Cross Border Data Exchange IG
1.0.0 - CI Build International flag

Cross Border Data Exchange IG, published by IEHR-Workgroup. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/InteropEHRate-project/cross-border-data-exchange/ and changes regularly. See the Directory of published versions

Data Type Profile: ProvenanceSignatureIEHR - Detailed Descriptions

Draft as of 2024-04-08

Definitions for the Provenance-Signature-IEHR data type profile.

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

0. Signature
2. Signature.type
Definition

A code that defines the signature of the primary or sole author of a health information document.

Fixed value: Verification Signature

Control0..1
Must Supporttrue
Fixed Value{
  "system" : "urn:iso-astm:E1762-95:2013",
  "code" : "1.2.840.10065.1.12.1.5",
  "display" : "Verification Signature"
}
4. Signature.onBehalfOf
Control0..0
Must Supporttrue
6. Signature.targetFormat
Control1..?
BindingThe codes SHALL be taken from TargetFormat ValueSet-IEHR
(required to http://interopehrate.eu/fhir/ValueSet/TargetFormat-IEHR)
Must Supporttrue
8. Signature.sigFormat
Definition

A mime type that indicates the technical format of the signature.

Fixed value: JSON Digital Signature

Control1..?
Must Supporttrue
Fixed Valueapplication/jose
10. Signature.data
Control1..?
Must Supporttrue

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

0. Signature
Definition

A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.

ShortA Signature - XML DigSig, JWS, Graphical image of signature, etc.
Comments

The elements of the Signature Resource are for ease of access of these elements. For digital signatures (Xml DigSig, JWS), the non-repudiation proof comes from the Signature validation, which includes validation of the referenced objects (e.g. Resources) (a.k.a., Content) in the XML-Signature Detached form.

Control0..*
This element is affected by the following invariants: ele-1
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
2. Signature.type
Definition

A code that defines the signature of the primary or sole author of a health information document.

Fixed value: Verification Signature


An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

ShortIndication of the reason the entity signed the object(s)
Comments

Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

Control1..1*
BindingThe codes SHOULD be taken from SignatureTypeCodeshttp://hl7.org/fhir/ValueSet/signature-type
(preferred to http://hl7.org/fhir/ValueSet/signature-type)

An indication of the reason that an entity signed the object.

TypeCoding
Is Modifierfalse
Must Supporttrue
Summarytrue
Fixed Value{
  "system" : "urn:iso-astm:E1762-95:2013",
  "code" : "1.2.840.10065.1.12.1.5",
  "display" : "Verification Signature"
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Signature.when
Definition

When the digital signature was signed.

ShortWhen the signature was created
Comments

This should agree with the information in the signature.

Control1..1
Typeinstant
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()))
6. Signature.who
Definition

A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).

ShortWho signed
Comments

This should agree with the information in the signature.

Control1..1
TypeReference(Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Signature.onBehalfOf
Definition

A reference to an application-usable description of the identity that is represented by the signature.

ShortThe party represented
Comments

The party that can't sign. For example a child.

Control0..01
TypeReference(Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Requirements

used when the signature is on behalf of a non-signer.

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

A mime type that indicates the technical format of the target resources signed by the signature.

ShortThe technical format of the signed resources
Comments

"xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.

Control10..1
BindingThe codes SHALL be taken from TargetFormat ValueSet-IEHRhttp://hl7.org/fhir/ValueSet/mimetypes|4.0.1
(required to http://interopehrate.eu/fhir/ValueSet/TargetFormat-IEHR)
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Signature.sigFormat
Definition

A mime type that indicates the technical format of the signature.

Fixed value: JSON Digital Signature


A mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc.

ShortThe technical format of the signature
Control10..1
BindingThe codes SHALL be taken from Mime Typeshttp://hl7.org/fhir/ValueSet/mimetypes|4.0.1
(required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

The mime type of an attachment. Any valid mime type is allowed.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valueapplication/jose
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Signature.data
Definition

The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

ShortThe actual signature content (XML DigSig. JWS, picture, etc.)
Comments

Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

Control10..1
Typebase64Binary
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
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. Signature
Definition

A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.

ShortA Signature - XML DigSig, JWS, Graphical image of signature, etc.
Comments

The elements of the Signature Resource are for ease of access of these elements. For digital signatures (Xml DigSig, JWS), the non-repudiation proof comes from the Signature validation, which includes validation of the referenced objects (e.g. Resources) (a.k.a., Content) in the XML-Signature Detached form.

Control0..*
This element is affected by the following invariants: ele-1
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
2. Signature.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
4. Signature.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 Signature.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Signature.type
    Definition

    A code that defines the signature of the primary or sole author of a health information document.

    Fixed value: Verification Signature

    ShortIndication of the reason the entity signed the object(s)
    Comments

    Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

    Control1..1
    BindingThe codes SHOULD be taken from SignatureTypeCodes
    (preferred to http://hl7.org/fhir/ValueSet/signature-type)

    An indication of the reason that an entity signed the object.

    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Fixed Value{
      "system" : "urn:iso-astm:E1762-95:2013",
      "code" : "1.2.840.10065.1.12.1.5",
      "display" : "Verification Signature"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. Signature.when
    Definition

    When the digital signature was signed.

    ShortWhen the signature was created
    Comments

    This should agree with the information in the signature.

    Control1..1
    Typeinstant
    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()))
    10. Signature.who
    Definition

    A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).

    ShortWho signed
    Comments

    This should agree with the information in the signature.

    Control1..1
    TypeReference(Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Signature.onBehalfOf
    Definition

    A reference to an application-usable description of the identity that is represented by the signature.

    ShortThe party represented
    Comments

    The party that can't sign. For example a child.

    Control0..0
    TypeReference(Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summarytrue
    Requirements

    used when the signature is on behalf of a non-signer.

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

    A mime type that indicates the technical format of the target resources signed by the signature.

    ShortThe technical format of the signed resources
    Comments

    "xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.

    Control1..1
    BindingThe codes SHALL be taken from TargetFormat ValueSet-IEHR
    (required to http://interopehrate.eu/fhir/ValueSet/TargetFormat-IEHR)
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Signature.sigFormat
    Definition

    A mime type that indicates the technical format of the signature.

    Fixed value: JSON Digital Signature

    ShortThe technical format of the signature
    Control1..1
    BindingThe codes SHALL be taken from Mime Types
    (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

    The mime type of an attachment. Any valid mime type is allowed.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Fixed Valueapplication/jose
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Signature.data
    Definition

    The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

    ShortThe actual signature content (XML DigSig. JWS, picture, etc.)
    Comments

    Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

    Control1..1
    Typebase64Binary
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))