Da Vinci Health Record Exchange (HRex)
0.2.0 - STU R1 - 2nd ballot

Da Vinci Health Record Exchange (HRex), published by HL7 International - Clinical Interoperability Council. This is not an authorized publication; it is the continuous build for version 0.2.0). This version is based on the current content of https://github.com/HL7/davinci-ehrx/ and changes regularly. See the Directory of published versions

Resource Profile: HRexProvenance

Additional constraints on US Core Provenance to ensure it meets payer needs, including indicating when the event occurred and retaining signatures if present

The official URL for this profile is:

http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-provenance

Provenance is essential when sharing information in the payer space because any given record may have passed through multiple hands before it arrives at a payer. Provenance provides traceability as to where the data originated and helps in the evaluation of the information as well as rationalizing duplicate data acquired through multiple sources. Da Vinci makes a couple of improvements to the US Core Provenance profile that will hopefully be migrated into that profile in the future:

  • Capturing the time of the creation/update, not just the time the Provenance instance was created
  • Ensuring that the Provenance target in fact resolves to a specific resource reference, not allowing only display or an identifier

In addition, in Da Vinci, signatures on Provenances must be retained if present.

Formal Views of Profile Content

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

This structure is derived from USCoreProvenance

Summary

Mandatory: 2 elements
Must-Support: 4 elements

This structure is derived from USCoreProvenance

NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance 0..*USCoreProvenanceUS Core Provenance
... target 1..*Reference(Resource)The Resource this Provenance record supports
.... reference S1..1stringLiteral reference, Relative, internal or absolute URL
..... value S1..1stringPrimitive value for string
... occurred[x] S0..1Period, dateTimeWhen the activity occurred
... signature S0..*SignatureSignature on target

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance I0..*USCoreProvenanceUS Core Provenance
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... target SΣI1..*Reference(Resource)The Resource this Provenance record supports
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣI1..1stringLiteral reference, Relative, internal or absolute URL
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension I0..*ExtensionAdditional content defined by implementations
..... value S1..1stringPrimitive value for string
Max Length: 1048576
.... type ΣI0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier ΣI0..1IdentifierLogical reference, when literal reference is not known
.... display ΣI0..1stringText alternative for the resource
... occurred[x] SI0..1When the activity occurred
.... occurredPeriodPeriod
.... occurredDateTimedateTime
... recorded SΣI1..1instantTimestamp when the activity was recorded / updated
... policy I0..*uriPolicy or plan the activity was defined by
... location I0..1Reference(Location)Where the activity occurred, if relevant
... reason I0..*CodeableConceptReason the activity is occurring
Binding: PurposeOfUse (extensible)
... activity I0..1CodeableConceptActivity that occurred
Binding: ProvenanceActivityType (extensible)
... agent SI1..*(Slice Definition)Actor involved
Slice: Unordered, Open by pattern:type
.... agent:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI0..1CodeableConceptHow the agent participated
Binding: US Core Provenance Participant Type Codes (extensible)
..... role I0..*CodeableConceptWhat the agents role was
Binding: SecurityRoleType (example)
..... who SΣI1..1Reference(US Core Practitioner Profile | PractitionerRole | RelatedPerson | US Core Patient Profile | Device | US Core Organization Profile)Who participated
..... onBehalfOf SI0..1Reference(US Core Organization Profile)Who the agent is representing
provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
.... agent:ProvenanceAuthor SI0..*BackboneElementActor involved
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI1..1CodeableConceptHow the agent participated
Binding: ProvenanceParticipantType (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: author
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... role I0..*CodeableConceptWhat the agents role was
Binding: SecurityRoleType (example)
..... who ΣI1..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who participated
..... onBehalfOf I0..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who the agent is representing
.... agent:ProvenanceTransmitter SI0..1BackboneElementActor involved
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI1..1CodeableConceptHow the agent participated
Binding: ProvenanceParticipantType (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: transmitter
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... role I0..*CodeableConceptWhat the agents role was
Binding: SecurityRoleType (example)
..... who ΣI1..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who participated
..... onBehalfOf I0..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who the agent is representing
... entity I0..*BackboneElementAn entity used in this activity
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... role ΣI1..1codederivation | revision | quotation | source | removal
Binding: ProvenanceEntityRole (required)
.... what ΣI1..1Reference(Resource)Identity of entity
.... agent I0..*See agentEntity is attributed to this agent
... signature SI0..*SignatureSignature on target

