Release 4 5 Snapshot #1

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). (v5.0.0-snapshot1: R5 Snapshot #1). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

6.3 Resource Provenance - Content

Security Work Group Maturity Level : 3   Trial Use Security Category : Not Classified Compartments : Device , Patient , Practitioner , RelatedPerson

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

6.3.1 Scope and Usage

The Provenance resource tracks information about the activity that created, revised, deleted, or signed a version of a resource, describing the entities and agents involved. This information can be used to form assessments about its quality, reliability, trustworthiness, or to provide pointers for where to go to further investigate the origins of the resource and the information in it.

Provenance resources are a record-keeping assertion that gathers information about the context in which the information in a resource was obtained. Provenance resources are prepared by the application that initiates the create/update etc. of the resource. An AuditEvent resource contains overlapping information, but is created as events occur, to track and audit the events. AuditEvent resources are often (though not exclusively) created by the application responding to the read/query/create/update/etc. event.

6.3.2 Boundaries and Relationships

Many other FHIR resources contain some elements that represent information about how the resource was obtained, and therefore they overlap with the functionality of the Provenance resource. These properties in other resources should always be used in preference to the Provenance resource, and the Provenance resource should be used where additional information is required, or explicit record or provenance is desired. Details on this overlap can be found on the FiveWs , including a mapping from the at the Resource Element level.

The relationship between a resource and its provenance is established by a reference from the provenance resource to its target. In this way, provenance may be provided about any resource or version, including past versions. There may be multiple provenance records for a given resource or version of a resource.

6.3.3 Background and Context

The Provenance resource is based on the W3C Provenance specification , and mappings are provided. The Provenance resource is tailored to fit the FHIR use-cases for provenance more directly. In terms of W3C Provenance the FHIR Provenance resource covers "Generation" of "Entity" with respect to FHIR defined resources for creation or updating; whereas AuditEvent covers "Usage" of "Entity" and all other "Activity" as defined in W3C Provenance.

The W3C Provenance Specification has the following fundamental model:

Key concepts

Where:

  • Entity - An entity is a physical, digital, conceptual or other kind of thing with some fixed aspects; entities may be real or imaginary. One or more entities can be the input (.entity) of an activity, and one or more entities can be the output (.target).
  • Agent - An agent is something that bears some form of the responsibility for an identified by the type of participation in the activity taking place, for the existence of an entity, or for another agent's activity. An Agent may be a person, device, system, organization, group, care-team, or identifiable thing.
  • Activity - An activity is something that occurs over a time period and acts upon or with entities. It may include consuming, processing, transforming, modifying, relocating, using, or generating entities.

The Provenance resource corresponds to a single activity that identifies a set of resources ( target ) generated by the activity. The activity also references other entities ( entity ) that were used and the agents ( agent ) that were associated with the activity. To record multiple activities that resulted in one ( target ), record each ( activity ) in independent Provenance records all pointing at that ( target ).

The Provenance resource depends upon having References to all the resources, entities, and agents involved in the activity. These References need not be resolvable. The references must provide a unique and unambiguous identification. If a resource, entity, or agent can have different versions that must be identified, then the Reference must have versioning information included.

Versioning and unique identification are not mandated for all systems that provide Resources, entities, and agents. But, inclusion of Provenance requirements may introduce requirements for versioning and unique identification on those systems

The Provenance resource is based on leveraging the W3C Provenance specification to represent HL7 support of provenance throughout its standards and explicitly modeled as functional capabilities in ISO/HL7 10781 EHR System Functional Model Release 2 and ISO 21089 Trusted End-to-End Information Flows. Mappings are provided. The Provenance resource is tailored to fit the FHIR use-cases for provenance more directly. In terms of W3C Provenance the FHIR Provenance resources covers "Generation" of "Entity" with respect to FHIR defined resources for creation or updating; whereas AuditEvent covers "Usage" of "Entity" and all other "Activity" as defined in W3C Provenance.

6.3.4 References

This resource is referenced by Contract , DeviceDispense , DeviceRequest , MedicationAdministration , MedicationDispense , MedicationRequest , ServiceRequest and Task .

This resource implements the Event pattern.

