Guía de Implementación Core de Costa Rica
0.1.0 - ci-build Costa Rica bandera

Guía de Implementación Core de Costa Rica - Versión en desarrollo (v0.1.0): borrador de trabajo de la Iniciativa HL7® Costa Rica, que puede cambiar sin aviso.

Perfil de los recursos: Firma del documento clínico - Descripciones detalladas

Estado de las normas de la página: Draft

Definiciones del cr-provenance-firma-documento perfil de los recursos.

Las indicaciones para interpretar el contenido de esta tabla estánaquí

0. Provenance
Definición

Firma digital de un documento clínico (detached): quién firma, cuándo y la firma JAdES de GAUDÍ, referida a la versión exacta del documento.


Provenance of a resource is a record that describes entities and processes involved in producing and delivering or otherwise influencing that resource. Provenance provides a critical foundation for assessing authenticity, enabling trust, and allowing reproducibility. Provenance assertions are a form of contextual metadata and can themselves become important records with their own provenance. Provenance statement indicates clinical significance in terms of confidence in authenticity, reliability, and trustworthiness, integrity, and stage in lifecycle (e.g. Document Completion - has the artifact been legally authenticated), all of which may impact security, privacy, and trust policies.

ResumenFirma digital de un documento clínico, separada del documentoWho, What, When for a set of resources
Comentarios

Some parties may be duplicated between the target resource and its provenance. For instance, the prescriber is usually (but not always) the author of the prescription resource. This resource is defined with close consideration for W3C Provenance.

Control0..*
Es modificadorfalse
Must Supportfalse
Resumenfalse
Nombres alternativosHistory, Event, Activity
Invariantesdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
cr-firma-documento-target-version: El documento se referencia en su versión exacta: Bundle/<id>/_history/<versión>. (target.reference.matches('^(.*/)?Bundle/[A-Za-z0-9\\-\\.]{1,64}/_history/[A-Za-z0-9\\-\\.]{1,64}$'))
cr-firma-documento-firmante: Quien firma es un agente de tipo attester. (signature.who.reference.empty() or agent.where(type.coding.where(code = 'attester').exists()).who.reference contains signature.who.reference)
2. Provenance.implicitRules
Definición

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.

ResumenA set of rules under which this content was created
Comentarios

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
Tipouri
Es modificadortrue porque This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supportfalse
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Provenance.contained
Definición

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.

ResumenContained, inline Resources
Comentarios

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.

Control0..*
Este elemento está afectado por las siguientes invariantes: dom-2, dom-4, dom-3, dom-5
TipoResource
Es modificadorfalse
Must Supportfalse
Resumenfalse
Nombres alternativosinline resources, anonymous resources, contained resources
6. Provenance.modifierExtension
Definición

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).

ResumenExtensions that cannot be ignored
Comentarios

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..*
TipoExtension
Es modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Resumentrue
Requisitos

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.

Nombres alternativosextensions, user content
Invariantesele-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())
8. Provenance.target
Definición

The Reference(s) that were generated or updated by the activity described in this resource. A provenance can point to more than one target if multiple resources were created/updated by the same activity.

ResumenEl documento firmado, en su versión exacta: Bundle/<id>/_history/<versión>Target Reference(s) (usually version specific)
Comentarios

Target references are usually version specific, but might not be, if a version has not been assigned or if the provenance information is part of the set of resources being maintained (i.e. a document). When using the RESTful API, the identity of the resource might not be known (especially not the version specific one); the client may either submit the resource first, and then the provenance, or it may submit both using a single transaction. See the notes on transaction for further discussion.

Control1..1*
TipoReference(Documento clínico (Bundle), Resource)
Es modificadorfalse
Must Supporttrue
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Provenance.target.reference
Definición

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.

ResumenBundle/<id>/_history/<versión>Literal reference, Relative, internal or absolute URL
Comentarios

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.

Control10..1
Este elemento está afectado por las siguientes invariantes: ref-2, ref-1
Tipostring
Es modificadorfalse
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supporttrue
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Provenance.recorded
Definición

The instant of time at which the activity was recorded.

ResumenCuándo se registró la firmaWhen the activity was recorded / updated
Comentarios

This can be a little different from the time stamp on the resource if there is a delay between recording the event and updating the provenance and target resource.

Control10..1
Tipoinstant
Es modificadorfalse
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supporttrue
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Provenance.activity
Definición

An activity is something that occurs over a period of time and acts upon or with entities; it may include consuming, processing, transforming, modifying, relocating, using, or generating entities.

