Page Status: updated 2022-06-02 (Work in progress)

Consent scenarios

• Introduction
• Details
  • Multi dose dispensing consent
  • Access consent

Introduction

There are two different Provenance profiles for documenting valid data combinations for a Provenance related to a Consent.

Details

The differences between each specialtized profile and the general Provenance profile, NLLProvenance, are highlighted in black in the rendered structures below, i.e. common rules are grayed out.

Multi dose dispensing consent

The profile NLLProvenanceConsentMultiDose documents the valid data combinations in a Provencance related to a multi dose dispensing consent.

For this type of consent the following special contraints apply:

• the 'target' must point to a multi dose dispensing consent resource.
• the 'reason' attribute is not used.
• the 'activity' must be from the value set Händelsetyper för dossamtycke (multidosedispconsent-activity-types)
• the 'agent.who' must point to a practitioner resource.

Provenance

Provenance.id

Provenance.meta

Provenance.implicitRules

Provenance.language

Provenance.text

Provenance.contained

Provenance.extension

Provenance.modifierExtension

Provenance.target

Provenance.occurred[x]

Provenance.recorded

Provenance.policy

Provenance.location

Provenance.reason

Provenance.activity

Provenance.activity.id

Provenance.activity.extension

Provenance.activity.coding

Provenance.activity.coding.id

Provenance.activity.coding.extension

Provenance.activity.coding.system

Provenance.activity.coding.version

Provenance.activity.coding.code

Provenance.activity.coding.display

Provenance.activity.coding.userSelected

Provenance.activity.text

Provenance.agent

Provenance.agent.id

Provenance.agent.extension

Provenance.agent.modifierExtension

Provenance.agent.type

Provenance.agent.role

Provenance.agent.who

Provenance.agent.onBehalfOf

Provenance.entity

Provenance.entity.id

Provenance.entity.extension

Provenance.entity.modifierExtension

Provenance.entity.role

Provenance.entity.what

Provenance.entity.agent

Provenance.signature

Access consent

The profile NLLProvenanceConsentAccess documents the valid data combinations in a Provencance related to an access consent.

For this type of consent the following special contraints apply:

• the 'target' must point to an access consent resource.
• the 'reason' attribute is not used.
• the 'activity' must be from the value set Händelsetyper för åtkomstsamtycke (accessconsent-activity-types)
• the 'agent.who' must point to a practitioner resource.

  NLLProvenanceConsentAccess (Provenance)	I		NLLProvenance	There are no (further) constraints on this element Element id Provenance Short description When a change is made in the patient´s medication list a provenance provides information about who, what, when and where from the change is made. Alternate names History, Event, Activity Definition NLLProvenance describes a change that has been made on a resource affecting a patient medications list, e.g. a MedicationRequest, MedicationDispense or resource related to multi dose dispensing (sv: dosunderlag, dossamtycke) or a change affecting a data lock (sv spärr). The change describes What - in the form of which resource is the target in combination with a reason and activity. It describes by Who - in the form of agent and it describes When it occurred. A Provenance resource is created fron the X-Provenance header wich is mandatory in a number of scenarios. 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. Data type NLLProvenance Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.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-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-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Event rim: ControlAct[isNormalAct() and subsumes(CACT, classCode) and moodCode=EVN] w3c.prov: Activity EHM: Händelse
  id	S Σ	0..1	string	There are no (further) constraints on this element Element id Provenance.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string Mappings EHM: Händelse-id
  meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Provenance.meta Short description Metadata about the resource 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Provenance.implicitRules Short description A set of rules under which this content was created 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..1	codeBinding	There are no (further) constraints on this element Element id Provenance.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..1	Narrative	There are no (further) constraints on this element Element id Provenance.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display 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. 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..*	Resource	There are no (further) constraints on this element Element id Provenance.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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() Mappings rim: n/a rim: N/A
  modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition 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). 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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() Mappings rim: n/a rim: N/A
  target	S Σ I	1..*	Reference(NLLAccessConsent)	Element id Provenance.target Short description Target Consent Definition The Consent that was generated or updated by the activity described in this Provenance. 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. Data type Reference(NLLAccessConsent) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.what[x] rim: ./outboundRelationship[isNormalActRelationship() and typeCode=SUBJ]/target OR ./participation[isNormalParticipation() and typeCode=SBJ]/role OR ./participation[isNormalParticipation() and typeCode=SBJ]/role[isNormalRole()]/player fhirauditevent: AuditEvent.entity.reference w3c.prov: Entity Created/Updated EHM: Resursreferenser EHM: Referens till spärr
  occurred[x]		0..1		There are no (further) constraints on this element Element id Provenance.occurred[x] Short description When the activity occurred Definition The period during which the activity occurred. Comments This value is set by the system to reflect the date and time when the request was received Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.occurred[x] w5: FiveWs.done[x] rim: ./effectiveTime[type=IVL_TS] w3c.prov: Activity.startTime & Activity.endTime EHM: Tidpunkt
  occurredDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
  recorded	S Σ	1..1	instant	There are no (further) constraints on this element Element id Provenance.recorded Short description When the activity was recorded / updated Definition The instant of time at which the activity was recorded by the Swedish eHealth Agency. 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. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.recorded rim: unique(./participation[isNormalParticipation() and typeCode=AUT]/time[type=TS]) fhirauditevent: AuditEvent.recorded w3c.prov: Activity.when EHM: Händelsetidpunkt
  policy		0..*	uri	There are no (further) constraints on this element Element id Provenance.policy Short description Policy or plan the activity was defined by 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: ./inboundRelationship[isNormalActRelationship() and typeCode="SUBJ"]/source[isNormalAct and subsumes(POLICY, classCode) and moodCode=EVN]/text[typeCode='ED'/tel fhirauditevent: AuditEvent.agent.policy
  location	I	0..1	Reference(Location)	There are no (further) constraints on this element Element id Provenance.location Short description Where the activity occurred, if relevant Definition Where the activity occurred, if relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.location w5: FiveWs.where[x] rim: unique(./participation[isNormalParticipation() and typeCode=LOC]/role[isNormalRole() and subsumes(SDLOC, classCode)]/player[isNormalEntity and classCode="LOC" and determinerCode="INST"] fhirauditevent: AuditEvent.agent.location w3c.prov: Activity.location
  reason	S	0..0	CodeableConceptBinding	Element id Provenance.reason Short description Reason the activity is occurring Definition Reason is not used when creating or updating an access consent (sv Åtkomstsamtycke). Comments _ Data type CodeableConcept Binding The reason the activity took place. http://electronichealth.se/fhir/ValueSet/nll-reason-for-provenance (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.reasonCode w5: FiveWs.why[x] rim: unique(./reasonCode) fhirauditevent: AuditEvent.purposeOfEvent w3c.prov: Activity.Activity EHM: Händelseorsak
  activity	S	1..1	CodeableConceptBinding	Element id Provenance.activity Short description Activity that occurred Definition This type describes the activity that occurred for the Access Consent (sv Åtkomstsamtycke) Comments _ Data type CodeableConcept Binding The activity that took place. accessconsent-activity-types (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code w5: FiveWs.why[x] rim: Act.code w3c.prov: Activity.Activity EHM: Händelsetyp