6.3.4 6.3.5 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . Provenance TU DomainResource Who, What, When for a set of resources
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . target Σ 1..* Reference ( Any ) Target Reference(s) (usually version specific)
. . . occurred[x] 0..1 When the activity occurred
. . . . occurredPeriod Period
. . . . occurredDateTime dateTime
. . . recorded Σ 1..1 0..1 instant When the activity was recorded / updated
. . . location 0..1 Reference ( Location ) Where the activity occurred, if relevant
. . reason . authorization 0..* CodeableConcept CodeableReference () Reason Authorization (purposeOfUse) related to the activity is occurring event
V3 Value SetPurposeOfUse PurposeOfUse ( Extensible Example )
. . . activity 0..1 CodeableConcept Activity that occurred
Provenance activity type ProvenanceActivityType ( Extensible )
. . . basedOn TU 0..* Reference ( CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task ) Workflow authorization within which this event occurred
... encounter TU 0..1 Reference ( Encounter ) Encounter within which this event occurred or which the event is tightly associated
.. . agent 1..* BackboneElement Actor involved
. . . . type Σ 0..1 CodeableConcept How the agent participated
Provenance participant type ParticipationRoleType ( Extensible Example )
. . . . role 0..* CodeableConcept What the agents role was
SecurityRoleType ( Example )
. . . . who Σ 1..1 Reference ( Practitioner | PractitionerRole | RelatedPerson Organization | CareTeam | Patient | Device | Organization RelatedPerson ) Who The agent that participated in the event
. . . . onBehalfOf 0..1 Reference ( Practitioner | PractitionerRole | RelatedPerson Organization | Patient CareTeam | Device Patient | Organization RelatedPerson ) Who the The agent is representing that delegated
. . . entity TU 0..* BackboneElement An entity used in this activity
. . . . role Σ 1..1 code derivation | revision | quotation | source | instantiates | removal
ProvenanceEntityRole ( Required )
. . . . what Σ 1..1 Reference ( Any ) Identity of entity
. . . . agent 0..* see agent Entity is attributed to this agent
. . . signature TU 0..* Signature Signature on target

doco Documentation for this format

UML Diagram ( Legend )

Provenance ( DomainResource ) The Reference(s) that were generated or updated by the activity described in this resource. A provenance can point to more than one target if multiple resources were created/updated by the same activity target : Reference [1..*] « Any » The period during which the activity occurred occurred[x] : Type DataType [0..1] « Period | dateTime » The instant of time at which the activity was recorded recorded : instant [1..1] [0..1] 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 policy : uri [0..*] Where the activity occurred, if relevant location : Reference [0..1] « Location » The reason authorization (e.g., PurposeOfUse) that the activity was taking place used during the event being recorded reason authorization : CodeableConcept DataType [0..*] « ; The reason the activity took place. (Strength=Extensible) null (Strength=Example) v3.PurposeOfUse PurposeOfUse + ?? » An activity is something that occurs over a period of time and acts upon or with entities; it may include consuming, processing, transforming, modifying, relocating, using, or generating entities activity : CodeableConcept [0..1] « The activity that took place. null (Strength=Extensible) ProvenanceActivityType + » Allows tracing of authorizatino for the events and tracking whether proposals/recommendations were acted upon basedOn : Reference [0..*] « CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task » This will typically be the encounter the event occurred, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests) encounter : Reference [0..1] « Encounter » A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated signature : Signature [0..*] Agent The participation Functional Role of the agent had with respect to the activity type : CodeableConcept [0..1] « The type of participation that a provenance agent played with respect to the activity. (Strength=Extensible) null (Strength=Example) ProvenanceParticipantType ParticipationRoleType + ?? » The function structural roles of the agent with respect to indicating the activity. agent's competency. The security role enabling the agent with respect to the activity role : CodeableConcept [0..*] « The role that a provenance agent played with respect to the activity. null (Strength=Example) SecurityRoleType ?? » The individual, device Indicates who or organization that participated what performed in the event who : Reference [1..1] « Practitioner | PractitionerRole | RelatedPerson Organization | CareTeam | Patient | Device | Organization RelatedPerson » The individual, device, or organization for whom agent that delegated authority to perform the change was made activity performed by the agent.who element onBehalfOf : Reference [0..1] « Practitioner | PractitionerRole | RelatedPerson Organization | Patient CareTeam | Device Patient | Organization RelatedPerson » Entity How the entity was used during the activity role : code [1..1] « How an entity was used in an activity. null (Strength=Required) ProvenanceEntityRole ! » Identity of the Entity used. May be a logical or physical uri and maybe absolute or relative what : Reference [1..1] « Any » An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place agent [1..*] 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 used the entity agent [0..*] An entity used in this activity entity [0..*]

