Scope and usage

This profile is used as the Provenance resource for MedCom FHIR messages. The Provenance resource tracks information about the activity what was created, revised, or deleted, while referencing the current message and previous messages if such exist. This is why the Provenance resource is valuable in MedCom messaging.

MedComMessagingProvenance describes the activity and history of a message. The element Provenance.agent.who contains information about the organisation that was involved in the activity, the element Provenance.target references the MessageHeader in the current message, and the element Provenance.what references the event that initiated a message e.g., a previous message.

The figure below illustrates the references from the Provenance resource.

Please refer to the tab "Snapshot Table(Must support)" below for the definition of the required content of a MedComMessagingProvenance.

Activity

In MedCom messaging, the Provenance.target shall always be a reference to a MedComMessagingMessageHeader or an inherited of MedComMessagingMessageHeader. The target references the resources on which the activity has occurred. For instances if Provenance.activity is 'new-message', it describes that the message referenced from the Messageheader is a new message.

The activitycodes used to describe the activity of the MedCom message may differ between standard e.g. HospitalNotification and CareCommunication. Due to the different requirements of activities in a standard, it should be expected that there will be different invariants pointing at specific ValueSets for the given standard.

Provenance.agent describes the actor who is responsible for the activity that took place, by referencing the organisation responsible for the activity. The referenced organisation shall be an MedComMessagingOrganization.

History

MedComMessagingProvenance handles the message history in the Provenacne.entity element. This element shall be included if the message is a response to a previous message. In this case the element Provenance.entity.role is used to describe how the entity is used in the message. Provenance.entity.role shall be:

• revision when a message is a response, a correction, or a forwarding.
• removal when the message is a cancellation of a previously send message.

When a message is a response to a previous message, the previous message shall be referenced from the element Provenance.entity.what. The reference depends on the type of the previous message, which can be a MedCom FHIR message or a EDIFACT/OIOXML message. In the latter case, the reference shall be [lokationsnummer]#[brevid].

Timestamps

In MedComMessagingProvenance there are two timestamps, that represents the date and time the message was sent but in two different ways. Provenance.occuredDateTime is a human readable date and time and Provenance.recorded is a machine readable date and time.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Provenance		0..*	Provenance	Who, What, When for a set of resources
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SOΣ	1..1	Reference(MedComMessagingMessageHeader)	Targets the MedComMessagingMessageHeader from the current message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for occurred[x]	S	1..1	dateTime	When the activity occurred Slice: Unordered, Closed by type:$this
occurred[x]:occurredDateTime	SO	1..1	dateTime	A human readable date and time for when the message is sent. Shall include a date, a time and timezone. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recorded	SΣ	1..1	instant	A system readable date and time for when the message is sent.
activity	S	1..1	CodeableConcept	Activity that occurred Binding: MedComMessagingActivityCodes (required)
coding	SΣ	1..1	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
agent	S	1..*	BackboneElement	The actors involved in the activity taking place
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
who	SOΣ	1..1	Reference(MedComMessagingOrganization) {b}	A reference to the actor of the activity, which shall be a MedComMessagingOrganization. If more actors has been involved, the element must be sliced. Obligations Actor SHALL:in-narrative Producer of FHIR resources
entity	S	0..*	BackboneElement	An entity used in this activity
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SOΣ	1..1	code	derivation | revision | quotation | source | removal Binding: ProvenanceEntityRole (required): How an entity was used in an activity. Obligations Actor SHALL:in-narrative Producer of FHIR resources
what	SΣ	1..1	Reference(Resource)	A reference to the previous message. If the previous message is a FHIR message, the reference element must be used and if the previous message is an EDIFACT or OIOXML, the identifier element must be used.
reference	SOΣC	0..1	string	If the previous message is a FHIR message, this element must hold the MessageHeader.id from previous message, formatted as MessageHeader/[id]. Obligations Actor SHALL:in-narrative Producer of FHIR resources
identifier	SOΣ	0..1	Identifier	If previous message is EDIFACT or OIOXML, this element must be expressed as [lokationsnummer]#[brevid] from the EDIFACT or OIOXML message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Provenance.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Provenance.activity	required	MedComMessagingActivityCodes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-activityCodes
Provenance.entity.role	required	ProvenanceEntityRole http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Provenance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Provenance	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	error	Provenance	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	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Provenance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	Provenance.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Provenance.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

