Da Vinci Clinical Data Exchange (CDex)
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This page is part of the Da Vinci Clinical Documentation Exchange (v2.0.0: STU2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Data Type Profile: CDexSignature - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the cdex-signature data type profile.

Guidance on how to interpret the contents of this table can be found here.

1. Signature
Definition

A JWS digital signature along with supporting context.

A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.

InvariantsDefined on this element
cdex-13: The signature element must have either reference to the signer or the signer's identifier and name. (: who.reference.exists() or (who.identifier.exists() and who.display.exists()))
2. Signature.type
Must Supporttrue
SlicingThis element introduces a set of slices on Signature.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
3. Signature.type:verify
SliceNameverify
Control1..1
Must Supporttrue
Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="urn:iso-astm:E1762-95:2013"/>
  <code value="1.2.840.10065.1.12.1.5"/>
  <display value="Verification Signature"/>
</valueCoding>
4. Signature.when
Must Supporttrue
5. Signature.who
TypeReference(USCorePractitionerProfile|USCoreOrganizationProfile|USCorePractitionerRoleProfile|Practitioner|PractitionerRole|RelatedPerson|Patient|Device|Organization)
Must Supporttrue
Must Support TypesReference(USCorePractitionerProfile|USCoreOrganizationProfile)
6. Signature.who.reference
Control0..? This element is affected by the following invariants: cdex-13
Must Supporttrue
7. Signature.who.identifier
Definition

NPI or Tax ID representing the Provider or Organization

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..? This element is affected by the following invariants: cdex-13
Must Supporttrue
8. Signature.who.identifier.type
Control1..?
BindingThe codes SHALL be taken from CDex Identifier Types Value Set
Must Supporttrue
9. Signature.who.identifier.value
Control1..?
Must Supporttrue
10. Signature.who.display
Control0..? This element is affected by the following invariants: cdex-13
Must Supporttrue
11. Signature.data
Control10..1
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here.

1. Signature
Definition

A JWS digital signature along with supporting context.

A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.

Control0..* This element is affected by the following invariants: ele-1
Comments

The elements of the Signature Resource are for ease of access of these elements. For digital signatures (Xml DigSig, JWS), the non-repudiation proof comes from the Signature validation, which includes validation of the referenced objects (e.g. Resources) (a.k.a., Content) in the XML-Signature Detached form.

InvariantsDefined on this element
cdex-13: The signature element must have either reference to the signer or the signer's identifier and name. (: who.reference.exists() or (who.identifier.exists() and who.display.exists()))
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
2. Signature.type
Definition

An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

Control1..*
BindingThe codes SHOULD be taken from SignatureTypeCodes

An indication of the reason that an entity signed the object.

TypeCoding
Must Supporttrue
Summarytrue
Comments

Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Signature.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
3. Signature.type:verify
SliceNameverify
Definition

An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

Control1..1*
BindingThe codes SHOULD be taken from SignatureTypeCodes

An indication of the reason that an entity signed the object.

TypeCoding
Must Supporttrue
Summarytrue
Comments

Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="urn:iso-astm:E1762-95:2013"/>
  <code value="1.2.840.10065.1.12.1.5"/>
  <display value="Verification Signature"/>
</valueCoding>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Signature.when
Definition

When the digital signature was signed.

Control1..1
Typeinstant
Must Supporttrue
Summarytrue
Comments

This should agree with the information in the signature.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Signature.who
Definition

A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).

Control1..1
TypeReference(USCorePractitionerProfile|USCoreOrganizationProfile|USCorePractitionerRoleProfile|Practitioner|PractitionerRole|RelatedPerson|Patient|Device|Organization)
Must Supporttrue
Must Support TypesReference(USCorePractitionerProfile|USCoreOrganizationProfile)
Summarytrue
Comments

This should agree with the information in the signature.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Signature.who.reference
Definition

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.