XML Template 

<Provenance xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <target><!-- 1..* Reference(Any) Target Reference(s) (usually version specific) --></target>
 <occurred[x]><!-- 0..1 Period|dateTime When the activity occurred --></occurred[x]>
 <

 <recorded value="[instant]"/><!-- 0..1 When the activity was recorded / updated -->

 <policy value="[uri]"/><!-- 0..* Policy or plan the activity was defined by -->
 <location><!-- 0..1 Reference(Location) Where the activity occurred, if relevant --></location>
 <</reason>

 <authorization><!-- 0..* CodeableReference Authorization (purposeOfUse) related to the event  --></authorization>

 <activity><!-- 0..1 CodeableConcept Activity that occurred --></activity>
 <basedOn><!-- 0..* Reference(CarePlan|DeviceRequest|ImmunizationRecommendation|
   MedicationRequest|NutritionOrder|ServiceRequest|Task) Workflow authorization within which this event occurred --></basedOn>

 <encounter><!-- 0..1 Reference(Encounter) Encounter within which this event occurred or which the event is tightly associated --></encounter>

 <agent>  <!-- 1..* Actor involved -->
  <</type>
  <</role>
  <|
    </who>
  <|
    </onBehalfOf>

  <type><!-- 0..1 CodeableConcept How the agent participated --></type>
  <role><!-- 0..* CodeableConcept What the agents role was --></role>
  <who><!-- 1..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) The agent that participated in the event --></who>

  <onBehalfOf><!-- 0..1 Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) The agent that delegated --></onBehalfOf>
 </agent>
 <entity>  <!-- 0..* An entity used in this activity -->
  <

  <role value="[code]"/><!-- 1..1 derivation | revision | quotation | source | instantiates | removal -->

  <what><!-- 1..1 Reference(Any) Identity of entity --></what>
  <</agent>

  <agent><!-- 0..* Content as for Provenance.agent Entity is attributed to this agent --></agent>

 </entity>
 <signature><!-- 0..* Signature Signature on target --></signature>
</Provenance>

JSON Template 

{doco
  "resourceType" : "Provenance",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "target" : [{ Reference(Any) }], // R!  Target Reference(s) (usually version specific)
  // occurred[x]: When the activity occurred. One of these 2:
  "occurredPeriod" : { Period },
  "occurredDateTime" : "<dateTime>",
  "

  "recorded" : "<instant>", // When the activity was recorded / updated

  "policy" : ["<uri>"], // Policy or plan the activity was defined by
  "location" : { Reference(Location) }, // Where the activity occurred, if relevant
  "

  "authorization" : [{ CodeableReference }], // Authorization (purposeOfUse) related to the event 

  "activity" : { CodeableConcept }, // Activity that occurred
  "basedOn" : [{ Reference(CarePlan|DeviceRequest|ImmunizationRecommendation|
   MedicationRequest|NutritionOrder|ServiceRequest|Task) }], // Workflow authorization within which this event occurred

  "encounter" : { Reference(Encounter) }, // Encounter within which this event occurred or which the event is tightly associated

  "agent" : [{ // R!  Actor involved
    "
    "
    "|
    
    "|
    

    "type" : { CodeableConcept }, // How the agent participated
    "role" : [{ CodeableConcept }], // What the agents role was
    "who" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) }, // R!  The agent that participated in the event

    "onBehalfOf" : { Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // The agent that delegated
  }],
  "entity" : [{ // An entity used in this activity
    "

    "role" : "<code>", // R!  derivation | revision | quotation | source | instantiates | removal

    "what" : { Reference(Any) }, // R!  Identity of entity
    "

    "agent" : [{ Content as for Provenance.agent }] // Entity is attributed to this agent

