Generated Narrative: StructureDefinition profile-AuditEvent Name Flags Card. Type Description & Constraints AuditEvent 0..* AuditEvent(5.0.0) Record of an event #xD; meta #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:meta 0..1 Meta DSTU2: meta additional types URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.meta #xD; text #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:text 0..1 (Complex) DSTU2: text additional types URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.text #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:outcomeDesc 0..1 string DSTU2: Description of the event outcome (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.event.outcomeDesc #xD; outcome #xD; code #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:outcome 0..1 code DSTU2: outcome additional codes URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.event.outcome Binding: AuditEventOutcome (required): Indicates whether the event succeeded or failed #xD; agent #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:userId 0..1 Identifier DSTU2: Unique identifier for the user (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.participant.userId #xD; extension:altId 0..1 string DSTU2: Alternative User id e.g. authentication (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.participant.altId #xD; extension:name 0..1 string DSTU2: Human-meaningful name for the user (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.participant.name #xD; extension:media 0..1 Coding DSTU2: Type of media (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.participant.media Binding: R2Dicm405MediatypeForR5 (0.1.0) (extensible): Used when the event is about exporting/importing onto media. #xD; extension:address 0..1 string DSTU2: Identifier for the network access point of the user device (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.participant.network.address #xD; extension:type 0..1 code DSTU2: The type of network access point (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.participant.network.type Binding: R2NetworkTypeForR5 (0.1.0) (required): The type of network access point of this participant in the audit event #xD; who #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:reference 0..1 Reference(Resource) DSTU2: Direct reference to resource URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; location #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:location 0..1 Reference(Resource) DSTU2: Where additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; source #xD; site #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:site 0..1 string DSTU2: site additional types URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.source.site #xD; observer #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:identifier 0..1 Identifier DSTU2: identifier additional types URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.source.identifier #xD; entity #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:type 0..1 Coding DSTU2: Type of object involved (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.object.type Binding: R2ObjectTypeForR5 (0.1.0) (extensible): Code for the object type involved audited. #xD; extension:lifecycle 0..1 Coding DSTU2: Life-cycle stage for the object (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.object.lifecycle Binding: R2ObjectLifecycleForR5 (0.1.0) (extensible): Identifier for the data life-cycle stage for the object. #xD; extension:name 0..1 string DSTU2: Instance-specific descriptor for Object (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.object.name #xD; extension:description 0..1 string DSTU2: Descriptive text (new) URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.object.description #xD; what #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:identifier 0..1 Identifier DSTU2: Specific instance of object (e.g. versioned) additional types URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.object.identifier #xD; extension:reference 0..1 Reference(Resource) DSTU2: Specific instance of resource (e.g. versioned) additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; detail #xD; type #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:type 0..1 string DSTU2: type additional types URL: http://hl7.org/fhir/1.0/StructureDefinition/extension-AuditEvent.object.detail.type #xD; Documentation for this format
Cross-version Profile for DSTU2.AuditEvent for use in FHIR R5
This cross-version profile allows DSTU2 AuditEvent content to be represented via FHIR R5 AuditEvent resources.
A record of an event relevant for purposes such as operations, privacy, security, maintenance, and performance analysis.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
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()
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
Entity, Role, or Act,ControlAct[moodCode=EVN]
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Must have either extensions or value[x], not both
DSTU2: `AuditEvent.meta` additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)
Element `AuditEvent.meta` is mapped to FHIR R5 element `AuditEvent.meta` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.meta` do not cover the following types: Meta. The mappings for `AuditEvent.meta` do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.
The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
When the resource last changed - e.g. when the version changed.
This element is generally omitted in instances submitted in a PUT or POST. Instead, it is populated in the response instance and when retrieving information using a GET. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R5/http.html#read) interaction.
Identifies where the resource comes from
A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R5/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R5/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R5/structuredefinition-definitions.html#StructureDefinition.url).
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
DSTU2: `AuditEvent.text` additional types (Narrative) additional types from child elements (div, status)
Element `AuditEvent.text` is mapped to FHIR R5 element `AuditEvent.text` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.text` do not cover the following types: Narrative. The mappings for `AuditEvent.text` do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.
generated | extensions | additional | empty
The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.