Resumenattest (valor fijo): atestación del documentoActivity that occurred
Control10..1
VinculaciónPara códigos de ejemplo, vea ProvenanceActivityTypehttp://hl7.org/fhir/ValueSet/provenance-activity-type|5.0.0
(example to http://hl7.org/fhir/ValueSet/provenance-activity-type|5.0.0)

The activity that took place.

TipoCodeableConcept
Es modificadorfalse
Must Supporttrue
Resumenfalse
Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/iso-21089-lifecycle",
    "code" : "attest"
  }]
}
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Provenance.patient
Definición

The patient element is available to enable deterministic tracking of activities that involve the patient as the subject of the data used in an activity.

ResumenPaciente del documento (el subject de su Composition)The patient is the subject of the data created/updated (.target) by the activity
Control10..1
TipoReference(Paciente, Patient)
Es modificadorfalse
Must Supporttrue
Resumenfalse
Requisitos

When the .patient is populated it shall be accurate to the subject of the target data. The .patient shall not be populated when the target data created/updated (.target) by the activity does not involve a subject. Note that when the patient is an agent, they will be recorded as an agent. When the Patient resource is Created, Updated, or Deleted it will be recorded as an entity.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Provenance.agent
Definición

An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.

ResumenQuien firma (attester) y el sistema que pidió la firma (assembler)Actor involved
Comentarios

Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa.

Control1..*
TipoBackboneElement
Es modificadorfalse
Must Supporttrue
Resumentrue
Requisitos

An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
prov-1: Who and onBehalfOf cannot be the same (who.resolve().exists() and onBehalfOf.resolve().exists() implies who.resolve() != onBehalfOf.resolve())
prov-2: If who is a PractitionerRole, onBehalfOf can't reference the same Practitioner (who.resolve().ofType(PractitionerRole).practitioner.resolve().exists() and onBehalfOf.resolve().ofType(Practitioner).exists() implies who.resolve().practitioner.resolve() != onBehalfOf.resolve())
prov-3: If who is an organization, onBehalfOf can't be a PractitionerRole within that organization (who.resolve().ofType(Organization).exists() and onBehalfOf.resolve().ofType(PractitionerRole).organization.resolve().exists() implies who.resolve() != onBehalfOf.resolve().organization.resolve())
20. Provenance.agent.modifierExtension
Definición

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).

ResumenExtensions that cannot be ignored even if unrecognized
Comentarios

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..*
TipoExtension
Es modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Resumentrue
Requisitos

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.

Nombres alternativosextensions, user content, modifiers
Invariantesele-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. Provenance.agent.type
Definición

The Functional Role of the agent with respect to the activity.

Resumenattester (quien firma) | assembler (el sistema que pidió la firma)How the agent participated
Comentarios

For example: assembler, author, prescriber, signer, investigator, etc.

Control10..1
VinculaciónPara códigos de ejemplo, vea ParticipationRoleTypehttp://hl7.org/fhir/ValueSet/participation-role-type|5.0.0
(example to http://hl7.org/fhir/ValueSet/participation-role-type|5.0.0)

The type of participation that a provenance agent played with respect to the activity.

TipoCodeableConcept
Es modificadorfalse
Must Supporttrue
Resumentrue
Requisitos

Functional roles reflect functional aspects of relationships between entities. Functional roles are bound to the realization/performance of acts, where actions might be concatenated to an activity or even to a process. This element will hold the functional role that the agent played in the activity that is the focus of this Provenance. Where an agent played multiple functional roles, they will be listed as multiple .agent elements representing each functional participation. See ISO 21298:2018 - Health Informatics - Functional and structural roles, and ISO 22600-2:2014 - Health Informatics - Privilege Management and Access Control - Part 2: formal models.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Provenance.agent.who
Definición

Indicates who or what performed in the event.

ResumenQuien firma, o el sistema que pidió la firmaThe agent that participated in the event
Control1..1
Este elemento está afectado por las siguientes invariantes: prov-1, prov-2, prov-3
TipoReference(Rol del profesional, Profesional de salud, Organización, Sistema de información, Practitioner, PractitionerRole, Organization, CareTeam, Patient, Device, RelatedPerson)
Es modificadorfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Provenance.agent.onBehalfOf
Definición

The agent that delegated authority to perform the activity performed by the agent.who element.

ResumenThe agent that delegated
Control0..1
Este elemento está afectado por las siguientes invariantes: prov-1, prov-2, prov-3
TipoReference(Practitioner, PractitionerRole, Organization, CareTeam, Patient)
Es modificadorfalse
Must Supportfalse
Resumenfalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Provenance.signature
Definición

A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated.

