Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1
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
| 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:2.16.840.1.113883.4.642.40.21.42.9 | |||||
Copyright/Legal: Used by permission of HL7 International all rights reserved Creative Commons License |
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This Signature DataType profile enforces the various elements of digital signatures documented in Digital Signature Rules and Guidance For CDEX Bundle and QuestionnaireResponse.
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Name | Flags | Card. | Type | Description & Constraints Filter:   |
|---|---|---|---|---|
  Signature |
0..* | Signature(4.0.1) | CDex Bundle and QuestionnaireResponse signature | |
  Slices for type |
SΣ | 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 |
SΣ | 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 |
SΣ | 1..1 | instant | When the signature was created |
 who |
SΣ | 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 |
SΣ | 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 |
SΣ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value |
SΣ | 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 | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Signature.type | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.type:verify | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.who.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Signature.targetFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Signature.sigFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| ele-1 | error | Signature, Signature.type, Signature.type:verify, Signature.when, Signature.who, Signature.who.identifier, Signature.who.identifier.use, Signature.who.identifier.system, Signature.who.identifier.value, Signature.targetFormat, Signature.sigFormat, Signature.data | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
 Signature |
0..* | Signature(4.0.1) | 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: |
|---|---|---|---|---|
| Signature |
0..* | Signature(4.0.1) | 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 Constraints: ext-1 | |
| Slices for type |
SΣ | 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 |
SΣ | 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 |
SΣ | 1..1 | instant | When the signature was created |
| who |
SΣ | 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 Constraints: ext-1 | |
| reference |
ΣC | 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 |
SΣ | 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 Constraints: ext-1 | |
| 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 |
SΣ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value |
SΣ | 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 | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Signature.type | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.type:verify | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.who.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| Signature.who.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Signature.who.identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std. |
| Signature.targetFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Signature.sigFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| ele-1 | error | Signature, Signature.extension, Signature.type, Signature.type:verify, Signature.when, Signature.who, Signature.who.extension, Signature.who.reference, Signature.who.type, Signature.who.identifier, Signature.who.identifier.extension, Signature.who.identifier.use, Signature.who.identifier.type, Signature.who.identifier.system, Signature.who.identifier.value, Signature.who.identifier.period, Signature.who.identifier.assigner, Signature.who.display, Signature.onBehalfOf, Signature.targetFormat, Signature.sigFormat, Signature.data | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | Signature.extension, Signature.who.extension, Signature.who.identifier.extension | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
Summary
Mandatory: 7 elements
Must-Support: 10 elements
Fixed: 2 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Maturity: 2
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Signature |
0..* | Signature(4.0.1) | CDex Bundle and QuestionnaireResponse signature | |
| Slices for type |
SΣ | 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 |
SΣ | 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 |
SΣ | 1..1 | instant | When the signature was created |
| who |
SΣ | 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 |
SΣ | 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 |
SΣ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value |
SΣ | 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 | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Signature.type | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.type:verify | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.who.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Signature.targetFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Signature.sigFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| ele-1 | error | Signature, Signature.type, Signature.type:verify, Signature.when, Signature.who, Signature.who.identifier, Signature.who.identifier.use, Signature.who.identifier.system, Signature.who.identifier.value, Signature.targetFormat, Signature.sigFormat, Signature.data | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
Differential View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Signature |
0..* | Signature(4.0.1) | 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:$this |
| type:verify |
S | 1..1 | Coding | Verification Signature Required Pattern: At least the following |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: urn:iso-astm:E1762-95:2013 | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1.2.840.10065.1.12.1.5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Verification Signature | |
| when |
S | 1..1 | instant | When the signature was created |
| who |
S | 1..1 | Reference(US Core Practitioner Profile(3.1.1) S | US Core Practitioner Profile(6.1.0) S | US Core Practitioner Profile(7.0.0) S | HRex Organization Profile(1.1.0) S | HRex PractitionerRole Profile(1.1.0)) | Organization or practitioner who signed the Bundle |
| identifier |
S | 1..1 | Identifier | NPI or US Tax ID |
| system |
S | 0..1 | uri | The namespace for the identifier value |
| value |
S | 1..1 | string | The value that is unique |
| targetFormat |
S | 1..1 | code | Canonicalization method Fixed Value: application/fhir+json;canonicalization=http://hl7.org/fhir/canonicalization/json#document |
| sigFormat |
S | 1..1 | code | The JWS mime type Fixed Value: application/jose |
| data |
S | 1..1 | base64Binary | base64 encoded JSON Web Signature (JWS) |
| Documentation for this format | ||||
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Signature |
0..* | Signature(4.0.1) | CDex Bundle and QuestionnaireResponse signature | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1 | |
| Slices for type |
SΣ | 1..* | Coding | Indication of the reason the entity signed the object(s) Slice: Unordered, Open by value:$this Binding: SignatureTypeCodes (preferred): An indication of the reason that an entity signed the object. |
| type:verify |
SΣ | 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 |
SΣ | 1..1 | instant | When the signature was created |
| who |
SΣ | 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 Constraints: ext-1 | |
| reference |
ΣC | 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 |
SΣ | 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 Constraints: ext-1 | |
| 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 |
SΣ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value |
SΣ | 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 | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Signature.type | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.type:verify | Base | preferred | Signature Type Codes | 📍4.0.1 | FHIR Std. |
| Signature.who.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| Signature.who.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Signature.who.identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std. |
| Signature.targetFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Signature.sigFormat | Base | required | MimeType | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| ele-1 | error | Signature, Signature.extension, Signature.type, Signature.type:verify, Signature.when, Signature.who, Signature.who.extension, Signature.who.reference, Signature.who.type, Signature.who.identifier, Signature.who.identifier.extension, Signature.who.identifier.use, Signature.who.identifier.type, Signature.who.identifier.system, Signature.who.identifier.value, Signature.who.identifier.period, Signature.who.identifier.assigner, Signature.who.display, Signature.onBehalfOf, Signature.targetFormat, Signature.sigFormat, Signature.data | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | Signature.extension, Signature.who.extension, Signature.who.identifier.extension | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
Summary
Mandatory: 7 elements
Must-Support: 10 elements
Fixed: 2 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Maturity: 2
Other representations of profile: CSV, Excel, Schematron
IG © 2024+ HL7 International / Payer/Provider Information Exchange Work Group.
Package hl7.fhir.us.davinci-cdex#2.1.0 based on FHIR 4.0.1.
Generated
2026-06-10
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