Provenance
| Full Profile Definition: | Profile: Provenance |
Resource Content:
Differential
| Provenance | I | Provenance | There are no (further) constraints on this element Element idProvenance Who, What, When for a set of resources Alternate namesHistory, Event, Activity DefinitionProvenance 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. 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.
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| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idProvenance.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
| meta | Σ | 1..1 | Meta | There are no (further) constraints on this element Element idProvenance.meta Metadata about the resource DefinitionThe 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idProvenance.meta.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.meta.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idProvenance.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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| lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idProvenance.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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| meta-source | Σ | 1..1 | uri | Element idProvenance.meta.source:meta-source uri of the data source DefinitionTypically the data owner's URL followed by a source/file description mandatory for all resources in bWell's FHIR Server In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
example of meta.source https://www.icanbwell.com/provider-directory Mappings
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| profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idProvenance.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
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| meta-security | Σ | 1..* | CodingBinding | Element idProvenance.meta.security:meta-security security tags representing the data's owner, vendor, and accessibility Definitiondata owner: data vendor: data access: /owner & /access are mandatory for all resources in bWell's FHIR Server The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System.
example of data owner security tag {
"system": "https://www.icanbwell.com/owner",
"code": "bwell"
}example of data access security tag {
"system": "https://www.icanbwell.com/access",
"code": "bwell"
}example of data vendor security tag {
"system": "https://www.icanbwell.com/vendor",
"code": "bwell"
}Mappings
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| tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idProvenance.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idProvenance.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idProvenance.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idProvenance.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idProvenance.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| target | S Σ I | 1..1 | Reference(Profile: Enrollment Request) | Element idProvenance.target Link to EnrollmentRequest DefinitionThe 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. 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. Reference(Profile: Enrollment Request) Constraints
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| occurred[x] | 0..1 | There are no (further) constraints on this element Element idProvenance.occurred[x] When the activity occurred DefinitionThe period during which the activity occurred. The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.
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| occurredPeriod | Period | There are no (further) constraints on this element Data type | ||
| occurredDateTime | dateTime | There are no (further) constraints on this element Data type | ||
| recorded | S Σ | 1..1 | instant | There are no (further) constraints on this element Element idProvenance.recorded When the activity was recorded / updated DefinitionThe instant of time at which the activity was recorded. 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.
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| policy | 0..* | uri | There are no (further) constraints on this element Element idProvenance.policy Policy or plan the activity was defined by DefinitionPolicy or plan the activity was defined by. Typically, a single activity may have multiple applicable policy documents, such as patient consent, guarantor funding, etc. 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.
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| location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idProvenance.location Where the activity occurred, if relevant DefinitionWhere the activity occurred, if relevant. 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.
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| reason | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idProvenance.reason Reason the activity is occurring DefinitionThe reason that the activity was taking place. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason the activity took place.
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| activity | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idProvenance.activity Activity that occurred DefinitionAn 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. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The activity that took place.
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| agent | S | 1..* | BackboneElement | Element idProvenance.agent Actor involved DefinitionAn actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place. An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility. Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa. Unordered, Open, by slice by type Constraints
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| (All Slices) | There are no (further) constraints on this element | |||
| id | S | 1..1 | string | Element idProvenance.agent.id set to type code DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.agent.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.agent.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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| type | S Σ | 0..1 | CodeableConceptBindingPattern | Element idProvenance.agent.type How the agent participated DefinitionThe participation the agent had with respect to the activity. For example: author, performer, enterer, attester, etc. The type of participation that a provenance agent played with respect to the activity.
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code": "VERF"
}
]
}
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| role | 0..* | CodeableConcept | There are no (further) constraints on this element Element idProvenance.agent.role What the agents role was DefinitionThe function of the agent with respect to the activity. The security role enabling the agent with respect to the activity. For example: doctor, nurse, clerk, etc. The role that a provenance agent played with respect to the activity.
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| who | S Σ I | 1..1 | Reference(Profile: Patient) | Element idProvenance.agent.who Who participated DefinitionThe individual, device or organization that participated in the event. whoIdentity should be used when the agent is not a Resource type.
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| onBehalfOf | I | 0..1 | Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) | There are no (further) constraints on this element Element idProvenance.agent.onBehalfOf Who the agent is representing DefinitionThe individual, device, or organization for whom the change was made. onBehalfOfIdentity should be used when the agent is not a Resource type. Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) Constraints
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| entity | 0..* | BackboneElement | There are no (further) constraints on this element Element idProvenance.entity An entity used in this activity DefinitionAn entity used in this activity.
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| id | 0..1 | string | There are no (further) constraints on this element Element idProvenance.entity.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.entity.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.entity.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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| role | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idProvenance.entity.role derivation | revision | quotation | source | removal DefinitionHow the entity was used during the activity. Note that FHIR strings SHALL NOT exceed 1MB in size How an entity was used in an activity.
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| what | Σ I | 1..1 | Reference(Resource) | There are no (further) constraints on this element Element idProvenance.entity.what Identity of entity DefinitionIdentity of the Entity used. May be a logical or physical uri and maybe absolute or relative. whatIdentity should be used for entities that are not a Resource type.
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| agent | 0..* | see (agent) | There are no (further) constraints on this element Element idProvenance.entity.agent Entity is attributed to this agent DefinitionThe 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. 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.
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| signature | S | 0..* | CodeableConcept | Element idProvenance.signature Signature on target DefinitionA digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated. 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. Unordered, Open, by slice by type Constraints
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| (All Slices) | There are no (further) constraints on this element | |||
| id | S | 1..1 | string | Element idProvenance.signature.id signature DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.signature.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idProvenance.signature.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idProvenance.signature.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| type | S | 1..* | CodingPattern | Element idProvenance.signature.type A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. 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.
{
"system": "urn:iso-astm:E1762-95:2013",
"code": "1.2.840.10065.1.12.1.5",
"display": "Verification Signature"
}
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| when | S | 1..* | instant | Element idProvenance.signature.when When the signature was created DefinitionAn instant in time - known at least to the second Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required
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| who | S I | 1..* | Reference(Profile: Patient) | Element idProvenance.signature.who Who signed DefinitionA reference from one resource to another. 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.
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| targetFormat | S | 0..* | code | Element idProvenance.signature.targetFormat The technical format of the signed resources DefinitionA string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents Note that FHIR strings SHALL NOT exceed 1MB in size
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| data | S | 1..* | base64Binary | Element idProvenance.signature.data The actual signature content (xml, picture, etc) DefinitionA stream of bytes A stream of bytes, base64 encoded
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Hybrid
| Provenance | I | Provenance | There are no (further) constraints on this element Element idProvenance Who, What, When for a set of resources Alternate namesHistory, Event, Activity DefinitionProvenance 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. 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.
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| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idProvenance.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
| meta | Σ | 1..1 | Meta | There are no (further) constraints on this element Element idProvenance.meta Metadata about the resource DefinitionThe 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idProvenance.meta.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.meta.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idProvenance.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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| lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idProvenance.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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| meta-source | Σ | 1..1 | uri | Element idProvenance.meta.source:meta-source uri of the data source DefinitionTypically the data owner's URL followed by a source/file description mandatory for all resources in bWell's FHIR Server In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
example of meta.source https://www.icanbwell.com/provider-directory Mappings
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| profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idProvenance.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
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| meta-security | Σ | 1..* | CodingBinding | Element idProvenance.meta.security:meta-security security tags representing the data's owner, vendor, and accessibility Definitiondata owner: data vendor: data access: /owner & /access are mandatory for all resources in bWell's FHIR Server The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System.
example of data owner security tag {
"system": "https://www.icanbwell.com/owner",
"code": "bwell"
}example of data access security tag {
"system": "https://www.icanbwell.com/access",
"code": "bwell"
}example of data vendor security tag {
"system": "https://www.icanbwell.com/vendor",
"code": "bwell"
}Mappings
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| tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idProvenance.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idProvenance.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idProvenance.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idProvenance.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idProvenance.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| target | S Σ I | 1..1 | Reference(Profile: Enrollment Request) | Element idProvenance.target Link to EnrollmentRequest DefinitionThe 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. 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. Reference(Profile: Enrollment Request) Constraints
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| occurred[x] | 0..1 | There are no (further) constraints on this element Element idProvenance.occurred[x] When the activity occurred DefinitionThe period during which the activity occurred. The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.
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| occurredPeriod | Period | There are no (further) constraints on this element Data type | ||
| occurredDateTime | dateTime | There are no (further) constraints on this element Data type | ||
| recorded | S Σ | 1..1 | instant | There are no (further) constraints on this element Element idProvenance.recorded When the activity was recorded / updated DefinitionThe instant of time at which the activity was recorded. 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.
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| policy | 0..* | uri | There are no (further) constraints on this element Element idProvenance.policy Policy or plan the activity was defined by DefinitionPolicy or plan the activity was defined by. Typically, a single activity may have multiple applicable policy documents, such as patient consent, guarantor funding, etc. 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.
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| location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idProvenance.location Where the activity occurred, if relevant DefinitionWhere the activity occurred, if relevant. 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.