ResumenFirma JAdES de GAUDÍ sobre el documentoSignature on target
Control10..1*
TipoSignature
Es modificadorfalse
Must Supporttrue
Resumenfalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Provenance.signature.type
Definición

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.

Resumen1.2.840.10065.1.12.1.1 (autor) | 1.2.840.10065.1.12.1.6 (validación) | 1.2.840.10065.1.12.1.14 (sello de la organización)Indication of the reason the entity signed the object(s)
Comentarios

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

Control10..*
VinculaciónLos códigos DEBERÍAN tomarse de SignatureTypeCodeshttp://hl7.org/fhir/ValueSet/signature-type|5.0.0
(preferred to http://hl7.org/fhir/ValueSet/signature-type|5.0.0)

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

TipoCoding
Es modificadorfalse
Must Supporttrue
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Provenance.signature.when
Definición

When the digital signature was signed.

ResumenMomento de la solicitud de firmaWhen the signature was created
Comentarios

This should agree with the information in the signature.

Control10..1
Tipoinstant
Es modificadorfalse
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supporttrue
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Provenance.signature.who
Definición

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

ResumenQuien firma: el responsable de la validación legal o la organización que sellaWho signed
Comentarios

This should agree with the information in the signature.

Control10..1
TipoReference(Rol del profesional, Profesional de salud, Organización, Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
Es modificadorfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Provenance.signature.targetFormat
Definición

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

Resumenapplication/fhir+json (valor fijo)The technical format of the signed resources
Comentarios

"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.

Control10..1
VinculaciónLos códigos DEBEN tomarse de 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)

Tipocode
Es modificadorfalse
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supporttrue
Resumenfalse
Pattern Valueapplication/fhir+json
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Provenance.signature.sigFormat
Definición

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.

Resumenapplication/jose+json (valor fijo): JWS en serialización JSONThe technical format of the signature
Control10..1
VinculaciónLos códigos DEBEN tomarse de 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)

Tipocode
Es modificadorfalse
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supporttrue
Resumenfalse
Pattern Valueapplication/jose+json
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Provenance.signature.data
Definición

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

ResumenFirma JAdES B-LT de GAUDÍ sobre el Bundle de trabajo, en base64 con rellenoThe actual signature content (XML DigSig. JWS, picture, etc.)
Comentarios

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.

Control10..1
Tipobase64Binary
Es modificadorfalse
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supporttrue
Resumenfalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Las indicaciones para interpretar el contenido de esta tabla estánaquí

0. Provenance
Definición

Firma digital de un documento clínico (detached): quién firma, cuándo y la firma JAdES de GAUDÍ, referida a la versión exacta del documento.

ResumenFirma digital de un documento clínico, separada del documento
Invariantescr-firma-documento-target-version: El documento se referencia en su versión exacta: Bundle/<id>/_history/<versión>. (target.reference.matches('^(.*/)?Bundle/[A-Za-z0-9\\-\\.]{1,64}/_history/[A-Za-z0-9\\-\\.]{1,64}$'))
cr-firma-documento-firmante: Quien firma es un agente de tipo attester. (signature.who.reference.empty() or agent.where(type.coding.where(code = 'attester').exists()).who.reference contains signature.who.reference)
2. Provenance.target
ResumenEl documento firmado, en su versión exacta: Bundle/<id>/_history/<versión>
Control0..1
TipoReference(Documento clínico (Bundle))
Must Supporttrue
4. Provenance.target.reference
ResumenBundle/<id>/_history/<versión>
Control1..?
Must Supporttrue
6. Provenance.recorded
ResumenCuándo se registró la firma
Control1..?
Must Supporttrue
8. Provenance.activity
Resumenattest (valor fijo): atestación del documento
Control1..?
Must Supporttrue
Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/iso-21089-lifecycle",
    "code" : "attest"
  }]
}
10. Provenance.patient
ResumenPaciente del documento (el subject de su Composition)
Control1..?
TipoReference(Paciente)
Must Supporttrue
12. Provenance.agent
ResumenQuien firma (attester) y el sistema que pidió la firma (assembler)
Must Supporttrue
14. Provenance.agent.type
Resumenattester (quien firma) | assembler (el sistema que pidió la firma)
Control1..?
Must Supporttrue
16. Provenance.agent.who
ResumenQuien firma, o el sistema que pidió la firma
TipoReference(Rol del profesional, Profesional de salud, Organización, Sistema de información)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
18. Provenance.signature
ResumenFirma JAdES de GAUDÍ sobre el documento
Control1..1
Must Supporttrue
20. Provenance.signature.type
Resumen1.2.840.10065.1.12.1.1 (autor) | 1.2.840.10065.1.12.1.6 (validación) | 1.2.840.10065.1.12.1.14 (sello de la organización)
Control1..?
Must Supporttrue
22. Provenance.signature.when
ResumenMomento de la solicitud de firma
Control1..?
Must Supporttrue
24. Provenance.signature.who
ResumenQuien firma: el responsable de la validación legal o la organización que sella
Control1..?
TipoReference(Rol del profesional, Profesional de salud, Organización)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
26. Provenance.signature.targetFormat
Resumenapplication/fhir+json (valor fijo)
Control1..?
Must Supporttrue
Pattern Valueapplication/fhir+json
28. Provenance.signature.sigFormat
Resumenapplication/jose+json (valor fijo): JWS en serialización JSON
Control1..?
Must Supporttrue
Pattern Valueapplication/jose+json
30. Provenance.signature.data
ResumenFirma JAdES B-LT de GAUDÍ sobre el Bundle de trabajo, en base64 con relleno
Control1..?
Must Supporttrue

