Persona que recibe atención de salud en Costa Rica, con su identificación, su nombre, su sexo asignado al nacer, su fecha de nacimiento, sus datos de contacto, sus direcciones y sus contactos.

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.

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.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

An Extension

País del que el paciente es nacional. Una persona con doble nacionalidad lleva dos.

An Extension

An Extension

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Código ISO 3166-1 alfa-3 del país, con su nombre en español en text. Si no se conoce, lleva la extensión data-absent-reason con unknown; si la persona es apátrida, not-applicable y el texto Apátrida.

Period when nationality was effective.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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).

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.

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.

Documento o número con que se identifica al paciente. Puede tener varios (cédula y pasaporte), y al menos uno vigente. Si no tiene ningún documento oficial, se usa el expediente del establecimiento como identificador provisional.

Patients are almost always assigned specific numerical identifiers.

Indica si el identificador está vigente: official para un documento oficial vigente, temp para el expediente (identificador provisional) y old para uno que se conserva solo como histórico.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Tipo de documento del catálogo de tipos de identificación de Costa Rica. Es opcional, porque el system ya dice de qué documento se trata; puede llevar además el código equivalente de HL7 v2-0203 (NI, PRC, PPN, NH, MR).

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Allows users to make use of identifiers when the identifier system is not known.

Sistema de identificación, que dice qué documento es. El pasaporte lleva al final el código ISO 3166-1 alfa-3 del país emisor (pasaporte/USA) y el expediente, el código del establecimiento que lo asignó (expediente/cj-3101123456).

Identifier.system is always case sensitive.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Número de identificación tal como consta en el documento: la cédula con 9 dígitos, el DIMEX con 11 o 12 dígitos sin ceros a la izquierda y el pasaporte con 6 a 15 letras o dígitos.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Organización que asignó el identificador. Es obligatoria en el expediente, donde es el establecimiento de salud; en el pasaporte, puede llevar solo el nombre del país emisor en display.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Need to be able to mark a patient record as not to be used because it was created in error.

Nombre del paciente tal como consta en su documento de identidad: hasta dos nombres y los apellidos, juntos en family y por separado en las extensiones del primer y el segundo apellido.

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Animal names may be communicated as given names, and optionally may include a family name.

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

Teléfono o correo electrónico del paciente, para contactarlo, enviarle recordatorios y darle seguimiento. system dice qué es (phone, email) y use, de qué tipo (mobile, home, work). Los teléfonos van en formato E.164: en Costa Rica, +506 y 8 dígitos.

A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

People have (primary) ways to contact them in some way such as phone, email.

Sexo asignado al nacer, con fines clínicos, farmacológicos y de riesgo médico. En este perfil, gender lleva siempre el sexo asignado al nacer, no un sexo administrativo ni la identidad de género.

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

Needed for identification of the individual, in combination with (at least) name and birth date.

Fecha de nacimiento que consta en el documento de identidad. No es posterior a hoy ni anterior a 130 años.

Partial dates are allowed if the specific date of birth is unknown. There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

Age of the individual drives many clinical processes.

Indicates if the individual is deceased or not.

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Dirección del paciente: su residencia habitual (home) o una dirección temporal (temp), por ejemplo donde se aloja durante un tratamiento. En Costa Rica, la provincia, el cantón y el distrito llevan los códigos de la DTA.

Patient may have multiple addresses with different uses or applicable periods.

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Nombre del barrio o del poblado dentro del distrito, tal como aparece en la DTA publicada en La Gaceta. Texto de hasta 100 caracteres: el SNIT no publica barrios ni poblados con código.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Uso de la dirección: home para la residencia habitual, de la que hay a lo sumo una, y temp para una dirección temporal.

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

The use of an address (home / work / etc.).

Allows an appropriate address to be chosen from a list of many.

Dirección completa tal como se muestra o se imprime, con los nombres de la provincia, el cantón y el distrito.

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

A renderable, unencoded form.

Descripción para llegar al lugar: puntos de referencia en Costa Rica, o calle, número y apartamento en el extranjero.

En Costa Rica, el código del cantón de la DTA (3 dígitos), que pertenece a la provincia. En otro país, la ciudad, en texto libre.

En Costa Rica (CRI), el código de cantón de la DTA es obligatorio y pertenece a la provincia (invariantes cr-direccion-dta y cr-direccion-concordancia). En otro país, texto libre.

En Costa Rica, el código del distrito de la DTA (5 dígitos), que pertenece al cantón. No aplica a otros países.

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

En Costa Rica (CRI), el código de distrito de la DTA es obligatorio y pertenece al cantón (invariantes cr-direccion-dta y cr-direccion-concordancia).

En Costa Rica, el código de la provincia de la División Territorial Administrativa del SNIT (1 a 7). En otro país, el estado, la región o el departamento, en texto libre.

En Costa Rica (CRI), el código de provincia de la DTA es obligatorio (invariantes cr-direccion-dta y cr-direccion-concordancia). En otro país, texto libre.

Código postal, opcional en cualquier país.

