4.4.1.181 Value Set http://hl7.org/fhir/ValueSet/provenance-activity-type

This value set includes codes based on the following rules:

• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-DocumentCompletion

  Code	Display	Definition
  LA	legally authenticated	A completion status in which a document has been signed manually or electronically by the individual who is legally responsible for that document. This is the most mature state in the workflow progression.

• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode

  Code	Display	Definition
  ANONY	anonymize	Custodian system must remove any information that could result in identifying the information subject.
  DEID	deidentify	Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.
  MASK	mask	Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext. User may be provided a key to decrypt per license or "shared secret".
  LABEL	assign security label	Custodian security system must assign and bind security labels in order to classify information created in the information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the assignment and binding. *Usage Note:* In security systems, security policy label assignments do not change, they may supersede prior assignments, and such reassignments are always tracked for auditing and other purposes.
  PSEUD	pseudonymize	Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject.

• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-DataOperation

  Code	Display	Definition
  CREATE	create	Fundamental operation in an Information System (IS) that results only in the act of bringing an object into existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
  DELETE	delete	Fundamental operation in an Information System (IS) that results only in the removal of information about an object from memory or storage. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
  UPDATE	revise	Fundamental operation in an Information System (IS) that results only in the revision or alteration of an object. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
  APPEND	append	Fundamental operation in an Information System (IS) that results only in the addition of information to an object already in existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
  NULLIFY	nullify	Change the status of an object representing an Act to "nullified", i.e., treat as though it never existed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

• Include all codes defined in http://terminology.hl7.org/CodeSystem/v3-ParticipationType

