This profile sets minimum expectations for the Provenance resource to record, search, and fetch Provenance information associated with a record. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile. This FHIR Provenance profile here covers the minimal (basic) information to support lineage of information. Prior to reviewing this profile, implementers are encouraged to read the Basic Provenance guidance page which documents several key use cases, specifically, what organization was responsible for the most recent action on the resource.

Example Usage Scenarios:

The following are example usage scenarios for the US Core Provenance profile:

• Query for the Provenance records associated with an Allergy
• Query for the Provenance records associated with a Problem

Mandatory and Must Support Data Elements

The following data-elements are mandatory (i.e. data MUST be present) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Provenance must have:

1. a reference to the resource(s) the Provenance record is supporting (target)
2. a date and time for the activity

Each Provenance must support:

1. the author organization responsible for the information
2. the transmitter that provided the information
3. the transmitter organization responsible for the transmission (if the transmitter is a device the transmitter organization must also be valued).

Profile specific implementation guidance:

• The US Core Provenance resource SHALL be supported for these US Core resources:
  • US Core AllergyIntolerance Profile
  • US Core CarePlan Profile
  • US Core CareTeam Profile
  • US Core Condition Profile
  • US Core DiagnosticReport Profile for Laboratory Results Reporting
  • US Core DiagnosticReport Profile for Report and Note exchange
  • US Core DocumentReference Profile
  • US Core Encounter Profile
  • US Core Goal Profile
  • US Core Immunization Profile
  • US Core Implantable Device Profile
  • US Core Laboratory Result Observation Profile
  • US Core MedicationRequest Profile
  • US Core Patient Profile
  • US Core Pediatric BMI for Age Observation Profile
  • US Core Pediatric Weight for Height Observation Profile
  • US Core Procedure Profile
  • US Core Pulse Oximetry Profile
  • US Core Smoking Status Observation Profile
  • The Vital Signs Profile from the FHIR Specification
• If a system receives a provider in Provenance.agent.who as free text they must capture who sent them the information as the organization. On request they SHALL provide this organization as the source and MAY include the free text provider.
• Systems that need to know the activity has occurred SHOULD populate the activity.

Examples

• Allergyintolerance Provenance Example: A searchset Bundle including both AllergyIntolerance and Provenance

• Text Summary
• Differential Table
• Snapshot Table
• Snapshot Table (Must Support)
• All

This structure is derived from Provenance

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
target	S	1..*	Reference(Resource)	The Resource this Provenance record supports
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
recorded	S	1..1	instant	Timestamp when the activity was recorded / updated
agent	S	1..*	(Slice Definition)	Actor involved Slice: Unordered, Open by pattern:type
agent:All Slices				Content/Rules for all slices
type	S	0..1	CodeableConcept	How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
who	S	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | RelatedPerson | Device)	Who participated
onBehalfOf	SI	0..1	Reference(US Core Organization Profile)	Who the agent is representing provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:ProvenanceAuthor	S	0..*	BackboneElement	Actor involved
type	S	1..1	CodeableConcept	How the agent participated Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: author
agent:ProvenanceTransmitter	S	0..1	BackboneElement	Actor involved
type	S	1..1	CodeableConcept	How the agent participated Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: transmitter
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SΣ	1..*	Reference(Resource)	The Resource this Provenance record supports
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣI	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
occurred[x]		0..1		When the activity occurred
occurredPeriod			Period
occurredDateTime			dateTime
recorded	SΣ	1..1	instant	Timestamp when the activity was recorded / updated
policy		0..*	uri	Policy or plan the activity was defined by
location		0..1	Reference(Location)	Where the activity occurred, if relevant
reason		0..*	CodeableConcept	Reason the activity is occurring Binding: PurposeOfUse (extensible): The reason the activity took place.
activity		0..1	CodeableConcept	Activity that occurred Binding: ProvenanceActivityType (extensible): The activity that took place.
agent	S	1..*	(Slice Definition)	Actor involved Slice: Unordered, Open by pattern:type
agent:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	CodeableConcept	How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	SΣ	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | RelatedPerson | Device)	Who participated
onBehalfOf	SI	0..1	Reference(US Core Organization Profile)	Who the agent is representing provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:ProvenanceAuthor	S	0..*	BackboneElement	Actor involved
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: author
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
onBehalfOf		0..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who the agent is representing
agent:ProvenanceTransmitter	S	0..1	BackboneElement	Actor involved
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: transmitter
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
onBehalfOf		0..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who the agent is representing
entity		0..*	BackboneElement	An entity used in this activity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	Σ	1..1	code	derivation | revision | quotation | source | removal Binding: ProvenanceEntityRole (required): How an entity was used in an activity.
what	Σ	1..1	Reference(Resource)	Identity of entity
agent		0..*	See agent (Provenance)	Entity is attributed to this agent
signature		0..*	Signature	Signature on target
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
target	Σ	1..*	Reference(Resource)	The Resource this Provenance record supports
reference	ΣI	1..1	string	Literal reference, Relative, internal or absolute URL
recorded	Σ	1..1	instant	Timestamp when the activity was recorded / updated
agent		1..*	(Slice Definition)	Actor involved Slice: Unordered, Open by pattern:type
agent:All Slices				Content/Rules for all slices
type	Σ	0..1	CodeableConcept	How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
who	Σ	1..1	Reference(US Core Practitioner Profile)	Who participated
onBehalfOf	I	0..1	Reference(US Core Organization Profile)	Who the agent is representing provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:ProvenanceAuthor		0..*	BackboneElement	Actor involved
type	Σ	1..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: author
agent:ProvenanceTransmitter		0..1	BackboneElement	Actor involved
type	Σ	1..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: transmitter
Documentation for this format