The actual narrative content, a stripped down version of XHTML.
The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.
The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, elements (either name or href), images and internally contained style attributes
The narrative SHALL have some non-whitespace content
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
DSTU2: Description of the event outcome (new)
DSTU2: `AuditEvent.event.outcomeDesc` (new:string)
Element `AuditEvent.event.outcomeDesc` has a context of AuditEvent based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.event.outcomeDesc` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Codes that classify the general type of event that happened.
.code (type, subtype and action are pre-coordinated or sent as translations)
Describes what happened. The most specific code for the event.
This field enables queries of messages by implementation-defined event categories.
Type of action performed during the event
Indicator for type of action performed during the event that generated the audit.
This broadly indicates what kind of action was done on the AuditEvent.entity by the AuditEvent.agent.
emergency | alert | critical | error | warning | notice | informational | debug
Indicates and enables segmentation of various severity including debugging from critical.
ATNA will map this to the SYSLOG PRI element.
This is in the SysLog header, PRI. http://tools.ietf.org/html/rfc5424#appendix-A.3
The time or period during which the activity occurred.
The time or period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.
In a distributed system, some sort of common time base (e.g. an NTP [RFC1305] server) is a good implementation tactic.
This ties an event to a specific date and time. Security audits typically require a consistent time base (e.g. UTC), to eliminate time-zone issues arising from geographical distribution.
Indicates whether the event succeeded or failed. A free text descripiton can be given in outcome.text.
In some cases a "success" may be partial, for example, an incomplete or interrupted transfer of a radiological study. For the purpose of establishing accountability, these distinctions are not relevant.
when a code is given there must be one code from the given codeSystem, and may be other equivilant codes from other codeSystems (for example http response codes such as 2xx, 4xx, or 5xx).
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Indicates whether the event succeeded or failed.
when a code is given there must be one code from the given codeSystem.
EventOutcomeIndicator EventOutcomeIndicator
DSTU2: `AuditEvent.event.outcome` additional codes
Element `AuditEvent.event.outcome` is mapped to FHIR R5 element `AuditEvent.outcome.code` as `SourceIsNarrowerThanTarget`. The mappings for `AuditEvent.event.outcome` do not allow expression of the necessary codes, per the bindings on the source and target. In some cases a "success" may be partial, for example, an incomplete or interrupted transfer of a radiological study. For the purpose of establishing accountability, these distinctions are not relevant.
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Additional details about the error. This may be a text description of the error or a system code that identifies the error.
A human readable description of the error issue SHOULD be placed in details.text.
A code that provides details as the exact issue.
The authorization (e.g., PurposeOfUse) that was used during the event being recorded.
Use AuditEvent.agent.authorization when you know that it is specific to the agent, otherwise use AuditEvent.authorization. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.
Record of any relevant security context, not restricted to purposeOfUse valueSet. May include security compartments, refrain, obligation, or other security tags.
The authorized purposeOfUse for the activity.
* .reasonCode [ControlActReason when Act.class = CACT Control Act] *.outboundRelationship[typeCode=RSON].target
Workflow authorization within which this event occurred
Allows tracing of authorizatino for the events and tracking whether proposals/recommendations were acted upon.
The patient is the subject of the data used/created/updated/deleted during the activity
The patient element is available to enable deterministic tracking of activities that involve the patient as the subject of the data used in an activity.
When the .patient is populated it shall be accurate to the subject of the used data. The .patient shall not be populated when the used data used/created/updated/deleted (.entity) by the activity does not involve a subject. Note that when the patient is an agent, they will be recorded as an agent. When the Patient resource is Created, Updated, or Deleted it will be recorded as an entity.
Encounter within which this event occurred or which the event is tightly associated
This will typically be the encounter the event occurred, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission lab tests).
An actor taking an active role in the event or activity that is logged.
Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity. For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity. When a network are used in an event being recorded, there should be distinct agent elements for the known actors using the network. The agent with a network detail would be the responsible agent for use of that network.
An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.