  }],
  "signature" : [{ Signature }] // Signature on target
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Provenance;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Provenance.target [ Reference(Any) ], ... ; # 1..* Target Reference(s) (usually version specific)
  # Provenance.occurred[x] : 0..1 When the activity occurred. One of these 2
    fhir:Provenance.occurredPeriod [ Period ]
    fhir:Provenance.occurredDateTime [ dateTime ]
  fhir:

  fhir:Provenance.recorded [ instant ]; # 0..1 When the activity was recorded / updated

  fhir:Provenance.policy [ uri ], ... ; # 0..* Policy or plan the activity was defined by
  fhir:Provenance.location [ Reference(Location) ]; # 0..1 Where the activity occurred, if relevant
  fhir:

  fhir:Provenance.authorization [ CodeableReference ], ... ; # 0..* Authorization (purposeOfUse) related to the event

  fhir:Provenance.activity [ CodeableConcept ]; # 0..1 Activity that occurred
  fhir:Provenance.basedOn [ Reference(CarePlan|DeviceRequest|ImmunizationRecommendation|MedicationRequest|
  NutritionOrder|ServiceRequest|Task) ], ... ; # 0..* Workflow authorization within which this event occurred

  fhir:Provenance.encounter [ Reference(Encounter) ]; # 0..1 Encounter within which this event occurred or which the event is tightly associated

  fhir:Provenance.agent [ # 1..* Actor involved
    fhir:
    fhir:
    fhir:
    fhir:

    fhir:Provenance.agent.type [ CodeableConcept ]; # 0..1 How the agent participated
    fhir:Provenance.agent.role [ CodeableConcept ], ... ; # 0..* What the agents role was
    fhir:Provenance.agent.who [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 The agent that participated in the event
    fhir:Provenance.agent.onBehalfOf [ Reference(CareTeam|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 The agent that delegated

  ], ...;
  fhir:Provenance.entity [ # 0..* An entity used in this activity
    fhir:

    fhir:Provenance.entity.role [ code ]; # 1..1 derivation | revision | quotation | source | instantiates | removal

    fhir:Provenance.entity.what [ Reference(Any) ]; # 1..1 Identity of entity
    fhir:

    fhir:Provenance.entity.agent [ See Provenance.agent ], ... ; # 0..* Entity is attributed to this agent

  ], ...;
  fhir:Provenance.signature [ Signature ], ... ; # 0..* Signature on target
]

Changes since R3

Provenance
Provenance.occurred[x] Provenance.recorded
  • Renamed Min Cardinality changed from period 1 to occurred[x] Add Type dateTime 0
Provenance.reason Provenance.authorization
  • Type changed from Coding to CodeableConcept Added Element
Provenance.activity Provenance.basedOn
  • Type changed from Coding to CodeableConcept Added Element
Provenance.agent.type Provenance.encounter
  • Added Element
Provenance.agent.role Provenance.agent.type
  • Remove Binding http://hl7.org/fhir/ValueSet/security-role-type http://hl7.org/fhir/ValueSet/provenance-agent-type (extensible)
Provenance.agent.who
  • Renamed from who[x] to who Remove Type uri Reference: Added Target Type CareTeam
Provenance.agent.onBehalfOf
  • Renamed from onBehalfOf[x] to onBehalfOf Type Reference: Added Target Type CareTeam
  • Remove Type uri Reference: Removed Target Type Device
Provenance.entity.role
  • Change value set from http://hl7.org/fhir/ValueSet/provenance-entity-role to http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.1 Provenance.entity.what Renamed from what[x] http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.0 to what Remove Types uri, Identifier http://hl7.org/fhir/ValueSet/provenance-entity-role|5.0.0-snapshot1
Provenance.agent.relatedAgentType Provenance.reason
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 5 tests that all execute ok. All tests pass round-trip testing and 2 r3 resources are invalid (0 errors). )