País de la dirección, con su código ISO 3166-1 alfa-3 en mayúsculas. Si es CRI, la provincia, el cantón y el distrito son obligatorios y llevan los códigos de la DTA.

ISO 3166 2- or 3- letter codes MAY be used in place of a human readable country name.

Estado civil declarado por el paciente: soltero (S), casado (M), divorciado (D), viudo (W), unión de hecho (T) o desconocido (UNK). No condiciona la atención.

Most, if not all systems capture it.

Persona a quien contactar por el paciente: un familiar, su cónyuge o alguien que actúa en nombre de una institución. El tutor legal y el progenitor de una persona menor de edad se registran como persona relacionada, no aquí.

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

Need to track people you can contact about the patient.

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).

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.

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.

Vínculo del contacto con el paciente: cónyuge (SPS), padre (FTH), madre (MTH), tutor legal (GUARD), hijo (CHILD), hermano (SIB) u otro familiar (FAMMEMB). Puede tener varios.

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Nombre del contacto, con el mismo perfil del nombre del paciente.

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

Teléfono o correo electrónico del contacto. Los teléfonos van en formato E.164: en Costa Rica, +506 y 8 dígitos.

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

People have (primary) ways to contact them in some way such as phone, email.

Dirección del contacto, con el mismo perfil de la dirección del paciente.

Need to keep track where the contact person can be contacted per postal mail or visited.

Nombre del barrio o del poblado dentro del distrito, tal como aparece en la DTA publicada en La Gaceta. Texto de hasta 100 caracteres: el SNIT no publica barrios ni poblados con código.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

The purpose of this address.

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

The use of an address (home / work / etc.).

Allows an appropriate address to be chosen from a list of many.

Dirección completa tal como se muestra o se imprime, con los nombres de la provincia, el cantón y el distrito.

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

A renderable, unencoded form.

Descripción para llegar al lugar: puntos de referencia en Costa Rica, o calle, número y apartamento en el extranjero.

En Costa Rica, el código del cantón de la DTA (3 dígitos), que pertenece a la provincia. En otro país, la ciudad, en texto libre.

En Costa Rica (CRI), el código de cantón de la DTA es obligatorio y pertenece a la provincia (invariantes cr-direccion-dta y cr-direccion-concordancia). En otro país, texto libre.

En Costa Rica, el código del distrito de la DTA (5 dígitos), que pertenece al cantón. No aplica a otros países.

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

En Costa Rica (CRI), el código de distrito de la DTA es obligatorio y pertenece al cantón (invariantes cr-direccion-dta y cr-direccion-concordancia).

En Costa Rica, el código de la provincia de la División Territorial Administrativa del SNIT (1 a 7). En otro país, el estado, la región o el departamento, en texto libre.

En Costa Rica (CRI), el código de provincia de la DTA es obligatorio (invariantes cr-direccion-dta y cr-direccion-concordancia). En otro país, texto libre.

Código postal, opcional en cualquier país.

País de la dirección, con su código ISO 3166-1 alfa-3 en mayúsculas. Si es CRI, la provincia, el cantón y el distrito son obligatorios y llevan los códigos de la DTA.

ISO 3166 2- or 3- letter codes MAY be used in place of a human readable country name.

Sexo asignado al nacer del contacto.

Needed to address the person correctly.

Organización en cuyo nombre actúa el contacto, por ejemplo el PANI cuando tiene la tutela de una persona menor de edad. Se referencia por su cédula jurídica.

For guardians or business related contacts, the organization is relevant.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

The period during which this contact person or organization is valid to be contacted relating to this patient.

Link to a Patient or RelatedPerson resource that concerns the same actual individual.

There is no assumption that linked patient records have mutual links.

There are multiple use cases:

• Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
• Distribution of patient information across multiple servers.

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).

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.

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.

Link to a Patient or RelatedPerson resource that concerns the same actual individual.

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

The type of link between this patient resource and another patient resource.

The type of link between this patient resource and another Patient resource, or Patient/RelatedPerson when using the seealso code

Persona que recibe atención de salud en Costa Rica, con su identificación, su nombre, su sexo asignado al nacer, su fecha de nacimiento, sus datos de contacto, sus direcciones y sus contactos.

País del que el paciente es nacional. Una persona con doble nacionalidad lleva dos.

Código ISO 3166-1 alfa-3 del país, con su nombre en español en text. Si no se conoce, lleva la extensión data-absent-reason con unknown; si la persona es apátrida, not-applicable y el texto Apátrida.

Documento o número con que se identifica al paciente. Puede tener varios (cédula y pasaporte), y al menos uno vigente. Si no tiene ningún documento oficial, se usa el expediente del establecimiento como identificador provisional.

Indica si el identificador está vigente: official para un documento oficial vigente, temp para el expediente (identificador provisional) y old para uno que se conserva solo como histórico.

Tipo de documento del catálogo de tipos de identificación de Costa Rica. Es opcional, porque el system ya dice de qué documento se trata; puede llevar además el código equivalente de HL7 v2-0203 (NI, PRC, PPN, NH, MR).

