# steps to create/update dig signature examples # # 1. create unsigned Bundle or QuestionnaireResponse example source file with minified Narrative element(s) to prevent the publisher from adding its own. # 1. for Documents Bundles use the autogenerated narrative instead to get it to verify. ( use only the -i parameter to keep the meta elements ) # 1. optionally create certificate using this script file: https://github.com/HL7/davinci-ecdx/blob/master/CDEX-Signatures/Create_Cert.ipynb # 1. create signatures using this script file: https://github.com/HL7/davinci-ecdx/blob/master/CDEX-Signatures/Create_Digsign_Bundle_or_QR.ipynb # - remove elements from payload as defined by the signature canonical and publisher requirements (for example, meta profile elements) # 1. save to YAML source # 1. run sushi and publisher again with -ink parameters # 1. verify signatures using this script file: https://github.com/HL7/davinci-ecdx/blob/master/CDEX-Signatures/Verify_digsign_Bundle_or_QR.ipynb resourceType: Bundle identifier: system: urn:ietf:rfc:3986 value: urn:uuid:c173535e-135e-48e3-ab64-38bacc68dba8 type: document timestamp: '2021-10-25T20:16:29-07:00' entry: - fullUrl: urn:uuid:17a80a8d-4cf1-4deb-a1fd-2db1130e5f76 resource: resourceType: Composition id: 17a80a8d-4cf1-4deb-a1fd-2db1130e5f76 text: status: generated div: '

Medical Records Document

This document, titled "Active Conditions," was created on October 25, 2021, by Dr. John Hancock, who also legally attested to its accuracy on the same date. It summarizes the active medical conditions for a patient based on an emergency encounter on October 25, 2021. The document includes one section detailing an active condition: Type 2 Diabetes Mellitus.

' status: final type: coding: - system: http://loinc.org code: 11503-0 text: Medical records subject: reference: urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece display: Example Patient encounter: reference: urn:uuid:5ce5c83a-000f-47d2-941c-039358cc9112 display: Example Encounter date: '2021-10-25T20:16:29-07:00' author: - reference: urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc display: Example Practitioner title: Active Conditions attester: - mode: legal time: '2021-10-25T20:16:29-07:00' party: reference: urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc display: Example Practitioner section: - title: Active Condition 1 entry: - reference: urn:uuid:014a68ec-d691-49e0-b980-91b0d924e570 - fullUrl: urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc resource: resourceType: Practitioner id: 0820c16d-91de-4dfa-a3a6-f140a516a9bc meta: lastUpdated: '2013-05-05T16:13:03Z' profile: - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|3.1.1 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0 text: status: generated div:

Practitioner Information

Dr. John Hancock is a healthcare provider with National Provider Identifier (NPI) 9941339100. He authored and attested to the medical records document.

identifier: - system: http://hl7.org/fhir/sid/us-npi value: '9941339100' name: - family: Hancock given: - John - fullUrl: urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece resource: resourceType: Patient id: 970af6c9-5bbd-4067-b6c1-d9b2c823aece meta: profile: - http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|3.1.1 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0 text: status: generated div:

Patient Information

CDEX Example Patient, a male, is identified by member ID Member123 in the payer system http://example.org/cdex/payer/member-ids. He is the subject of this medical records document. The patient said, "I feel great!"

identifier: - type: coding: - system: http://terminology.hl7.org/CodeSystem/v2-0203 code: MB system: http://example.org/cdex/payer/member-ids value: Member123 active: true name: - text: CDEX Example Patient family: Patient given: - CDEX Example gender: male - fullUrl: urn:uuid:014a68ec-d691-49e0-b980-91b0d924e570 resource: resourceType: Condition id: 014a68ec-d691-49e0-b980-91b0d924e570 meta: profile: - http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition|3.1.1 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|7.0.0 text: status: generated div: "

Active Condition

The patient has an active diagnosis of Type\ \ 2 Diabetes Mellitus (SNOMED CT: 44054006), first identified in 2006. This\ \ condition was documented by Dr. John Hancock and is listed as a problem\ \ on the patient\u2019s problem list.

" identifier: - system: urn:oid:1.3.6.1.4.1.22812.4.111.0.4.1.2.1 value: '1' clinicalStatus: coding: - system: http://terminology.hl7.org/CodeSystem/condition-clinical code: active category: - coding: - system: http://terminology.hl7.org/CodeSystem/condition-category code: problem-list-item display: Problem List Item text: Problem List Item code: coding: - system: http://snomed.info/sct code: '44054006' display: Type 2 Diabetes Mellitus subject: reference: urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece onsetDateTime: '2006' asserter: reference: urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc - fullUrl: urn:uuid:5ce5c83a-000f-47d2-941c-039358cc9112 resource: resourceType: Encounter id: 5ce5c83a-000f-47d2-941c-039358cc9112 meta: profile: - http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|3.1.1 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|6.1.0 - http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|7.0.0 text: status: generated div: '

Encounter Details

An emergency encounter occurred on October 25, 2021, from 8:10 PM to 8:16 PM, involving CDEX Example Patient and attended by Dr. John Hancock at CDEX Example Organization. The encounter type is unspecified (SNOMED CT: 261665006).