This value set contains 70 concepts

Code	System	Display	Definition
LA	http://terminology.hl7.org/CodeSystem/v3-DocumentCompletion	legally authenticated	A completion status in which a document has been signed manually or electronically by the individual who is legally responsible for that document. This is the most mature state in the workflow progression.
ANONY	http://terminology.hl7.org/CodeSystem/v3-ActCode	anonymize	Custodian system must remove any information that could result in identifying the information subject.
DEID	http://terminology.hl7.org/CodeSystem/v3-ActCode	deidentify	Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.
MASK	http://terminology.hl7.org/CodeSystem/v3-ActCode	mask	Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext. User may be provided a key to decrypt per license or "shared secret".
LABEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	assign security label	Custodian security system must assign and bind security labels in order to classify information created in the information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the assignment and binding. *Usage Note:* In security systems, security policy label assignments do not change, they may supersede prior assignments, and such reassignments are always tracked for auditing and other purposes.
PSEUD	http://terminology.hl7.org/CodeSystem/v3-ActCode	pseudonymize	Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject.
CREATE	http://terminology.hl7.org/CodeSystem/v3-DataOperation	create	Fundamental operation in an Information System (IS) that results only in the act of bringing an object into existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
DELETE	http://terminology.hl7.org/CodeSystem/v3-DataOperation	delete	Fundamental operation in an Information System (IS) that results only in the removal of information about an object from memory or storage. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
UPDATE	http://terminology.hl7.org/CodeSystem/v3-DataOperation	revise	Fundamental operation in an Information System (IS) that results only in the revision or alteration of an object. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
APPEND	http://terminology.hl7.org/CodeSystem/v3-DataOperation	append	Fundamental operation in an Information System (IS) that results only in the addition of information to an object already in existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
NULLIFY	http://terminology.hl7.org/CodeSystem/v3-DataOperation	nullify	Change the status of an object representing an Act to "nullified", i.e., treat as though it never existed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
PART	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	Participation	Indicates that the target of the participation is involved in some manner in the act, but does not qualify how.
_ParticipationAncillary	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	ParticipationAncillary	Participations related, but not primary to an act. The Referring, Admitting, and Discharging practitioners must be the same person as those authoring the ControlAct event for their respective trigger events.
ADM	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	admitter	The practitioner who is responsible for admitting a patient to a patient encounter.
ATND	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	attender	The practitioner that has responsibility for overseeing a patient's care during a patient encounter.
CALLBCK	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	callback contact	A person or organization who should be contacted for follow-up questions about the act in place of the author.
CON	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	consultant	An advisor participating in the service by performing evaluations and making recommendations.
DIS	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	discharger	The practitioner who is responsible for the discharge of a patient from a patient encounter.
ESC	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	escort	Only with Transportation services. A person who escorts the patient.
REF	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	referrer	A person having referred the subject of the service to the performer (referring physician). Typically, a referring physician will receive a report.
_ParticipationInformationGenerator	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	ParticipationInformationGenerator	Parties that may or should contribute or have contributed information to the Act. Such information includes information leading to the decision to perform the Act and how to perform the Act (e.g., consultant), information that the Act itself seeks to reveal (e.g., informant of clinical history), or information about what Act was performed (e.g., informant witness).
AUT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	author (originator)	**Definition:** A party that originates the Act and therefore has responsibility for the information given in the Act and ownership of this Act. **Example:** the report writer, the person writing the act definition, the guideline author, the placer of an order, the EKG cart (device) creating a report etc. Every Act should have an author. Authorship is regardless of mood always actual authorship. Examples of such policies might include: * The author and anyone they explicitly delegate may update the report; * All administrators within the same clinic may cancel and reschedule appointments created by other administrators within that clinic; A party that is neither an author nor a party who is extended authorship maintenance rights by policy, may only amend, reverse, override, replace, or follow up in other ways on this Act, whereby the Act remains intact and is linked to another Act authored by that other party.
INF	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	informant	A source of reported information (e.g., a next of kin who answers questions about the patient's history). For history questions, the patient is logically an informant, yet the informant of history questions is implicitly the subject.
TRANS	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	Transcriber	An entity entering the data into the originating system. The data entry entity is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text transcribed into electronic form.
ENT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	data entry person	A person entering the data into the originating system. The data entry person is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text.
WIT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	witness	Only with service events. A person witnessing the action happening without doing anything. A witness is not necessarily aware, much less approves of anything stated in the service event. Example for a witness is students watching an operation or an advanced directive witness.
CST	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	custodian	An entity (person, organization or device) that is in charge of maintaining the information of this act (e.g., who maintains the report or the master service catalog item, etc.).
DIR	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	direct target	Target participant that is substantially present in the act and which is directly involved in the action (includes consumed material, devices, etc.).
ALY	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	analyte	The target of an Observation action. Links an observation to a Role whose player is the substance or most specific component entity (material, micro-organism, etc.) being measured within the subject. *Examples:* A "plasma porcelain substance concentration" has analyte a Role with player substance Entity "porcelain". *UsageNotes:* The Role that this participation connects to may be any Role whose player is that substance measured. Very often, the scoper may indicate the system in which the component is being measured. E.g., for "plasma porcelain" the scoper could be "Plasma".
BBY	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	baby	In an obstetric service, the baby.
CAT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	catalyst	The catalyst of a chemical reaction, such as an enzyme or a platinum surface. In biochemical reactions, connects the enzyme with the molecular interaction
CSM	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	consumable	Participant material that is taken up, diminished, altered, or disappears in the act.
TPA	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	therapeutic agent	Something incorporated in the subject of a therapy service to achieve a physiologic effect (e.g., heal, relieve, provoke a condition, etc.) on the subject. In an administration service the therapeutic agent is a consumable, in a preparation or dispense service, it is a product. Thus, consumable or product must be specified in accordance with the kind of service.
DEV	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	device	Participant used in performing the act without being substantially affected by the act (i.e. durable or inert with respect to that particular service). *Examples:* monitoring equipment, tools, but also access/drainage lines, prostheses, pace maker, etc.
NRD	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	non-reuseable device	A device that changes ownership due to the service, e.g., a pacemaker, a prosthesis, an insulin injection equipment (pen), etc. Such material may need to be restocked after he service.
RDV	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	reusable device	A device that does not change ownership due to the service, i.e., a surgical instrument or tool or an endoscope. The distinction between reuseable and non-reuseable must be made in order to know whether material must be re-stocked.
DON	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	donor	In some organ transplantation services and rarely in transfusion services a donor will be a target participant in the service. However, in most cases transplantation is decomposed in three services: explantation, transport, and implantation. The identity of the donor (recipient) is often irrelevant for the explantation (implantation) service.
EXPAGNT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	ExposureAgent	**Description:** The entity playing the associated role is the physical (including energy), chemical or biological substance that is participating in the exposure. For example in communicable diseases, the associated playing entity is the disease causing pathogen.