Structure

Name Flags Card. Type Description & Constraints doco
. . Provenance TU DomainResource Who, What, When for a set of resources
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . target Σ 1..* Reference ( Any ) Target Reference(s) (usually version specific)
. . . occurred[x] 0..1 When the activity occurred
. . . . occurredPeriod Period
. . . . occurredDateTime dateTime
. . . recorded Σ 1..1 0..1 instant When the activity was recorded / updated
. . . location 0..1 Reference ( Location ) Where the activity occurred, if relevant
. . reason . authorization 0..* CodeableConcept CodeableReference () Reason Authorization (purposeOfUse) related to the activity is occurring event
V3 Value SetPurposeOfUse PurposeOfUse ( Extensible Example )
. . . activity 0..1 CodeableConcept Activity that occurred
Provenance activity type ProvenanceActivityType ( Extensible )
. . . basedOn TU 0..* Reference ( CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task ) Workflow authorization within which this event occurred
. . . encounter TU 0..1 Reference ( Encounter ) Encounter within which this event occurred or which the event is tightly associated
.. . agent 1..* BackboneElement Actor involved
. . . . type Σ 0..1 CodeableConcept How the agent participated
Provenance participant type ParticipationRoleType ( Extensible Example )
. . . . role 0..* CodeableConcept What the agents role was
SecurityRoleType ( Example )
. . . . who Σ 1..1 Reference ( Practitioner | PractitionerRole | RelatedPerson Organization | CareTeam | Patient | Device | Organization RelatedPerson ) Who The agent that participated in the event
. . . . onBehalfOf 0..1 Reference ( Practitioner | PractitionerRole | RelatedPerson Organization | Patient CareTeam | Device Patient | Organization RelatedPerson ) Who the The agent is representing that delegated
. . . entity TU 0..* BackboneElement An entity used in this activity
. . . . role Σ 1..1 code derivation | revision | quotation | source | instantiates | removal
ProvenanceEntityRole ( Required )
. . . . what Σ 1..1 Reference ( Any ) Identity of entity
. . . . agent 0..* see agent Entity is attributed to this agent
. . . signature TU 0..* Signature Signature on target

doco Documentation for this format

UML Diagram ( Legend )

Provenance ( DomainResource ) The Reference(s) that were generated or updated by the activity described in this resource. A provenance can point to more than one target if multiple resources were created/updated by the same activity target : Reference [1..*] « Any » The period during which the activity occurred occurred[x] : Type DataType [0..1] « Period | dateTime » The instant of time at which the activity was recorded recorded : instant [1..1] [0..1] 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 policy : uri [0..*] Where the activity occurred, if relevant location : Reference [0..1] « Location » The reason authorization (e.g., PurposeOfUse) that the activity was taking place used during the event being recorded reason authorization : CodeableConcept DataType [0..*] « ; The reason the activity took place. (Strength=Extensible) null (Strength=Example) v3.PurposeOfUse PurposeOfUse + ?? » An activity is something that occurs over a period of time and acts upon or with entities; it may include consuming, processing, transforming, modifying, relocating, using, or generating entities activity : CodeableConcept [0..1] « The activity that took place. null (Strength=Extensible) ProvenanceActivityType + » Allows tracing of authorizatino for the events and tracking whether proposals/recommendations were acted upon basedOn : Reference [0..*] « CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest | Task » This will typically be the encounter the event occurred, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests) encounter : Reference [0..1] « Encounter » A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated signature : Signature [0..*] Agent The participation Functional Role of the agent had with respect to the activity type : CodeableConcept [0..1] « The type of participation that a provenance agent played with respect to the activity. (Strength=Extensible) null (Strength=Example) ProvenanceParticipantType ParticipationRoleType + ?? » The function structural roles of the agent with respect to indicating the activity. agent's competency. The security role enabling the agent with respect to the activity role : CodeableConcept [0..*] « The role that a provenance agent played with respect to the activity. null (Strength=Example) SecurityRoleType ?? » The individual, device Indicates who or organization that participated what performed in the event who : Reference [1..1] « Practitioner | PractitionerRole | RelatedPerson Organization | CareTeam | Patient | Device | Organization RelatedPerson » The individual, device, or organization for whom agent that delegated authority to perform the change was made activity performed by the agent.who element onBehalfOf : Reference [0..1] « Practitioner | PractitionerRole | RelatedPerson Organization | Patient CareTeam | Device Patient | Organization RelatedPerson » Entity How the entity was used during the activity role : code [1..1] « How an entity was used in an activity. null (Strength=Required) ProvenanceEntityRole ! » Identity of the Entity used. May be a logical or physical uri and maybe absolute or relative what : Reference [1..1] « Any » An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place agent [1..*] 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 used the entity agent [0..*] An entity used in this activity entity [0..*]

XML Template 

<Provenance xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <target><!-- 1..* Reference(Any) Target Reference(s) (usually version specific) --></target>
 <occurred[x]><!-- 0..1 Period|dateTime When the activity occurred --></occurred[x]>
 <