Las indicaciones para interpretar el contenido de esta tabla estánaquí

0. Provenance
Definición

Firma digital de un documento clínico (detached): quién firma, cuándo y la firma JAdES de GAUDÍ, referida a la versión exacta del documento.

ResumenFirma digital de un documento clínico, separada del documento
Comentarios

Some parties may be duplicated between the target resource and its provenance. For instance, the prescriber is usually (but not always) the author of the prescription resource. This resource is defined with close consideration for W3C Provenance.

Control0..*
Es modificadorfalse
Must Supportfalse
Resumenfalse
Nombres alternativosHistory, Event, Activity
Invariantesdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
cr-firma-documento-target-version: El documento se referencia en su versión exacta: Bundle/<id>/_history/<versión>. (target.reference.matches('^(.*/)?Bundle/[A-Za-z0-9\\-\\.]{1,64}/_history/[A-Za-z0-9\\-\\.]{1,64}$'))
cr-firma-documento-firmante: Quien firma es un agente de tipo attester. (signature.who.reference.empty() or agent.where(type.coding.where(code = 'attester').exists()).who.reference contains signature.who.reference)
2. Provenance.id
Definición

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

ResumenLogical id of this artifact
Comentarios

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
Tipoid
Es modificadorfalse
Must Supportfalse
Resumentrue
4. Provenance.meta
Definición

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.

ResumenMetadata about the resource
Control0..1
TipoMeta
Es modificadorfalse
Must Supportfalse
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Provenance.implicitRules
Definición

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.

ResumenA set of rules under which this content was created
Comentarios

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
Tipouri
Es modificadortrue porque This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supportfalse
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Provenance.language
Definición

The base language in which the resource is written.

ResumenLanguage of the resource content
Comentarios

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
VinculaciónLos códigos DEBEN tomarse de AllLanguages
(required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

IETF language tag for a human language

Tipocode
Es modificadorfalse
Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
Must Supportfalse
Resumenfalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Provenance.text
Definición

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.

ResumenText summary of the resource, for human interpretation
Comentarios

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.

Control0..1
Este elemento está afectado por las siguientes invariantes: dom-6
TipoNarrative
Es modificadorfalse
Must Supportfalse
Resumenfalse
Nombres alternativosnarrative, html, xhtml, display
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Provenance.contained
Definición

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.

ResumenContained, inline Resources
Comentarios

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.

Control0..*
Este elemento está afectado por las siguientes invariantes: dom-2, dom-4, dom-3, dom-5
TipoResource
Es modificadorfalse
Must Supportfalse
Resumenfalse
Nombres alternativosinline resources, anonymous resources, contained resources
14. Provenance.extension
Definición

May be used to represent additional information that is not part of the basic definition of the resource. 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.

ResumenAdditional content defined by implementations
Comentarios

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..*
TipoExtension
Es modificadorfalse
Must Supportfalse
Resumenfalse
Nombres alternativosextensions, user content
Invariantesele-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())
16. Provenance.modifierExtension
Definición

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).

ResumenExtensions that cannot be ignored
Comentarios

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..*
TipoExtension
Es modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Resumentrue
Requisitos

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.