This structure is derived from Provenance

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Provenance		0..*	Provenance	Who, What, When for a set of resources
id	SO	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
target	SO	1..1	Reference(MedComMessagingMessageHeader)	Targets the MedComMessagingMessageHeader from the current message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for occurred[x]	S	1..1	dateTime	When the activity occurred Slice: Unordered, Open by type:$this
occurred[x]:occurredDateTime	SO	1..1	dateTime	A human readable date and time for when the message is sent. Shall include a date, a time and timezone. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recorded	S	1..1	instant	A system readable date and time for when the message is sent.
activity	S	1..1	CodeableConcept	Activity that occurred Binding: MedComMessagingActivityCodes (required)
coding	S	1..1	Coding	Code defined by a terminology system
system	S	1..1	uri	Identity of the terminology system
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
agent	S	1..*	BackboneElement	The actors involved in the activity taking place
who	SO	1..1	Reference(MedComMessagingOrganization) {b}	A reference to the actor of the activity, which shall be a MedComMessagingOrganization. If more actors has been involved, the element must be sliced. Obligations Actor SHALL:in-narrative Producer of FHIR resources
entity	S	0..*	BackboneElement	An entity used in this activity
role	SO	1..1	code	derivation | revision | quotation | source | removal Obligations Actor SHALL:in-narrative Producer of FHIR resources
what	S	1..1	Reference(Resource)	A reference to the previous message. If the previous message is a FHIR message, the reference element must be used and if the previous message is an EDIFACT or OIOXML, the identifier element must be used.
reference	SO	0..1	string	If the previous message is a FHIR message, this element must hold the MessageHeader.id from previous message, formatted as MessageHeader/[id]. Obligations Actor SHALL:in-narrative Producer of FHIR resources
identifier	SO	0..1	Identifier	If previous message is EDIFACT or OIOXML, this element must be expressed as [lokationsnummer]#[brevid] from the EDIFACT or OIOXML message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Provenance.activity	required	MedComMessagingActivityCodes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-activityCodes