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| reason | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idProvenance.reason Reason the activity is occurring DefinitionThe reason that the activity was taking place. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason the activity took place.
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| activity | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idProvenance.activity Activity that occurred DefinitionAn 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. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The activity that took place.
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| agent | S | 1..* | BackboneElement | Element idProvenance.agent Actor involved DefinitionAn actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place. An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility. Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa. Unordered, Open, by slice by type Constraints
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| (All Slices) | There are no (further) constraints on this element | |||
| id | S | 1..1 | string | Element idProvenance.agent.id set to type code DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.agent.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.agent.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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| type | S Σ | 0..1 | CodeableConceptBindingPattern | Element idProvenance.agent.type How the agent participated DefinitionThe participation the agent had with respect to the activity. For example: author, performer, enterer, attester, etc. The type of participation that a provenance agent played with respect to the activity.
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code": "VERF"
}
]
}
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| role | 0..* | CodeableConcept | There are no (further) constraints on this element Element idProvenance.agent.role What the agents role was DefinitionThe function of the agent with respect to the activity. The security role enabling the agent with respect to the activity. For example: doctor, nurse, clerk, etc. The role that a provenance agent played with respect to the activity.
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| who | S Σ I | 1..1 | Reference(Profile: Patient) | Element idProvenance.agent.who Who participated DefinitionThe individual, device or organization that participated in the event. whoIdentity should be used when the agent is not a Resource type.
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| onBehalfOf | I | 0..1 | Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) | There are no (further) constraints on this element Element idProvenance.agent.onBehalfOf Who the agent is representing DefinitionThe individual, device, or organization for whom the change was made. onBehalfOfIdentity should be used when the agent is not a Resource type. Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization) Constraints
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| entity | 0..* | BackboneElement | There are no (further) constraints on this element Element idProvenance.entity An entity used in this activity DefinitionAn entity used in this activity.
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| id | 0..1 | string | There are no (further) constraints on this element Element idProvenance.entity.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.entity.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.entity.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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| role | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idProvenance.entity.role derivation | revision | quotation | source | removal DefinitionHow the entity was used during the activity. Note that FHIR strings SHALL NOT exceed 1MB in size How an entity was used in an activity.
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| what | Σ I | 1..1 | Reference(Resource) | There are no (further) constraints on this element Element idProvenance.entity.what Identity of entity DefinitionIdentity of the Entity used. May be a logical or physical uri and maybe absolute or relative. whatIdentity should be used for entities that are not a Resource type.
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| agent | 0..* | see (agent) | There are no (further) constraints on this element Element idProvenance.entity.agent Entity is attributed to this agent DefinitionThe 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. 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.
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| signature | S | 0..* | CodeableConcept | Element idProvenance.signature Signature on target DefinitionA digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated. 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. Unordered, Open, by slice by type Constraints
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| (All Slices) | There are no (further) constraints on this element | |||
| id | S | 1..1 | string | Element idProvenance.signature.id signature DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idProvenance.signature.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idProvenance.signature.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idProvenance.signature.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| type | S | 1..* | CodingPattern | Element idProvenance.signature.type A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. 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.
{
"system": "urn:iso-astm:E1762-95:2013",
"code": "1.2.840.10065.1.12.1.5",
"display": "Verification Signature"
}
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| when | S | 1..* | instant | Element idProvenance.signature.when When the signature was created DefinitionAn instant in time - known at least to the second Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required
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| who | S I | 1..* | Reference(Profile: Patient) | Element idProvenance.signature.who Who signed DefinitionA reference from one resource to another. 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.
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| targetFormat | S | 0..* | code | Element idProvenance.signature.targetFormat The technical format of the signed resources DefinitionA string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents Note that FHIR strings SHALL NOT exceed 1MB in size
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| data | S | 1..* | base64Binary | Element idProvenance.signature.data The actual signature content (xml, picture, etc) DefinitionA stream of bytes A stream of bytes, base64 encoded
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Examples:
{ "resourceType": "Provenance", "id": "DC-AAA111", "target": [ { "reference": "EnrollmentRequest/DC-AAA111" } ], "recorded": "2022-01-31T08:39:24+10:00", "agent": [ { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes", "code": "VERF" } ] }, "who": { "reference": "Patient/medicare-AAA111" } } ], "signature": [ { "type": [ { "system": "urn:iso-astm:E1762-95:2013", "code": "1.2.840.10065.1.12.1.5", "display": "Verification Signature" } ], "when": "2022-01-31T08:39:24+10:00", "who": { "reference": "Patient/medicare-AAA111" }, "targetFormat": "application/fhir+xml", "sigFormat": "application/signature+xml", "data": "Li4u" } ] }