Mobile access to Health Documents (MHD)
4.2.2 - Trial-Implementation International flag

Mobile access to Health Documents (MHD), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 4.2.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.MHD/ and changes regularly. See the Directory of published versions

Resource Profile: AuditProvideBundleSource - Detailed Descriptions

Active as of 2024-05-17

Definitions for the IHE.MHD.ProvideBundle.Audit.Source resource profile.

Guidance on how to interpret the contents of this table can be found here

0. AuditEvent
2. AuditEvent.modifierExtension
Control0..0
4. AuditEvent.type
Pattern Value{
  "system" : "http://dicom.nema.org/resources/ontology/DCM",
  "code" : "110106",
  "display" : "Export"
}
6. AuditEvent.subtype
Control1..?
SlicingThis element introduces a set of slices on AuditEvent.subtype. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
  • 8. AuditEvent.subtype:iti65
    Slice Nameiti65
    Control1..1
    Pattern Value{
      "system" : "urn:ihe:event-type-code",
      "code" : "ITI-65",
      "display" : "Provide Document Bundle"
    }
    10. AuditEvent.action
    Pattern ValueR
    12. AuditEvent.outcome
    Control1..?
    14. AuditEvent.outcomeDesc
    Must Supporttrue
    16. AuditEvent.agent
    Control2..?
    SlicingThis element introduces a set of slices on AuditEvent.agent. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ type
    • 18. AuditEvent.agent:documentSource
      Slice NamedocumentSource
      ShortDocument Source
      Control1..1
      Invariantsval-audit-source: The Audit Source is this agent too. ($this.who = %resource.source.observer)
      20. AuditEvent.agent:documentSource.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://dicom.nema.org/resources/ontology/DCM",
          "code" : "110153",
          "display" : "Source Role ID"
        }]
      }
      22. AuditEvent.agent:documentSource.who
      Control1..?
      24. AuditEvent.agent:documentSource.network
      Control1..?
      26. AuditEvent.agent:documentRecipient
      Slice NamedocumentRecipient
      ShortDocument Recipient
      Control1..1
      28. AuditEvent.agent:documentRecipient.type
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://dicom.nema.org/resources/ontology/DCM",
          "code" : "110152",
          "display" : "Destination Role ID"
        }]
      }
      30. AuditEvent.agent:documentRecipient.who
      Control1..?
      32. AuditEvent.agent:documentRecipient.network
      Control1..?
      34. AuditEvent.entity
      Control2..?
      SlicingThis element introduces a set of slices on AuditEvent.entity. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • pattern @ type
      • 36. AuditEvent.entity:patient
        Slice Namepatient
        ShortPatient
        Control1..1
        38. AuditEvent.entity:patient.what
        Control1..?
        TypeReference(Patient)
        40. AuditEvent.entity:patient.type
        Control1..?
        Pattern Value{
          "system" : "http://terminology.hl7.org/CodeSystem/audit-entity-type",
          "code" : "1",
          "display" : "Person"
        }
        42. AuditEvent.entity:patient.role
        Pattern Value{
          "system" : "http://terminology.hl7.org/CodeSystem/object-role",
          "code" : "1",
          "display" : "Patient"
        }
        44. AuditEvent.entity:submissionSet
        Slice NamesubmissionSet
        ShortSubmissionSet
        Control1..1
        46. AuditEvent.entity:submissionSet.what
        Control1..?
        TypeReference(List)
        48. AuditEvent.entity:submissionSet.type
        Control1..?
        Pattern Value{
          "system" : "http://terminology.hl7.org/CodeSystem/audit-entity-type",
          "code" : "2",
          "display" : "System Object"
        }
        50. AuditEvent.entity:submissionSet.role
        Pattern Value{
          "system" : "http://terminology.hl7.org/CodeSystem/object-role",
          "code" : "20",
          "display" : "Job"
        }

        Guidance on how to interpret the contents of this table can be found here

        0. AuditEvent
        Definition

        A record of an event made for purposes of maintaining a security log. Typical uses include detection of intrusion attempts and monitoring for inappropriate usage.

        ShortEvent record kept for security purposes
        Comments

        Based on IHE-ATNA.

        Control0..*
        Is Modifierfalse
        Summaryfalse
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        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 (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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        2. AuditEvent.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        4. AuditEvent.modifierExtension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensionExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..0*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        6. AuditEvent.type
        Definition

        Identifier for a family of the event. For example, a menu item, program, rule, policy, function code, application name or URL. It identifies the performed function.

        ShortType/identifier of event
        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from AuditEventIDhttp://hl7.org/fhir/ValueSet/audit-event-type
        (extensible to http://hl7.org/fhir/ValueSet/audit-event-type)

        Type of event.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Requirements

        This identifies the performed function. For "Execute" Event Action Code audit records, this identifies the application function performed.

        Pattern Value{
          "system" : "http://dicom.nema.org/resources/ontology/DCM",
          "code" : "110106",
          "display" : "Export"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. AuditEvent.subtype
        Definition

        Identifier for the category of event.

        ShortMore specific type/id for the event
        Control10..*
        BindingUnless not suitable, these codes SHALL be taken from AuditEventSub-Typehttp://hl7.org/fhir/ValueSet/audit-event-sub-type
        (extensible to http://hl7.org/fhir/ValueSet/audit-event-sub-type)

        Sub-type of event.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Requirements

        This field enables queries of messages by implementation-defined event categories.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on AuditEvent.subtype. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ $this
        • 10. AuditEvent.subtype:iti65
          Slice Nameiti65
          Definition

          Identifier for the category of event.

          ShortMore specific type/id for the event
          Control10..1*
          BindingUnless not suitable, these codes SHALL be taken from AuditEventSub-Typehttp://hl7.org/fhir/ValueSet/audit-event-sub-type
          (extensible to http://hl7.org/fhir/ValueSet/audit-event-sub-type)

          Sub-type of event.

          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

          This field enables queries of messages by implementation-defined event categories.

          Pattern Value{
            "system" : "urn:ihe:event-type-code",
            "code" : "ITI-65",
            "display" : "Provide Document Bundle"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. AuditEvent.action
          Definition

          Indicator for type of action performed during the event that generated the audit.

          ShortType of action performed during the event
          Control0..1
          BindingThe codes SHALL be taken from AuditEventActionhttp://hl7.org/fhir/ValueSet/audit-event-action|4.0.1
          (required to http://hl7.org/fhir/ValueSet/audit-event-action|4.0.1)

          Indicator for type of action performed during the event that generated the event.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          This broadly indicates what kind of action was done on the AuditEvent.entity by the AuditEvent.agent.

          Pattern ValueR
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. AuditEvent.recorded
          Definition

          The time when the event was recorded.

          ShortTime when the event was recorded
          Comments

          In a distributed system, some sort of common time base (e.g. an NTP [RFC1305] server) is a good implementation tactic.

          Control1..1
          Typeinstant
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          This ties an event to a specific date and time. Security audits typically require a consistent time base (e.g. UTC), to eliminate time-zone issues arising from geographical distribution.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. AuditEvent.outcome
          Definition

          Indicates whether the event succeeded or failed.

          ShortWhether the event succeeded or failed
          Comments

          In some cases a "success" may be partial, for example, an incomplete or interrupted transfer of a radiological study. For the purpose of establishing accountability, these distinctions are not relevant.

          Control10..1
          BindingThe codes SHALL be taken from AuditEventOutcomehttp://hl7.org/fhir/ValueSet/audit-event-outcome|4.0.1
          (required to http://hl7.org/fhir/ValueSet/audit-event-outcome|4.0.1)

          Indicates whether the event succeeded or failed.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. AuditEvent.outcomeDesc
          Definition

          A free text description of the outcome of the event.

          ShortDescription of the event outcome
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. AuditEvent.agent
          Definition

          An actor taking an active role in the event or activity that is logged.

          ShortActor involved in the event
          Comments

          Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

          For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

          Control21..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

          Alternate NamesActiveParticipant
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on AuditEvent.agent. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ type
          • 22. AuditEvent.agent.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            24. AuditEvent.agent.requestor
            Definition

            Indicator that the user is or is not the requestor, or initiator, for the event being audited.

            ShortWhether user is initiator
            Comments

            There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

            Control1..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. AuditEvent.agent:documentSource
            Slice NamedocumentSource
            Definition

            An actor taking an active role in the event or activity that is logged.

            ShortDocument SourceActor involved in the event
            Comments

            Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

            For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

            Control1..1*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

            Alternate NamesActiveParticipant
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            val-audit-source: The Audit Source is this agent too. ($this.who = %resource.source.observer)
            28. AuditEvent.agent:documentSource.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            30. AuditEvent.agent:documentSource.type
            Definition

            Specification of the participation type the user plays when performing the event.

            ShortHow agent participated
            Control10..1
            BindingUnless not suitable, these codes SHALL be taken from ParticipationRoleTypehttp://hl7.org/fhir/ValueSet/participation-role-type
            (extensible to http://hl7.org/fhir/ValueSet/participation-role-type)

            The Participation type of the agent to the event.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Pattern Value{
              "coding" : [{
                "system" : "http://dicom.nema.org/resources/ontology/DCM",
                "code" : "110153",
                "display" : "Source Role ID"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. AuditEvent.agent:documentSource.who
            Definition

            Reference to who this agent is that was involved in the event.

            ShortIdentifier of who
            Comments

            Where a User ID is available it will go into who.identifier.

            Control10..1
            TypeReference(PractitionerRole, Practitioner, Organization, Device, Patient, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Requirements

            This field ties an audit event to a specific resource or identifier.

            Alternate NamesuserId
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. AuditEvent.agent:documentSource.requestor
            Definition

            Indicator that the user is or is not the requestor, or initiator, for the event being audited.

            ShortWhether user is initiator
            Comments

            There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

            Control1..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. AuditEvent.agent:documentSource.network
            Definition

            Logical network location for application activity, if the activity has a network location.

            ShortLogical network location for application activity
            Control10..1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. AuditEvent.agent:documentSource.network.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            40. AuditEvent.agent:documentRecipient
            Slice NamedocumentRecipient
            Definition

            An actor taking an active role in the event or activity that is logged.

            ShortDocument RecipientActor involved in the event
            Comments

            Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

            For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

            Control1..1*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

            Alternate NamesActiveParticipant
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. AuditEvent.agent:documentRecipient.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            44. AuditEvent.agent:documentRecipient.type
            Definition

            Specification of the participation type the user plays when performing the event.

            ShortHow agent participated
            Control10..1
            BindingUnless not suitable, these codes SHALL be taken from ParticipationRoleTypehttp://hl7.org/fhir/ValueSet/participation-role-type
            (extensible to http://hl7.org/fhir/ValueSet/participation-role-type)

            The Participation type of the agent to the event.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Pattern Value{
              "coding" : [{
                "system" : "http://dicom.nema.org/resources/ontology/DCM",
                "code" : "110152",
                "display" : "Destination Role ID"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. AuditEvent.agent:documentRecipient.who
            Definition

            Reference to who this agent is that was involved in the event.

            ShortIdentifier of who
            Comments

            Where a User ID is available it will go into who.identifier.

            Control10..1
            TypeReference(PractitionerRole, Practitioner, Organization, Device, Patient, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Requirements

            This field ties an audit event to a specific resource or identifier.

            Alternate NamesuserId
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. AuditEvent.agent:documentRecipient.requestor
            Definition

            Indicator that the user is or is not the requestor, or initiator, for the event being audited.

            ShortWhether user is initiator
            Comments

            There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

            Control1..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. AuditEvent.agent:documentRecipient.network
            Definition

            Logical network location for application activity, if the activity has a network location.

            ShortLogical network location for application activity
            Control10..1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. AuditEvent.agent:documentRecipient.network.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            54. AuditEvent.source
            Definition

            The system that is reporting the event.

            ShortAudit Event Reporter
            Comments

            Since multi-tier, distributed, or composite applications make source identification ambiguous, this collection of fields may repeat for each application or process actively involved in the event. For example, multiple value-sets can identify participating web servers, application processes, and database server threads in an n-tier distributed application. Passive event participants (e.g. low-level network transports) need not be identified.

            Control1..1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            The event is reported by one source.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. AuditEvent.source.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            58. AuditEvent.source.observer
            Definition

            Identifier of the source where the event was detected.

            ShortThe identity of source detecting the event
            Control1..1
            TypeReference(PractitionerRole, Practitioner, Organization, Device, Patient, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Requirements

            This field ties the event to a specific source system. It may be used to group events for analysis according to where the event was detected.

            Alternate NamesSourceId
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. AuditEvent.entity
            Definition

            Specific instances of data or objects that have been accessed.

            ShortData or objects used
            Comments

            Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

            Control20..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            The event may have other entities involved.

            Alternate NamesParticipantObject
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
            sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
            SlicingThis element introduces a set of slices on AuditEvent.entity. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • pattern @ type
            • 62. AuditEvent.entity.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              64. AuditEvent.entity:patient
              Slice Namepatient
              Definition

              Specific instances of data or objects that have been accessed.

              ShortPatientData or objects used
              Comments

              Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

              Control10..1*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Requirements

              The event may have other entities involved.

              Alternate NamesParticipantObject
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
              sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
              66. AuditEvent.entity:patient.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              68. AuditEvent.entity:patient.what
              Definition

              Identifies a specific instance of the entity. The reference should be version specific.

              ShortSpecific instance of resource
              Control10..1
              TypeReference(Patient, Resource)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. AuditEvent.entity:patient.type
              Definition

              The type of the object that was involved in this audit event.

              ShortType of entity involved
              Comments

              This value is distinct from the user's role or any user relationship to the entity.

              Control10..1
              BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityTypehttp://hl7.org/fhir/ValueSet/audit-entity-type
              (extensible to http://hl7.org/fhir/ValueSet/audit-entity-type)

              Code for the entity type involved in the audit event.

              TypeCoding
              Is Modifierfalse
              Summaryfalse
              Requirements

              To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

              Pattern Value{
                "system" : "http://terminology.hl7.org/CodeSystem/audit-entity-type",
                "code" : "1",
                "display" : "Person"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. AuditEvent.entity:patient.role
              Definition

              Code representing the role the entity played in the event being audited.

              ShortWhat role the entity played
              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityRolehttp://hl7.org/fhir/ValueSet/object-role
              (extensible to http://hl7.org/fhir/ValueSet/object-role)

              Code representing the role the entity played in the audit event.

              TypeCoding
              Is Modifierfalse
              Summaryfalse
              Requirements

              For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

              Pattern Value{
                "system" : "http://terminology.hl7.org/CodeSystem/object-role",
                "code" : "1",
                "display" : "Patient"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. AuditEvent.entity:submissionSet
              Slice NamesubmissionSet
              Definition

              Specific instances of data or objects that have been accessed.

              ShortSubmissionSetData or objects used
              Comments

              Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

              Control10..1*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Requirements

              The event may have other entities involved.

              Alternate NamesParticipantObject
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
              sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
              76. AuditEvent.entity:submissionSet.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              78. AuditEvent.entity:submissionSet.what
              Definition

              Identifies a specific instance of the entity. The reference should be version specific.

              ShortSpecific instance of resource
              Control10..1
              TypeReference(List, Resource)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. AuditEvent.entity:submissionSet.type
              Definition

              The type of the object that was involved in this audit event.

              ShortType of entity involved
              Comments

              This value is distinct from the user's role or any user relationship to the entity.

              Control10..1
              BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityTypehttp://hl7.org/fhir/ValueSet/audit-entity-type
              (extensible to http://hl7.org/fhir/ValueSet/audit-entity-type)

              Code for the entity type involved in the audit event.

              TypeCoding
              Is Modifierfalse
              Summaryfalse
              Requirements

              To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

              Pattern Value{
                "system" : "http://terminology.hl7.org/CodeSystem/audit-entity-type",
                "code" : "2",
                "display" : "System Object"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. AuditEvent.entity:submissionSet.role
              Definition

              Code representing the role the entity played in the event being audited.

              ShortWhat role the entity played
              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityRolehttp://hl7.org/fhir/ValueSet/object-role
              (extensible to http://hl7.org/fhir/ValueSet/object-role)

              Code representing the role the entity played in the audit event.

              TypeCoding
              Is Modifierfalse
              Summaryfalse
              Requirements

              For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

              Pattern Value{
                "system" : "http://terminology.hl7.org/CodeSystem/object-role",
                "code" : "20",
                "display" : "Job"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

              Guidance on how to interpret the contents of this table can be found here

              0. AuditEvent
              Definition

              A record of an event made for purposes of maintaining a security log. Typical uses include detection of intrusion attempts and monitoring for inappropriate usage.

              ShortEvent record kept for security purposes
              Comments

              Based on IHE-ATNA.

              Control0..*
              Is Modifierfalse
              Summaryfalse
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              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 (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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              2. AuditEvent.id
              Definition

              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

              ShortLogical id of this artifact
              Comments

              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

              Control0..1
              Typeid
              Is Modifierfalse
              Summarytrue
              4. AuditEvent.meta
              Definition

              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              6. AuditEvent.implicitRules
              Definition

              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

              ShortA set of rules under which this content was created
              Comments

              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

              Control0..1
              Typeuri
              Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              8. AuditEvent.language
              Definition

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

              Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

              Control0..1
              BindingThe codes SHOULD be taken from CommonLanguages
              (preferred to http://hl7.org/fhir/ValueSet/languages)

              A human language.

              Additional BindingsPurpose
              AllLanguagesMax Binding
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              10. AuditEvent.text
              Definition

              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

              ShortText summary of the resource, for human interpretation
              Comments

              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

              Control0..1
              TypeNarrative
              Is Modifierfalse
              Summaryfalse
              Alternate Namesnarrative, html, xhtml, display
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              12. AuditEvent.contained
              Definition

              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

              ShortContained, inline Resources
              Comments

              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

              Control0..*
              TypeResource
              Is Modifierfalse
              Summaryfalse
              Alternate Namesinline resources, anonymous resources, contained resources
              14. AuditEvent.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              16. AuditEvent.modifierExtension
              Definition

              An Extension

              ShortExtension
              Control0..0
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. AuditEvent.type
              Definition

              Identifier for a family of the event. For example, a menu item, program, rule, policy, function code, application name or URL. It identifies the performed function.

              ShortType/identifier of event
              Control1..1
              BindingUnless not suitable, these codes SHALL be taken from AuditEventID
              (extensible to http://hl7.org/fhir/ValueSet/audit-event-type)

              Type of event.

              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              This identifies the performed function. For "Execute" Event Action Code audit records, this identifies the application function performed.

              Pattern Value{
                "system" : "http://dicom.nema.org/resources/ontology/DCM",
                "code" : "110106",
                "display" : "Export"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. AuditEvent.subtype
              Definition

              Identifier for the category of event.

              ShortMore specific type/id for the event
              Control1..*
              BindingUnless not suitable, these codes SHALL be taken from AuditEventSub-Type
              (extensible to http://hl7.org/fhir/ValueSet/audit-event-sub-type)

              Sub-type of event.

              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              This field enables queries of messages by implementation-defined event categories.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on AuditEvent.subtype. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ $this
              • 22. AuditEvent.subtype:iti65
                Slice Nameiti65
                Definition

                Identifier for the category of event.

                ShortMore specific type/id for the event
                Control1..1
                BindingUnless not suitable, these codes SHALL be taken from AuditEventSub-Type
                (extensible to http://hl7.org/fhir/ValueSet/audit-event-sub-type)

                Sub-type of event.

                TypeCoding
                Is Modifierfalse
                Summarytrue
                Requirements

                This field enables queries of messages by implementation-defined event categories.

                Pattern Value{
                  "system" : "urn:ihe:event-type-code",
                  "code" : "ITI-65",
                  "display" : "Provide Document Bundle"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. AuditEvent.action
                Definition

                Indicator for type of action performed during the event that generated the audit.

                ShortType of action performed during the event
                Control0..1
                BindingThe codes SHALL be taken from AuditEventAction
                (required to http://hl7.org/fhir/ValueSet/audit-event-action|4.0.1)

                Indicator for type of action performed during the event that generated the event.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                This broadly indicates what kind of action was done on the AuditEvent.entity by the AuditEvent.agent.

                Pattern ValueR
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                26. AuditEvent.period
                Definition

                The period during which the activity occurred.

                ShortWhen the activity occurred
                Comments

                The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.

                Control0..1
                TypePeriod
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. AuditEvent.recorded
                Definition

                The time when the event was recorded.

                ShortTime when the event was recorded
                Comments

                In a distributed system, some sort of common time base (e.g. an NTP [RFC1305] server) is a good implementation tactic.

                Control1..1
                Typeinstant
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                This ties an event to a specific date and time. Security audits typically require a consistent time base (e.g. UTC), to eliminate time-zone issues arising from geographical distribution.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                30. AuditEvent.outcome
                Definition

                Indicates whether the event succeeded or failed.

                ShortWhether the event succeeded or failed
                Comments

                In some cases a "success" may be partial, for example, an incomplete or interrupted transfer of a radiological study. For the purpose of establishing accountability, these distinctions are not relevant.

                Control1..1
                BindingThe codes SHALL be taken from AuditEventOutcome
                (required to http://hl7.org/fhir/ValueSet/audit-event-outcome|4.0.1)

                Indicates whether the event succeeded or failed.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                32. AuditEvent.outcomeDesc
                Definition

                A free text description of the outcome of the event.

                ShortDescription of the event outcome
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                34. AuditEvent.purposeOfEvent
                Definition

                The purposeOfUse (reason) that was used during the event being recorded.

                ShortThe purposeOfUse of the event
                Comments

                Use AuditEvent.agent.purposeOfUse when you know that it is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.

                Control0..*
                BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
                (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

                The reason the activity took place.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. AuditEvent.agent
                Definition

                An actor taking an active role in the event or activity that is logged.

                ShortActor involved in the event
                Comments

                Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

                For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

                Control2..*
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Requirements

                An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

                Alternate NamesActiveParticipant
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on AuditEvent.agent. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • pattern @ type
                • 38. AuditEvent.agent.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  40. AuditEvent.agent.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  42. AuditEvent.agent.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  44. AuditEvent.agent.type
                  Definition

                  Specification of the participation type the user plays when performing the event.

                  ShortHow agent participated
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from ParticipationRoleType
                  (extensible to http://hl7.org/fhir/ValueSet/participation-role-type)

                  The Participation type of the agent to the event.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. AuditEvent.agent.role
                  Definition

                  The security role that the user was acting under, that come from local codes defined by the access control security system (e.g. RBAC, ABAC) used in the local context.

                  ShortAgent role in the event
                  Comments

                  Should be roles relevant to the event. Should not be an exhaustive list of roles.

                  Control0..*
                  BindingFor example codes, see SecurityRoleType
                  (example to http://hl7.org/fhir/ValueSet/security-role-type)

                  What security role enabled the agent to participate in the event.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  This value ties an audited event to a user's role(s). It is an optional value that might be used to group events for analysis by user functional role categories.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. AuditEvent.agent.who
                  Definition

                  Reference to who this agent is that was involved in the event.

                  ShortIdentifier of who
                  Comments

                  Where a User ID is available it will go into who.identifier.

                  Control0..1
                  TypeReference(PractitionerRole, Practitioner, Organization, Device, Patient, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  This field ties an audit event to a specific resource or identifier.

                  Alternate NamesuserId
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. AuditEvent.agent.altId
                  Definition

                  Alternative agent Identifier. For a human, this should be a user identifier text string from authentication system. This identifier would be one known to a common authentication system (e.g. single sign-on), if available.

                  ShortAlternative User identity
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  In some situations, a human user may authenticate with one identity but, to access a specific application system, may use a synonymous identify. For example, some "single sign on" implementations will do this. The alternative identifier would then be the original identify used for authentication, and the User ID is the one known to and used by the application.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. AuditEvent.agent.name
                  Definition

                  Human-meaningful name for the agent.

                  ShortHuman friendly name for the agent
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  The User ID and Authorization User ID may be internal or otherwise obscure values. This field assists the auditor in identifying the actual user.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. AuditEvent.agent.requestor
                  Definition

                  Indicator that the user is or is not the requestor, or initiator, for the event being audited.

                  ShortWhether user is initiator
                  Comments

                  There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

                  Control1..1
                  Typeboolean
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. AuditEvent.agent.location
                  Definition

                  Where the event occurred.

                  ShortWhere
                  Control0..1
                  TypeReference(Location)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. AuditEvent.agent.policy
                  Definition

                  The policy or plan that authorized the activity being recorded. Typically, a single activity may have multiple applicable policies, such as patient consent, guarantor funding, etc. The policy would also indicate the security token used.

                  ShortPolicy that authorized event
                  Comments

                  For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element.

                  Control0..*
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This value is used retrospectively to determine the authorization policies.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  60. AuditEvent.agent.media
                  Definition

                  Type of media involved. Used when the event is about exporting/importing onto media.

                  ShortType of media
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from MediaTypeCode
                  (extensible to http://hl7.org/fhir/ValueSet/dicm-405-mediatype)

                  Used when the event is about exporting/importing onto media.

                  TypeCoding
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Usually, this is used instead of specifying a network address. This field is not used for Media Id (i.e. the serial number of a CD).

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  62. AuditEvent.agent.network
                  Definition

                  Logical network location for application activity, if the activity has a network location.

                  ShortLogical network location for application activity
                  Control0..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  64. AuditEvent.agent.network.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  66. AuditEvent.agent.network.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  68. AuditEvent.agent.network.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  70. AuditEvent.agent.network.address
                  Definition

                  An identifier for the network access point of the user device for the audit event.

                  ShortIdentifier for the network access point of the user device
                  Comments

                  This could be a device id, IP address or some other identifier associated with a device.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This datum identifies the user's network access point, which may be distinct from the server that performed the action. It is an optional value that may be used to group events recorded on separate servers for analysis of a specific network access point's data access across all servers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  72. AuditEvent.agent.network.type
                  Definition

                  An identifier for the type of network access point that originated the audit event.

                  ShortThe type of network access point
                  Control0..1
                  BindingThe codes SHALL be taken from AuditEventAgentNetworkType
                  (required to http://hl7.org/fhir/ValueSet/network-type|4.0.1)

                  The type of network access point of this agent in the audit event.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This datum identifies the type of network access point identifier of the user device for the audit event. It is an optional value that may be used to group events recorded on separate servers for analysis of access according to a network access point's type.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. AuditEvent.agent.purposeOfUse
                  Definition

                  The reason (purpose of use), specific to this agent, that was used during the event being recorded.

                  ShortReason given for this user
                  Comments

                  Use AuditEvent.agent.purposeOfUse when you know that is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.

                  Control0..*
                  BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
                  (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

                  The reason the activity took place.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. AuditEvent.agent:documentSource
                  Slice NamedocumentSource
                  Definition

                  An actor taking an active role in the event or activity that is logged.

                  ShortDocument Source
                  Comments

                  Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

                  For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

                  Control1..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

                  Alternate NamesActiveParticipant
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  val-audit-source: The Audit Source is this agent too. ($this.who = %resource.source.observer)
                  78. AuditEvent.agent:documentSource.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  80. AuditEvent.agent:documentSource.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  82. AuditEvent.agent:documentSource.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  84. AuditEvent.agent:documentSource.type
                  Definition

                  Specification of the participation type the user plays when performing the event.

                  ShortHow agent participated
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from ParticipationRoleType
                  (extensible to http://hl7.org/fhir/ValueSet/participation-role-type)

                  The Participation type of the agent to the event.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://dicom.nema.org/resources/ontology/DCM",
                      "code" : "110153",
                      "display" : "Source Role ID"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  86. AuditEvent.agent:documentSource.role
                  Definition

                  The security role that the user was acting under, that come from local codes defined by the access control security system (e.g. RBAC, ABAC) used in the local context.

                  ShortAgent role in the event
                  Comments

                  Should be roles relevant to the event. Should not be an exhaustive list of roles.

                  Control0..*
                  BindingFor example codes, see SecurityRoleType
                  (example to http://hl7.org/fhir/ValueSet/security-role-type)

                  What security role enabled the agent to participate in the event.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  This value ties an audited event to a user's role(s). It is an optional value that might be used to group events for analysis by user functional role categories.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. AuditEvent.agent:documentSource.who
                  Definition

                  Reference to who this agent is that was involved in the event.

                  ShortIdentifier of who
                  Comments

                  Where a User ID is available it will go into who.identifier.

                  Control1..1
                  TypeReference(PractitionerRole, Practitioner, Organization, Device, Patient, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  This field ties an audit event to a specific resource or identifier.

                  Alternate NamesuserId
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. AuditEvent.agent:documentSource.altId
                  Definition

                  Alternative agent Identifier. For a human, this should be a user identifier text string from authentication system. This identifier would be one known to a common authentication system (e.g. single sign-on), if available.

                  ShortAlternative User identity
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  In some situations, a human user may authenticate with one identity but, to access a specific application system, may use a synonymous identify. For example, some "single sign on" implementations will do this. The alternative identifier would then be the original identify used for authentication, and the User ID is the one known to and used by the application.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. AuditEvent.agent:documentSource.name
                  Definition

                  Human-meaningful name for the agent.

                  ShortHuman friendly name for the agent
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  The User ID and Authorization User ID may be internal or otherwise obscure values. This field assists the auditor in identifying the actual user.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. AuditEvent.agent:documentSource.requestor
                  Definition

                  Indicator that the user is or is not the requestor, or initiator, for the event being audited.

                  ShortWhether user is initiator
                  Comments

                  There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

                  Control1..1
                  Typeboolean
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. AuditEvent.agent:documentSource.location
                  Definition

                  Where the event occurred.

                  ShortWhere
                  Control0..1
                  TypeReference(Location)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. AuditEvent.agent:documentSource.policy
                  Definition

                  The policy or plan that authorized the activity being recorded. Typically, a single activity may have multiple applicable policies, such as patient consent, guarantor funding, etc. The policy would also indicate the security token used.

                  ShortPolicy that authorized event
                  Comments

                  For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element.

                  Control0..*
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This value is used retrospectively to determine the authorization policies.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. AuditEvent.agent:documentSource.media
                  Definition

                  Type of media involved. Used when the event is about exporting/importing onto media.

                  ShortType of media
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from MediaTypeCode
                  (extensible to http://hl7.org/fhir/ValueSet/dicm-405-mediatype)

                  Used when the event is about exporting/importing onto media.

                  TypeCoding
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Usually, this is used instead of specifying a network address. This field is not used for Media Id (i.e. the serial number of a CD).

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. AuditEvent.agent:documentSource.network
                  Definition

                  Logical network location for application activity, if the activity has a network location.

                  ShortLogical network location for application activity
                  Control1..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  104. AuditEvent.agent:documentSource.network.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  106. AuditEvent.agent:documentSource.network.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  108. AuditEvent.agent:documentSource.network.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  110. AuditEvent.agent:documentSource.network.address
                  Definition

                  An identifier for the network access point of the user device for the audit event.

                  ShortIdentifier for the network access point of the user device
                  Comments

                  This could be a device id, IP address or some other identifier associated with a device.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This datum identifies the user's network access point, which may be distinct from the server that performed the action. It is an optional value that may be used to group events recorded on separate servers for analysis of a specific network access point's data access across all servers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. AuditEvent.agent:documentSource.network.type
                  Definition

                  An identifier for the type of network access point that originated the audit event.

                  ShortThe type of network access point
                  Control0..1
                  BindingThe codes SHALL be taken from AuditEventAgentNetworkType
                  (required to http://hl7.org/fhir/ValueSet/network-type|4.0.1)

                  The type of network access point of this agent in the audit event.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This datum identifies the type of network access point identifier of the user device for the audit event. It is an optional value that may be used to group events recorded on separate servers for analysis of access according to a network access point's type.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  114. AuditEvent.agent:documentSource.purposeOfUse
                  Definition

                  The reason (purpose of use), specific to this agent, that was used during the event being recorded.

                  ShortReason given for this user
                  Comments

                  Use AuditEvent.agent.purposeOfUse when you know that is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.

                  Control0..*
                  BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
                  (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

                  The reason the activity took place.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  116. AuditEvent.agent:documentRecipient
                  Slice NamedocumentRecipient
                  Definition

                  An actor taking an active role in the event or activity that is logged.

                  ShortDocument Recipient
                  Comments

                  Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

                  For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

                  Control1..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

                  Alternate NamesActiveParticipant
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  118. AuditEvent.agent:documentRecipient.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  120. AuditEvent.agent:documentRecipient.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  122. AuditEvent.agent:documentRecipient.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  124. AuditEvent.agent:documentRecipient.type
                  Definition

                  Specification of the participation type the user plays when performing the event.

                  ShortHow agent participated
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from ParticipationRoleType
                  (extensible to http://hl7.org/fhir/ValueSet/participation-role-type)

                  The Participation type of the agent to the event.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://dicom.nema.org/resources/ontology/DCM",
                      "code" : "110152",
                      "display" : "Destination Role ID"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  126. AuditEvent.agent:documentRecipient.role
                  Definition

                  The security role that the user was acting under, that come from local codes defined by the access control security system (e.g. RBAC, ABAC) used in the local context.

                  ShortAgent role in the event
                  Comments

                  Should be roles relevant to the event. Should not be an exhaustive list of roles.

                  Control0..*
                  BindingFor example codes, see SecurityRoleType
                  (example to http://hl7.org/fhir/ValueSet/security-role-type)

                  What security role enabled the agent to participate in the event.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  This value ties an audited event to a user's role(s). It is an optional value that might be used to group events for analysis by user functional role categories.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  128. AuditEvent.agent:documentRecipient.who
                  Definition

                  Reference to who this agent is that was involved in the event.

                  ShortIdentifier of who
                  Comments

                  Where a User ID is available it will go into who.identifier.

                  Control1..1
                  TypeReference(PractitionerRole, Practitioner, Organization, Device, Patient, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  This field ties an audit event to a specific resource or identifier.

                  Alternate NamesuserId
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  130. AuditEvent.agent:documentRecipient.altId
                  Definition

                  Alternative agent Identifier. For a human, this should be a user identifier text string from authentication system. This identifier would be one known to a common authentication system (e.g. single sign-on), if available.

                  ShortAlternative User identity
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  In some situations, a human user may authenticate with one identity but, to access a specific application system, may use a synonymous identify. For example, some "single sign on" implementations will do this. The alternative identifier would then be the original identify used for authentication, and the User ID is the one known to and used by the application.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  132. AuditEvent.agent:documentRecipient.name
                  Definition

                  Human-meaningful name for the agent.

                  ShortHuman friendly name for the agent
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  The User ID and Authorization User ID may be internal or otherwise obscure values. This field assists the auditor in identifying the actual user.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  134. AuditEvent.agent:documentRecipient.requestor
                  Definition

                  Indicator that the user is or is not the requestor, or initiator, for the event being audited.

                  ShortWhether user is initiator
                  Comments

                  There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

                  Control1..1
                  Typeboolean
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  136. AuditEvent.agent:documentRecipient.location
                  Definition

                  Where the event occurred.

                  ShortWhere
                  Control0..1
                  TypeReference(Location)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  138. AuditEvent.agent:documentRecipient.policy
                  Definition

                  The policy or plan that authorized the activity being recorded. Typically, a single activity may have multiple applicable policies, such as patient consent, guarantor funding, etc. The policy would also indicate the security token used.

                  ShortPolicy that authorized event
                  Comments

                  For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element.

                  Control0..*
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This value is used retrospectively to determine the authorization policies.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  140. AuditEvent.agent:documentRecipient.media
                  Definition

                  Type of media involved. Used when the event is about exporting/importing onto media.

                  ShortType of media
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from MediaTypeCode
                  (extensible to http://hl7.org/fhir/ValueSet/dicm-405-mediatype)

                  Used when the event is about exporting/importing onto media.

                  TypeCoding
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Usually, this is used instead of specifying a network address. This field is not used for Media Id (i.e. the serial number of a CD).

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  142. AuditEvent.agent:documentRecipient.network
                  Definition

                  Logical network location for application activity, if the activity has a network location.

                  ShortLogical network location for application activity
                  Control1..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  144. AuditEvent.agent:documentRecipient.network.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  146. AuditEvent.agent:documentRecipient.network.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  148. AuditEvent.agent:documentRecipient.network.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  150. AuditEvent.agent:documentRecipient.network.address
                  Definition

                  An identifier for the network access point of the user device for the audit event.

                  ShortIdentifier for the network access point of the user device
                  Comments

                  This could be a device id, IP address or some other identifier associated with a device.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This datum identifies the user's network access point, which may be distinct from the server that performed the action. It is an optional value that may be used to group events recorded on separate servers for analysis of a specific network access point's data access across all servers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  152. AuditEvent.agent:documentRecipient.network.type
                  Definition

                  An identifier for the type of network access point that originated the audit event.

                  ShortThe type of network access point
                  Control0..1
                  BindingThe codes SHALL be taken from AuditEventAgentNetworkType
                  (required to http://hl7.org/fhir/ValueSet/network-type|4.0.1)

                  The type of network access point of this agent in the audit event.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This datum identifies the type of network access point identifier of the user device for the audit event. It is an optional value that may be used to group events recorded on separate servers for analysis of access according to a network access point's type.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  154. AuditEvent.agent:documentRecipient.purposeOfUse
                  Definition

                  The reason (purpose of use), specific to this agent, that was used during the event being recorded.

                  ShortReason given for this user
                  Comments

                  Use AuditEvent.agent.purposeOfUse when you know that is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.

                  Control0..*
                  BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
                  (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

                  The reason the activity took place.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  156. AuditEvent.source
                  Definition

                  The system that is reporting the event.

                  ShortAudit Event Reporter
                  Comments

                  Since multi-tier, distributed, or composite applications make source identification ambiguous, this collection of fields may repeat for each application or process actively involved in the event. For example, multiple value-sets can identify participating web servers, application processes, and database server threads in an n-tier distributed application. Passive event participants (e.g. low-level network transports) need not be identified.

                  Control1..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  The event is reported by one source.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  158. AuditEvent.source.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  160. AuditEvent.source.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  162. AuditEvent.source.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  164. AuditEvent.source.site
                  Definition

                  Logical source location within the healthcare enterprise network. For example, a hospital or other provider location within a multi-entity provider group.

                  ShortLogical source location within the enterprise
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  This value differentiates among the sites in a multi-site enterprise health information system.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  166. AuditEvent.source.observer
                  Definition

                  Identifier of the source where the event was detected.

                  ShortThe identity of source detecting the event
                  Control1..1
                  TypeReference(PractitionerRole, Practitioner, Organization, Device, Patient, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  This field ties the event to a specific source system. It may be used to group events for analysis according to where the event was detected.

                  Alternate NamesSourceId
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  168. AuditEvent.source.type
                  Definition

                  Code specifying the type of source where event originated.

                  ShortThe type of source where event originated
                  Control0..*
                  BindingUnless not suitable, these codes SHALL be taken from AuditEventSourceType
                  (extensible to http://hl7.org/fhir/ValueSet/audit-source-type)

                  Code specifying the type of system that detected and recorded the event.