 <recorded value="[instant]"/><!-- 0..1 When the activity was recorded / updated -->

 <policy value="[uri]"/><!-- 0..* Policy or plan the activity was defined by -->
 <location><!-- 0..1 Reference(Location) Where the activity occurred, if relevant --></location>
 <</reason>

 <authorization><!-- 0..* CodeableReference Authorization (purposeOfUse) related to the event  --></authorization>

 <activity><!-- 0..1 CodeableConcept Activity that occurred --></activity>
 <basedOn><!-- 0..* Reference(CarePlan|DeviceRequest|ImmunizationRecommendation|
   MedicationRequest|NutritionOrder|ServiceRequest|Task) Workflow authorization within which this event occurred --></basedOn>

 <encounter><!-- 0..1 Reference(Encounter) Encounter within which this event occurred or which the event is tightly associated --></encounter>

 <agent>  <!-- 1..* Actor involved -->
  <</type>
  <</role>
  <|
    </who>
  <|
    </onBehalfOf>

  <type><!-- 0..1 CodeableConcept How the agent participated --></type>
  <role><!-- 0..* CodeableConcept What the agents role was --></role>
  <who><!-- 1..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) The agent that participated in the event --></who>

  <onBehalfOf><!-- 0..1 Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) The agent that delegated --></onBehalfOf>
 </agent>
 <entity>  <!-- 0..* An entity used in this activity -->
  <

  <role value="[code]"/><!-- 1..1 derivation | revision | quotation | source | instantiates | removal -->

  <what><!-- 1..1 Reference(Any) Identity of entity --></what>
  <</agent>

  <agent><!-- 0..* Content as for Provenance.agent Entity is attributed to this agent --></agent>

 </entity>
 <signature><!-- 0..* Signature Signature on target --></signature>
</Provenance>

JSON Template 

{doco
  "resourceType" : "Provenance",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "target" : [{ Reference(Any) }], // R!  Target Reference(s) (usually version specific)
  // occurred[x]: When the activity occurred. One of these 2:
  "occurredPeriod" : { Period },
  "occurredDateTime" : "<dateTime>",
  "

  "recorded" : "<instant>", // When the activity was recorded / updated

  "policy" : ["<uri>"], // Policy or plan the activity was defined by
  "location" : { Reference(Location) }, // Where the activity occurred, if relevant
  "

  "authorization" : [{ CodeableReference }], // Authorization (purposeOfUse) related to the event 

  "activity" : { CodeableConcept }, // Activity that occurred
  "basedOn" : [{ Reference(CarePlan|DeviceRequest|ImmunizationRecommendation|
   MedicationRequest|NutritionOrder|ServiceRequest|Task) }], // Workflow authorization within which this event occurred

  "encounter" : { Reference(Encounter) }, // Encounter within which this event occurred or which the event is tightly associated

  "agent" : [{ // R!  Actor involved
    "
    "
    "|
    
    "|
    

    "type" : { CodeableConcept }, // How the agent participated
    "role" : [{ CodeableConcept }], // What the agents role was
    "who" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) }, // R!  The agent that participated in the event

    "onBehalfOf" : { Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // The agent that delegated
  }],
  "entity" : [{ // An entity used in this activity
    "

    "role" : "<code>", // R!  derivation | revision | quotation | source | instantiates | removal

    "what" : { Reference(Any) }, // R!  Identity of entity
    "

    "agent" : [{ Content as for Provenance.agent }] // Entity is attributed to this agent

  }],
  "signature" : [{ Signature }] // Signature on target
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Provenance;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Provenance.target [ Reference(Any) ], ... ; # 1..* Target Reference(s) (usually version specific)
  # Provenance.occurred[x] : 0..1 When the activity occurred. One of these 2
    fhir:Provenance.occurredPeriod [ Period ]
    fhir:Provenance.occurredDateTime [ dateTime ]
  fhir:

  fhir:Provenance.recorded [ instant ]; # 0..1 When the activity was recorded / updated

  fhir:Provenance.policy [ uri ], ... ; # 0..* Policy or plan the activity was defined by
  fhir:Provenance.location [ Reference(Location) ]; # 0..1 Where the activity occurred, if relevant
  fhir:

  fhir:Provenance.authorization [ CodeableReference ], ... ; # 0..* Authorization (purposeOfUse) related to the event

  fhir:Provenance.activity [ CodeableConcept ]; # 0..1 Activity that occurred
  fhir:Provenance.basedOn [ Reference(CarePlan|DeviceRequest|ImmunizationRecommendation|MedicationRequest|
  NutritionOrder|ServiceRequest|Task) ], ... ; # 0..* Workflow authorization within which this event occurred

  fhir:Provenance.encounter [ Reference(Encounter) ]; # 0..1 Encounter within which this event occurred or which the event is tightly associated

  fhir:Provenance.agent [ # 1..* Actor involved
    fhir:
    fhir:
    fhir:
    fhir:

    fhir:Provenance.agent.type [ CodeableConcept ]; # 0..1 How the agent participated
    fhir:Provenance.agent.role [ CodeableConcept ], ... ; # 0..* What the agents role was
    fhir:Provenance.agent.who [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 The agent that participated in the event
    fhir:Provenance.agent.onBehalfOf [ Reference(CareTeam|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 The agent that delegated

  ], ...;
  fhir:Provenance.entity [ # 0..* An entity used in this activity
    fhir:

    fhir:Provenance.entity.role [ code ]; # 1..1 derivation | revision | quotation | source | instantiates | removal

    fhir:Provenance.entity.what [ Reference(Any) ]; # 1..1 Identity of entity
    fhir:

    fhir:Provenance.entity.agent [ See Provenance.agent ], ... ; # 0..* Entity is attributed to this agent

  ], ...;
  fhir:Provenance.signature [ Signature ], ... ; # 0..* Signature on target
]

Changes since Release 3

Provenance
Provenance.occurred[x] Provenance.recorded
  • Renamed Min Cardinality changed from period 1 to occurred[x] Add Type dateTime 0
Provenance.reason Provenance.authorization
  • Type changed from Coding to CodeableConcept Added Element
Provenance.activity Provenance.basedOn
  • Type changed from Coding to CodeableConcept Added Element
Provenance.agent.type Provenance.encounter
  • Added Element
Provenance.agent.role Provenance.agent.type
  • Remove Binding http://hl7.org/fhir/ValueSet/security-role-type http://hl7.org/fhir/ValueSet/provenance-agent-type (extensible)
Provenance.agent.who
  • Renamed from who[x] to who Remove Type uri Reference: Added Target Type CareTeam
Provenance.agent.onBehalfOf
  • Renamed from onBehalfOf[x] to onBehalfOf Type Reference: Added Target Type CareTeam
  • Remove Type uri Reference: Removed Target Type Device
Provenance.entity.role
  • Change value set from http://hl7.org/fhir/ValueSet/provenance-entity-role to http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.1 Provenance.entity.what Renamed from what[x] http://hl7.org/fhir/ValueSet/provenance-entity-role|4.0.0 to what Remove Types uri, Identifier http://hl7.org/fhir/ValueSet/provenance-entity-role|5.0.0-snapshot1
Provenance.agent.relatedAgentType Provenance.reason
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 5 tests that all execute ok. All tests pass round-trip testing and 2 r3 resources are invalid (0 errors). )

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

6.3.4.1 6.3.5.1 Terminology Bindings

Provenance.reason
Path Definition Type Reference
Provenance.authorization The reason the activity took place. Extensible Example v3.PurposeOfUse PurposeOfUse
Provenance.activity The activity that took place. Extensible ProvenanceActivityType
Provenance.agent.type The type of participation that a provenance agent played with respect to the activity. Extensible Example ProvenanceParticipantType ParticipationRoleType
Provenance.agent.role The role that a provenance agent played with respect to the activity. Example SecurityRoleType
Provenance.entity.role How an entity was used in an activity. Required ProvenanceEntityRole

6.3.4.2 6.3.5.2 Using the Provenance Resource

The Provenance resource identifies information about another resource (the reference element). The Provenance resource may be used in several different ways:

  • As part of a document bundle where it identifies the provenance of part or all of the document
  • On a RESTful system where it keeps track of provenance information relating to resources

When used in a document bundle, the references are often not explicitly versioned, but they always implicitly pertain to the version of the resource found in the document. On a RESTful system, the target resource reference should be version specific, but this requires special care: For new resources that need to have a corresponding Provenance resource, the version-specific reference is often not knowable until after the target resource has been updated. This can create an integrity problem for the system - what if the Provenance resource cannot be created after the target resource has been updated? To avoid any such integrity problems, the target resource and the Provenance resources should be submitted as a pair using a transaction .