' status: finished class: system: http://terminology.hl7.org/CodeSystem/v3-ActCode code: EMER type: - coding: - system: http://snomed.info/sct code: '261665006' display: Unknown (qualifier value) text: Unknown (qualifier value) subject: reference: urn:uuid:970af6c9-5bbd-4067-b6c1-d9b2c823aece display: CDEX Example Patient participant: - individual: reference: urn:uuid:0820c16d-91de-4dfa-a3a6-f140a516a9bc display: John Hancock period: start: '2021-10-25T20:10:29-07:00' end: '2021-10-25T20:16:29-07:00' serviceProvider: reference: urn:uuid:e37f004b-dc10-422b-b833-cdaa10a055a3 display: CDEX Example Organization - fullUrl: urn:uuid:e37f004b-dc10-422b-b833-cdaa10a055a3 resource: resourceType: Organization id: e37f004b-dc10-422b-b833-cdaa10a055a3 meta: profile: - http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization text: status: generated div: '

Organization Information

CDEX Example Organization, located at 1 CDEX Lane, Boston, MA 01002, USA, is the service provider for the documented encounter. Contact details include phone: (+1) 555-555-5555 and email: customer-service@example.org. The organization''s NPI is 1234567893.

' identifier: - system: http://hl7.org/fhir/sid/us-npi value: '1234567893' active: true name: CDEX Example Organization telecom: - system: phone value: (+1) 555-555-5555 - system: email value: customer-service@example.org address: - line: - 1 CDEX Lane city: Boston state: MA postalCode: '01002' country: USA id: cdex-document-digital-sig-example meta: profile: - http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-signature-bundle extension: - url: http://hl7.org/fhir/StructureDefinition/instance-name valueString: CDEX Document with Digital Signature Example - url: http://hl7.org/fhir/StructureDefinition/instance-description valueMarkdown: Digital signature example showing how it is used to sign a FHIR Document. The CDEX use case would be the target resource in response to a Task-based request where a digital signature was required. If no signature was required, the response would typically be in the form of an individual resource. signature: type: - system: urn:iso-astm:E1762-95:2013 code: 1.2.840.10065.1.12.1.5 display: Verification Signature when: '2020-10-23T04:54:56.048+00:00' who: identifier: system: http://hl7.org/fhir/sid/us-npi type: coding: - system: http://terminology.hl7.org/CodeSystem/v2-0203 