Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1

Da Vinci Clinical Data Exchange (CDex), published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ecdx/ and changes regularly. See the Directory of published versions

## Data Type Profile: CDex Digital Signature Profile

Official URL: http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-digital-signature | Version: 2.1.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: CDexDigitalSignature
Other Identifiers: OID:2.16.840.1.113883.4.642.40.21.42.1
Copyright/Legal: Used by permission of HL7 International all rights reserved Creative Commons License

This Signature DataType profile enforces the various elements of digital signatures documented in Digital Signature Rules and Guidance For CDEX Bundle and QuestionnaireResponse.

Usages:

- Use this DataType Profile: CDex SDC QuestionnaireResponse Profile and CDex Signature Bundle Profile

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Signature |  | 0..* | Signature | CDex Bundle and QuestionnaireResponse signature
Slices for type | S Σ | 1..* | Coding | Indication of the reason the entity signed the object(s) Slice: Unordered, Open by value:$this Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object.
type:verify | S Σ | 1..1 | Coding | Verification Signature Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: urn:iso-astm:E1762-95:2013
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1.2.840.10065.1.12.1.5
display |  | 1..1 | string | Representation defined by the system Fixed Value: Verification Signature
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
when | S Σ | 1..1 | instant | When the signature was created
who | S Σ | 1..1 | Reference(US Core Practitioner Profile(3.1.1) S | US Core Practitioner Profile(6.1.0) S | US Core Practitioner Profile(7.0.0) S | HRex Organization Profile(1.1.0) S | HRex PractitionerRole Profile(1.1.0)) | Organization or practitioner who signed the Bundle
identifier | S Σ | 1..1 | Identifier | NPI or US Tax ID
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
targetFormat | S | 1..1 | code | Canonicalization method Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document
sigFormat | S | 1..1 | code | The JWS mime type Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/jose
data | S | 1..1 | base64Binary | base64 encoded JSON Web Signature (JWS)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Signature.type | preferred | SignatureTypeCodes `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.type:verify | preferred | Pattern Value: 1.2.840.10065.1.12.1.5("Verification Signature") `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.who.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Signature.targetFormat | required | Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard
Signature.sigFormat | required | Fixed Value: application/jose `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |

This structure is derived from Signature

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Signature |  | 0..* | Signature | CDex Bundle and QuestionnaireResponse signature
Slices for type | S | 1..* | Coding | Indication of the reason the entity signed the object(s) Slice: Unordered, Open by value:$this
type:verify | S | 1..1 | Coding | Verification Signature Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: urn:iso-astm:E1762-95:2013
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1.2.840.10065.1.12.1.5
display |  | 1..1 | string | Representation defined by the system Fixed Value: Verification Signature
when | S | 1..1 | instant | When the signature was created
who | S | 1..1 | Reference(US Core Practitioner Profile(3.1.1) S | US Core Practitioner Profile(6.1.0) S | US Core Practitioner Profile(7.0.0) S | HRex Organization Profile(1.1.0) S | HRex PractitionerRole Profile(1.1.0)) | Organization or practitioner who signed the Bundle
identifier | S | 1..1 | Identifier | NPI or US Tax ID
system | S | 0..1 | uri | The namespace for the identifier value
value | S | 1..1 | string | The value that is unique
targetFormat | S | 1..1 | code | Canonicalization method Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document
sigFormat | S | 1..1 | code | The JWS mime type Fixed Value: application/jose
data | S | 1..1 | base64Binary | base64 encoded JSON Web Signature (JWS)
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Signature |  | 0..* | Signature | CDex Bundle and QuestionnaireResponse signature
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for type | S Σ | 1..* | Coding | Indication of the reason the entity signed the object(s) Slice: Unordered, Open by value:$this Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object.
type:verify | S Σ | 1..1 | Coding | Verification Signature Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: urn:iso-astm:E1762-95:2013
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1.2.840.10065.1.12.1.5
display |  | 1..1 | string | Representation defined by the system Fixed Value: Verification Signature
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
when | S Σ | 1..1 | instant | When the signature was created
who | S Σ | 1..1 | Reference(US Core Practitioner Profile(3.1.1) S | US Core Practitioner Profile(6.1.0) S | US Core Practitioner Profile(7.0.0) S | HRex Organization Profile(1.1.0) S | HRex PractitionerRole Profile(1.1.0)) | Organization or practitioner who signed the Bundle
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | S Σ | 1..1 | Identifier | NPI or US Tax ID
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
display | Σ | 0..1 | string | Text alternative for the resource
onBehalfOf | Σ | 0..1 | Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) | The party represented
targetFormat | S | 1..1 | code | Canonicalization method Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document
sigFormat | S | 1..1 | code | The JWS mime type Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/jose
data | S | 1..1 | base64Binary | base64 encoded JSON Web Signature (JWS)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Signature.type | preferred | SignatureTypeCodes `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.type:verify | preferred | Pattern Value: 1.2.840.10065.1.12.1.5("Verification Signature") `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.who.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` From the FHIR Standard
Signature.who.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Signature.who.identifier.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Signature.targetFormat | required | Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard
Signature.sigFormat | required | Fixed Value: application/jose `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from Signature