Control0..1 This element is affected by the following invariants: ref-1, cdex-13
Typestring
Must Supporttrue
Summarytrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Signature.who.identifier
Definition

NPI or Tax ID representing the Provider or Organization

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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1 This element is affected by the following invariants: cdex-13
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
8. Signature.who.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. Signature.who.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control10..1
BindingThe codes SHALL be taken from CDex Identifier Types Value SetThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
10. Signature.who.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control10..1
Typestring
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. Signature.who.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control0..1 This element is affected by the following invariants: cdex-13
Typestring
Must Supporttrue
Summarytrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Signature.data
Definition

The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

Control10..1
Typebase64Binary
Must Supporttrue
Summaryfalse
Comments

Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here.

1. Signature
Definition

A JWS digital signature along with supporting context.

Control0..* This element is affected by the following invariants: ele-1
Comments

The elements of the Signature Resource are for ease of access of these elements. For digital signatures (Xml DigSig, JWS), the non-repudiation proof comes from the Signature validation, which includes validation of the referenced objects (e.g. Resources) (a.k.a., Content) in the XML-Signature Detached form.

2. Signature.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
3. Signature.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Signature.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. Signature.type
Definition

An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

Control1..*
BindingThe codes SHOULD be taken from SignatureTypeCodes An indication of the reason that an entity signed the object
TypeCoding
Must Supporttrue
Summarytrue
Comments

Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Signature.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
5. Signature.type:verify
SliceNameverify
Definition

An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

Control1..1
BindingThe codes SHOULD be taken from SignatureTypeCodes An indication of the reason that an entity signed the object
TypeCoding
Must Supporttrue
Summarytrue
Comments

Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="urn:iso-astm:E1762-95:2013"/>
  <code value="1.2.840.10065.1.12.1.5"/>
  <display value="Verification Signature"/>
</valueCoding>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Signature.when
Definition

When the digital signature was signed.

Control1..1
Typeinstant
Must Supporttrue
Summarytrue
Comments

This should agree with the information in the signature.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Signature.who
Definition

A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).

Control1..1
TypeReference(USCorePractitionerProfile|USCoreOrganizationProfile|USCorePractitionerRoleProfile)
Must Supporttrue
Must Support TypesReference(USCorePractitionerProfile|USCoreOrganizationProfile)
Summarytrue
Comments

This should agree with the information in the signature.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
8. Signature.who.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
9. Signature.who.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Signature.who.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
10. Signature.who.reference
Definition

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.

Control0..1 This element is affected by the following invariants: ref-1, cdex-13
Typestring
Must Supporttrue
Summarytrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. Signature.who.type
Definition

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).

Control0..1
BindingThe codes SHALL be taken from ResourceType; other codes may be used where these codes are not suitable Aa resource (or, for logical models, the URI of the logical model)
Typeuri
Summarytrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Signature.who.identifier
Definition

NPI or Tax ID representing the Provider or Organization

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1 This element is affected by the following invariants: cdex-13
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Signature.who.identifier.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
14. Signature.who.identifier.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Signature.who.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
15. Signature.who.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known
Typecode
Is Modifiertrue
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Signature.who.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control1..1
BindingThe codes SHALL be taken from CDex Identifier Types Value Set
TypeCodeableConcept
Must Supporttrue
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Signature.who.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control0..1
Typeuri
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Signature.who.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Signature.who.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Signature.who.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Summarytrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Signature.who.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control0..1 This element is affected by the following invariants: cdex-13
Typestring
Must Supporttrue
Summarytrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Signature.onBehalfOf
Definition

A reference to an application-usable description of the identity that is represented by the signature.

Control0..1
TypeReference(Practitioner|PractitionerRole|RelatedPerson|Patient|Device|Organization)
Summarytrue
Requirements

used when the signature is on behalf of a non-signer.

Comments

The party that can't sign. For example a child.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Signature.targetFormat
Definition

A mime type that indicates the technical format of the target resources signed by the signature.

Control0..1
BindingThe codes SHALL be taken from Mime Types The mime type of an attachment. Any valid mime type is allowed
Typecode
Summaryfalse
Comments

"xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Signature.sigFormat
Definition

A mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc.

Control0..1
BindingThe codes SHALL be taken from Mime Types The mime type of an attachment. Any valid mime type is allowed
Typecode
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Signature.data
Definition

The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

Control1..1
Typebase64Binary
Must Supporttrue
Summaryfalse
Comments

Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))