code: NPI value: '9941339100' display: John Hancock, MD onBehalfOf: identifier: system: http://hl7.org/fhir/sid/us-npi value: '1234567893' targetFormat: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document sigFormat: application/jose data: ZXlKaGJHY2lPaUpTVXpJMU5pSXNJbXRwWkNJNkltSm1ZbVV6WlRWak1EUTNNRFEwTkRVM05qVTBPREV4TXpreU9HUTFaakZsTkdVelpqSmxaV0lpTENKcmRIa2lPaUpTVXlJc0luTnBaMVFpT2lJeU1ESXdMVEV3TFRJelZEQTBPalUwT2pVMkxqQTBPQ3N3TURvd01DSXNJbk55UTIxeklqcGJleUpqYjIxdFNXUWlPbnNpWkdWell5STZJbFpsY21sbWFXTmhkR2x2YmlCVGFXZHVZWFIxY21VaUxDSnBaQ0k2SW5WeWJqcHZhV1E2TVM0eUxqZzBNQzR4TURBMk5TNHhMakV5TGpFdU5TSjlMQ0pqYjIxdFVYVmhiSE1pT2xzaVZtVnlhV1pwWTJGMGFXOXVJRzltSUcxbFpHbGpZV3dnY21WamIzSmtJR2x1ZEdWbmNtbDBlU0pkZlYwc0luUjVjQ0k2SWtwWFZDSXNJbmcxWXlJNld5Sk5TVWxHVm5wRFEwRTNLMmRCZDBsQ1FXZEpWVUp1TkROR05FOHhNVEI2Vms1SVVGVjBRbTV1V0dZek0wWlJkM2RFVVZsS1MyOWFTV2gyWTA1QlVVVk1RbEZCZDJkYVZYaERla0ZLUW1kT1ZrSkJXVlJCYkZaVVRWSk5kMFZSV1VSV1VWRkpSRUZ3UkZsWGVIQmFiVGw1WW0xc2FFMVNTWGRGUVZsRVZsRlJTRVJCYkZSWldGWjZXVmQ0Y0dSSE9IaElWRUZpUW1kT1ZrSkJiMDFHUlZZMFdWY3hkMkpIVldkVU0wcHVXVmMxY0dWdFJqQmhWemwxVFZKcmQwWjNXVVJXVVZGRVJFSkNTMkl5YUhWSlJXaG9ZbTFPZGxreWMzTkpSVEZGVFZOTmQwbFJXVXBMYjFwSmFIWmpUa0ZSYTBKR2FGSnhZVWRHZFZreU9XcGhNRUpzWlVkR2RHTkhlR3hNYlRsNVducEJaVVozTUhsT1ZFRXlUV3BWZVUxNlJYbE5lbXhoUm5jd2VVNTZRVEpOVkZWNVRYcEZlVTE2YkdGTlNVZFdUVkZ6ZDBOUldVUldVVkZIUlhkS1ZsVjZSVlJOUWtWSFFURlZSVU5CZDB0Uk1rWnpZVmRhZG1OdE5YQlpWRVZUVFVKQlIwRXhWVVZDZDNkS1ZUSkdNV015Um5OaFdGSjJUVkl3ZDBkM1dVUldVVkZMUkVKU1JtVkhSblJqUjNoc1NVVTVlVm95Um5WaFdIQm9aRWRzZG1KcVJWcE5RbU5IUVRGVlJVRjNkMUZUYlRsdlltbENTVmxYTldwaU1rNXlURU5DVGxKRVJXcE5RMFZIUTFOeFIxTkpZak5FVVVWS1FWSlpWV0Z0YUdoaWJVNTJXVEowUVZwWWFHaGlXRUp6V2xNMWRtTnRZM2RuWjBkcFRVRXdSME5UY1VkVFNXSXpSRkZGUWtGUlZVRkJORWxDYW5kQmQyZG5SMHRCYjBsQ1oxRkRZMWh0ZGxnMk1FZEJOVWNyUkd3MGFWSnVPVlJUTDNkVVJqRkdWRWc1VW0xeVVESTVSelpZVTA5MVZrUkZaMGRhZDFWVVNra3ZUMnRTVEZCcUswcFZTM2t2YTAxWk0xbHROREZyTTBwU2NqaE9ja28zVldOcVpqTlVaVEpaTUhwdFVrMW1SMHRQTWxnM2NEQXhTV1E0Y2tkb2JtSnpWR3RYYW5ONlkyTnJha3RQVkdzM1JUUklXRTgzV0ZGdFZuWlNXbUZRY21wdVZsWnplalpoU1ZWdGJWVjVRbVZ0VlhoelVGRjRjV3RrTnpkNlVrdGxNVW9yWmsxaWNHSlRibUZHTWxNMVNEbEpOVWx3VVhVelpYSlRhazUzZFc1MWJVcEJMelZ6VGtGVFRWVm1LMXB5U3pWb2RIZFFabXh2Ym14V1FUbElSVkJ2Tms0MWRFcHpRMDFGV1RWeGExcEJXRVExTlZCVlltWTRTWGh5WkRNcmRERnBXRTVCWjAxa1dGQndPVTVxWm0xcmVtRklUM05TTlVWTU56aHZWbVowUzBnNFdFMW5jemxNSzFoWWFHTnRjQ3RUZFZOaVZWUXJiR0ZSUm01TFdsbzJOakZGUWpoVlZsRkhVR2h6U0dOMVdYbzNUUzhyUjBRM2JHdHRialYzTjJjMmFYcFpNRFZFY3pGMFpIUm9NMmhDSzBVeFpUQldPR0ZzTUN0SVdYaFlkRzFNTWpoUFluSjFjbHAwTlZaUFZEWXpObUZDVjJWaGF6TnRNV3gwSzBwTWFWUlhkMk5KV0hWeWFVcDNXRU5STjFjeVQyaEpjbXhsUW01ME5WbFNaRVl2Vm5kclFXWTFRbkEwTUVSTGNsbFRka0pVTDNnelVHRnlZbU5CY3pWeWRXRTBUV2w2ZEhwM2VrMURRWGRGUVVGaFQwSnVSRU5DYlZSQlNrSm5UbFpJVWsxRlFXcEJRVTFCYzBkQk1WVmtSSGRSUlVGM1NVWTBSRUpuUW1kT1ZraFNSVVZYVkVKWVoyYzVNMlF6WTNWYVdHaG9ZbGhDYzFwVE5YWmpiV1ZuUjFGWlNsbEpXa2xCV1dJMVYzZFJSMjlCZDAxRGFtczFUa1JGZWsxNmEzaE5SRU5IUzFkb01HUklRbnBQYVRoMldsaG9hR0pZUW5OYVV6VjJZMjFqZGxwdGFIQmphVGxSWTIxR2FtUkhiREJoVnpsMVdsaEpkazFVU1hwTlFqQkhRVEZWWkVSblVWZENRbE12ZG1vMVkwSklRa1ZTV0ZwVloxSlBVMnBXT0dWVWFqaDFObnBCVGtKbmEzRm9hMmxIT1hjd1FrRlJjMFpCUVU5RFFWbEZRV1pIYURCbWRqYzJRazE1VW5CcGJpODJiVEpPYms5QmQxbE9LMWRaVGxjMFduZFJTMUJ2YUN0cFFrWnFaMkl2WjFoYUwzZ3paRzVIY1RKU1ZXNVNTRXg1WW1OMmNVOTNRemgwTkN0TU1sRmhaVzUwZWk5NlUweG1Ra2xwU0ZBcmRuUmhkVlp2TkZscGNsVkxTVVpQTlU1clJHSlFVbmRGV0RaYWNHOTBkMUpGTW5BeldWQlBjVzFNYWxWd2RYRmxla3RTWm5WNlptWkZVMGxIUTFkbU5tSkJXbTlJT0c5MmVYcHJjRlZQZUZReWJHTktUREpaVVdkNFlVVkZLeTlOVDBWRWVHSjVMMGMxZEU1c1NGZFZNWEp0TWpsRVdrUTJhVlJ1T0VaSVRVOWlORVJCWlV4ek4yUmxWVUpMWlVGNGJVTk9NWGN3TjBsaVNHWlVXQ3M0ZUc5NlFtczRiVFJ5VVdGU1NUSkdZV05IWTA0dlV6UlBhMmxwYW14b2ExbHVSR1JpWWpaYWIwbENPVGxCVFVjdk1IUk5aMWRuYURVMVJrTk1PWGN5ZVhWaVJrUnpVaXN4ZVZwWE5YYzJlSFpXZFdKR2IzRXlja3RKV1U0MlFsUk5WRE0wT1U0clMxbEdVbFJpSzNCWU1EUlJSa1pEY1ZneFQzbDFVVVZLYWtwd1dtRjFURWxXVTIxVllWWjZSRmRrWVZKdGREQnlhMHhFTmxJNE5YUm9XVXB3VG5oTmNqUnZRWEp6ZVRWcGJEVk1NRXBXVFVWWVJ6RXhRMmhGZUZKRFNqZFljMmhyZEV4cWFpdEJPR3hrVlZKeVRFaFNWMWh2ZEhnMmJVNVdjRE1yVFc5cFEyaDROMUJtYmtkMlExQmhVSFpyVEZGeGFXVTRaRGh5YXpCbGFrNHpJbDE5Li5JU2JVQ3J5T29oQjB3U3RoSWdOVkhSaVNTLVBmcjh1dnRKb29ac3dSQlE0R3R0Vk4taG13c0VKQTNMcVE5Nmd3NkRWcHBfYkNsUy0yeDBZZWRvejJiT212REZLNmdrekhMdW83LXJVbHhfR0dZYUJNQ25qWjJNZnpZZmZLR3VzeGRqNHBYQzJlRHIyeHQyYlNJZG4wR3JnRnJxM21idFNXdmtvTTdRcVE5czZZQTZnSEI2RVJjcjVpREgteEhIZW0ydzNGRWNrWUpRODBiVVhxeVladS1MbGFYWnluNW11RW02MVVxeGFCMjdFeElkeGZJUnRIbGdPMUh3VldQYVZUa01hNzYwTXNwNmxzMDduQ0FKVnVrOFZ6VkFCbWg3M3FXZ3JEcC1UdU5DNWJiSzFSY3RXM1dWOXZteVE4MF84Z28xOE9ONjJZb2NLeGFWRWwxQzFzdGI2dW9oUE9kbU5CQUhxYzJtM2F6UlFxVU9rdkt0UHl5V3hlQkNoSVR6LWhqNmpCTS1ERDVZWERFdFVJd21OTDVnZXB1STdzZFZNemZtX2R4ZjcyM3Y4bEhFTjAyd1JXSUh3UldIWkFiMndpempsYVZJSEptUWJ5YXVyQi1BVUdvb0dNM2FGaC1YVkJLSFVIMVhwZldwRmtfS2thMmE1Vkw0bldrWG9VbXEyRw==