Summary

Mandatory: 7 elements
Must-Support: 10 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|3.1.1)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0)
- HRex Organization Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Signature.type

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Signature |  | 0..* | Signature | CDex Bundle and QuestionnaireResponse signature
Slices for type | S Σ | 1..* | Coding | Indication of the reason the entity signed the object(s) Slice: Unordered, Open by value:$this Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object.
type:verify | S Σ | 1..1 | Coding | Verification Signature Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: urn:iso-astm:E1762-95:2013
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1.2.840.10065.1.12.1.5
display |  | 1..1 | string | Representation defined by the system Fixed Value: Verification Signature
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
when | S Σ | 1..1 | instant | When the signature was created
who | S Σ | 1..1 | Reference(US Core Practitioner Profile(3.1.1) S | US Core Practitioner Profile(6.1.0) S | US Core Practitioner Profile(7.0.0) S | HRex Organization Profile(1.1.0) S | HRex PractitionerRole Profile(1.1.0)) | Organization or practitioner who signed the Bundle
identifier | S Σ | 1..1 | Identifier | NPI or US Tax ID
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
targetFormat | S | 1..1 | code | Canonicalization method Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document
sigFormat | S | 1..1 | code | The JWS mime type Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/jose
data | S | 1..1 | base64Binary | base64 encoded JSON Web Signature (JWS)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Signature.type | preferred | SignatureTypeCodes `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.type:verify | preferred | Pattern Value: 1.2.840.10065.1.12.1.5("Verification Signature") `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.who.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Signature.targetFormat | required | Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard
Signature.sigFormat | required | Fixed Value: application/jose `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |

Differential View

This structure is derived from Signature

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Signature |  | 0..* | Signature | CDex Bundle and QuestionnaireResponse signature
Slices for type | S | 1..* | Coding | Indication of the reason the entity signed the object(s) Slice: Unordered, Open by value:$this
type:verify | S | 1..1 | Coding | Verification Signature Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: urn:iso-astm:E1762-95:2013
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1.2.840.10065.1.12.1.5
display |  | 1..1 | string | Representation defined by the system Fixed Value: Verification Signature
when | S | 1..1 | instant | When the signature was created
who | S | 1..1 | Reference(US Core Practitioner Profile(3.1.1) S | US Core Practitioner Profile(6.1.0) S | US Core Practitioner Profile(7.0.0) S | HRex Organization Profile(1.1.0) S | HRex PractitionerRole Profile(1.1.0)) | Organization or practitioner who signed the Bundle
identifier | S | 1..1 | Identifier | NPI or US Tax ID
system | S | 0..1 | uri | The namespace for the identifier value
value | S | 1..1 | string | The value that is unique
targetFormat | S | 1..1 | code | Canonicalization method Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document
sigFormat | S | 1..1 | code | The JWS mime type Fixed Value: application/jose
data | S | 1..1 | base64Binary | base64 encoded JSON Web Signature (JWS)
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Signature |  | 0..* | Signature | CDex Bundle and QuestionnaireResponse signature
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for type | S Σ | 1..* | Coding | Indication of the reason the entity signed the object(s) Slice: Unordered, Open by value:$this Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object.
type:verify | S Σ | 1..1 | Coding | Verification Signature Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: urn:iso-astm:E1762-95:2013
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1.2.840.10065.1.12.1.5
display |  | 1..1 | string | Representation defined by the system Fixed Value: Verification Signature
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
when | S Σ | 1..1 | instant | When the signature was created
who | S Σ | 1..1 | Reference(US Core Practitioner Profile(3.1.1) S | US Core Practitioner Profile(6.1.0) S | US Core Practitioner Profile(7.0.0) S | HRex Organization Profile(1.1.0) S | HRex PractitionerRole Profile(1.1.0)) | Organization or practitioner who signed the Bundle
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | S Σ | 1..1 | Identifier | NPI or US Tax ID
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
display | Σ | 0..1 | string | Text alternative for the resource
onBehalfOf | Σ | 0..1 | Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) | The party represented
targetFormat | S | 1..1 | code | Canonicalization method Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document
sigFormat | S | 1..1 | code | The JWS mime type Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Fixed Value: application/jose
data | S | 1..1 | base64Binary | base64 encoded JSON Web Signature (JWS)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Signature.type | preferred | SignatureTypeCodes `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.type:verify | preferred | Pattern Value: 1.2.840.10065.1.12.1.5("Verification Signature") `http://hl7.org/fhir/ValueSet/signature-type` From the FHIR Standard
Signature.who.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` From the FHIR Standard
Signature.who.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Signature.who.identifier.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Signature.targetFormat | required | Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard
Signature.sigFormat | required | Fixed Value: application/jose `http://hl7.org/fhir/ValueSet/mimetypes|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from Signature

Summary

Mandatory: 7 elements
Must-Support: 10 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|3.1.1)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0)
- HRex Organization Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Signature.type

Maturity: 2

Other representations of profile: CSV, Excel, Schematron