Nombres alternativosextensions, user content
Invariantesele-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())
18. Provenance.target
Definición

The Reference(s) that were generated or updated by the activity described in this resource. A provenance can point to more than one target if multiple resources were created/updated by the same activity.

ResumenEl documento firmado, en su versión exacta: Bundle/<id>/_history/<versión>
Comentarios

Target references are usually version specific, but might not be, if a version has not been assigned or if the provenance information is part of the set of resources being maintained (i.e. a document). When using the RESTful API, the identity of the resource might not be known (especially not the version specific one); the client may either submit the resource first, and then the provenance, or it may submit both using a single transaction. See the notes on transaction for further discussion.

Control1..1
TipoReference(Documento clínico (Bundle))
Es modificadorfalse
Must Supporttrue
Resumentrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Provenance.target.id
Definición

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

ResumenUnique id for inter-element referencing
Control0..1
Este elemento está afectado por las siguientes invariantes: ele-1
Tipoid
Es modificadorfalse
Formato XMLEn el formato XML, esta propiedad se representa como un atributo.
Resumenfalse
22. Provenance.target.extension
Definición

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.

ResumenAdditional content defined by implementations
Comentarios

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..*
TipoExtension
Es modificadorfalse
Resumenfalse
Nombres alternativosextensions, user content
Invariantesele-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())
SlicingEste elemento introduce un conjunto de slices en Provenance.target.extension. Los slices sonSin orden y Open, y se distinguen con los siguientes discriminadores:
  • value @ url
  • 24. Provenance.target.reference
    Definición

    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.

    ResumenBundle/<id>/_history/<versión>
    Comentarios

    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.

    Control1..1
    Este elemento está afectado por las siguientes invariantes: ref-2, ref-1
    Tipostring
    Es modificadorfalse
    Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
    Must Supporttrue
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Provenance.target.type
    Definición

    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

    ResumenType the reference refers to (e.g. "Patient") - must be a resource in resources
    Comentarios

    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

    Control0..1
    VinculaciónSalvo que no sean adecuados, estos códigos DEBEN tomarse de ResourceType
    (extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

    Aa resource (or, for logical models, the URI of the logical model).

    Tipouri
    Es modificadorfalse
    Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Provenance.target.identifier
    Definición

    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.

    ResumenLogical reference, when literal reference is not known
    Comentarios

    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.

    NotaThis is a business identifier, not a resource identifier (see discusión)
    Control0..1
    Este elemento está afectado por las siguientes invariantes: ref-2
    TipoIdentifier
    Es modificadorfalse
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Provenance.target.display
    Definición

    Plain text narrative that identifies the resource in addition to the resource reference.

    ResumenText alternative for the resource
    Comentarios

    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

    Control0..1
    Este elemento está afectado por las siguientes invariantes: ref-2
    Tipostring
    Es modificadorfalse
    Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Provenance.occurred[x]
    Definición

    The period during which the activity occurred.

    ResumenWhen the activity occurred
    Comentarios

    The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.

    Control0..1
    TipoElección de: Period, dateTime
    Nota sobre [x]VeaElección de tipos de datospara más información sobre cómo usar [x]
    Es modificadorfalse
    Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
    Must Supportfalse
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Provenance.recorded
    Definición

    The instant of time at which the activity was recorded.

    ResumenCuándo se registró la firma
    Comentarios

    This can be a little different from the time stamp on the resource if there is a delay between recording the event and updating the provenance and target resource.

    Control1..1
    Tipoinstant
    Es modificadorfalse
    Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
    Must Supporttrue
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Provenance.policy
    Definición

    Policy or plan the activity was defined by. Typically, a single activity may have multiple applicable policy documents, such as patient consent, guarantor funding, etc.

    ResumenPolicy or plan the activity was defined by
    Comentarios

    For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element.

    Control0..*
    Tipouri
    Es modificadorfalse
    Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
    Must Supportfalse
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Provenance.location
    Definición

    Where the activity occurred, if relevant.

    ResumenWhere the activity occurred, if relevant
    Control0..1
    TipoReference(Location)
    Es modificadorfalse
    Must Supportfalse
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Provenance.authorization
    Definición

    The authorization (e.g., PurposeOfUse) that was used during the event being recorded.

    ResumenAuthorization (purposeOfUse) related to the event
    Control0..*
    VinculaciónPara códigos de ejemplo, vea PurposeOfUse
    (example to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

    The authorized purposeOfUse for the activity.

    TipoCodeableReference
    Es modificadorfalse
    Must Supportfalse
    Resumenfalse
    Requisitos

    Record of any relevant security context, not restricted to purposeOfUse valueSet. May include security compartments, refrain, obligation, or other security tags.

