevant)
    Comments

    Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    106. Bundle.entry.response.lastModified
    Definition

    The date/time that the resource was modified on the server.

    ShortServer's date time modified
    Comments

    This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.

    Control0..1
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    108. Bundle.entry.response.outcome
    Definition

    An OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction.

    ShortOperationOutcome with hints and warnings (for batch/transaction)
    Comments

    For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned.

    This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error.

    Control0..1
    TypeResource
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    110. Bundle.signature
    Definition

    Firma digital que autentica el documento clínico, asegurando su integridad y origen.

    ShortFirma digital del documento clínico.
    Comments

    Se recomienda incluir una firma digital para garantizar la autenticidad del documento clínico. Para Costa Rica se debe soportar el formato de firma digital JAdES.

    Control1..1
    TypeSignature
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    112. Bundle.signature.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    This element is affected by the following invariants: ele-1
    Typeid
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    114. Bundle.signature.extension
    Definition

    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 managable, 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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    SlicingThis element introduces a set of slices on Bundle.signature.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 116. Bundle.signature.type
      Definition

      Tipo de firma digital utilizada en el documento clínico.

      ShortTipo de firma digital.
      Comments

      Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

      Control1..*
      BindingThe codes SHALL be taken from SignatureTypeCodes
      (required to http://hl7.org/fhir/ValueSet/signature-type|5.0.0)

      ValueSet de tipos de firma definidos en FHIR.

      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      118. Bundle.signature.when
      Definition

      Fecha y hora en que se realizó la firma digital del documento clínico.

      ShortFecha y hora de la firma digital.
      Comments

      This should agree with the information in the signature.

      Control1..1
      Typeinstant
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      120. Bundle.signature.who
      Definition

      Referencia a la entidad (persona u organización) que realizó la firma digital del documento clínico.

      ShortEntidad que realizó la firma digital.
      Comments

      This should agree with the information in the signature.

      Control1..1
      TypeReference(Profesional de la Salud, Organización)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      122. Bundle.signature.onBehalfOf
      Definition

      Referencia a la entidad en cuyo nombre se realizó la firma digital del documento clínico.

      ShortFirma en representación de otra entidad.
      Comments

      The party that can't sign. For example a child.

      Control0..1
      TypeReference(Organización)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      used when the signature is on behalf of a non-signer.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      124. Bundle.signature.targetFormat
      Definition

      Formato en el que se desea representar el documento clínico al exportarlo o compartirlo.

      ShortFormato de destino del documento clínico.
      Comments

      "xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.

      Control0..1
      BindingThe codes SHALL be taken from MimeTypes
      (required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

      BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Pattern Valuejson
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      126. Bundle.signature.sigFormat
      Definition

      Formato utilizado para la firma digital del documento clínico.

      ShortFormato de la firma digital.
      Control0..1
      BindingThe codes SHALL be taken from MimeTypes
      (required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

      BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049)

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Pattern Valuejades
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      128. Bundle.signature.data
      Definition

      The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

      ShortThe actual signature content (XML DigSig. JWS, picture, etc.)
      Comments

      Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

      Control0..1
      Typebase64Binary
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      130. Bundle.issues
      Definition

      Captures issues and warnings that relate to the construction of the Bundle and the content within it.

      ShortIssues with the Bundle
      Comments

      Usage notes: These issues and warnings must apply to the Bundle as a whole, not to individual entries.Messages relating to the processing of individual entries (e.g. in a batch or transaction) SHALL be reported in the entry.response.outcome for that entry. If there are errors that arise in the creation of the Bundle, then that should be handled by an OperationOutcome being returned instead of the Bundle.

      Control0..0
      This element is affected by the following invariants: bdl-16, bdl-17
      TypeResource(OperationOutcome)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue