Mobile access to Health Documents (MHD)
4.2.3-current - ci-build 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 4.2.3-current 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: AuditSimplifiedPublishRecipient - Detailed Descriptions

Active as of 2024-11-26

Definitions for the IHE.MHD.SimplifiedPublish.Audit.Recipient 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.subtype
Control2..?
6. AuditEvent.subtype:iti105
Slice Nameiti105
Control1..1
Pattern Value{
  "system" : "urn:ihe:event-type-code",
  "code" : "ITI-105",
  "display" : "Simplified Publish"
}
8. AuditEvent.agent:client
Slice Nameclient
ShortDocument Source
10. AuditEvent.agent:server
Slice Nameserver
ShortDocument Recipient
Invariantsval-audit-source: The Audit Source is this agent too. ($this.who = %resource.source.observer)
12. AuditEvent.entity:data
Slice Namedata
ShortDocumentReference
14. AuditEvent.entity:data.what
TypeReference(DocumentReference)
16. AuditEvent.entity:patient
Slice Namepatient
ShortPatient

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://terminology.hl7.org/CodeSystem/audit-event-type",
  "code" : "rest"
}
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
Control20..*
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:anyCreate
    Slice NameanyCreate
    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" : "http://hl7.org/fhir/restful-interaction",
      "code" : "create"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. AuditEvent.subtype:iti105
    Slice Nameiti105
    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-105",
      "display" : "Simplified Publish"
    }
    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
    Pattern Value0
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. 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
    • 20. 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())
      22. 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()))
      24. AuditEvent.agent:client
      Slice Nameclient
      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()))
      26. AuditEvent.agent:client.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())
      28. AuditEvent.agent:client.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"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. AuditEvent.agent:client.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()))
      32. AuditEvent.agent:client.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()))
      34. AuditEvent.agent:client.media
      Definition

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

      ShortType of media
      Control0..01
      BindingUnless not suitable, these codes SHALL be taken from MediaTypeCodehttp://hl7.org/fhir/ValueSet/dicm-405-mediatype
      (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()))
      36. AuditEvent.agent:client.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:client.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:server
      Slice Nameserver
      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()))
      val-audit-source: The Audit Source is this agent too. ($this.who = %resource.source.observer)
      42. AuditEvent.agent:server.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:server.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"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. AuditEvent.agent:server.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:server.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:server.media
      Definition

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

      ShortType of media
      Control0..01
      BindingUnless not suitable, these codes SHALL be taken from MediaTypeCodehttp://hl7.org/fhir/ValueSet/dicm-405-mediatype
      (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()))
      52. AuditEvent.agent:server.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()))
      54. AuditEvent.agent:server.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())
      56. AuditEvent.agent:user
      Slice Nameuser
      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.

      Control01..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()))
      58. AuditEvent.agent:user.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())
      60. AuditEvent.agent:user.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 SecurityRoleTypehttp://hl7.org/fhir/ValueSet/security-role-type
      (example to http://hl7.org/fhir/ValueSet/security-role-type)

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

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      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()))
      62. AuditEvent.agent:user.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()))
      64. AuditEvent.agent:user.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
      Must Supporttrue
      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()))
      66. AuditEvent.agent:user.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.

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

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

      ShortType of media
      Control0..01
      BindingUnless not suitable, these codes SHALL be taken from MediaTypeCodehttp://hl7.org/fhir/ValueSet/dicm-405-mediatype
      (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()))
      70. AuditEvent.agent:user.network
      Definition

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

      ShortLogical network location for application activity
      Control0..01
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      73. AuditEvent.agent:user.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 PurposeOfUsehttp://terminology.hl7.org/ValueSet/v3-PurposeOfUse
      (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

      The reason the activity took place.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      75. 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
      Must Supporttrue
      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()))
      77. 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())
      79. 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()))
      81. 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
      • 83. 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())
        85. AuditEvent.entity:transaction
        Slice Nametransaction
        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.

        Control0..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())
        87. AuditEvent.entity:transaction.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())
        89. AuditEvent.entity:transaction.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" : "https://profiles.ihe.net/ITI/BALP/CodeSystem/BasicAuditEntityType",
          "code" : "XrequestId"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        91. AuditEvent.entity:data
        Slice Namedata
        Definition

        Specific instances of data or objects that have been accessed.

        ShortDocumentReferenceData 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())
        93. AuditEvent.entity:data.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())
        95. AuditEvent.entity:data.what
        Definition

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

        ShortSpecific instance of resource
        Control10..1
        TypeReference(DocumentReference, Resource)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        97. AuditEvent.entity:data.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"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        99. AuditEvent.entity:data.role
        Definition

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

        ShortWhat role the entity played
        Control10..1
        BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from RESTful objects role in the eventhttp://hl7.org/fhir/ValueSet/object-role
        (required to https://profiles.ihe.net/ITI/BALP/ValueSet/RestObjectRoles)
        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()))
        101. 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())
        103. 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())
        105. 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()))
        107. 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"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        109. AuditEvent.entity:patient.role
        Definition

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

        ShortWhat role the entity played
        Control10..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"
        }
        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://terminology.hl7.org/CodeSystem/audit-event-type",
          "code" : "rest"
        }
        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
        Control2..*
        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:anyCreate
          Slice NameanyCreate
          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" : "http://hl7.org/fhir/restful-interaction",
            "code" : "create"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. AuditEvent.subtype:iti105
          Slice Nameiti105
          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-105",
            "display" : "Simplified Publish"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. 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 ValueC
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. 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()))
          30. 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()))
          32. 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
          Pattern Value0
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. 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
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. 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()))
          38. 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
          • 40. 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
            42. 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())
            44. 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())
            46. 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()))
            48. 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()))
            50. 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()))
            52. 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()))
            54. 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()))
            56. 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()))
            58. 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()))
            60. 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()))
            62. 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()))
            64. 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()))
            66. 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
            68. 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())
            70. 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())
            72. 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()))
            74. 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()))
            76. 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()))
            78. AuditEvent.agent:client
            Slice Nameclient
            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()))
            80. AuditEvent.agent:client.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
            82. AuditEvent.agent:client.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())
            84. AuditEvent.agent:client.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())
            86. AuditEvent.agent:client.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"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. AuditEvent.agent:client.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()))
            90. AuditEvent.agent:client.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()))
            92. AuditEvent.agent:client.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()))
            94. AuditEvent.agent:client.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()))
            96. AuditEvent.agent:client.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()))
            98. AuditEvent.agent:client.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()))
            100. AuditEvent.agent:client.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()))
            102. AuditEvent.agent:client.media
            Definition

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

            ShortType of media
            Control0..0
            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()))
            104. AuditEvent.agent:client.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()))
            106. AuditEvent.agent:client.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
            108. AuditEvent.agent:client.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())
            110. AuditEvent.agent:client.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())
            112. AuditEvent.agent:client.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()))
            114. AuditEvent.agent:client.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()))
            116. AuditEvent.agent:client.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()))
            118. AuditEvent.agent:server
            Slice Nameserver
            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()))
            val-audit-source: The Audit Source is this agent too. ($this.who = %resource.source.observer)
            120. AuditEvent.agent:server.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
            122. AuditEvent.agent:server.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())
            124. AuditEvent.agent:server.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())
            126. AuditEvent.agent:server.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"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            128. AuditEvent.agent:server.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()))
            130. AuditEvent.agent:server.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()))
            132. AuditEvent.agent:server.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()))
            134. AuditEvent.agent:server.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()))
            136. AuditEvent.agent:server.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()))
            138. AuditEvent.agent:server.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()))
            140. AuditEvent.agent:server.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()))
            142. AuditEvent.agent:server.media
            Definition

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

            ShortType of media
            Control0..0
            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()))
            144. AuditEvent.agent:server.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()))
            146. AuditEvent.agent:server.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
            148. AuditEvent.agent:server.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())
            150. AuditEvent.agent:server.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())
            152. AuditEvent.agent:server.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()))
            154. AuditEvent.agent:server.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()))
            156. AuditEvent.agent:server.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()))
            158. AuditEvent.agent:user
            Slice Nameuser
            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.

