Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## US Core Provenance

Page standards status: Informative

Previous Page - PDex Provenance

US Core 3.1.1 Procvenance or US Core 6.1.0 Provenance is provided as a reference for situations where payers receive detailed clinical data via formats such as C-CDA and in converting to a FHIR format are able to identify the detailed information about the originating event and can therefore create an appropriate Provenance record.

In all other cases a payer SHALL create a PDex Provenance profile that identifies their role as a "Transmitter" of the information.

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the US Core 3.1.1 Procvenance or US Core 6.1.0 Provenance are:

R4 Element | Name | Cardinality | Type
--- | --- | --- | ---
Provenance.target | target | 1..* | Reference(Resource)
Provenance.recorded | recorded | 1..1 | instant
Provenance.agent | agent | 1..* | (Slice Definition)
Provenance.agent:All Slices.type | type | 0..1 | CodeableConcept
Provenance.agent:All Slices.who | who | 1..1 | Reference(US Core Practitioner Profile | US Core Patient Profile | US Core Organization Profile)
Provenance.agent:All Slices.onBehalfOf | onBehalfOf | 0..1 | Reference(US Core Organization Profile)
Provenance.agent:ProvenanceAuthor | agent:ProvenanceAuthor | 0..* | BackboneElement
Provenance.agent:ProvenanceAuthor.type | type | 1..1 | CodeableConcept
Provenance.agent:ProvenanceAuthor.type.coding | coding | 1..* | Coding
Provenance.agent:ProvenanceAuthor.type.coding.system | system | 1..1 | uri
Provenance.agent:ProvenanceAuthor.type.coding.code | code | 1..1 | code
Provenance.agent:ProvenanceTransmitter | agent:ProvenanceTransmitter | 0..1 | BackboneElement
Provenance.agent:ProvenanceTransmitter.type | type | 1..1 | CodeableConcept
Provenance.agent:ProvenanceTransmitter.type.coding | coding | 1..* | Coding
Provenance.agent:ProvenanceTransmitter.type.coding.system | system | 1..1 | uri
Provenance.agent:ProvenanceTransmitter.type.coding.code | code | 1..1 | code
| who | 1..1 | Reference(Practitioner| PractitionerRole | RelatedPerson | Patient | Device | Organization)
Provenance.entity.role | role | 1..1 | code
Provenance.entity.what | what | 1..1 | Reference(Resource)

Table Definition

### Example US Core Provenance Resource

The example below is for a Provenance resource that is provided for an Allergyintolerance resource.

###

###

    {
      "resourceType" : "Bundle",
      "id" : "c887e62f-6166-419f-8268-b5ecd6c7b901",
      "meta" : {
        "lastUpdated" : "2019-07-09T18:49:01.235+00:00"
      },
      "type" : "searchset",
      "total" : 1,
      "link" : [
        {
          "relation" : "self",
          "url" : "http://example.org/fhir/AllergyIntolerance?_revinclude=Provenance%3Atarget&patient=Examples"
        }
      ],
      "entry" : [
        {
          "fullUrl" : "http://example.org/fhir/AllergyIntolerance/79613",
          "resource" : {
            "resourceType" : "AllergyIntolerance",
            "id" : "79613",
            "meta" : {
              "versionId" : "1",
              "lastUpdated" : "2019-07-09T15:26:23.217+00:00",
              "profile" : [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Generated Narrativeid: 79613meta: clinicalStatus: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical active}\">Active</span>verificationStatus: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/allergyintolerance-verification confirmed}\">Confirmed</span>category: medicationcriticality: highcode: <span title=\"Codes: {http://snomed.info/sct 762952008}\">Peanuts</span>patient: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical Record Number: 1032702 (USUAL); active; Amy V. Shaw , Amy V. Baxter ; ph: 555-555-5555(HOME), amy.shaw@example.com; gender: female; birthDate: 1987-02-20</a>onset: 2017-06-09Reactions<table class=\"grid\">-ManifestationOnset*<span title=\"Codes: {http://snomed.info/sct 247472004}\">Hives</span>2017-06-09</table></div>"
            },
            "clinicalStatus" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
                  "code" : "active",
                  "display" : "Active"
                }
              ]
            },
            "verificationStatus" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
                  "code" : "confirmed",
                  "display" : "Confirmed"
                }
              ]
            },
            "category" : [
              "medication"
            ],
            "criticality" : "high",
            "code" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "762952008",
                  "display" : "Peanuts"
                }
              ],
              "text" : "Peanuts"
            },
            "patient" : {
              "reference" : "Patient/example"
            },
            "onsetDateTime" : "2017-06-09",
            "reaction" : [
              {
                "manifestation" : [
                  {
                    "coding" : [
                      {
                        "system" : "http://snomed.info/sct",
                        "code" : "247472004",
                        "display" : "Hives"
                      }
                    ]
                  }
                ],
                "onset" : "2017-06-09"
              }
            ]
          },
          "search" : {
            "mode" : "match"
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/Provenance/79614",
          "resource" : {
            "resourceType" : "Provenance",
            "id" : "79614",
            "meta" : {
              "versionId" : "1",
              "lastUpdated" : "2019-07-09T15:26:23.217+00:00",
              "profile" : [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Generated Narrativeid: 79614meta: target: <a href=\"#AllergyIntolerance_79613\">See above (AllergyIntolerance/79613)</a>recorded: 10/07/2019 1:26:23 AMAgents<table class=\"grid\">-TypeWhoOnBehalfOf*<span title=\"Codes: {http://terminology.hl7.org/CodeSystem/provenance-participant-type author}\">Author</span><a href=\"Practitioner-practitioner-1.html\">Generated Summary: id: practitioner-1; id: 9941339108, id: 25456; Ronald Bone </a><a href=\"Organization-saint-luke-w-endpoint.html\">Generated Summary: id: saint-luke-w-endpoint; id: 1063494177, id: 00-0000000; active; name: Saint Luke's Hospital of Kansas City; ph: (816)932-2000(WORK), http://www.saintlukeshealthsystem.org/locations/saint-lukes-hospital-kansas-city(WORK)</a></table></div>"
            },
            "target" : [
              {
                "reference" : "AllergyIntolerance/79613"
              }
            ],
            "recorded" : "2019-07-09T15:26:23.217+00:00",
            "agent" : [
              {
                "type" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                      "code" : "author",
                      "display" : "Author"
                    }
                  ]
                },
                "who" : {
                  "reference" : "Practitioner/practitioner-1"
                },
                "onBehalfOf" : {
                  "reference" : "Organization/saint-luke-w-endpoint"
                }
              }
            ]
          },
          "search" : {
            "mode" : "include"
          }
        }
      ]
    }

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