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance I0..*USCoreProvenanceUS Core Provenance
... target ΣI1..*Reference(Resource)The Resource this Provenance record supports
.... reference ΣI1..1stringLiteral reference, Relative, internal or absolute URL
..... value 1..1stringPrimitive value for string
Max Length: 1048576
... occurred[x] I0..1When the activity occurred
.... occurredPeriodPeriod
.... occurredDateTimedateTime
... recorded ΣI1..1instantTimestamp when the activity was recorded / updated
.... agent:All Slices Content/Rules for all slices
..... type ΣI0..1CodeableConceptHow the agent participated
Binding: US Core Provenance Participant Type Codes (extensible)
..... who ΣI1..1Reference(US Core Practitioner Profile | PractitionerRole | RelatedPerson | US Core Patient Profile | Device | US Core Organization Profile)Who participated
..... onBehalfOf I0..1Reference(US Core Organization Profile)Who the agent is representing
provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
.... agent:ProvenanceAuthor I0..*BackboneElementActor involved
..... type ΣI1..1CodeableConceptHow the agent participated
Binding: ProvenanceParticipantType (extensible)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: author
.... agent:ProvenanceTransmitter I0..1BackboneElementActor involved
..... type ΣI1..1CodeableConceptHow the agent participated
Binding: ProvenanceParticipantType (extensible)
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: transmitter
... signature I0..*SignatureSignature on target

doco Documentation for this format

This structure is derived from USCoreProvenance

Summary

Mandatory: 2 elements
Must-Support: 4 elements

Differential View

This structure is derived from USCoreProvenance

NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance 0..*USCoreProvenanceUS Core Provenance
... target 1..*Reference(Resource)The Resource this Provenance record supports
.... reference S1..1stringLiteral reference, Relative, internal or absolute URL
..... value S1..1stringPrimitive value for string
... occurred[x] S0..1Period, dateTimeWhen the activity occurred
... signature S0..*SignatureSignature on target

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance I0..*USCoreProvenanceUS Core Provenance
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... target SΣI1..*Reference(Resource)The Resource this Provenance record supports
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣI1..1stringLiteral reference, Relative, internal or absolute URL
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension I0..*ExtensionAdditional content defined by implementations
..... value S1..1stringPrimitive value for string
Max Length: 1048576
.... type ΣI0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier ΣI0..1IdentifierLogical reference, when literal reference is not known
.... display ΣI0..1stringText alternative for the resource
... occurred[x] SI0..1When the activity occurred
.... occurredPeriodPeriod
.... occurredDateTimedateTime
... recorded SΣI1..1instantTimestamp when the activity was recorded / updated
... policy I0..*uriPolicy or plan the activity was defined by
... location I0..1Reference(Location)Where the activity occurred, if relevant
... reason I0..*CodeableConceptReason the activity is occurring
Binding: PurposeOfUse (extensible)
... activity I0..1CodeableConceptActivity that occurred
Binding: ProvenanceActivityType (extensible)
... agent SI1..*(Slice Definition)Actor involved
Slice: Unordered, Open by pattern:type
.... agent:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI0..1CodeableConceptHow the agent participated
Binding: US Core Provenance Participant Type Codes (extensible)
..... role I0..*CodeableConceptWhat the agents role was
Binding: SecurityRoleType (example)
..... who SΣI1..1Reference(US Core Practitioner Profile | PractitionerRole | RelatedPerson | US Core Patient Profile | Device | US Core Organization Profile)Who participated
..... onBehalfOf SI0..1Reference(US Core Organization Profile)Who the agent is representing
provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
.... agent:ProvenanceAuthor SI0..*BackboneElementActor involved
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI1..1CodeableConceptHow the agent participated
Binding: ProvenanceParticipantType (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: author
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... role I0..*CodeableConceptWhat the agents role was
Binding: SecurityRoleType (example)
..... who ΣI1..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who participated
..... onBehalfOf I0..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who the agent is representing
.... agent:ProvenanceTransmitter SI0..1BackboneElementActor involved
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI1..1CodeableConceptHow the agent participated
Binding: ProvenanceParticipantType (extensible)
Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: transmitter
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... role I0..*CodeableConceptWhat the agents role was
Binding: SecurityRoleType (example)
..... who ΣI1..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who participated
..... onBehalfOf I0..1Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)Who the agent is representing
... entity I0..*BackboneElementAn entity used in this activity
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... role ΣI1..1codederivation | revision | quotation | source | removal
Binding: ProvenanceEntityRole (required)
.... what ΣI1..1Reference(Resource)Identity of entity
.... agent I0..*See agentEntity is attributed to this agent
... signature SI0..*SignatureSignature on target