                  TypeCoding
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  This field indicates which type of source is identified by the Audit Source ID. It is an optional value that may be used to group events for analysis according to the type of source where the event occurred.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  170. AuditEvent.entity
                  Definition

                  Specific instances of data or objects that have been accessed.

                  ShortData or objects used
                  Comments

                  Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

                  Control2..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  The event may have other entities involved.

                  Alternate NamesParticipantObject
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
                  SlicingThis element introduces a set of slices on AuditEvent.entity. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • pattern @ type
                  • 172. AuditEvent.entity.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    174. AuditEvent.entity.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    176. AuditEvent.entity.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    178. AuditEvent.entity.what
                    Definition

                    Identifies a specific instance of the entity. The reference should be version specific.

                    ShortSpecific instance of resource
                    Control0..1
                    TypeReference(Resource)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    180. AuditEvent.entity.type
                    Definition

                    The type of the object that was involved in this audit event.

                    ShortType of entity involved
                    Comments

                    This value is distinct from the user's role or any user relationship to the entity.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityType
                    (extensible to http://hl7.org/fhir/ValueSet/audit-entity-type)

                    Code for the entity type involved in the audit event.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    182. AuditEvent.entity.role
                    Definition

                    Code representing the role the entity played in the event being audited.

                    ShortWhat role the entity played
                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityRole
                    (extensible to http://hl7.org/fhir/ValueSet/object-role)

                    Code representing the role the entity played in the audit event.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    184. AuditEvent.entity.lifecycle
                    Definition

                    Identifier for the data life-cycle stage for the entity.

                    ShortLife-cycle stage for the entity
                    Comments

                    This can be used to provide an audit trail for data, over time, as it passes through the system.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from ObjectLifecycleEvents
                    (extensible to http://hl7.org/fhir/ValueSet/object-lifecycle-events)

                    Identifier for the data life-cycle stage for the entity.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Institutional policies for privacy and security may optionally fall under different accountability rules based on data life cycle. This provides a differentiating value for those cases.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    186. AuditEvent.entity.securityLabel
                    Definition

                    Security labels for the identified entity.

                    ShortSecurity labels on the entity
                    Comments

                    Copied from entity meta security tags.

                    Control0..*
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    This field identifies the security labels for a specific instance of an object, such as a patient, to detect/track privacy and security issues.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    188. AuditEvent.entity.name
                    Definition

                    A name of the entity in the audit event.

                    ShortDescriptor for entity
                    Comments

                    This field may be used in a query/report to identify audit events for a specific person. For example, where multiple synonymous entity identifiers (patient number, medical record number, encounter number, etc.) have been used.

                    Control0..1
                    This element is affected by the following invariants: sev-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Use only where entity can't be identified with an identifier.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    190. AuditEvent.entity.description
                    Definition

                    Text that describes the entity in more detail.

                    ShortDescriptive text
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Use only where entity can't be identified with an identifier.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    192. AuditEvent.entity.query
                    Definition

                    The query parameters for a query-type entities.

                    ShortQuery parameters
                    Comments

                    The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example, if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                    Control0..1
                    This element is affected by the following invariants: sev-1
                    Typebase64Binary
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    For query events, it may be necessary to capture the actual query input to the query process in order to identify the specific event. Because of differences among query implementations and data encoding for them, this is a base 64 encoded data blob. It may be subsequently decoded or interpreted by downstream audit analysis processing.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    194. AuditEvent.entity.detail
                    Definition

                    Tagged value pairs for conveying additional information about the entity.

                    ShortAdditional Information about the entity
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Implementation-defined data about specific details of the object accessed or used.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    196. AuditEvent.entity.detail.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    198. AuditEvent.entity.detail.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    200. AuditEvent.entity.detail.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    202. AuditEvent.entity.detail.type
                    Definition

                    The type of extra detail provided in the value.

                    ShortName of the property
                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    204. AuditEvent.entity.detail.value[x]
                    Definition

                    The value of the extra detail.

                    ShortProperty value
                    Comments

                    The value can be string when known to be a string, else base64 encoding should be used to protect binary or undefined content. The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                    Control1..1
                    TypeChoice of: string, base64Binary
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Should not duplicate the entity value unless absolutely necessary.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    206. AuditEvent.entity:patient
                    Slice Namepatient
                    Definition

                    Specific instances of data or objects that have been accessed.

                    ShortPatient
                    Comments

                    Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

                    Control1..1
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    The event may have other entities involved.

                    Alternate NamesParticipantObject
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
                    208. AuditEvent.entity:patient.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    210. AuditEvent.entity:patient.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    212. AuditEvent.entity:patient.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    214. AuditEvent.entity:patient.what
                    Definition

                    Identifies a specific instance of the entity. The reference should be version specific.

                    ShortSpecific instance of resource
                    Control1..1
                    TypeReference(Patient)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    216. AuditEvent.entity:patient.type
                    Definition

                    The type of the object that was involved in this audit event.

                    ShortType of entity involved
                    Comments

                    This value is distinct from the user's role or any user relationship to the entity.

                    Control1..1
                    BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityType
                    (extensible to http://hl7.org/fhir/ValueSet/audit-entity-type)

                    Code for the entity type involved in the audit event.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

                    Pattern Value{
                      "system" : "http://terminology.hl7.org/CodeSystem/audit-entity-type",
                      "code" : "1",
                      "display" : "Person"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    218. AuditEvent.entity:patient.role
                    Definition

                    Code representing the role the entity played in the event being audited.

                    ShortWhat role the entity played
                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityRole
                    (extensible to http://hl7.org/fhir/ValueSet/object-role)

                    Code representing the role the entity played in the audit event.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

                    Pattern Value{
                      "system" : "http://terminology.hl7.org/CodeSystem/object-role",
                      "code" : "1",
                      "display" : "Patient"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    220. AuditEvent.entity:patient.lifecycle
                    Definition

                    Identifier for the data life-cycle stage for the entity.

                    ShortLife-cycle stage for the entity
                    Comments

                    This can be used to provide an audit trail for data, over time, as it passes through the system.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from ObjectLifecycleEvents
                    (extensible to http://hl7.org/fhir/ValueSet/object-lifecycle-events)

                    Identifier for the data life-cycle stage for the entity.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Institutional policies for privacy and security may optionally fall under different accountability rules based on data life cycle. This provides a differentiating value for those cases.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    222. AuditEvent.entity:patient.securityLabel
                    Definition

                    Security labels for the identified entity.

                    ShortSecurity labels on the entity
                    Comments

                    Copied from entity meta security tags.