    Nombres alternativosPurposeOfEvent
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Provenance.activity
    Definición

    An activity is something that occurs over a period of time and acts upon or with entities; it may include consuming, processing, transforming, modifying, relocating, using, or generating entities.

    Resumenattest (valor fijo): atestación del documento
    Control1..1
    VinculaciónPara códigos de ejemplo, vea ProvenanceActivityType
    (example to http://hl7.org/fhir/ValueSet/provenance-activity-type|5.0.0)

    The activity that took place.

    TipoCodeableConcept
    Es modificadorfalse
    Must Supporttrue
    Resumenfalse
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/iso-21089-lifecycle",
        "code" : "attest"
      }]
    }
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Provenance.basedOn
    Definición

    Allows tracing of authorizatino for the events and tracking whether proposals/recommendations were acted upon.

    ResumenWorkflow authorization within which this event occurred
    Control0..*
    TipoReference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest, Task)
    Es modificadorfalse
    Must Supportfalse
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Provenance.patient
    Definición

    The patient element is available to enable deterministic tracking of activities that involve the patient as the subject of the data used in an activity.

    ResumenPaciente del documento (el subject de su Composition)
    Control1..1
    TipoReference(Paciente)
    Es modificadorfalse
    Must Supporttrue
    Resumenfalse
    Requisitos

    When the .patient is populated it shall be accurate to the subject of the target data. The .patient shall not be populated when the target data created/updated (.target) by the activity does not involve a subject. Note that when the patient is an agent, they will be recorded as an agent. When the Patient resource is Created, Updated, or Deleted it will be recorded as an entity.

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Provenance.encounter
    Definición

    This will typically be the encounter the event occurred, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests).

    ResumenEncounter within which this event occurred or which the event is tightly associated
    Control0..1
    TipoReference(Encounter)
    Es modificadorfalse
    Must Supportfalse
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Provenance.agent
    Definición

    An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.

    ResumenQuien firma (attester) y el sistema que pidió la firma (assembler)
    Comentarios

    Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa.

    Control1..*
    TipoBackboneElement
    Es modificadorfalse
    Must Supporttrue
    Resumentrue
    Requisitos

    An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility.

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    prov-1: Who and onBehalfOf cannot be the same (who.resolve().exists() and onBehalfOf.resolve().exists() implies who.resolve() != onBehalfOf.resolve())
    prov-2: If who is a PractitionerRole, onBehalfOf can't reference the same Practitioner (who.resolve().ofType(PractitionerRole).practitioner.resolve().exists() and onBehalfOf.resolve().ofType(Practitioner).exists() implies who.resolve().practitioner.resolve() != onBehalfOf.resolve())
    prov-3: If who is an organization, onBehalfOf can't be a PractitionerRole within that organization (who.resolve().ofType(Organization).exists() and onBehalfOf.resolve().ofType(PractitionerRole).organization.resolve().exists() implies who.resolve() != onBehalfOf.resolve().organization.resolve())
    52. Provenance.agent.id
    Definición

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

    ResumenUnique id for inter-element referencing
    Control0..1
    Este elemento está afectado por las siguientes invariantes: ele-1
    Tipostring
    Es modificadorfalse
    Formato XMLEn el formato XML, esta propiedad se representa como un atributo.
    Resumenfalse
    54. Provenance.agent.extension
    Definición

    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.

    ResumenAdditional content defined by implementations
    Comentarios

    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..*
    TipoExtension
    Es modificadorfalse
    Resumenfalse
    Nombres alternativosextensions, user content
    Invariantesele-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())
    56. Provenance.agent.modifierExtension
    Definición

    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).

    ResumenExtensions that cannot be ignored even if unrecognized
    Comentarios

    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..*
    TipoExtension
    Es modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Resumentrue
    Requisitos

    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.

    Nombres alternativosextensions, user content, modifiers
    Invariantesele-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())
    58. Provenance.agent.type
    Definición

    The Functional Role of the agent with respect to the activity.

    Resumenattester (quien firma) | assembler (el sistema que pidió la firma)
    Comentarios

    For example: assembler, author, prescriber, signer, investigator, etc.

    Control1..1
    VinculaciónPara códigos de ejemplo, vea ParticipationRoleType
    (example to http://hl7.org/fhir/ValueSet/participation-role-type|5.0.0)

    The type of participation that a provenance agent played with respect to the activity.

