Example Usage Scenarios:

The following are example usage scenarios for this 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 Views 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:
  • AllergyIntolerance
  • CarePlan
  • CareTeam
  • Condition
  • Coverage
  • Device
  • DiagnosticReport
  • DocumentReference
  • Encounter
  • Goal
  • Immunization
  • MedicationDispense
  • MedicationRequest
  • Observation
  • Patient
  • Procedure
  • QuestionnaireResponse
  • RelatedPerson
  • ServiceRequest

• 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.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Provenance

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
target	S	1..*	Reference(Resource)	(USCDI) The Resource this Provenance record supports
reference	S	0..1	string	(USCDI) Literal reference, Relative, internal or absolute URL
recorded	S	1..1	instant	(USCDI) Timestamp when the activity was recorded / updated
Slices for agent	SC	1..*	BackboneElement	(USCDI) Actor involved Slice: Unordered, Open by pattern:type provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:All Slices				Content/Rules for all slices
type	S	0..1	CodeableConcept	(USCDI) How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
who	S	1..1	Reference(US Core Organization Profile S | US Core Practitioner Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Who participated
onBehalfOf	S	0..1	Reference(US Core Organization Profile)	(USCDI) Who the agent is representing
agent:ProvenanceAuthor	S	0..*	BackboneElement	(USCDI) Actor involved
type	S	1..1	CodeableConcept	(USCDI) 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..*	BackboneElement	(USCDI) Actor involved
type	S	1..1	CodeableConcept	(USCDI) 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

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Provenance.agent.type	extensible	USCoreProvenancePaticipantTypeCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
provenance-1	error	Provenance.agent	onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device : who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SΣ	1..*	Reference(Resource)	(USCDI) The Resource this Provenance record supports
reference	SΣC	0..1	string	(USCDI) Literal reference, Relative, internal or absolute URL
recorded	SΣ	1..1	instant	(USCDI) Timestamp when the activity was recorded / updated
Slices for agent	SC	1..*	BackboneElement	(USCDI) Actor involved Slice: Unordered, Open by pattern:type provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	CodeableConcept	(USCDI) How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
who	SΣ	1..1	Reference(US Core Organization Profile)	(USCDI) Who participated
onBehalfOf	S	0..1	Reference(US Core Organization Profile)	(USCDI) Who the agent is representing
agent:ProvenanceAuthor	S	0..*	BackboneElement	(USCDI) Actor involved
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	(USCDI) 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
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
agent:ProvenanceTransmitter	S	0..*	BackboneElement	(USCDI) Actor involved
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	(USCDI) 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
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Provenance.agent.type	extensible	USCoreProvenancePaticipantTypeCodes
Provenance.agent:ProvenanceAuthor.type	extensible	Pattern: author
Provenance.agent:ProvenanceTransmitter.type	extensible	Pattern: transmitter

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Provenance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Provenance	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Provenance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
provenance-1	error	Provenance.agent	onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device : who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
id	Σ	0..1	id	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): A human language. Additional Bindings Purpose AllLanguages Max Binding
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)	(USCDI) 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	SΣC	0..1	string	(USCDI) 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	(USCDI) 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.
Slices for agent	SC	1..*	BackboneElement	(USCDI) Actor involved Slice: Unordered, Open by pattern:type provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
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	(USCDI) 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 Organization Profile S | US Core Practitioner Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Who participated
onBehalfOf	S	0..1	Reference(US Core Organization Profile)	(USCDI) Who the agent is representing
agent:ProvenanceAuthor	S	0..*	BackboneElement	(USCDI) 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	(USCDI) 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..*	BackboneElement	(USCDI) 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	(USCDI) 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

Terminology Bindings

Path	Conformance	ValueSet / Code
Provenance.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Provenance.target.type	extensible	ResourceType
Provenance.reason	extensible	PurposeOfUse
Provenance.activity	extensible	ProvenanceActivityType
Provenance.agent.type	extensible	USCoreProvenancePaticipantTypeCodes
Provenance.agent.role	example	SecurityRoleType
Provenance.agent:ProvenanceAuthor.type	extensible	Pattern: author
Provenance.agent:ProvenanceAuthor.role	example	SecurityRoleType
Provenance.agent:ProvenanceTransmitter.type	extensible	Pattern: transmitter
Provenance.agent:ProvenanceTransmitter.role	example	SecurityRoleType
Provenance.entity.role	required	ProvenanceEntityRole

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
provenance-1	error	Provenance.agent	onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device : who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()