            Control0..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()))
            160. AuditEvent.agent:user.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
            162. AuditEvent.agent:user.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())
            164. AuditEvent.agent:user.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())
            166. AuditEvent.agent:user.type
            Definition

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

            ShortHow agent participated
            Control0..1
            BindingThe codes SHALL be taken from participant source types for RESTful create
            (required to https://profiles.ihe.net/ITI/BALP/ValueSet/DataSources)
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            168. AuditEvent.agent:user.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
            Must Supporttrue
            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()))
            170. AuditEvent.agent:user.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()))
            172. AuditEvent.agent:user.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()))
            174. AuditEvent.agent:user.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
            Must Supporttrue
            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()))
            176. AuditEvent.agent:user.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.

            Pattern Valuetrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            178. AuditEvent.agent:user.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()))
            180. AuditEvent.agent:user.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()))
            182. AuditEvent.agent:user.media
            Definition

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

            ShortType of media
            Control0..0
            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()))
            184. AuditEvent.agent:user.network
            Definition

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

            ShortLogical network location for application activity
            Control0..0
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            191. AuditEvent.agent:user.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
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            193. 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
            Must Supporttrue
            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()))
            195. 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
            197. 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())
            199. 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())
            201. 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()))
            203. 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()))
            205. 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()))
            207. 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
            • 209. 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
              211. 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())
              213. 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())
              215. 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()))
              217. 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()))
              219. 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()))
              221. 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()))
              223. 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()))
              225. 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()))
              227. 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()))
              229. 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()))
              231. 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()))
              233. 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
              235. 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())
              237. 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())
              239. 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()))
              241. 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] NoteSeeChoice of Data Typesfor 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()))
              243. AuditEvent.entity:transaction
              Slice Nametransaction
              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.

              Control0..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())
              245. AuditEvent.entity:transaction.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
              247. AuditEvent.entity:transaction.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())
              249. AuditEvent.entity:transaction.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())
              251. AuditEvent.entity:transaction.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()))
              253. AuditEvent.entity:transaction.what.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
              255. AuditEvent.entity:transaction.what.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())
              SlicingThis element introduces a set of slices on AuditEvent.entity.what.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 257. AuditEvent.entity:transaction.what.reference
                Definition

                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                ShortLiteral reference, Relative, internal or absolute URL
                Comments

                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                Control0..1
                This element is affected by the following invariants: ref-1
                Typestring
                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()))
                259. AuditEvent.entity:transaction.what.type
                Definition

                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                ShortType the reference refers to (e.g. "Patient")
                Comments

                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                Aa resource (or, for logical models, the URI of the logical model).

                Typeuri
                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()))
                261. AuditEvent.entity:transaction.what.identifier
                Definition

                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                ShortLogical reference, when literal reference is not known
                Comments

                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                263. AuditEvent.entity:transaction.what.identifier.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
                265. AuditEvent.entity:transaction.what.identifier.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())
                SlicingThis element introduces a set of slices on AuditEvent.entity.what.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 267. AuditEvent.entity:transaction.what.identifier.use
                  Definition

                  The purpose of this identifier.

                  Shortusual | official | temp | secondary | old (If known)
                  Comments

                  Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                  Control0..1
                  BindingThe codes SHALL be taken from IdentifierUse
                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                  Identifies the purpose for this identifier, if known .

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                  A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                  ShortDescription of identifier
                  Comments

                  This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                  A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows users to make use of identifiers when the identifier system is not known.

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

                  Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                  ShortThe namespace for the identifier value
                  Comments

                  Identifier.system is always case sensitive.