                    Control0..*
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    This field identifies the security labels for a specific instance of an object, such as a patient, to detect/track privacy and security issues.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    224. AuditEvent.entity:patient.name
                    Definition

                    A name of the entity in the audit event.

                    ShortDescriptor for entity
                    Comments

                    This field may be used in a query/report to identify audit events for a specific person. For example, where multiple synonymous entity identifiers (patient number, medical record number, encounter number, etc.) have been used.

                    Control0..1
                    This element is affected by the following invariants: sev-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Use only where entity can't be identified with an identifier.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    226. AuditEvent.entity:patient.description
                    Definition

                    Text that describes the entity in more detail.

                    ShortDescriptive text
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Use only where entity can't be identified with an identifier.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    228. AuditEvent.entity:patient.query
                    Definition

                    The query parameters for a query-type entities.

                    ShortQuery parameters
                    Comments

                    The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example, if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                    Control0..1
                    This element is affected by the following invariants: sev-1
                    Typebase64Binary
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    For query events, it may be necessary to capture the actual query input to the query process in order to identify the specific event. Because of differences among query implementations and data encoding for them, this is a base 64 encoded data blob. It may be subsequently decoded or interpreted by downstream audit analysis processing.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    230. AuditEvent.entity:patient.detail
                    Definition

                    Tagged value pairs for conveying additional information about the entity.

                    ShortAdditional Information about the entity
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Implementation-defined data about specific details of the object accessed or used.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    232. AuditEvent.entity:patient.detail.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    234. AuditEvent.entity:patient.detail.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    236. AuditEvent.entity:patient.detail.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    238. AuditEvent.entity:patient.detail.type
                    Definition

                    The type of extra detail provided in the value.

                    ShortName of the property
                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    240. AuditEvent.entity:patient.detail.value[x]
                    Definition

                    The value of the extra detail.

                    ShortProperty value
                    Comments

                    The value can be string when known to be a string, else base64 encoding should be used to protect binary or undefined content. The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                    Control1..1
                    TypeChoice of: string, base64Binary
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Should not duplicate the entity value unless absolutely necessary.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    242. AuditEvent.entity:submissionSet
                    Slice NamesubmissionSet
                    Definition

                    Specific instances of data or objects that have been accessed.

                    ShortSubmissionSet
                    Comments

                    Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

                    Control1..1
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    The event may have other entities involved.

                    Alternate NamesParticipantObject
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
                    244. AuditEvent.entity:submissionSet.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    246. AuditEvent.entity:submissionSet.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    248. AuditEvent.entity:submissionSet.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    250. AuditEvent.entity:submissionSet.what
                    Definition

                    Identifies a specific instance of the entity. The reference should be version specific.

                    ShortSpecific instance of resource
                    Control1..1
                    TypeReference(List)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    252. AuditEvent.entity:submissionSet.type
                    Definition

                    The type of the object that was involved in this audit event.

                    ShortType of entity involved
                    Comments

                    This value is distinct from the user's role or any user relationship to the entity.

                    Control1..1
                    BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityType
                    (extensible to http://hl7.org/fhir/ValueSet/audit-entity-type)

                    Code for the entity type involved in the audit event.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

                    Pattern Value{
                      "system" : "http://terminology.hl7.org/CodeSystem/audit-entity-type",
                      "code" : "2",
                      "display" : "System Object"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    254. AuditEvent.entity:submissionSet.role
                    Definition

                    Code representing the role the entity played in the event being audited.

                    ShortWhat role the entity played
                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityRole
                    (extensible to http://hl7.org/fhir/ValueSet/object-role)

                    Code representing the role the entity played in the audit event.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

                    Pattern Value{
                      "system" : "http://terminology.hl7.org/CodeSystem/object-role",
                      "code" : "20",
                      "display" : "Job"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    256. AuditEvent.entity:submissionSet.lifecycle
                    Definition

                    Identifier for the data life-cycle stage for the entity.

                    ShortLife-cycle stage for the entity
                    Comments

                    This can be used to provide an audit trail for data, over time, as it passes through the system.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from ObjectLifecycleEvents
                    (extensible to http://hl7.org/fhir/ValueSet/object-lifecycle-events)

                    Identifier for the data life-cycle stage for the entity.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Institutional policies for privacy and security may optionally fall under different accountability rules based on data life cycle. This provides a differentiating value for those cases.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    258. AuditEvent.entity:submissionSet.securityLabel
                    Definition

                    Security labels for the identified entity.

                    ShortSecurity labels on the entity
                    Comments

                    Copied from entity meta security tags.

                    Control0..*
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    This field identifies the security labels for a specific instance of an object, such as a patient, to detect/track privacy and security issues.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    260. AuditEvent.entity:submissionSet.name
                    Definition

                    A name of the entity in the audit event.

                    ShortDescriptor for entity
                    Comments

                    This field may be used in a query/report to identify audit events for a specific person. For example, where multiple synonymous entity identifiers (patient number, medical record number, encounter number, etc.) have been used.

                    Control0..1
                    This element is affected by the following invariants: sev-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Use only where entity can't be identified with an identifier.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    262. AuditEvent.entity:submissionSet.description
                    Definition

                    Text that describes the entity in more detail.

                    ShortDescriptive text
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Use only where entity can't be identified with an identifier.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    264. AuditEvent.entity:submissionSet.query
                    Definition

                    The query parameters for a query-type entities.

                    ShortQuery parameters
                    Comments

                    The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example, if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                    Control0..1
                    This element is affected by the following invariants: sev-1
                    Typebase64Binary
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    For query events, it may be necessary to capture the actual query input to the query process in order to identify the specific event. Because of differences among query implementations and data encoding for them, this is a base 64 encoded data blob. It may be subsequently decoded or interpreted by downstream audit analysis processing.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    266. AuditEvent.entity:submissionSet.detail
                    Definition

                    Tagged value pairs for conveying additional information about the entity.

                    ShortAdditional Information about the entity
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Implementation-defined data about specific details of the object accessed or used.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    268. AuditEvent.entity:submissionSet.detail.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    270. AuditEvent.entity:submissionSet.detail.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    272. AuditEvent.entity:submissionSet.detail.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    274. AuditEvent.entity:submissionSet.detail.type
                    Definition

                    The type of extra detail provided in the value.

                    ShortName of the property
                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    276. AuditEvent.entity:submissionSet.detail.value[x]
                    Definition

                    The value of the extra detail.

                    ShortProperty value
                    Comments

                    The value can be string when known to be a string, else base64 encoding should be used to protect binary or undefined content. The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                    Control1..1
                    TypeChoice of: string, base64Binary
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Should not duplicate the entity value unless absolutely necessary.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))