    TipoCodeableConcept
    Es modificadorfalse
    Must Supporttrue
    Resumentrue
    Requisitos

    Functional roles reflect functional aspects of relationships between entities. Functional roles are bound to the realization/performance of acts, where actions might be concatenated to an activity or even to a process. This element will hold the functional role that the agent played in the activity that is the focus of this Provenance. Where an agent played multiple functional roles, they will be listed as multiple .agent elements representing each functional participation. See ISO 21298:2018 - Health Informatics - Functional and structural roles, and ISO 22600-2:2014 - Health Informatics - Privilege Management and Access Control - Part 2: formal models.

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. Provenance.agent.role
    Definición

    The structural roles of the agent indicating the agent's competency. The security role enabling the agent with respect to the activity.

    ResumenWhat the agents role was
    Comentarios

    For example: Chief-of-Radiology, Nurse, Physician, Medical-Student, etc.

    Control0..*
    VinculaciónPara códigos de ejemplo, vea SecurityRoleType
    (example to http://hl7.org/fhir/ValueSet/security-role-type|5.0.0)

    The role that a provenance agent played with respect to the activity.

    TipoCodeableConcept
    Es modificadorfalse
    Must Supportfalse
    Resumenfalse
    Requisitos

    Structural roles reflect the structural aspects of relationships between entities. Structural roles describe prerequisites, feasibilities, or competences for acts. Functional roles reflect functional aspects of relationships between entities. Functional roles are bound to the realization/performance of acts, where actions might be concatenated to an activity or even to a process. See ISO 21298:2018 - Health Informatics - Functional and structural roles, and ISO 22600-2:2014 - Health Informatics - Privilege Management and Access Control - Part 2: formal models..

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. Provenance.agent.who
    Definición

    Indicates who or what performed in the event.

    ResumenQuien firma, o el sistema que pidió la firma
    Control1..1
    Este elemento está afectado por las siguientes invariantes: prov-1, prov-2, prov-3
    TipoReference(Rol del profesional, Profesional de salud, Organización, Sistema de información)
    Es modificadorfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    64. Provenance.agent.onBehalfOf
    Definición

    The agent that delegated authority to perform the activity performed by the agent.who element.

    ResumenThe agent that delegated
    Control0..1
    Este elemento está afectado por las siguientes invariantes: prov-1, prov-2, prov-3
    TipoReference(Practitioner, PractitionerRole, Organization, CareTeam, Patient)
    Es modificadorfalse
    Must Supportfalse
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    66. Provenance.entity
    Definición

    An entity used in this activity.

    ResumenAn entity used in this activity
    Control0..*
    TipoBackboneElement
    Es modificadorfalse
    Must Supportfalse
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    68. Provenance.entity.id
    Definición

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

    ResumenUnique id for inter-element referencing
    Control0..1
    Este elemento está afectado por las siguientes invariantes: ele-1
    Tipostring
    Es modificadorfalse
    Formato XMLEn el formato XML, esta propiedad se representa como un atributo.
    Resumenfalse
    70. Provenance.entity.extension
    Definición

    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.

    ResumenAdditional content defined by implementations
    Comentarios

    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..*
    TipoExtension
    Es modificadorfalse
    Resumenfalse
    Nombres alternativosextensions, user content
    Invariantesele-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())
    72. Provenance.entity.modifierExtension
    Definición

    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).

    ResumenExtensions that cannot be ignored even if unrecognized
    Comentarios

    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..*
    TipoExtension
    Es modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Resumentrue
    Requisitos

    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.

    Nombres alternativosextensions, user content, modifiers
    Invariantesele-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())
    74. Provenance.entity.role
    Definición

    How the entity was used during the activity.

    Resumenrevision | quotation | source | instantiates | removal
    Control1..1
    VinculaciónLos códigos DEBEN tomarse de ProvenanceEntityRole
    (required to http://hl7.org/fhir/ValueSet/provenance-entity-role|5.0.0)

    How an entity was used in an activity.

    Tipocode
    Es modificadorfalse
    Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
    Must Supportfalse
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    76. Provenance.entity.what
    Definición

    Identity of the Entity used. May be a logical or physical uri and maybe absolute or relative.

    ResumenIdentity of entity
    Comentarios

    whatIdentity should be used for entities that are not a Resource type.

    Control1..1
    TipoReference(Resource)
    Es modificadorfalse
    Must Supportfalse
    Resumentrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    78. Provenance.entity.agent
    Definición

    The entity is attributed to an agent to express the agent's responsibility for that entity, possibly along with other agents. This description can be understood as shorthand for saying that the agent was responsible for the activity which used the entity.