6.3.4.2.1 6.3.5.2.1 HTTP Header

The custom header X-Provenance to provide a provenance resource when performing PUT or POST operations using the RESTful interface : 

POST [base]/Observation
Content-Type: application/fhir+?
X-Provenance: { "resourceType": "Provenance", "location": { "reference": "Location/1" }," agent" ... }

[body]

The intent is that the server picks up the provenance, fills out the target , and then stores the provenance information as it normally would. Notes:

  • Irrespective of the Content-Type or Accept headers, the Provenance resource is in the JSON format
  • The provenance SHALL not have a specified Provenance.target . The server will fill the target in as it processes the contents of the POST/PUT and determines the ids of the resource(s) to which the interaction applies
  • Servers MAY ignore the header, but SHOULD process it if they support provenance
  • Some server frameworks impose a length limit on individual HTTP headers, or on the the headers as a whole. Servers MAY reject a request if the X-Provenance header is too long
  • The use of the header is not documented for other HTTP methods (GET etc)

6.3.4.3 6.3.5.3 Signatures

The Provenance resource includes a signature element (digital signature) which can be used for standards based integrity verification and non-repudiation purposes. The Signature datatype provides details on use of the signature element. The Signature.type coded value of "Source" should be used when the signature is for simply proving that the resource content is the same as it was when the resource was updated or created.

6.3.4.4 6.3.5.4 Provenance of Removal

A Provenance record can be recorded to indicate who deleted a Resource. If versioning is supported, the version that was deleted is referenced in Provenance.target; if versioning is not supported then Provenance.target contains the non-version reference. Provenance.entity is not used unless there is a business requirement to do so.

6.3.4.5

6.3.5.5 Use of Provenance to record Import and Transform

Provenance can be used to record activities of an automaton that transforms input. Such as middleware that extracts information from a HL7 v2 message and creates FHIR resources, or middleware that extracts information from an HL7 CDA document and creates FHIR resources, etc. The Provenance in these cases is recording the activity of the middleware.

The middleware in this case would, in addition to creating the target resources, create a Provenance resource that indicates all the target resources (using Provenance.target). Provenance.target ). The middleware is identified as one of the Provenance.agent elements, with the Provenance.agent.role Provenance.agent.type of assembler. assembler .

The middleware may record the source as another Provenance.agent element.

The original content is optionally saved. This might be as a DocumentReference, or Binary. The Provenance.entity would then point at this original content.

The original source might include some form of 'provenance' to cover the history of the original content prior to the import transformation. This original source 'provenance' should be converted into FHIR Provenance records as appropriate.

Examples of this activity with Provenance profile can be found in the IHE Implementation Guides for

  • Query for Existing Data for Mobile - QEDm
  • Reconciliation of Clinical Content and Care Providers - RECON

6.3.5 6.3.6 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
activity token Activity that occurred Provenance.activity
agent reference Who participated Provenance.agent.who
( Practitioner , Organization , CareTeam , Device , Patient , PractitionerRole , RelatedPerson )
agent-role token What the agents role was Provenance.agent.role
agent-type token How the agent participated Provenance.agent.type
based-on reference Reference to the service request. Provenance.basedOn
( CarePlan , MedicationRequest , Task , NutritionOrder , DeviceRequest , ServiceRequest , ImmunizationRecommendation )
encounter reference Encounter related to the Provenance Provenance.encounter
( Encounter )
entity reference Identity of entity Provenance.entity.what
(Any)
location reference Where the activity occurred, if relevant Provenance.location
( Location )
patient reference Target Reference(s) (usually version specific) Provenance.target.where(resolve() is Patient)
( Patient ) (Any)
recorded N date When the activity was recorded / updated Provenance.recorded
signature-type token Indication of the reason the entity signed the object(s) Provenance.signature.type
target reference Target Reference(s) (usually version specific) Provenance.target
(Any)
when date When the activity occurred (Provenance.occurred as dateTime)