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet / Code
Provenance.languagepreferredCommonLanguages
Max Binding: AllLanguages
Provenance.target.typeextensibleResourceType
Provenance.reasonextensiblePurposeOfUse
Provenance.activityextensibleProvenanceActivityType
Provenance.agent.typeextensibleUSCoreProvenancePaticipantTypeCodes
Provenance.agent.roleexampleSecurityRoleType
Provenance.agent:ProvenanceAuthor.typeextensiblePattern: author
Provenance.agent:ProvenanceAuthor.roleexampleSecurityRoleType
Provenance.agent:ProvenanceTransmitter.typeextensiblePattern: transmitter
Provenance.agent:ProvenanceTransmitter.roleexampleSecurityRoleType
Provenance.entity.rolerequiredProvenanceEntityRole

Constraints

IdPathDetailsRequirements
dom-2ProvenanceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3ProvenanceIf 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4ProvenanceIf 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-5ProvenanceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6ProvenanceA resource should have narrative for robust management
: text.`div`.exists()
ele-1Provenance.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.targetAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.target.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.target.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.target.referenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.target.reference.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.target.reference.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.target.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.target.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.target.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.occurred[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.recordedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.policyAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.locationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.reasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.activityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.agent.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.agent.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.agent.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.agent.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent.roleAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent.whoAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent.onBehalfOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
provenance-1Provenance.agent.onBehalfOfonBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
: ($this.agent.who.resolve().is Practitioner or Device) implies exists()
ele-1Provenance.agent:ProvenanceAuthorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceAuthor.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.agent:ProvenanceAuthor.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.agent:ProvenanceAuthor.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.agent:ProvenanceAuthor.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.agent:ProvenanceAuthor.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceAuthor.roleAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceAuthor.whoAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceAuthor.onBehalfOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceTransmitterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceTransmitter.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.agent:ProvenanceTransmitter.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.agent:ProvenanceTransmitter.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.agent:ProvenanceTransmitter.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.agent:ProvenanceTransmitter.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceTransmitter.roleAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceTransmitter.whoAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.agent:ProvenanceTransmitter.onBehalfOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.entityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.entity.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.entity.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.entity.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Provenance.entity.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Provenance.entity.roleAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.entity.whatAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.entity.agentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Provenance.signatureAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

Notes:

The following guidance applies to the use of Providence across Da Vinci IGs. IGs may impose additional expectations with respect to the use of Provenance either across their whole use-case or in the context of specific events.

Searching

There is no expectation for support for querying Provenance except using _revinclude using the ‘target’ parameter (to return Provenance instances associated with a returned resource).

Aligning Provenance and Resource elements

Provenance should align with information present in the record. Where a Provenance deals with the creation of an instance, the author, performer and (if present) informer should align with the equivalent elements on the record. Similarly, Provenance.occurred should align with the creation date for the record.

Populating Provenance.agent

The following table lists the various agent codes and what resource types are appropriate. These recommendations SHOULD be followed

| transmitter | This could be Patient, RelatedPerson, Practitioner or PractitionerRole or Organization. A second transmitter could capture the specific Device used | | enterer | Patient, RelatedPerson, Practitioner or PractitionerRole | | performer | could be anything | | author | could be anything | | verifier | generally only Practitioner or PractitionerRole | | legal | Only Practitioner or PractitionerRole | | attester | Patient, RelatedPerson, Practitioner or PractitionerRole | | informant | Patient, RelatedPerson, Practitioner or PractitionerRole | | custodian | usually Organization, could also be Device, Practitioner or PractitionerRole | | assembler | usually a Device, could be Practitioner or PractitionerRole | ——————————————

Handling agents with multiple roles

In general, the most important role to capture is “author”. If they are the only role present, the presumption is that they are also the enterer, performer, verifier, legal, attester, informant, etc. Specifying other roles is only necessary if they differ from the author. Not all systems will necessarily track all participants. Roles other than author only need to be shared if the system captures them and feels they may be relevant to downstream use of the information.

Populating onBehalfOf

Provenance.agent.onBehalfOf is only relevant in certain circumstances:

  • onBehalfOf SHOULD NOT be populated if RelatedPerson is acting on behalf of the Patient. (Because that is the assumption and there is already a link to the Patient on that resource)
  • onBehalfOf SHOULD NOT be populated with an Organization if the agent is Practitioner - use PractitionerRole instead (even if it is a contained PractitionerRole)
  • onBehalfOf SHOULD NOT be populated with an Organization if the agent is PractitionerRole unless PractitionerRole is pointing to an organization and the onBehalfOf is different (i.e. Dr. Smith for Clinic A did something on behalf of clinic B)
  • It is unusual for onBehalfOf to be populated if the agent is Patient or RelatedPerson
  • onBehalfOf SHOULD NOT be populated with an Organization if it is the same as Device.owner