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)	(USCDI) The Resource this Provenance record supports
reference	S	0..1	string	(USCDI) Literal reference, Relative, internal or absolute URL
recorded	S	1..1	instant	(USCDI) Timestamp when the activity was recorded / updated
Slices for agent	SC	1..*	BackboneElement	(USCDI) Actor involved Slice: Unordered, Open by pattern:type provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:All Slices				Content/Rules for all slices
type	S	0..1	CodeableConcept	(USCDI) How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
who	S	1..1	Reference(US Core Organization Profile S | US Core Practitioner Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Who participated
onBehalfOf	S	0..1	Reference(US Core Organization Profile)	(USCDI) Who the agent is representing
agent:ProvenanceAuthor	S	0..*	BackboneElement	(USCDI) Actor involved
type	S	1..1	CodeableConcept	(USCDI) 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..*	BackboneElement	(USCDI) Actor involved
type	S	1..1	CodeableConcept	(USCDI) 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

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Provenance.agent.type	extensible	USCoreProvenancePaticipantTypeCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
provenance-1	error	Provenance.agent	onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device : who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
target	SΣ	1..*	Reference(Resource)	(USCDI) The Resource this Provenance record supports
reference	SΣC	0..1	string	(USCDI) Literal reference, Relative, internal or absolute URL
recorded	SΣ	1..1	instant	(USCDI) Timestamp when the activity was recorded / updated
Slices for agent	SC	1..*	BackboneElement	(USCDI) Actor involved Slice: Unordered, Open by pattern:type provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
agent:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	CodeableConcept	(USCDI) How the agent participated Binding: US Core Provenance Participant Type Codes (extensible)
who	SΣ	1..1	Reference(US Core Organization Profile)	(USCDI) Who participated
onBehalfOf	S	0..1	Reference(US Core Organization Profile)	(USCDI) Who the agent is representing
agent:ProvenanceAuthor	S	0..*	BackboneElement	(USCDI) Actor involved
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	(USCDI) 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
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
agent:ProvenanceTransmitter	S	0..*	BackboneElement	(USCDI) Actor involved
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	(USCDI) 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
who	Σ	1..1	Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Device | Organization)	Who participated
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Provenance.agent.type	extensible	USCoreProvenancePaticipantTypeCodes
Provenance.agent:ProvenanceAuthor.type	extensible	Pattern: author
Provenance.agent:ProvenanceTransmitter.type	extensible	Pattern: transmitter

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Provenance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Provenance	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Provenance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Provenance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
provenance-1	error	Provenance.agent	onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device : who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Provenance		0..*	Provenance	US Core Provenance
id	Σ	0..1	id	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): A human language. Additional Bindings Purpose AllLanguages Max Binding
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)	(USCDI) 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	SΣC	0..1	string	(USCDI) 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	(USCDI) 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.
Slices for agent	SC	1..*	BackboneElement	(USCDI) Actor involved Slice: Unordered, Open by pattern:type provenance-1: onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device
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	(USCDI) 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 Organization Profile S | US Core Practitioner Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Who participated
onBehalfOf	S	0..1	Reference(US Core Organization Profile)	(USCDI) Who the agent is representing
agent:ProvenanceAuthor	S	0..*	BackboneElement	(USCDI) 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	(USCDI) 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..*	BackboneElement	(USCDI) 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	(USCDI) 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

Terminology Bindings

Path	Conformance	ValueSet / Code
Provenance.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Provenance.target.type	extensible	ResourceType
Provenance.reason	extensible	PurposeOfUse
Provenance.activity	extensible	ProvenanceActivityType
Provenance.agent.type	extensible	USCoreProvenancePaticipantTypeCodes
Provenance.agent.role	example	SecurityRoleType
Provenance.agent:ProvenanceAuthor.type	extensible	Pattern: author
Provenance.agent:ProvenanceAuthor.role	example	SecurityRoleType
Provenance.agent:ProvenanceTransmitter.type	extensible	Pattern: transmitter
Provenance.agent:ProvenanceTransmitter.role	example	SecurityRoleType
Provenance.entity.role	required	ProvenanceEntityRole

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
provenance-1	error	Provenance.agent	onBehalfOf SHALL be present when Provenance.agent.who is a Practitioner or Device : who.exists((resolve() is Practitioner) or (resolve() is Device)) implies onBehalfOf.exists()

This structure is derived from Provenance

Summary

Mandatory: 0 element (2 nested mandatory elements)
Must-Support: 11 elements

Structures

This structure refers to these other structures:

• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson)

Slices

This structure defines the following Slices:

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

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• The syntax used to describe the interactions is described here.

• Servers providing access to provenance data can use US Core SMART Scopes for:
  • resource level scopes (for example, patient/Provenance.rs).
• See the General Requirements section for additional rules and expectations when a server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

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 theySHOULD 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)