DSTU2: Unique identifier for the user (new)
DSTU2: `AuditEvent.participant.userId` (new:Identifier)
Element `AuditEvent.participant.userId` has a context of AuditEvent.agent based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.participant.userId` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). a unique value within the Audit Source ID. For node-based authentication -- where only the system hardware or process, but not a human user, is identified -- User ID would be the node name.
DSTU2: Alternative User id e.g. authentication (new)
DSTU2: `AuditEvent.participant.altId` (new:string)
Element `AuditEvent.participant.altId` has a context of AuditEvent.agent based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.participant.altId` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).
DSTU2: Human-meaningful name for the user (new)
DSTU2: `AuditEvent.participant.name` (new:string)
Element `AuditEvent.participant.name` has a context of AuditEvent.agent based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.participant.name` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).
DSTU2: `AuditEvent.participant.media` (new:Coding)
Element `AuditEvent.participant.media` has a context of AuditEvent.agent based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.participant.media` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).
DSTU2: Identifier for the network access point of the user device (new)
DSTU2: `AuditEvent.participant.network.address` (new:string)
Element `AuditEvent.participant.network.address` has a context of AuditEvent.agent.network[x] based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.participant.network.address` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). The target context `AuditEvent.agent.network[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `AuditEvent.agent`. This could be a device id, IP address or some other identifier associated with a device.
DSTU2: The type of network access point (new)
DSTU2: `AuditEvent.participant.network.type` (new:code)
Element `AuditEvent.participant.network.type` has a context of AuditEvent.agent.network[x] based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.participant.network.type` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). The target context `AuditEvent.agent.network[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `AuditEvent.agent`.
The Functional Role of the user when performing the event.
For example: assembler, author, prescriber, signer, investigator, etc.
Functional roles reflect functional aspects of relationships between entities. Functional roles are bound to the realization/performance of acts, where actions might be concatenated to an activity or even to a process. This element will hold the functional role that the agent played in the activity that is the focus of this Provenance. Where an agent played multiple functional roles, they will be listed as multiple .agent elements representing each functional participation. See ISO 21298:2018 - Health Informatics - Functional and structural roles, and ISO 22600-2:2014 - Health Informatics - Privilege Management and Access Control - Part 2: formal models.
The Participation type of the agent to the event.
The structural roles of the agent indicating the agent's competency. The security role enabling the agent with respect to the activity.
For example: Chief-of-Radiology, Nurse, Physician, Medical-Student, etc.
Structural roles reflect the structural aspects of relationships between entities. Structural roles describe prerequisites, feasibilities, or competences for acts. Functional roles reflect functional aspects of relationships between entities. Functional roles are bound to the realization/performance of acts, where actions might be concatenated to an activity or even to a process. See ISO 21298:2018 - Health Informatics - Functional and structural roles, and ISO 22600-2:2014 - Health Informatics - Privilege Management and Access Control - Part 2: formal models..
What security role enabled the agent to participate in the event.
Reference to who this agent is that was involved in the event.
Where a User ID is available it will go into who.identifier. Where a name of the user (human readable) it will go into who.display.
This field ties an audit event to a specific resource or identifier.
DSTU2: `AuditEvent.participant.reference`
Element `AuditEvent.participant.reference` is mapped to FHIR R5 element `AuditEvent.agent.who` as `RelatedTo`. The standard extension `alternate-reference` has been mapped as the representation of FHIR DSTU2 element `AuditEvent.participant.reference` with unmapped reference targets: Device, Organization, Patient, Practitioner, RelatedPerson.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient") - must be a resource in resources
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). This element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Indicator that the user is or is not the requestor, or initiator, for the event being audited.
There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.
This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.
If participation.typeCode was author, then true
The agent location when the event occurred
Where the agent location is known, the agent location when the event occurred.
* Role.Class =SDLOC *Role.Code = ServiceDeliveryLocationRoleType *Entity.Code = PlaceEntityType = df.Types of places for Entity.Class = PLC *EntityClass = PLC = df.A physical place or site with its containing structure. May be natural or man-made. The geographic position of a place might or might not be constant.