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

                  There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                  Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  273. AuditEvent.entity:transaction.what.identifier.value
                  Definition

                  The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                  Shortthe value of X-Request-Id
                  Comments

                  If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Example<br/><b>General</b>:123456
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  275. AuditEvent.entity:transaction.what.identifier.period
                  Definition

                  Time period during which identifier is/was valid for use.

                  ShortTime period when id is/was valid for use
                  Control0..1
                  TypePeriod
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  277. AuditEvent.entity:transaction.what.identifier.assigner
                  Definition

                  Organization that issued/manages the identifier.

                  ShortOrganization that issued id (may be just text)
                  Comments

                  The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                  Control0..1
                  TypeReference(Organization)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  279. AuditEvent.entity:transaction.what.display
                  Definition

                  Plain text narrative that identifies the resource in addition to the resource reference.

                  ShortText alternative for the resource
                  Comments

                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                  Control0..1
                  Typestring
                  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()))
                  281. AuditEvent.entity:transaction.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" : "https://profiles.ihe.net/ITI/BALP/CodeSystem/BasicAuditEntityType",
                    "code" : "XrequestId"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  283. AuditEvent.entity:transaction.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()))
                  285. AuditEvent.entity:transaction.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()))
                  287. AuditEvent.entity:transaction.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()))
                  289. AuditEvent.entity:transaction.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()))
                  291. AuditEvent.entity:transaction.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()))
                  293. AuditEvent.entity:transaction.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()))
                  295. AuditEvent.entity:transaction.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()))
                  297. AuditEvent.entity:transaction.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
                  299. AuditEvent.entity:transaction.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())
                  301. AuditEvent.entity:transaction.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())
                  303. AuditEvent.entity:transaction.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()))
                  305. AuditEvent.entity:transaction.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] NoteSeeChoice of Data Typesfor 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()))
                  307. AuditEvent.entity:data
                  Slice Namedata
                  Definition

                  Specific instances of data or objects that have been accessed.

                  ShortDocumentReference
                  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())
                  309. AuditEvent.entity:data.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
                  311. AuditEvent.entity:data.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())
                  313. AuditEvent.entity:data.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())
                  315. AuditEvent.entity:data.what
                  Definition

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

                  ShortSpecific instance of resource
                  Control1..1
                  TypeReference(DocumentReference)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  317. AuditEvent.entity:data.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"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  319. AuditEvent.entity:data.role
                  Definition

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

                  ShortWhat role the entity played
                  Control1..1
                  BindingThe codes SHALL be taken from RESTful objects role in the event
                  (required to https://profiles.ihe.net/ITI/BALP/ValueSet/RestObjectRoles)
                  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()))
                  321. AuditEvent.entity:data.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()))
                  323. AuditEvent.entity:data.securityLabel
                  Definition

                  Security labels for the identified entity.

                  Shortmay contain the security labels on the resource returned
                  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()))
                  325. AuditEvent.entity:data.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()))
                  327. AuditEvent.entity:data.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()))
                  329. AuditEvent.entity:data.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()))
                  331. AuditEvent.entity:data.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()))
                  333. AuditEvent.entity:data.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
                  335. AuditEvent.entity:data.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())
                  337. AuditEvent.entity:data.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())
                  339. AuditEvent.entity:data.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()))
                  341. AuditEvent.entity:data.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] NoteSeeChoice of Data Typesfor 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()))
                  343. 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())
                  345. 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
                  347. 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())
                  349. 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())
                  351. 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()))
                  353. 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"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  355. AuditEvent.entity:patient.role
                  Definition

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

                  ShortWhat role the entity played
                  Control1..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"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  357. 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()))
                  359. 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()))
                  361. 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()))
                  363. 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()))
                  365. 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()))
                  367. 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()))
                  369. 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
                  371. 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())
                  373. 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())
                  375. 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()))
                  377. 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] NoteSeeChoice of Data Typesfor 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()))