This page is part of the CCDA: Consolidated CDA Release (v3.0.0-ballot: CCDA 3.0 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions
This content is an example of the Provenance - Author Participation Logical Model and is not a FHIR Resource
<structuredBody xmlns="urn:hl7-org:v3">
<component>
<!-- Some section in a document -->
<section>
<!-- Provenance Author Participation template -->
<author>
<templateId root="2.16.840.1.113883.10.20.22.5.6" extension="2019-10-01"/>
<time value="201308011235-0800" />
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="1234567890"/>
<code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health Care Provider Taxonomy" displayName="Registered nurse" />
<addr use="WP">
<streetAddressLine>22 Sample Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-2008" use="MC" />
<assignedPerson>
<name>
<given>Nurse</given>
<family>Nightingale</family>
<suffix>RN</suffix>
</name>
</assignedPerson>
<representedOrganization>
<id root="2.16.840.1.113883.4.2" extension="1111-22"/>
<id root="2.16.840.1.113883.4.6" extension="1112233344" />
<name>Good Health Hospital</name>
<telecom value="tel:+1(555)555-2003" />
</representedOrganization>
</assignedAuthor>
</author>
<!-- Provenance Author Participation template for a non-clinician -->
<author>
<templateId root="2.16.840.1.113883.10.20.22.5.6" extension="2019-10-01"/>
<time value="201308011235-0800" />
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" nullFlavor="NA"/>
<addr use="H">
<streetAddressLine>123 Main St</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-8002" use="MC" />
<assignedPerson>
<name>
<given>Patient</given>
<family>Author</family>
</name>
</assignedPerson>
<!-- Represented organization may contain only nullFlavor if non-clinician -->
<representedOrganization nullFlavor="NA" />
</assignedAuthor>
</author>
</section>
</component>
<!-- Elsewhere in the document-->
<component>
<section>
<!-- The same Author can be represented solely via assignedAuthor/id-->
<author>
<templateId root="2.16.840.1.113883.10.20.22.5.6" extension="2019-10-01"/>
<time value="201308011235-0800" />
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="1234567890"/>
<telecom value="tel:+1(555)555-2003" use="HP"/>
</assignedAuthor>
</author>
</section>
</component>
</structuredBody>