This structure is derived from Provenance

Summary

Mandatory: 5 elements (2 nested mandatory elements)
Must-Support: 11 elements

Structures

This structure refers to these other structures:

• http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
• http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
• http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient
• http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole

Slices

This structure defines the following Slices:

• The element Provenance.agent is sliced based on the value of pattern:type

Differential View

This structure is derived from Provenance

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
target	S	1..*	Reference(Resource)	The Resource this Provenance record supports
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
recorded	S	1..1	instant	Timestamp when the activity was recorded / updated
agent	S	1..*	(Slice Definition)	Actor involved Slice: Unordered, Open by pattern:type
agent:All Slices				Content/Rules for all slices
type	S	0..1	CodeableConcept	How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
who	S	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | RelatedPerson | Device)	Who participated
onBehalfOf	SI	0..1	Reference(US Core Organization Profile)	Who the agent is representing provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:ProvenanceAuthor	S	0..*	BackboneElement	Actor involved
type	S	1..1	CodeableConcept	How the agent participated Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: author
agent:ProvenanceTransmitter	S	0..1	BackboneElement	Actor involved
type	S	1..1	CodeableConcept	How the agent participated Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: transmitter
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SΣ	1..*	Reference(Resource)	The Resource this Provenance record supports
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣI	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
occurred[x]		0..1		When the activity occurred
occurredPeriod			Period
occurredDateTime			dateTime
recorded	SΣ	1..1	instant	Timestamp when the activity was recorded / updated
policy		0..*	uri	Policy or plan the activity was defined by
location		0..1	Reference(Location)	Where the activity occurred, if relevant
reason		0..*	CodeableConcept	Reason the activity is occurring Binding: PurposeOfUse (extensible): The reason the activity took place.
activity		0..1	CodeableConcept	Activity that occurred Binding: ProvenanceActivityType (extensible): The activity that took place.
agent	S	1..*	(Slice Definition)	Actor involved Slice: Unordered, Open by pattern:type
agent:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	CodeableConcept	How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	SΣ	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | RelatedPerson | Device)	Who participated
onBehalfOf	SI	0..1	Reference(US Core Organization Profile)	Who the agent is representing provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:ProvenanceAuthor	S	0..*	BackboneElement	Actor involved
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/provenance-participant-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: author
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
onBehalfOf		0..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who the agent is representing
agent:ProvenanceTransmitter	S	0..1	BackboneElement	Actor involved
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: transmitter
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
role		0..*	CodeableConcept	What the agents role was Binding: SecurityRoleType (example): The role that a provenance agent played with respect to the activity.
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
onBehalfOf		0..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who the agent is representing
entity		0..*	BackboneElement	An entity used in this activity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	Σ	1..1	code	derivation | revision | quotation | source | removal Binding: ProvenanceEntityRole (required): How an entity was used in an activity.
what	Σ	1..1	Reference(Resource)	Identity of entity
agent		0..*	See agent (Provenance)	Entity is attributed to this agent
signature		0..*	Signature	Signature on target
Documentation for this format

Quick Start

Below is an overview of the required set of Server RESTful FHIR interactions - for example, search and read operations - for this profile. See the Capability Statements for a complete list of supported RESTful interactions for this IG.

Mandatory Search Parameters:

The following search parameters, search parameter combinations SHALL be supported. Any listed search parameter modifiers, comparators, chains and composites SHALL also be supported UNLESS they are listed as “optional” in which case they SHOULD be supported.:

1. SHALL support searching for all US Core Profile resource types listed above for a patient and all the Provenance records for those resources using a combination of the patient and _revinclude search parameters:

   GET [base]/[Resource]?patient=[id]&_revinclude=Provenance:target

   Example:

   1. GET [base]/AllergyIntolerance?patient=[id]5&_revinclude=Provenance:target

   Implementation Notes: Fetches a bundle of all resources of a particular type for the specified patient (how to search by reference) and any corresponding Provenance resources.

2. SHALL support searching for a particular instance of a US Core Profile resource type listed above and all its Provenance resources using combination of the _id and the _revinclude search parameters:

   GET [base]/[Resource]?_id=[id]&_revinclude=Provenance:target

   Example:

   1. GET [base]/AllergyIntolerance?_id=[id]&_revinclude=Provenance:target

   Implementation Notes: Fetches a bundle of a resource of a particular type (within the clients authorization scope) and any corresponding Provenance resources. (how to search by token)