FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
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Security icon Work GroupMaturity Level: 3 Trial UseSecurity Category: Not Classified Compartments: Device, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the Provenance resource.

Provenance
Element IdProvenance
Definition

Provenance of a resource is a record that describes entities and processes involved in producing and delivering or otherwise influencing that resource. Provenance provides a critical foundation for assessing authenticity, enabling trust, and allowing reproducibility. Provenance assertions are a form of contextual metadata and can themselves become important records with their own provenance. Provenance statement indicates clinical significance in terms of confidence in authenticity, reliability, and trustworthiness, integrity, and stage in lifecycle (e.g. Document Completion - has the artifact been legally authenticated), all of which may impact security, privacy, and trust policies.

Short DisplayWho, What, When for a set of resources
Cardinality0..*
TypeDomainResource
Alternate NamesHistory; Event; Activity
Summaryfalse
Comments

Some parties may be duplicated between the target resource and its provenance. For instance, the prescriber is usually (but not always) the author of the prescription resource. This resource is defined with close consideration for W3C Provenance.

Provenance.target
Element IdProvenance.target
Definition

The Reference(s) that were generated or updated by the activity described in this resource. A provenance can point to more than one target if multiple resources were created/updated by the same activity.

Short DisplayTarget Reference(s) (usually version specific)
Cardinality1..*
TypeReference(Any)
Summarytrue
Comments

Target references are usually version specific, but might not be, if a version has not been assigned or if the provenance information is part of the set of resources being maintained (i.e. a document). When using the RESTful API, the identity of the resource might not be known (especially not the version specific one); the client may either submit the resource first, and then the provenance, or it may submit both using a single transaction. See the notes on transaction for further discussion.

Provenance.occurred[x]
Element IdProvenance.occurred[x]
Definition

The period during which the activity occurred.

Short DisplayWhen the activity occurred
Cardinality0..1
TypePeriod|dateTime
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Summaryfalse
Comments

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

Provenance.recorded
Element IdProvenance.recorded
Definition

The instant of time at which the activity was recorded.

Short DisplayWhen the activity was recorded / updated
Cardinality0..1
Typeinstant
Summarytrue
Comments

This can be a little different from the time stamp on the resource if there is a delay between recording the event and updating the provenance and target resource.

Provenance.policy
Element IdProvenance.policy
Definition

Policy or plan the activity was defined by. Typically, a single activity may have multiple applicable policy documents, such as patient consent, guarantor funding, etc.

Short DisplayPolicy or plan the activity was defined by
Cardinality0..*
Typeuri
Summaryfalse
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.

Provenance.location
Element IdProvenance.location
Definition

Where the activity occurred, if relevant.

Short DisplayWhere the activity occurred, if relevant
Cardinality0..1
TypeReference(Location)
Summaryfalse
Provenance.authorization
Element IdProvenance.authorization
Definition

The authorization (e.g., PurposeOfUse) that was used during the event being recorded.

Short DisplayAuthorization (purposeOfUse) related to the event
Cardinality0..*
Terminology BindingPurposeOfUse icon (Example)
TypeCodeableReference
Requirements

Record of any relevant security context, not restricted to purposeOfUse valueSet. May include security compartments, refrain, obligation, or other security tags.

Alternate NamesPurposeOfEvent
Summaryfalse
Provenance.activity
Element IdProvenance.activity
Definition

An activity is something that occurs over a period of time and acts upon or with entities; it may include consuming, processing, transforming, modifying, relocating, using, or generating entities.

Short DisplayActivity that occurred
Cardinality0..1
Terminology BindingValueSet of sample of representative activity type codes. (Example)
TypeCodeableConcept
Summaryfalse
Provenance.basedOn
Element IdProvenance.basedOn
Definition

Allows tracing of authorizatino for the events and tracking whether proposals/recommendations were acted upon.

Short DisplayWorkflow authorization within which this event occurred
Cardinality0..*
TypeReference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task)
Summaryfalse
Provenance.patient
Element IdProvenance.patient
Definition

The patient element is available to enable deterministic tracking of activities that involve the patient as the subject of the data used in an activity.

Short DisplayThe patient is the subject of the data created/updated (.target) by the activity
Cardinality0..1
TypeReference(Patient)
Requirements

When the .patient is populated it shall be accurate to the subject of the target data. The .patient shall not be populated when the target data created/updated (.target) by the activity does not involve a subject. Note that when the patient is an agent, they will be recorded as an agent. When the Patient resource is Created, Updated, or Deleted it will be recorded as an entity.

Summaryfalse
Provenance.encounter
Element IdProvenance.encounter
Definition

This will typically be the encounter the event occurred, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests).

Short DisplayEncounter within which this event occurred or which the event is tightly associated
Cardinality0..1
TypeReference(Encounter)
Summaryfalse
Provenance.agent
Element IdProvenance.agent
Definition

An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.