Sistema de identificación, que dice qué documento es. El pasaporte lleva al final el código ISO 3166-1 alfa-3 del país emisor (pasaporte/USA) y el expediente, el código del establecimiento que lo asignó (expediente/cj-3101123456).

Número de identificación tal como consta en el documento: la cédula con 9 dígitos, el DIMEX con 11 o 12 dígitos sin ceros a la izquierda y el pasaporte con 6 a 15 letras o dígitos.

Organización que asignó el identificador. Es obligatoria en el expediente, donde es el establecimiento de salud; en el pasaporte, puede llevar solo el nombre del país emisor en display.

Nombre del paciente tal como consta en su documento de identidad: hasta dos nombres y los apellidos, juntos en family y por separado en las extensiones del primer y el segundo apellido.

Teléfono o correo electrónico del paciente, para contactarlo, enviarle recordatorios y darle seguimiento. system dice qué es (phone, email) y use, de qué tipo (mobile, home, work). Los teléfonos van en formato E.164: en Costa Rica, +506 y 8 dígitos.

Sexo asignado al nacer, con fines clínicos, farmacológicos y de riesgo médico. En este perfil, gender lleva siempre el sexo asignado al nacer, no un sexo administrativo ni la identidad de género.

Fecha de nacimiento que consta en el documento de identidad. No es posterior a hoy ni anterior a 130 años.

Dirección del paciente: su residencia habitual (home) o una dirección temporal (temp), por ejemplo donde se aloja durante un tratamiento. En Costa Rica, la provincia, el cantón y el distrito llevan los códigos de la DTA.

Uso de la dirección: home para la residencia habitual, de la que hay a lo sumo una, y temp para una dirección temporal.

Estado civil declarado por el paciente: soltero (S), casado (M), divorciado (D), viudo (W), unión de hecho (T) o desconocido (UNK). No condiciona la atención.

Persona a quien contactar por el paciente: un familiar, su cónyuge o alguien que actúa en nombre de una institución. El tutor legal y el progenitor de una persona menor de edad se registran como persona relacionada, no aquí.

Vínculo del contacto con el paciente: cónyuge (SPS), padre (FTH), madre (MTH), tutor legal (GUARD), hijo (CHILD), hermano (SIB) u otro familiar (FAMMEMB). Puede tener varios.

Nombre del contacto, con el mismo perfil del nombre del paciente.

Teléfono o correo electrónico del contacto. Los teléfonos van en formato E.164: en Costa Rica, +506 y 8 dígitos.

Dirección del contacto, con el mismo perfil de la dirección del paciente.

Sexo asignado al nacer del contacto.

Organización en cuyo nombre actúa el contacto, por ejemplo el PANI cuando tiene la tutela de una persona menor de edad. Se referencia por su cédula jurídica.

Persona que recibe atención de salud en Costa Rica, con su identificación, su nombre, su sexo asignado al nacer, su fecha de nacimiento, sus datos de contacto, sus direcciones y sus contactos.

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

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.

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.

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.

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.

The base language in which the resource is written.

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).

IETF language tag for a human language

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

An Extension

País del que el paciente es nacional. Una persona con doble nacionalidad lleva dos.

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

An Extension

An Extension

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

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Código ISO 3166-1 alfa-3 del país, con su nombre en español en text. Si no se conoce, lleva la extensión data-absent-reason con unknown; si la persona es apátrida, not-applicable y el texto Apátrida.

Period when nationality was effective.

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

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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).

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.

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.

Documento o número con que se identifica al paciente. Puede tener varios (cédula y pasaporte), y al menos uno vigente. Si no tiene ningún documento oficial, se usa el expediente del establecimiento como identificador provisional.

Patients are almost always assigned specific numerical identifiers.

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

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.

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.

Indica si el identificador está vigente: official para un documento oficial vigente, temp para el expediente (identificador provisional) y old para uno que se conserva solo como histórico.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Tipo de documento del catálogo de tipos de identificación de Costa Rica. Es opcional, porque el system ya dice de qué documento se trata; puede llevar además el código equivalente de HL7 v2-0203 (NI, PRC, PPN, NH, MR).

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Allows users to make use of identifiers when the identifier system is not known.

Sistema de identificación, que dice qué documento es. El pasaporte lleva al final el código ISO 3166-1 alfa-3 del país emisor (pasaporte/USA) y el expediente, el código del establecimiento que lo asignó (expediente/cj-3101123456).

Identifier.system is always case sensitive.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Número de identificación tal como consta en el documento: la cédula con 9 dígitos, el DIMEX con 11 o 12 dígitos sin ceros a la izquierda y el pasaporte con 6 a 15 letras o dígitos.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Time period during which identifier is/was valid for use.

Organización que asignó el identificador. Es obligatoria en el expediente, donde es el establecimiento de salud; en el pasaporte, puede llevar solo el nombre del país emisor en display.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Need to be able to mark a patient record as not to be used because it was created in error.