A record of an event made for purposes of maintaining a security log. Typical uses include detection of intrusion attempts and monitoring for inappropriate usage.

Based on IHE-ATNA.

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 it's narrative along with other profiles, value sets, etc.

An Extension

R5: AuditEvent.severity (new:code)

Element AuditEvent.severity has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.severity has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). ATNA will map this to the SYSLOG PRI element.

R5: AuditEvent.basedOn (new:Reference(CarePlan,DeviceRequest,ImmunizationRecommendation,MedicationRequest,NutritionOrder,ServiceRequest,Task))

Element AuditEvent.basedOn has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.basedOn has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

R5: AuditEvent.patient (new:Reference(Patient))

Element AuditEvent.patient has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.patient has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

R5: AuditEvent.encounter (new:Reference(Encounter))

Element AuditEvent.encounter has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.encounter has no mapping targets in FHIR R4. 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 manageable, 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.

Identifier for a family of the event. For example, a menu item, program, rule, policy, function code, application name or URL. It identifies the performed function.

Type of event.

This identifies the performed function. For "Execute" Event Action Code audit records, this identifies the application function performed.

An Extension

R5: AuditEvent.category additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.category is mapped to FHIR R4 element AuditEvent.type as SourceIsBroaderThanTarget. The mappings for AuditEvent.category do not cover the following types: CodeableConcept. The mappings for AuditEvent.category do not cover the following types based on type expansion: text.

The time when the event was recorded.

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.

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.

An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

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 manageable, 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).

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.

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.

The system that is reporting the event.

Since multi-tier, distributed, or composite applications make source identification ambiguous, this collection of fields may repeat for each application or process actively involved in the event. For example, multiple value-sets can identify participating web servers, application processes, and database server threads in an n-tier distributed application. Passive event participants (e.g. low-level network transports) need not be identified.

The event is reported by one source.

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 manageable, 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).

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.

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.

An Extension

R5: AuditEvent.source.observer

Element AuditEvent.source.observer is mapped to FHIR R4 element AuditEvent.source.observer as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element AuditEvent.source.observer with unmapped reference targets: CareTeam.

R5: AuditEvent.severity (new:code)

Element AuditEvent.severity has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.severity has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). ATNA will map this to the SYSLOG PRI element.

R5: AuditEvent.basedOn (new:Reference(CarePlan,DeviceRequest,ImmunizationRecommendation,MedicationRequest,NutritionOrder,ServiceRequest,Task))

Element AuditEvent.basedOn has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.basedOn has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

R5: AuditEvent.patient (new:Reference(Patient))

Element AuditEvent.patient has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.patient has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

R5: AuditEvent.encounter (new:Reference(Encounter))

Element AuditEvent.encounter has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.encounter has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

R5: AuditEvent.category additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.category is mapped to FHIR R4 element AuditEvent.type as SourceIsBroaderThanTarget. The mappings for AuditEvent.category do not cover the following types: CodeableConcept. The mappings for AuditEvent.category do not cover the following types based on type expansion: text.

R5: AuditEvent.code additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.code is mapped to FHIR R4 element AuditEvent.subtype as RelatedTo. The mappings for AuditEvent.code do not cover the following types: CodeableConcept. The mappings for AuditEvent.code do not cover the following types based on type expansion: text.

R5: AuditEvent.occurred[x] additional types (dateTime) additional types from child elements (value)

Element AuditEvent.occurred[x] is mapped to FHIR R4 element AuditEvent.period as SourceIsBroaderThanTarget. The mappings for AuditEvent.occurred[x] do not cover the following types: dateTime. The mappings for AuditEvent.occurred[x] do not cover the following types based on type expansion: value. The time or period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.

R5: AuditEvent.outcome.code (new:Coding)

Element AuditEvent.outcome.code has a context of AuditEvent.outcome based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.outcome.code has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). 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.

R5: AuditEvent.outcome.detail (new:CodeableConcept)

Element AuditEvent.outcome.detail has a context of AuditEvent.outcome based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.outcome.detail has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). A human readable description of the error issue SHOULD be placed in details.text.