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Provenance		0..*	Provenance	Who, What, When for a set of resources
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SOΣ	1..1	Reference(MedComMessagingMessageHeader)	Targets the MedComMessagingMessageHeader from the current message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for occurred[x]	S	1..1	dateTime	When the activity occurred Slice: Unordered, Closed by type:$this
occurred[x]:occurredDateTime	SO	1..1	dateTime	A human readable date and time for when the message is sent. Shall include a date, a time and timezone. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recorded	SΣ	1..1	instant	A system readable date and time for when the message is sent.
policy		0..*	uri	Policy or plan the activity was defined by
location		0..1	Reference(Location)	Where the activity occurred, if relevant
reason		0..*	CodeableConcept	Reason the activity is occurring Binding: PurposeOfUse (3.1.0) (extensible): The reason the activity took place.
activity	S	1..1	CodeableConcept	Activity that occurred Binding: MedComMessagingActivityCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
agent	S	1..*	BackboneElement	The actors involved in the activity taking place
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity.
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	SOΣ	1..1	Reference(MedComMessagingOrganization) {b}	A reference to the actor of the activity, which shall be a MedComMessagingOrganization. If more actors has been involved, the element must be sliced. Obligations Actor SHALL:in-narrative Producer of FHIR resources
onBehalfOf		0..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who the agent is representing
entity	S	0..*	BackboneElement	An entity used in this activity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SOΣ	1..1	code	derivation | revision | quotation | source | removal Binding: ProvenanceEntityRole (required): How an entity was used in an activity. Obligations Actor SHALL:in-narrative Producer of FHIR resources
what	SΣ	1..1	Reference(Resource)	A reference to the previous message. If the previous message is a FHIR message, the reference element must be used and if the previous message is an EDIFACT or OIOXML, the identifier element must be used.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SOΣC	0..1	string	If the previous message is a FHIR message, this element must hold the MessageHeader.id from previous message, formatted as MessageHeader/[id]. Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SOΣ	0..1	Identifier	If previous message is EDIFACT or OIOXML, this element must be expressed as [lokationsnummer]#[brevid] from the EDIFACT or OIOXML message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Text alternative for the resource
agent		0..*	See agent (Provenance)	Entity is attributed to this agent
signature		0..*	Signature	Signature on target
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Provenance.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Provenance.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Provenance.reason	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0
Provenance.activity	required	MedComMessagingActivityCodes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-activityCodes
Provenance.agent.type	extensible	ProvenanceParticipantType http://hl7.org/fhir/ValueSet/provenance-agent-type|4.0.1 From the FHIR Standard
Provenance.agent.role	example	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type|4.0.1 From the FHIR Standard
Provenance.entity.role	required	ProvenanceEntityRole http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.1 From the FHIR Standard
Provenance.entity.what.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Provenance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Provenance	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	error	Provenance	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	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Provenance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	Provenance.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Provenance.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Provenance		0..*	Provenance	Who, What, When for a set of resources
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SOΣ	1..1	Reference(MedComMessagingMessageHeader)	Targets the MedComMessagingMessageHeader from the current message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for occurred[x]	S	1..1	dateTime	When the activity occurred Slice: Unordered, Closed by type:$this
occurred[x]:occurredDateTime	SO	1..1	dateTime	A human readable date and time for when the message is sent. Shall include a date, a time and timezone. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recorded	SΣ	1..1	instant	A system readable date and time for when the message is sent.
activity	S	1..1	CodeableConcept	Activity that occurred Binding: MedComMessagingActivityCodes (required)
coding	SΣ	1..1	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
agent	S	1..*	BackboneElement	The actors involved in the activity taking place
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
who	SOΣ	1..1	Reference(MedComMessagingOrganization) {b}	A reference to the actor of the activity, which shall be a MedComMessagingOrganization. If more actors has been involved, the element must be sliced. Obligations Actor SHALL:in-narrative Producer of FHIR resources
entity	S	0..*	BackboneElement	An entity used in this activity
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SOΣ	1..1	code	derivation | revision | quotation | source | removal Binding: ProvenanceEntityRole (required): How an entity was used in an activity. Obligations Actor SHALL:in-narrative Producer of FHIR resources
what	SΣ	1..1	Reference(Resource)	A reference to the previous message. If the previous message is a FHIR message, the reference element must be used and if the previous message is an EDIFACT or OIOXML, the identifier element must be used.
reference	SOΣC	0..1	string	If the previous message is a FHIR message, this element must hold the MessageHeader.id from previous message, formatted as MessageHeader/[id]. Obligations Actor SHALL:in-narrative Producer of FHIR resources
identifier	SOΣ	0..1	Identifier	If previous message is EDIFACT or OIOXML, this element must be expressed as [lokationsnummer]#[brevid] from the EDIFACT or OIOXML message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Provenance.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Provenance.activity	required	MedComMessagingActivityCodes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-activityCodes
Provenance.entity.role	required	ProvenanceEntityRole http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Provenance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Provenance	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	error	Provenance	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	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Provenance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	Provenance.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Provenance.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Differential View

This structure is derived from Provenance

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Provenance		0..*	Provenance	Who, What, When for a set of resources
id	SO	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
target	SO	1..1	Reference(MedComMessagingMessageHeader)	Targets the MedComMessagingMessageHeader from the current message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for occurred[x]	S	1..1	dateTime	When the activity occurred Slice: Unordered, Open by type:$this
occurred[x]:occurredDateTime	SO	1..1	dateTime	A human readable date and time for when the message is sent. Shall include a date, a time and timezone. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recorded	S	1..1	instant	A system readable date and time for when the message is sent.
activity	S	1..1	CodeableConcept	Activity that occurred Binding: MedComMessagingActivityCodes (required)
coding	S	1..1	Coding	Code defined by a terminology system
system	S	1..1	uri	Identity of the terminology system
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
agent	S	1..*	BackboneElement	The actors involved in the activity taking place
who	SO	1..1	Reference(MedComMessagingOrganization) {b}	A reference to the actor of the activity, which shall be a MedComMessagingOrganization. If more actors has been involved, the element must be sliced. Obligations Actor SHALL:in-narrative Producer of FHIR resources
entity	S	0..*	BackboneElement	An entity used in this activity
role	SO	1..1	code	derivation | revision | quotation | source | removal Obligations Actor SHALL:in-narrative Producer of FHIR resources
what	S	1..1	Reference(Resource)	A reference to the previous message. If the previous message is a FHIR message, the reference element must be used and if the previous message is an EDIFACT or OIOXML, the identifier element must be used.
reference	SO	0..1	string	If the previous message is a FHIR message, this element must hold the MessageHeader.id from previous message, formatted as MessageHeader/[id]. Obligations Actor SHALL:in-narrative Producer of FHIR resources
identifier	SO	0..1	Identifier	If previous message is EDIFACT or OIOXML, this element must be expressed as [lokationsnummer]#[brevid] from the EDIFACT or OIOXML message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Provenance.activity	required	MedComMessagingActivityCodes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-activityCodes