EXPART	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	ExposureParticipation	**Description:**Direct participation in an exposure act where it is unknown that the participant is the source or subject of the exposure. If the participant is known to be the contact of an exposure then the SBJ participation type should be used. If the participant is known to be the source then the EXSRC participation type should be used.
EXPTRGT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	ExposureTarget	**Description:** The entity playing the associated role is the target (contact) of exposure.
EXSRC	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	ExposureSource	**Description:**The entity playing the associated role is the source of exposure.
PRD	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	product	Participant material that is brought forth (produced) in the act (e.g., specimen in a specimen collection, access or drainage in a placement service, medication package in a dispense service). It does not matter whether the material produced had existence prior to the service, or whether it is created in the service (e.g., in supply services the product is taken from a stock).
SBJ	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	subject	The principle target on which the action happens. *Examples:* The patient in physical examination, a specimen in a lab observation. May also be a patient's family member (teaching) or a device or room (cleaning, disinfecting, housekeeping). *UsageNotes:* Not all direct targets are subjects. Consumables and devices used as tools for an act are not subjects. However, a device may be a subject of a maintenance action.
SPC	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	specimen	The subject of non-clinical (e.g. laboratory) observation services is a specimen.
IND	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	indirect target	Target that is not substantially present in the act and which is not directly affected by the act, but which will be a focus of the record or documentation of the act.
BEN	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	beneficiary	Target on behalf of whom the service happens, but that is not necessarily present in the service. Can occur together with direct target to indicate that a target is both, as in the case where the patient is the indirect beneficiary of a service rendered to a family member, e.g. counseling or given home care instructions. This concept includes a participant, such as a covered party, who derives benefits from a service act covered by a coverage act. Note that the semantic role of the intended recipient who benefits from the happening denoted by the verb in the clause. Thus, a patient who has no coverage under a policy or program may be a beneficiary of a health service while not being the beneficiary of coverage for that service.
CAGNT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	causative agent	Definition: A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or (in deficiency diseases) relative absence is essential, in whole or in part, for the occurrence of a condition. Constraint: The use of this participation is limited to observations.
COV	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	coverage target	The target participation for an individual in a health care coverage act in which the target role is either the policy holder of the coverage, or a covered party under the coverage.
GUAR	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	guarantor party	The target person or organization contractually recognized by the issuer as a participant who has assumed fiscal responsibility for another personaTMs financial obligations by guaranteeing to pay for amounts owed to a particular account *Example:*The subscriber of the patientaTMs health insurance policy signs a contract with the provider to be fiscally responsible for the patient billing account balance amount owed.
HLD	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	holder	Participant who posses an instrument such as a financial contract (insurance policy) usually based on some agreement with the author.
RCT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	record target	The record target indicates whose medical record holds the documentation of this act. This is especially important when the subject of a service is not the patient himself.
RCV	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	receiver	The person (or organization) who receives the product of an Act.
IRCP	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	information recipient	A party, who may or should receive or who has recieved the Act or subsequent or derivative information of that Act. Information recipient is inert, i.e., independent of mood." Rationale: this is a generalization of a too diverse family that the definition can't be any more specific, and the concept is abstract so one of the specializations should be used.
NOT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	ugent notification contact	An information recipient to notify for urgent matters about this Act. (e.g., in a laboratory order, critical results are being called by phone right away, this is the contact to call; or for an inpatient encounter, a next of kin to notify when the patient becomes critically ill).
PRCP	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	primary information recipient	Information recipient to whom an act statement is primarily directed. E.g., a primary care provider receiving a discharge letter from a hospitalist, a health department receiving information on a suspected case of infectious disease. Multiple of these participations may exist on the same act without requiring that recipients be ranked as primary vs. secondary.
REFB	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	Referred By	A participant (e.g. provider) who has referred the subject of an act (e.g. patient). Typically, a referred by participant will provide a report (e.g. referral).
REFT	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	Referred to	The person who receives the patient
TRC	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	tracker	A secondary information recipient, who receives copies (e.g., a primary care provider receiving copies of results as ordered by specialist).
LOC	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	location	The facility where the service is done. May be a static building (or room therein) or a moving location (e.g., ambulance, helicopter, aircraft, train, truck, ship, etc.)
DST	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	destination	The destination for services. May be a static building (or room therein) or a movable facility (e.g., ship).
ELOC	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	entry location	A location where data about an Act was entered.
ORG	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	origin	The location of origin for services. May be a static building (or room therein) or a movable facility (e.g., ship).
RML	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	remote	Some services take place at multiple concurrent locations (e.g., telemedicine, telephone consultation). The location where the principal performing actor is located is taken as the primary location (LOC) while the other location(s) are considered "remote."
VIA	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	via	For services, an intermediate location that specifies a path between origin an destination.
PRF	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	performer	**Definition:** A person, non-person living subject, organization or device that who actually and principally carries out the action. Device should only be assigned as a performer in circumstances where the device is performing independent of human intervention. Need not be the principal responsible actor. **Exampe:** A surgery resident operating under supervision of attending surgeon, a search and rescue dog locating survivors, an electronic laboratory analyzer or the laboratory discipline requested to perform a laboratory test. The performer may also be the patient in self-care, e.g. fingerstick blood sugar. The traditional order filler is a performer. This information should accompany every service event. **Note:** that existing HL7 designs assign an organization as the playing entity of the Role that is the performer. These designs should be revised in subsequent releases to make this the scooping entity for the role involved.
DIST	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	distributor	Distributes material used in or generated during the act.
PPRF	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	primary performer	The principal or primary performer of the act.
SPRF	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	secondary performer	A person assisting in an act through his substantial presence and involvement This includes: assistants, technicians, associates, or whatever the job titles may be.
RESP	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	responsible party	The person or organization that has primary responsibility for the act. The responsible party is not necessarily present in an action, but is accountable for the action through the power to delegate, and the duty to review actions with the performing actor after the fact. This responsibility may be ethical, legal, contractual, fiscal, or fiduciary in nature. *Example:* A person who is the head of a biochemical laboratory; a sponsor for a policy or government program.
VRF	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	verifier	A person who verifies the correctness and appropriateness of the service (plan, order, event, etc.) and hence takes on accountability.
AUTHEN	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	authenticator	A verifier who attests to the accuracy of an act, but who does not have privileges to legally authenticate the act. An example would be a resident physician who sees a patient and dictates a note, then later signs it. Their signature constitutes an authentication.
LA	http://terminology.hl7.org/CodeSystem/v3-ParticipationType	legal authenticator	A verifier who legally authenticates the accuracy of an act. An example would be a staff physician who sees a patient and dictates a note, then later signs it. Their signature constitutes a legal authentication.