R5: AuditEvent.source.site additional types (Reference(http://hl7.org/fhir/StructureDefinition/Location)) additional types from child elements (identifier)

Element AuditEvent.source.site is mapped to FHIR R4 element AuditEvent.source.site as SourceIsBroaderThanTarget. The mappings for AuditEvent.source.site do not cover the following types: Reference. The mappings for AuditEvent.source.site do not cover the following types based on type expansion: identifier.

R5: AuditEvent.source.observer

Element AuditEvent.source.observer is mapped to FHIR R4 element AuditEvent.source.observer as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element AuditEvent.source.observer with unmapped reference targets: CareTeam.

R5: AuditEvent.source.type additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.source.type is mapped to FHIR R4 element AuditEvent.source.type as SourceIsBroaderThanTarget. The mappings for AuditEvent.source.type do not cover the following types: CodeableConcept. The mappings for AuditEvent.source.type do not cover the following types based on type expansion: text.

R5: AuditEvent.entity.agent (new:AuditEvent.agent)

Element AuditEvent.entity.agent has a context of AuditEvent.entity based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.entity.agent has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). 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.

R5: AuditEvent.entity.role additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.entity.role is mapped to FHIR R4 element AuditEvent.entity.role as SourceIsBroaderThanTarget. The mappings for AuditEvent.entity.role do not cover the following types: CodeableConcept. The mappings for AuditEvent.entity.role do not cover the following types based on type expansion: text.

R5: AuditEvent.entity.securityLabel additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.entity.securityLabel is mapped to FHIR R4 element AuditEvent.entity.securityLabel as SourceIsBroaderThanTarget. The mappings for AuditEvent.entity.securityLabel do not cover the following types: CodeableConcept. The mappings for AuditEvent.entity.securityLabel do not cover the following types based on type expansion: text. Copied from entity meta security tags.

R5: AuditEvent.entity.detail.value[x] additional types (Quantity, CodeableConcept, boolean, integer, Range, Ratio, time, dateTime, Period)

Element AuditEvent.entity.detail.value[x] is mapped to FHIR R4 element AuditEvent.entity.detail.value[x] as SourceIsBroaderThanTarget. The mappings for AuditEvent.entity.detail.value[x] do not cover the following types: boolean, CodeableConcept, dateTime, integer, Period, Quantity, Range, Ratio, time. The target context AuditEvent.entity.detail.value[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element AuditEvent.entity.detail.

R5: AuditEvent.entity.detail.type additional types (CodeableConcept) additional types from child elements (coding)

Element AuditEvent.entity.detail.type is mapped to FHIR R4 element AuditEvent.entity.detail.type as SourceIsBroaderThanTarget. The mappings for AuditEvent.entity.detail.type do not cover the following types: CodeableConcept. The mappings for AuditEvent.entity.detail.type do not cover the following types based on type expansion: coding.

A record of an event made for purposes of maintaining a security log. Typical uses include detection of intrusion attempts and monitoring for inappropriate usage.

Based on IHE-ATNA.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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.

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 it's narrative along with other profiles, value sets, etc.

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).

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

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 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.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

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.

An Extension

R5: AuditEvent.severity (new:code)

Element AuditEvent.severity has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.severity has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). ATNA will map this to the SYSLOG PRI element.

R5: AuditEvent.basedOn (new:Reference(CarePlan,DeviceRequest,ImmunizationRecommendation,MedicationRequest,NutritionOrder,ServiceRequest,Task))

Element AuditEvent.basedOn has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.basedOn has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

R5: AuditEvent.patient (new:Reference(Patient))

Element AuditEvent.patient has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.patient has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

R5: AuditEvent.encounter (new:Reference(Encounter))

Element AuditEvent.encounter has a context of AuditEvent based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.encounter has no mapping targets in FHIR R4. 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 manageable, 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.

