US Core Implementation Guide
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US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 8.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core Provenance Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance Version: 8.0.0-ballot
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreProvenance
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.53

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Provenance Profile inherits from the FHIR Provenance resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Provenance resource to record, search, and fetch provenance information associated with a record. It covers the minimal (basic) information to support lineage of information. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Before reviewing this profile, implementers are encouraged to read the Basic Provenance guidance page, which documents several key use cases, specifically, the organization responsible for the most recent action on the resource.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

  • Query for the Provenance records associated with an Allergy
  • Query for the Provenance records associated with a Problem

Mandatory and Must Support Data Elements

The following data elements are mandatory (i.e., data MUST be present) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Provenance Must Have:

  1. a reference to the resource(s) the Provenance record is supporting (target)
  2. a date and time for the activity

Each Provenance Must Support:

  1. the author organization responsible for the information
  2. the transmitter that provided the information
  3. the transmitter organization responsible for the transmission (if the transmitter is a device, the transmitter organization must also be valued).

Profile Specific Implementation Guidance:

  • The US Core Provenance resource SHALL be supported for these US Core resource types:
    • AllergyIntolerance
    • CarePlan
    • CareTeam
    • Condition
    • Coverage
    • Device
    • DiagnosticReport
    • DocumentReference
    • Encounter
    • Goal
    • Immunization
    • MedicationDispense
    • MedicationRequest
    • Observation
    • Patient
    • Procedure
    • QuestionnaireResponse
    • RelatedPerson
    • ServiceRequest
  • If a system receives a provider in Provenance.agent.who as free text, they must capture who sent them the information as the organization. On request, they SHALL provide this organization as the source and MAY include the free text provider.
  • Systems that need to know the activity has occurred SHOULD populate the activity.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Changes since version 7.0.0:

  • No changes

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Provenance 0..* Provenance US Core Provenance
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... target SΣ 1..* Reference(Resource) The Resource this Provenance record supports
    ele-1: All FHIR elements must have a @value or children
    .... reference SΣC 0..1 string Literal reference, Relative, internal or absolute URL
    ele-1: All FHIR elements must have a @value or children
    ... recorded SΣ 1..1 instant Timestamp when the activity was recorded / updated
    ele-1: All FHIR elements must have a @value or children
    ... Slices for agent SC 1..* BackboneElement Actor involved
    Slice: Unordered, Open by value:type
    ele-1: All FHIR elements must have a @value or children
    provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
    .... agent:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... type SΣ 0..1 CodeableConcept How the agent participated
    Binding: US Core Provenance Participant Type Codes (extensible)
    ele-1: All FHIR elements must have a @value or children
    ..... who SΣ 1..1 Reference(US Core Organization Profile) Who participated
    ele-1: All FHIR elements must have a @value or children
    ..... onBehalfOf S 0..1 Reference(US Core Organization Profile) Who the agent is representing
    ele-1: All FHIR elements must have a @value or children
    .... agent:ProvenanceAuthor S 0..* BackboneElement Actor involved
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... type SΣ 1..1 CodeableConcept How the agent participated
    Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: author
    ..... who Σ 1..1 Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) Who participated
    ele-1: All FHIR elements must have a @value or children
    .... agent:ProvenanceTransmitter S 0..* BackboneElement Actor involved
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... type SΣ 1..1 CodeableConcept How the agent participated
    Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: transmitter
    ..... who Σ 1..1 Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) Who participated
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Provenance.agent.typeextensibleUSCoreProvenancePaticipantTypeCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-provenance-participant-type
    from this IG
    Provenance.agent:ProvenanceAuthor.typeextensiblePattern: author
    http://hl7.org/fhir/ValueSet/provenance-agent-type
    from the FHIR Standard
    Provenance.agent:ProvenanceTransmitter.typeextensiblePattern: transmitter
    http://hl7.org/fhir/ValueSet/provenance-agent-type
    from the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    provenance-1errorProvenance.agentonBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
    : who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    Quick Start

    Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

    • See the Scopes Format section for a description of the SMART scopes syntax.
    • See the Search Syntax section for a description of the US Core search syntax.
    • See the General Requirements section for additional rules and expectations when a Server requires status parameters.
    • See the General Guidance section for additional guidance on searching for multiple patients.

    US Core Scopes

    Servers providing access to provenance data SHALL support these US Core SMART Scopes:

    Mandatory Search Parameters:

    The following search parameters, search parameter combinations SHALL be supported. Any listed search parameter modifiers, comparators, chains and composites SHALL also be supported UNLESS they are listed as "optional" in which case theySHOULD be supported:

    1. SHALL support searching for all US Core Profile resource types listed above for a patient and all the Provenance records for those resources using a combination of the patient and _revinclude search parameters:

      GET [base]/[Resource]?patient=[id]&_revinclude=Provenance:target

      Example:

      1. GET [base]/AllergyIntolerance?patient=[id]5&_revinclude=Provenance:target

      Implementation Notes:

      • Fetches a bundle of all resources of a particular type for the specified patient (how to search by reference) and any corresponding Provenance resources.
      • The "inline" search result parameter _revinclude will return the last Provenance for the version named in the reference. To return all the Provenance resources associated with a resource irrespective of its version, search against Provenance using the target search parameter.
      • See the [AllergyIntolerance Provenance Example1] Bundle.

    2. SHALL support searching for a particular instance of a US Core Profile resource type listed above and all its Provenance resources using combination of the _id and the _revinclude search parameters:

      GET [base]/[Resource]?_id=[id]&_revinclude=Provenance:target

      Example:

      1. GET [base]/AllergyIntolerance?_id=[id]&_revinclude=Provenance:target

      Implementation Notes:

      • Fetches a Bundle of a resource of a particular type (within the Clients authorization scope) and any corresponding Provenance resources. (how to search by token)
      • The "inline" search result parameter _revinclude will return the last Provenance for the version named in the reference. To return all the Provenance resources associated with a resource irrespective of its version, search against Provenance using the target search parameter.
      • See the [AllergyIntolerance Provenance Example2] Bundle.