Short DisplayActor involved
Cardinality1..*
Requirements

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

Summarytrue
Comments

Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa.

Invariants
Defined on this element
prov-1Rule Who and onBehalfOf cannot be the samewho.resolve().exists() and onBehalfOf.resolve().exists() implies who.resolve() != onBehalfOf.resolve()
prov-2Rule If who is a PractitionerRole, onBehalfOf can't reference the same Practitionerwho.resolve().ofType(PractitionerRole).practitioner.resolve().exists() and onBehalfOf.resolve().ofType(Practitioner).exists() implies who.resolve().practitioner.resolve() != onBehalfOf.resolve()
prov-3Rule If who is an organization, onBehalfOf can't be a PractitionerRole within that organizationwho.resolve().ofType(Organization).exists() and onBehalfOf.resolve().ofType(PractitionerRole).organization.resolve().exists() implies who.resolve() != onBehalfOf.resolve().organization.resolve()
Provenance.agent.type
Element IdProvenance.agent.type
Definition

The Functional Role of the agent with respect to the activity.

Short DisplayHow the agent participated
Cardinality0..1
Terminology BindingParticipationRoleType (Example)
TypeCodeableConcept
Requirements

Functional roles reflect functional aspects of relationships between entities. Functional roles are bound to the realization/performance of acts, where actions might be concatenated to an activity or even to a process. This element will hold the functional role that the agent played in the activity that is the focus of this Provenance. Where an agent played multiple functional roles, they will be listed as multiple .agent elements representing each functional participation. See ISO 21298:2018 - Health Informatics - Functional and structural roles, and ISO 22600-2:2014 - Health Informatics - Privilege Management and Access Control - Part 2: formal models.

Summarytrue
Comments

For example: assembler, author, prescriber, signer, investigator, etc.

Provenance.agent.role
Element IdProvenance.agent.role
Definition

The structural roles of the agent indicating the agent's competency. The security role enabling the agent with respect to the activity.

Short DisplayWhat the agents role was
Cardinality0..*
Terminology BindingSecurityRoleType (Example)
TypeCodeableConcept
Requirements

Structural roles reflect the structural aspects of relationships between entities. Structural roles describe prerequisites, feasibilities, or competences for acts. Functional roles reflect functional aspects of relationships between entities. Functional roles are bound to the realization/performance of acts, where actions might be concatenated to an activity or even to a process. See ISO 21298:2018 - Health Informatics - Functional and structural roles, and ISO 22600-2:2014 - Health Informatics - Privilege Management and Access Control - Part 2: formal models..

Summaryfalse
Comments

For example: Chief-of-Radiology, Nurse, Physician, Medical-Student, etc.

Provenance.agent.who
Element IdProvenance.agent.who
Definition

Indicates who or what performed in the event.

Short DisplayThe agent that participated in the event
Cardinality1..1
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)
Summarytrue
Provenance.agent.onBehalfOf
Element IdProvenance.agent.onBehalfOf
Definition

The agent that delegated authority to perform the activity performed by the agent.who element.

Short DisplayThe agent that delegated
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam | Patient)
Summaryfalse
Provenance.entity
Element IdProvenance.entity
Definition

An entity used in this activity.

Short DisplayAn entity used in this activity
Cardinality0..*
Summarytrue
Provenance.entity.role
Element IdProvenance.entity.role
Definition

How the entity was used during the activity.

Short Displayrevision | quotation | source | instantiates | removal
Cardinality1..1
Terminology BindingProvenanceEntityRole (Required)
Typecode
Summarytrue
Provenance.entity.what
Element IdProvenance.entity.what
Definition

Identity of the Entity used. May be a logical or physical uri and maybe absolute or relative.

Short DisplayIdentity of entity
Cardinality1..1
TypeReference(Any)
Summarytrue
Comments

whatIdentity should be used for entities that are not a Resource type.

Provenance.entity.agent
Element IdProvenance.entity.agent
Definition

The entity is attributed to an agent to express the agent's responsibility for that entity, possibly along with other agents. This description can be understood as shorthand for saying that the agent was responsible for the activity which used the entity.

Short DisplayEntity is attributed to this agent
Cardinality0..*
TypeSee Provenance.agent
Summaryfalse
Comments

A usecase where one Provenance.entity.agent is used where the Entity that was used in the creation/updating of the Target, is not in the context of the same custodianship as the Target, and thus the meaning of Provenance.entity.agent is to say that the entity referenced is managed elsewhere and that this Agent provided access to it. This would be similar to where the Entity being referenced is managed outside FHIR, such as through HL7 v2, v3, or XDS. This might be where the Entity being referenced is managed in another FHIR resource server. Thus it explains the Provenance of that Entity's use in the context of this Provenance activity.

Provenance.signature
Element IdProvenance.signature
Definition

A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated.

Short DisplaySignature on target
Cardinality0..*
TypeSignature
Summaryfalse