DSTU2: `AuditEvent.participant.location` additional types from child elements (display, reference)
Element `AuditEvent.participant.location` is mapped to FHIR R5 element `AuditEvent.agent.location` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.participant.location` do not cover the following types based on type expansion: display, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR DSTU2 element `AuditEvent.participant.location` with unmapped reference targets: Location.
Policy that authorized the agent participation in the event
Where the policy(ies) are known that authorized the agent participation in the event. Typically, a single activity may have multiple applicable policies, such as patient consent, guarantor funding, etc. The policy would also indicate the security token used.
For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element.
This value is used retrospectively to determine the authorization policies.
This agent network location for the activity
When the event utilizes a network there should be an agent describing the local system, and an agent describing remote system, with the network interface details.
When remote network endpoint is known, another agent representing the remote agent would indicate the remote network endpoint used. Convention is to indicate data flowing from Source to Destination. The convention for Search, given data flows both ways (query parameters vs results), is to have the Source as the initiator of the Search Transaction, and the Destination the responder to the Search transaction.
When a network protocol is used the endpoint is associated with the agent most directly using the endpoint. This is usually the software agent that has implemented the application level protocol. Preference is to define network in terms of a Reference(Endpoint), or URI; use string only when address or hostname is all that is known. When encoding using string it is best to encode using the formal canonical host name, but if you can't, then you can encode numeric in Literal address form using square brackets '[]' as a v4 string (in dotted notation), or v6 string (in colon notation).
NetworkAccessPointID and NetworkAccessPointTypeCode
Use AuditEvent.agent.authorization when you know that is specific to the agent, otherwise use AuditEvent.authorization. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.
*.reasonCode [ActHealthInformationPurposeOfUseReason codes/v:PurposeOfUse (2.16.840.1.113883.1.11.20448) * .outboundRelationship[typeCode=RSON or SUBJ].target
Events are reported by the actor that detected them. This may be one of the participating actors, but may also be different. The actor may be a human such as a medical-records clerk disclosing data manually, that clerk would be the source for the record of disclosure.
.participation[typeCode=INF].role[classCode=ASSIGN].player[classCode=DEV, determinerCode=INSTANCE]
Logical source location within the enterprise
Logical source location within the healthcare enterprise network. For example, a hospital or other provider location within a multi-entity provider group.
This value differentiates among the sites in a multi-site enterprise health information system.
DSTU2: `AuditEvent.source.site` additional types (string) additional types from child elements (value)
Element `AuditEvent.source.site` is mapped to FHIR R5 element `AuditEvent.source.site` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.source.site` do not cover the following types: string. The mappings for `AuditEvent.source.site` do not cover the following types based on type expansion: value.
The identity of source detecting the event
Identifier of the source where the event was detected.
This field ties the event to a specific source system. It may be used to group events for analysis according to where the event was detected.
DSTU2: `AuditEvent.source.identifier` additional types (Identifier) additional types from child elements (period, system, type, use, value)
Element `AuditEvent.source.identifier` is mapped to FHIR R5 element `AuditEvent.source.observer` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.source.identifier` do not cover the following types: Identifier. The mappings for `AuditEvent.source.identifier` do not cover the following types based on type expansion: period, system, type, use, value.
The type of source where event originated
Code specifying the type of source where event originated.
This field indicates which type of source is identified by the Audit Source ID. It is an optional value that may be used to group events for analysis according to the type of source where the event occurred.
Code specifying the type of system that detected and recorded the event. Use of these codes is not required but is encouraged to maintain translation with DICOM AuditMessage schema.
Specific instances of data or objects that have been accessed.
Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.
The event may have other entities involved.
.outboundRelationship[typeCode=SUBJ].target or .participation[typeCode=SBJ].role
DSTU2: `AuditEvent.object.type` (new:Coding)
Element `AuditEvent.object.type` has a context of AuditEvent.entity based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.object.type` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). This value is distinct from the user's role or any user relationship to the participant object.
DSTU2: Life-cycle stage for the object (new)
DSTU2: `AuditEvent.object.lifecycle` (new:Coding)
Element `AuditEvent.object.lifecycle` has a context of AuditEvent.entity based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.object.lifecycle` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). This can be used to provide an audit trail for data, over time, as it passes through the system.
