Release 5

Publish-box (todo)

Example Provenance/example-anon0 (XML)

Security Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Patient, Practitioner, RelatedPerson

Raw XML (canonical form + also see XML Format Specification)

Example of using Provenance as De-Identifiation linkage with security tag protection, enabling Re-Identification with authorization. (id = "example-anon0")

<?xml version="1.0" encoding="UTF-8"?>

<Bundle xmlns="http://hl7.org/fhir">
  <id value="example-anon0"/> 
        <!--    a search bundle on anon0 patient by a HIGHLY Priviliaged User that is authorized
   to see linkage    -->
  <meta> 
        <lastUpdated value="2014-08-18T01:43:30Z"/> 
        <security> 
                <!--    Bundle confidentiality at high water mark of most sensitive    -->
            <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> 
            <code value="V"/> 
        </security> 
        <security> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> 
            <code value="PSEUDED"/> 
        </security> 
    </meta>  
    <type value="searchset"/>   
    <link> 
        <relation value="self"/> 
        <url value="https://example.com/fhir/Patient/anon0/$everything"/> 
    </link> 

  <entry> 
    <fullUrl value="http://example.org/fhir/Provenance/anon0"/> 
    <resource> 
      <Provenance> 
                    <!--    This Provenance shows a link between real-world and anon for a given patient
            -->
        <id value="anon0"/> 
        <meta> 
          <security> 
                            <!--    Provenance is the link between real-world and anon, so is highest possible confidentiality
                -->
            <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> 
            <code value="V"/> 
          </security> 
          <security> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> 
            <code value="PSEUDED"/> 
          </security> 
        </meta> 

        <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: Provenance</b> <a name="anon0"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
             1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Provenance &quot;anon0&quot; </p> <p style="margin-bottom: 0px">Security Labels: <span title="{http://terminology.hl7.org/CodeSystem/v3-Confidentiality http://terminology.hl7.org/CodeSyst
                em/v3-Confidentiality}">http://terminology.hl7.org/CodeSystem/v3-Confidentiality</span> , <span title="{http://terminology.hl7.org/CodeSystem/v3-ObservationValue http://terminology.hl7.org/CodeSys
                tem/v3-ObservationValue}">http://terminology.hl7.org/CodeSystem/v3-ObservationValue</span> </p> </div> <p> <b> target</b> : <a href="broken-link.html">http://example.org/fhir/Patient/anon0</a> </p> <p> <b> recorded</b> : 27 June 2015, 8:39:24 am</p> <p> <b> policy</b> : <span title="  policy would indicate the rules used for De-Identification, and appropriate purposes
               of use of the data  "><a href="http://example.org/policies/666">http://example.org/policies/666</a> </span> </p> <p> <b> activity</b> : De-Identify (Anononymize) Record Lifecycle Event <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-iso-21089-lifecycle.html">ISO 21089 2017 Health Record Lifecycle Events</a> #deidentify)</span> </p> <h3> Agents</h3> <table class="grid"><tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Who</b> </td> </tr> <tr> <td> *</td> <td> Assembler <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-provenance-participant-type.html">Provenance participant type</a> #assembler)</span> </td> <td> <span> : Device/software</span> </td> </tr> </table> <h3> Entities</h3> <table class="grid"><tr> <td> -</td> <td> <b> Role</b> </td> <td> <b> What</b> </td> </tr> <tr> <td> *</td> <td> source</td> <td> <a href="patient-example.html">Patient/example</a>  &quot;Peter CHALMERS&quot;</td> </tr> </table> </div> </text> <target> 
          <reference value="http://example.org/fhir/Patient/anon0"/> 
        </target> 
        <recorded value="2015-06-27T08:39:24+10:00"/> 
                    <!--    policy would indicate the rules used for De-Identification, and appropriate
         purposes of use of the data    -->
        <policy value="http://example.org/policies/666"/> 
        <activity> 
          <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/iso-21089-lifecycle"/> 
          <code value="deidentify"/> 
          </coding> 
        </activity> 
                    <!--    not identified in original patient compartment as should not show up there (confidentiatlt
        yCode V protected too)    -->
        <agent> 
          <type> 
            <coding> 
                            <system value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/> 
                            <code value="assembler"/> 
            </coding> 
          </type> 
          <who> 
            <display value="Device/software"/> 
          </who> 
        </agent> 
        <entity> 
          <role value="source"/> 
          <what> 
            <reference value="Patient/example"/>     
          </what> 
        </entity> 
      </Provenance> 
    </resource> 
    <search> 
      <mode value="match"/> 
    </search> 
  </entry> 
  <entry> 
    <fullUrl value="http://example.org/fhir/Patient/anon0"/> 
    <resource> 
      <Patient> 
        <id value="anon0"/> 
            <!--    De-Identifed equivilant, removing all direct identifiers, and keeping only minimally
         necessary indirect identifiers    -->
        <meta> 
          <security> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> 
            <code value="L"/> 
          </security> 
          <security> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> 
            <code value="PSEUDED"/> 
          </security> 
        </meta> 