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Provenance		0..*	Provenance	Who, What, When for a set of resources
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SOΣ	1..1	Reference(MedComMessagingMessageHeader)	Targets the MedComMessagingMessageHeader from the current message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for occurred[x]	S	1..1	dateTime	When the activity occurred Slice: Unordered, Closed by type:$this
occurred[x]:occurredDateTime	SO	1..1	dateTime	A human readable date and time for when the message is sent. Shall include a date, a time and timezone. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recorded	SΣ	1..1	instant	A system readable date and time for when the message is sent.
policy		0..*	uri	Policy or plan the activity was defined by
location		0..1	Reference(Location)	Where the activity occurred, if relevant
reason		0..*	CodeableConcept	Reason the activity is occurring Binding: PurposeOfUse (3.1.0) (extensible): The reason the activity took place.
activity	S	1..1	CodeableConcept	Activity that occurred Binding: MedComMessagingActivityCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
agent	S	1..*	BackboneElement	The actors involved in the activity taking place
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity.
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	SOΣ	1..1	Reference(MedComMessagingOrganization) {b}	A reference to the actor of the activity, which shall be a MedComMessagingOrganization. If more actors has been involved, the element must be sliced. Obligations Actor SHALL:in-narrative Producer of FHIR resources
onBehalfOf		0..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who the agent is representing
entity	S	0..*	BackboneElement	An entity used in this activity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SOΣ	1..1	code	derivation | revision | quotation | source | removal Binding: ProvenanceEntityRole (required): How an entity was used in an activity. Obligations Actor SHALL:in-narrative Producer of FHIR resources
what	SΣ	1..1	Reference(Resource)	A reference to the previous message. If the previous message is a FHIR message, the reference element must be used and if the previous message is an EDIFACT or OIOXML, the identifier element must be used.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SOΣC	0..1	string	If the previous message is a FHIR message, this element must hold the MessageHeader.id from previous message, formatted as MessageHeader/[id]. Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SOΣ	0..1	Identifier	If previous message is EDIFACT or OIOXML, this element must be expressed as [lokationsnummer]#[brevid] from the EDIFACT or OIOXML message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Text alternative for the resource
agent		0..*	See agent (Provenance)	Entity is attributed to this agent
signature		0..*	Signature	Signature on target
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Provenance.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Provenance.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Provenance.reason	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0
Provenance.activity	required	MedComMessagingActivityCodes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-messaging-activityCodes
Provenance.agent.type	extensible	ProvenanceParticipantType http://hl7.org/fhir/ValueSet/provenance-agent-type|4.0.1 From the FHIR Standard
Provenance.agent.role	example	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type|4.0.1 From the FHIR Standard
Provenance.entity.role	required	ProvenanceEntityRole http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.1 From the FHIR Standard
Provenance.entity.what.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Provenance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Provenance	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	error	Provenance	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	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Provenance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	Provenance.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Provenance.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

This structure is derived from Provenance

Summary

Mandatory: 6 elements
Must-Support: 19 elements

Structures

This structure refers to these other structures:

• MedComMessagingMessageHeader (http://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-messageHeader)
• MedComMessagingOrganization (http://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-messaging-organization)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Provenance.occurred[x]