Identifier for a family of the event. For example, a menu item, program, rule, policy, function code, application name or URL. It identifies the performed function.

Type of event.

This identifies the performed function. For "Execute" Event Action Code audit records, this identifies the application function performed.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: AuditEvent.category additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.category is mapped to FHIR R4 element AuditEvent.type as SourceIsBroaderThanTarget. The mappings for AuditEvent.category do not cover the following types: CodeableConcept. The mappings for AuditEvent.category do not cover the following types based on type expansion: text.

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 reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

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.

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.

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.

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.

Identifier for the category of event.

Sub-type of event.

This field enables queries of messages by implementation-defined event categories.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: AuditEvent.code additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.code is mapped to FHIR R4 element AuditEvent.subtype as RelatedTo. The mappings for AuditEvent.code do not cover the following types: CodeableConcept. The mappings for AuditEvent.code do not cover the following types based on type expansion: text.

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 reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

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.

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.

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.

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.

Indicator for type of action performed during the event that generated the audit.

Indicator for type of action performed during the event that generated the event.

This broadly indicates what kind of action was done on the AuditEvent.entity by the AuditEvent.agent.

The period during which the activity occurred.

The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: AuditEvent.occurred[x] additional types (dateTime) additional types from child elements (value)

Element AuditEvent.occurred[x] is mapped to FHIR R4 element AuditEvent.period as SourceIsBroaderThanTarget. The mappings for AuditEvent.occurred[x] do not cover the following types: dateTime. The mappings for AuditEvent.occurred[x] do not cover the following types based on type expansion: value. The time or period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.

The start of the period. The boundary is inclusive.

If the low element is missing, the meaning is that the low boundary is not known.

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

The time when the event was recorded.

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.

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.

Indicates whether the event succeeded or failed.

unique id for the element within a resource (for internal references)

An Extension

R5: AuditEvent.outcome.code (new:Coding)

Element AuditEvent.outcome.code has a context of AuditEvent.outcome based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.outcome.code has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). 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.

R5: AuditEvent.outcome.detail (new:CodeableConcept)

Element AuditEvent.outcome.detail has a context of AuditEvent.outcome based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.outcome.detail has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). A human readable description of the error issue SHOULD be placed in details.text.

Primitive value for code

A free text description of the outcome of the event.

The purposeOfUse (reason) that was used during the event being recorded.

Use AuditEvent.agent.purposeOfUse when you know that it is specific to the agent, otherwise use AuditEvent.purposeOfEvent. 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.

The reason the activity took place.

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.

An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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 manageable, 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.

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.

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 manageable, 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).

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.

Specification of the participation type the user plays when performing the event.

The Participation type of the agent to the event.

The security role that the user was acting under, that come from local codes defined by the access control security system (e.g. RBAC, ABAC) used in the local context.

Should be roles relevant to the event. Should not be an exhaustive list of roles.

What security role enabled the agent to participate in the event.

This value ties an audited event to a user's role(s). It is an optional value that might be used to group events for analysis by user functional role categories.

Reference to who this agent is that was involved in the event.

Where a User ID is available it will go into who.identifier.

This field ties an audit event to a specific resource or identifier.

Alternative agent Identifier. For a human, this should be a user identifier text string from authentication system. This identifier would be one known to a common authentication system (e.g. single sign-on), if available.

In some situations, a human user may authenticate with one identity but, to access a specific application system, may use a synonymous identify. For example, some "single sign on" implementations will do this. The alternative identifier would then be the original identify used for authentication, and the User ID is the one known to and used by the application.

Human-meaningful name for the agent.

The User ID and Authorization User ID may be internal or otherwise obscure values. This field assists the auditor in identifying the actual user.

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.

Where the event occurred.

The policy or plan that authorized the activity being recorded. 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.

Type of media involved. Used when the event is about exporting/importing onto media.

Used when the event is about exporting/importing onto media.

Usually, this is used instead of specifying a network address. This field is not used for Media Id (i.e. the serial number of a CD).

