HL7 FHIR® US Core Implementation Guide CI Build

US Core, published by HL7 International - US Realm Steering Committee. This is not an authorized publication; it is the continuous build for version current). This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

StructureDefinition-us-core-provenance

This profile sets minimum expectations for the Provenance resource to record, search, and fetch Provenance information associated with a record. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile. This FHIR Provenance profile here covers the minimal (basic) information to support lineage of information. Prior to reviewing this profile, implementers are encouraged to read the Basic Provenance guidance page which documents several key use cases.

Example Usage Scenarios:

The following are example usage scenarios for the US Core Provenance 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 Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Provenance must have:

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

Each Provenance must support:

  1. an author responsible for the update
  2. the author organization responsible for the information
  3. the transmitter that provided the information
  4. 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 resources:
    • US Core AllergyIntolerance Profile
    • US Core CarePlan Profile
    • US Core CareTeam Profile
    • US Core Condition Profile
    • US Core DiagnosticReport Profile for Laboratory Results Reporting
    • US Core DiagnosticReport Profile for Report and Note exchange
    • US Core DocumentReference Profile
    • US Core Encounter Profile
    • US Core Goal Profile
    • US Core Immunization Profile
    • US Core Implantable Device Profile
    • US Core Laboratory Result Observation Profile
    • US Core MedicationRequest Profile
    • US Core Patient Profile
    • US Core Pediatric BMI for Age Observation Profile
    • US Core Pediatric Weight for Height Observation Profile
    • US Core Procedure Profile
    • US Core Pulse Oximetry Profile
    • US Core Smoking Status Observation Profile
    • The Vital Signs Profile from the FHIR Specification
  • 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.

Examples

Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance

Published on Mon Aug 05 00:00:00 UTC 2019 as active by the HL7 US Realm Steering Committee.

This profile builds on Provenance


Provenance

Summary of the Mandatory Requirements

  1. One or more Target References in Provenance.target
  2. An instant in Provenance.recorded
  3. One or more Agents in Provenance.agent
    • which should have a CodeableConcept value in Provenance.agent.type with an extensible binding to US Core Provenance Participant Type Codes
    • which must have a Who Reference value in Provenance.agent.who
    • which should have an Onbehalfof Reference value in Provenance.agent.onBehalfOf

Summary of the Must Support Requirements

  1. One or more Agents in Provenance.agent
    • which must have a Provenance.agent.type = {"coding": [{"code": "author", "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type"}]}
  2. An Agent in Provenance.agent
    • which must have a Provenance.agent.type = {"coding": [{"code": "transmitter", "system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type"}]}

Summary of Constraints

  1. onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance 0..*ProvenanceUS Core Provenance
... target S1..*Reference(Resource)The Resource this Provenance record supports
... recorded S1..1instantTimestamp when the activity was recorded / updated
... agent S1..*(Slice Definition)Actor involved
Slice: Unordered, Open by pattern:type
.... agent:All Slices Content/Rules for all slices
..... type S0..1CodeableConceptHow the agent participated
Binding: US Core Provenance Participant Type Codes (extensible)
..... who S1..1Reference(US Core Practitioner Profile | US Core Patient Profile | 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 S0..*BackboneElementActor involved
..... type S1..1CodeableConceptHow the agent participated
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 S0..1BackboneElementActor involved
..... type S1..1CodeableConceptHow the agent participated
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

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance I0..*ProvenanceUS 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
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... 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
... occurred[x] I0..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 | US Core Patient Profile | 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 I0..*SignatureSignature on target

doco Documentation for this format

Provenance

Summary of the Mandatory Requirements

  1. One or more Target References in Provenance.target
  2. An instant in Provenance.recorded
  3. One or more Agents in Provenance.agent
    • which should have a CodeableConcept value in Provenance.agent.type with an extensible binding to US Core Provenance Participant Type Codes
    • which must have a Who Reference value in Provenance.agent.who
    • which should have an Onbehalfof Reference value in Provenance.agent.onBehalfOf

Summary of the Must Support Requirements

  1. One or more Agents in Provenance.agent
    • which must have a Provenance.agent.type = {"coding": [{"code": "author", "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type"}]}
  2. An Agent in Provenance.agent
    • which must have a Provenance.agent.type = {"coding": [{"code": "transmitter", "system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type"}]}

Summary of Constraints

  1. onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance 0..*ProvenanceUS Core Provenance
... target S1..*Reference(Resource)The Resource this Provenance record supports
... recorded S1..1instantTimestamp when the activity was recorded / updated
... agent S1..*(Slice Definition)Actor involved
Slice: Unordered, Open by pattern:type
.... agent:All Slices Content/Rules for all slices
..... type S0..1CodeableConceptHow the agent participated
Binding: US Core Provenance Participant Type Codes (extensible)
..... who S1..1Reference(US Core Practitioner Profile | US Core Patient Profile | 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 S0..*BackboneElementActor involved
..... type S1..1CodeableConceptHow the agent participated
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 S0..1BackboneElementActor involved
..... type S1..1CodeableConceptHow the agent participated
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

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Provenance I0..*ProvenanceUS 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
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... 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
... occurred[x] I0..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 | US Core Patient Profile | 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 I0..*SignatureSignature on target

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron


Quick Start

Below is an overview of the required set of Server RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.

  • See the General Guidance 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.

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 they SHOULD 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.

  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)