  id		0..1	string	There are no (further) constraints on this element Element id Provenance.activity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.activity.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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() Mappings rim: n/a rim: N/A
  coding	S Σ	1..1	Coding	There are no (further) constraints on this element Element id Provenance.activity.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Provenance.activity.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.activity.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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() Mappings rim: n/a rim: N/A
  system	S Σ	0..1	uri	There are no (further) constraints on this element Element id Provenance.activity.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	S Σ	0..1	string	There are no (further) constraints on this element Element id Provenance.activity.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	S Σ	1..1	code	There are no (further) constraints on this element Element id Provenance.activity.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Provenance.activity.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Provenance.activity.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Provenance.activity.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  agent	S	1..*	BackboneElement	Element id Provenance.agent Short description Practitioner involved for the Consent. Definition Allowed actors are: enterer (sv: utförare) and author (sv: uppdragsgivare). Enterer MUST always be present, author CAN be present in case a practitioner is performing a change on behalf of someone Requirements _ Comments Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.performer w5: FiveWs.who rim: ./participation[isNormalParticipation()] OR ./outboundRelationship[isNormalActRelationship() and typeCode='DRIV'] fhirauditevent: AuditEvent.agent w3c.prov: Agent EHM: Uppdragsgivare EHM: Utförare
  id		0..1	string	There are no (further) constraints on this element Element id Provenance.agent.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.agent.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.agent.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints ele-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() Mappings rim: n/a rim: N/A
  type	S Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Provenance.agent.type Short description How the agent participated Definition The participation the agent had with respect to the activity. Comments _ Data type CodeableConcept Binding The type of participation that a provenance agent played with respect to the activity. provenance-participant-types (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.performer.function rim: .role fhirauditevent: AuditEvent.agent.type w3c.prov: Agent.Attribution
  role		0..*	CodeableConcept	There are no (further) constraints on this element Element id Provenance.agent.role Short description What the agents role was Definition The function of the agent with respect to the activity. The security role enabling the agent with respect to the activity. Comments For example: doctor, nurse, clerk, etc. Data type CodeableConcept Binding The role that a provenance agent played with respect to the activity. SecurityRoleType (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .typecode fhirauditevent: AuditEvent.agent.role
  who	S Σ I	1..1	Reference(NLLPractitioner | NLLPatient)	Element id Provenance.agent.who Short description Who participated Definition The practitioners that participated in the event as contained resources. Comments whoIdentity should be used when the agent is not a Resource type. Data type Reference(NLLPractitioner | NLLPatient) Allowed aggregation: contained Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor w5: FiveWs.actor rim: .id EHM: Uppdragsgivare / Utförare
  onBehalfOf	I	0..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	There are no (further) constraints on this element Element id Provenance.agent.onBehalfOf Short description Who the agent is representing Definition The individual, device, or organization for whom the change was made. Comments onBehalfOfIdentity should be used when the agent is not a Resource type. Data type Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: Person, Practitioner, Organization, Device :* .role [classCode = RoleClassMutualRelationship; role.code and * .scopes[Role](classCode=IDENT) and *.plays [Role.Code]
  entity		0..*	BackboneElement	There are no (further) constraints on this element Element id Provenance.entity Short description An entity used in this activity Definition An entity used in this activity. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: ./subjectOf fhirauditevent: AuditEvent.entity w3c.prov: Entity
  id		0..1	string	There are no (further) constraints on this element Element id Provenance.entity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.entity.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Provenance.entity.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints ele-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() Mappings rim: n/a rim: N/A
  role	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Provenance.entity.role Short description derivation | revision | quotation | source | removal Definition How the entity was used during the activity. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding How an entity was used in an activity. ProvenanceEntityRole (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: ./typeCode fhirauditevent: AuditEvent.entity.lifecycle w3c.prov: Entity.role
  what	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element id Provenance.entity.what Short description Identity of entity Definition Identity of the Entity used. May be a logical or physical uri and maybe absolute or relative. Comments whatIdentity should be used for entities that are not a Resource type. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: ./text/reference fhirauditevent: AuditEvent.entity.reference w3c.prov: Entity.Identity
  agent		0..*	see (agent)	There are no (further) constraints on this element Element id Provenance.entity.agent Short description Entity is attributed to this 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 generated the entity. 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. Mappings rim: ./author/role
  signature		0..*	Signature	There are no (further) constraints on this element Element id Provenance.signature Short description Signature on target Definition A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated. 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. Data type Signature Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: ./signatureText