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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.

This resource is referenced by Contract , DeviceRequest , MedicationAdministration , MedicationDispense , MedicationRequest , ProcedureRequest , ReferralRequest ServiceRequest and Task

6.3.4 Resource Content

 

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

6.3.4.1 Terminology Bindings

Provenance.agent.role Provenance.agent.relatedAgentType

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

6.3.4.2 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 .

6.3.4.3 6.3.4.2.1 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 Digital 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" "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 Party References Because the Provenance resource often refers to parties that are not represented as FHIR resources, agent and entity references can be either references to other resources, or they can refer to other entities that are not FHIR resources. For Provenance.agent, the actor element is used to reference an existing resource. To reference an entity that is not a FHIR resource, the userId element is used. A version specific reference to a FHIR resource on the same server: <agent> <actor> <reference value="Patient/34/_history/3"/> </actor> </agent> A reference to a user (a person) not represented by a FHIR resource: <agent> <userId> <value value="http://acme.com/users/34"/> </userId> </agent> For Provenance.entity, the code in the .type element is used to differentiate between the two cases: if the code is in the system "http://hl7.org/fhir/resource-types", then the reference is to a resource, and the element reference functions exactly the same as in a resource reference . A version specific reference to a FHIR resource on the same server: <entity> <type> <system value="http://hl7.org/fhir/resource-types"/> <code value="Patient"/> </type> <reference value="Patient/34/_history/3"/> </entity> In effect, this is the same pattern as a standard resource reference, but the type becomes extensible to allow referencing other kinds of resources. A reference to an entity (a person) not represented by a FHIR resource: <entity> <type> <system value="http://hl7.org/fhir/provenance-participant-type"/> <code value="person"/> </type> <reference value="http://acme.com/users/34"/> </entity> One subtle issue with the use of the Provenance resource is to differentiate between whether the reference is to the resource itself, or whether the reference is to the real-world thing that the resource represents, e.g. was it the person involved in the activity, or the record of the person. For agents, it should be understood that the reference is to the real-world thing that the resource represents. Removal 6.3.4.5

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.

6.3.4.6 6.3.4.5 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). The middleware is identified as one of the Provenance.agent elements, with the Provenance.agent.role of 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.

6.3.5 Search Parameters

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

end

Name	Type	Description	Expression	In Common
agent	reference	Who participated	Provenance.agent.who ( Practitioner , Organization , Device , Patient , PractitionerRole , RelatedPerson )
agent-role	token	What the agents role was	Provenance.agent.role	date End time with inclusive boundary, if not ongoing Provenance.period.end
entity-id agent-type	token	Identity of entity How the agent participated	Provenance.entity.what.as(Identifier) Provenance.agent.type
entity-ref entity	reference	Identity of entity	Provenance.entity.what.as(Reference) 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 Provenance.target.where(resolve() is Patient) ( Patient )
recorded	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
start target	date reference	Starting time with inclusive boundary Target Reference(s) (usually version specific)	Provenance.period.start Provenance.target (Any)
target when	reference date	Target Reference(s) (usually version specific) When the activity occurred	Provenance.target (Any) (Provenance.occurred as dateTime)