DSTU2: Instance-specific descriptor for Object (new)
DSTU2: `AuditEvent.object.name` (new:string)
Element `AuditEvent.object.name` has a context of AuditEvent.entity based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.object.name` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). This field may be used in a query/report to identify audit events for a specific person. For example, where multiple synonymous Participant Object IDs (patient number, medical record number, encounter number, etc.) have been used.
DSTU2: `AuditEvent.object.description` (new:string)
Element `AuditEvent.object.description` has a context of AuditEvent.entity based on following the parent source element upwards and mapping to `AuditEvent`. Element `AuditEvent.object.description` has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).
Identifies a specific instance of the entity. The reference should be version specific. This is allowed to be a Parameters resource.
Use .what.display when all you have is a string (e.g. ParticipantObjectName).
ParticipantObjectTypeCode, ParticipantObjectName, ParticipantObjectID and ParticipantObjectIDTypeCode
Provenance.target, Provenance.entity.what
DSTU2: Specific instance of object (e.g. versioned) additional types
DSTU2: `AuditEvent.object.identifier` additional types (Identifier) additional types from child elements (period, system, type, use, value)
Element `AuditEvent.object.identifier` is mapped to FHIR R5 element `AuditEvent.entity.what` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.object.identifier` do not cover the following types: Identifier. The mappings for `AuditEvent.object.identifier` do not cover the following types based on type expansion: period, system, type, use, value. Identifier detail depends on object type.
DSTU2: Specific instance of resource (e.g. versioned) additional types
DSTU2: `AuditEvent.object.reference` additional types from child elements (display, reference)
Element `AuditEvent.object.reference` is mapped to FHIR R5 element `AuditEvent.entity.what` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.object.reference` do not cover the following types based on type expansion: display, reference. The standard extension `alternate-reference` has been mapped as the representation of FHIR DSTU2 element `AuditEvent.object.reference` with unmapped reference targets: Resource.
Code representing the role the entity played in the event being audited.
For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.
role.code (not sure what this would mean for an Act)
Security labels for the identified entity.
This field identifies the security labels for a specific instance of an object, such as a patient, to detect/track privacy and security issues.
Example Security Labels from the Healthcare Privacy and Security Classification System.
The query parameters for a query-type entities.
The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example, if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob. The DICOM AuditMessage schema does not support both .name and .query being populated.
For query events, it may be necessary to capture the actual query input to the query process in order to identify the specific event. Because of differences among query implementations and data encoding for them, this is a base 64 encoded data blob. It may be subsequently decoded or interpreted by downstream audit analysis processing.
Tagged value pairs for conveying additional information about the entity.
Implementation-defined data about specific details of the object accessed or used.
.inboundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN]
The type of extra detail provided in the value.
Additional detail about an entity used in an event.
DSTU2: `AuditEvent.object.detail.type` additional types (string) additional types from child elements (value)
Element `AuditEvent.object.detail.type` is mapped to FHIR R5 element `AuditEvent.entity.detail.type` as `SourceIsBroaderThanTarget`. The mappings for `AuditEvent.object.detail.type` do not cover the following types: string. The mappings for `AuditEvent.object.detail.type` do not cover the following types based on type expansion: value.
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Should not duplicate the entity value unless absolutely necessary.
The entity is attributed to an agent to express the agent's responsibility for that entity in the activity. This is most used to indicate when persistence media (the entity) are used by an agent. For example when importing data from a device, the device would be described in an entity, and the user importing data from that media would be indicated as the entity.agent.
A usecase where one AuditEvent.entity.agent is used where the Entity that was used in the creation/updating of a target resource, is not in the context of the same custodianship as the target resource, and thus the meaning of AuditEvent.entity.agent is to say that the entity referenced is managed elsewhere and that this Agent provided access to it. This would be similar to where the Entity being referenced is managed outside FHIR, such as through HL7 V2, v3, or XDS. This might be where the Entity being referenced is managed in another FHIR resource server. Thus it explains the provenance of that Entity's use in the context of this AuditEvent activity.