Logical network location for application activity, if the activity has a network location.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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 manageable, 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.

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.

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 manageable, 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).

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.

An identifier for the network access point of the user device for the audit event.

This could be a device id, IP address or some other identifier associated with a device.

This datum identifies the user's network access point, which may be distinct from the server that performed the action. It is an optional value that may be used to group events recorded on separate servers for analysis of a specific network access point's data access across all servers.

An identifier for the type of network access point that originated the audit event.

The type of network access point of this agent in the audit event.

This datum identifies the type of network access point identifier of the user device for the audit event. It is an optional value that may be used to group events recorded on separate servers for analysis of access according to a network access point's type.

The reason (purpose of use), specific to this agent, that was used during the event being recorded.

Use AuditEvent.agent.purposeOfUse when you know that is specific to the agent, otherwise use AuditEvent.purposeOfEvent. 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.

The reason the activity took place.

The system that is reporting the event.

Since multi-tier, distributed, or composite applications make source identification ambiguous, this collection of fields may repeat for each application or process actively involved in the event. For example, multiple value-sets can identify participating web servers, application processes, and database server threads in an n-tier distributed application. Passive event participants (e.g. low-level network transports) need not be identified.

The event is reported by one source.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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 manageable, 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.

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.

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 manageable, 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).

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.

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.

unique id for the element within a resource (for internal references)

An Extension

R5: AuditEvent.source.site additional types (Reference(http://hl7.org/fhir/StructureDefinition/Location)) additional types from child elements (identifier)

Element AuditEvent.source.site is mapped to FHIR R4 element AuditEvent.source.site as SourceIsBroaderThanTarget. The mappings for AuditEvent.source.site do not cover the following types: Reference. The mappings for AuditEvent.source.site do not cover the following types based on type expansion: identifier.

The actual value

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.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: AuditEvent.source.observer

Element AuditEvent.source.observer is mapped to FHIR R4 element AuditEvent.source.observer as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element AuditEvent.source.observer with unmapped reference targets: CareTeam.

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.

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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

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).

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.

Code specifying the type of source where event originated.

Code specifying the type of system that detected and recorded the event.

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.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: AuditEvent.source.type additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.source.type is mapped to FHIR R4 element AuditEvent.source.type as SourceIsBroaderThanTarget. The mappings for AuditEvent.source.type do not cover the following types: CodeableConcept. The mappings for AuditEvent.source.type do not cover the following types based on type expansion: text.

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 reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

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.

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.

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.

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.

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.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: AuditEvent.entity.agent (new:AuditEvent.agent)

Element AuditEvent.entity.agent has a context of AuditEvent.entity based on following the parent source element upwards and mapping to AuditEvent. Element AuditEvent.entity.agent has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). 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.

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 manageable, 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).

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.

Identifies a specific instance of the entity. The reference should be version specific.

The type of the object that was involved in this audit event.

This value is distinct from the user's role or any user relationship to the entity.

Code for the entity type involved in the audit event.

To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

Code representing the role the entity played in the event being audited.

Code representing the role the entity played in the audit event.

For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: AuditEvent.entity.role additional types (CodeableConcept) additional types from child elements (text)

Element AuditEvent.entity.role is mapped to FHIR R4 element AuditEvent.entity.role as SourceIsBroaderThanTarget. The mappings for AuditEvent.entity.role do not cover the following types: CodeableConcept. The mappings for AuditEvent.entity.role do not cover the following types based on type expansion: text.

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 reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

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.

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.

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.

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.

Identifier for the data life-cycle stage for the entity.

This can be used to provide an audit trail for data, over time, as it passes through the system.

Identifier for the data life-cycle stage for the entity.

Institutional policies for privacy and security may optionally fall under different accountability rules based on data life cycle. This provides a differentiating value for those cases.

Security labels for the identified entity.

Copied from entity meta security tags.

Security Labels from the Healthcare Privacy and Security Classification System.

This field identifies the security labels for a specific instance of an object, such as a patient, to detect/track privacy and security issues.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.