    ResumenEntity is attributed to this agent
    Comentarios

    A usecase where one Provenance.entity.agent is used where the Entity that was used in the creation/updating of the Target, is not in the context of the same custodianship as the Target, and thus the meaning of Provenance.entity.agent is to say that the entity referenced is managed elsewhere and that this Agent provided access to it. This would be similar to where the Entity being referenced is managed outside FHIR, such as through HL7 V2, v3, or XDS. This might be where the Entity being referenced is managed in another FHIR resource server. Thus it explains the Provenance of that Entity's use in the context of this Provenance activity.

    Control0..*
    TipoVeattp://hl7.org/fhir/StructureDefinition/Provenance#Provenance.agent
    Es modificadorfalse
    Must Supportfalse
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    80. Provenance.signature
    Definición

    A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated.

    ResumenFirma JAdES de GAUDÍ sobre el documento
    Control1..1
    TipoSignature
    Es modificadorfalse
    Must Supporttrue
    Resumenfalse
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    82. Provenance.signature.id
    Definición

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

    ResumenUnique id for inter-element referencing
    Control0..1
    Este elemento está afectado por las siguientes invariantes: ele-1
    Tipoid
    Es modificadorfalse
    Formato XMLEn el formato XML, esta propiedad se representa como un atributo.
    Resumenfalse
    84. Provenance.signature.extension
    Definición

    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.

    ResumenAdditional content defined by implementations
    Comentarios

    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..*
    TipoExtension
    Es modificadorfalse
    Resumenfalse
    Nombres alternativosextensions, user content
    Invariantesele-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())
    SlicingEste elemento introduce un conjunto de slices en Provenance.signature.extension. Los slices sonSin orden y Open, y se distinguen con los siguientes discriminadores:
    • value @ url
    • 86. Provenance.signature.type
      Definición

      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.

      Resumen1.2.840.10065.1.12.1.1 (autor) | 1.2.840.10065.1.12.1.6 (validación) | 1.2.840.10065.1.12.1.14 (sello de la organización)
      Comentarios

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

      Control1..*
      VinculaciónLos códigos DEBERÍAN tomarse de SignatureTypeCodes
      (preferred to http://hl7.org/fhir/ValueSet/signature-type|5.0.0)

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

      TipoCoding
      Es modificadorfalse
      Must Supporttrue
      Resumentrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      88. Provenance.signature.when
      Definición

      When the digital signature was signed.

      ResumenMomento de la solicitud de firma
      Comentarios

      This should agree with the information in the signature.

      Control1..1
      Tipoinstant
      Es modificadorfalse
      Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
      Must Supporttrue
      Resumentrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      90. Provenance.signature.who
      Definición

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

      ResumenQuien firma: el responsable de la validación legal o la organización que sella
      Comentarios

      This should agree with the information in the signature.

      Control1..1
      TipoReference(Rol del profesional, Profesional de salud, Organización)
      Es modificadorfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Resumentrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      92. Provenance.signature.onBehalfOf
      Definición

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

      ResumenThe party represented
      Comentarios

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

      Control0..1
      TipoReference(Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
      Es modificadorfalse
      Resumentrue
      Requisitos

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

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      94. Provenance.signature.targetFormat
      Definición

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

      Resumenapplication/fhir+json (valor fijo)
      Comentarios

      "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.

      Control1..1
      VinculaciónLos códigos DEBEN tomarse de MimeTypes
      (required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

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

      Tipocode
      Es modificadorfalse
      Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
      Must Supporttrue
      Resumenfalse
      Pattern Valueapplication/fhir+json
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      96. Provenance.signature.sigFormat
      Definición

      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.

      Resumenapplication/jose+json (valor fijo): JWS en serialización JSON
      Control1..1
      VinculaciónLos códigos DEBEN tomarse de MimeTypes
      (required to http://hl7.org/fhir/ValueSet/mimetypes|5.0.0)

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

      Tipocode
      Es modificadorfalse
      Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
      Must Supporttrue
      Resumenfalse
      Pattern Valueapplication/jose+json
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      98. Provenance.signature.data
      Definición

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

      ResumenFirma JAdES B-LT de GAUDÍ sobre el Bundle de trabajo, en base64 con relleno
      Comentarios

      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.

      Control1..1
      Tipobase64Binary
      Es modificadorfalse
      Valor primitivoEste elemento primitivo puede estar presente, ausente o reemplazado por una extensión
      Must Supporttrue
      Resumenfalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))