        <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b> First-0 Anon-0 </b>  male, DoB: 1974-12-01</p> <hr/>  </div> </text> <name> 
              <!--    some made up name    -->
          <family value="Anon-0"/> 
          <given value="First-0"/> 
        </name> 
            <!--    male/female gender is needed, and group is big enough.     -->
        <gender value="male"/> 
            <!--    birthdate is generalized to 1st of month of the birth year    -->
        <birthDate value="1974-12-01"/> 
      </Patient> 
    </resource> 
    <search> 
      <mode value="match"/> 
    </search> 
  </entry> 
  <entry> 
    <fullUrl value="http://example.org/fhir/Condition/anon0"/> 
    <resource> 
            <Condition> 
                <id value="anon0"/>  
                    <!--    De-Identified data, change reference to Patient, eliminate free-text, and fuzz
         dates    -->
        <meta> 
          <security> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> 
            <code value="L"/> 
          </security> 
          <security> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> 
            <code value="PSEUDED"/> 
          </security> 
        </meta> 
                <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: Condition</b> <a name="anon0"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
             1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Condition &quot;anon0&quot; </p> <p style="margin-bottom: 0px">Security Labels: <span title="{http://terminology.hl7.org/CodeSystem/v3-Confidentiality http://terminology.hl7.org/CodeSyst
                em/v3-Confidentiality}">http://terminology.hl7.org/CodeSystem/v3-Confidentiality</span> , <span title="{http://terminology.hl7.org/CodeSystem/v3-ObservationValue http://terminology.hl7.org/CodeSys
                tem/v3-ObservationValue}">http://terminology.hl7.org/CodeSystem/v3-ObservationValue</span> </p> </div> <p> <b> clinicalStatus</b> : Active <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-condition-clinical.html">Condition Clinical Status Codes</a> #active)</span> </p> <p> <b> verificationStatus</b> : Confirmed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-condition-ver-status.html">ConditionVerificationStatus</a> #confirmed)</span> </p> <p> <b> category</b> : Encounter Diagnosis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-condition-category.html">Condition Category Codes</a> #encounter-diagnosis; <a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #439401001 &quot;Diagnosis&quot;)</span> </p> <p> <b> severity</b> : Severe <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #24484000)</span> </p> <p> <b> code</b> : Burn of ear <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #39065001)</span> </p> <p> <b> bodySite</b> : Left external ear structure <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #49521004)</span> </p> <p> <b> subject</b> : <a href="broken-link.html">Patient/anon0</a> </p> <p> <b> onset</b> : <span title="  dates aligned to first of month  ">2012-05-01</span> </p> </div> </text> <clinicalStatus>  
                    <coding>  
                        <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>  
                        <code value="active"/>  
                    </coding>  
                </clinicalStatus>  

                <verificationStatus>  
                    <coding>  
                        <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>  
                        <code value="confirmed"/>  
                    </coding>  
                </verificationStatus>  
                <category>  
                    <coding>  
                        <system value="http://terminology.hl7.org/CodeSystem/condition-category"/>  
                        <code value="encounter-diagnosis"/>  
                        <display value="Encounter Diagnosis"/>  
                    </coding>  
                        <!--      and also a SNOMED CT coding      -->
                    <coding>  
                        <system value="http://snomed.info/sct"/>  
                        <code value="439401001"/>  
                        <display value="Diagnosis"/>  
                    </coding>  
                </category>  
                <severity>  
                    <coding>  
                        <system value="http://snomed.info/sct"/>  
                        <code value="24484000"/>  
                        <display value="Severe"/>  
                    </coding>  
                </severity>  
                <code>  
                    <coding>  
                        <system value="http://snomed.info/sct"/>  
                        <code value="39065001"/>  
                        <display value="Burn of ear"/>  
                    </coding>  
                </code>  
                <bodySite>  
                    <coding>  
                        <system value="http://snomed.info/sct"/>  
                        <code value="49521004"/>  
                        <display value="Left external ear structure"/>  
                    </coding>  
                </bodySite>  
                <subject>  
                        <!--    patient as anon0 id    -->
                    <reference value="Patient/anon0"/>  
                </subject>  
                    <!--    dates aligned to first of month    -->
                <onsetDateTime value="2012-05-01"/>  
            </Condition>  
    </resource> 
    <search> 
      <mode value="match"/> 
    </search> 
  </entry> 

</Bundle> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.