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StructureDefinition: ehealth-provenance

Introduction

Provenance of a resource is a record that describes entities and processes involved in producing and delivering or otherwise influencing that resource. Provenance provides a critical foundation for assessing authenticity, enabling trust, and allowing reproducibility. Provenance assertions are a form of contextual metadata and can themselves become important records with their own provenance. Provenance statement indicates clinical significance in terms of confidence in authenticity, reliability, and trustworthiness, integrity, and stage in lifecycle (e.g. Document Completion - has the artifact been legally authenticated), all of which may impact security, privacy, and trust policies.

Scope and Usage

In scope of the eHealth Infrastructure, Provenance resources are used for a number of different purposes. Some of these purposes are purely internal to the infrastructure, whereas others are of relevance to clients of the infrastructure.

The details of different usages of Provenance resources relevant to clients are described in the following sections together with the resources and operations they are supporting.

Reuse of measurements

When a client submits measurements in the form of Observation, QuestionnaireResponse and/or Media, the client can submit one or more of these as reused resources, provided that reuse requirements have been met. For each resource where data is reused, the client must construct a Provenance that:

• identifies the resource containing reused data through the target element
• identifies the resource from where data was reused through the entity[0].what element
• identifies a policy which states reuse

Each such Provenance must be submitted along with the resources containing reused data.

See eHealth-observation for further details.

Tracking measurements submitted in the same bundle

Provenance resources are created internally by the eHealth infrastructure to link correlated resources which are submitted together in one bundle:

See eHealth-observation for further details.

Stating legal frameworks and data privacy regulations for episodes of care

Provenance resources are submitted by a client for creation when an EpisodeOfCare (in profile ehealth-episodeofcare) is created using the create-episode-of-care operation.

Some of these provenance resources hold information about which legal frame the EpisodeOfCare is created under through the Provenance element policy. This could be for instance the health law (in Danish: “Sundhedsloven”) or other relevant legal frameworks.

Other of these provenance resources define which data privacy regulations are applicable to data concerning patient, practitioners, and suppliers under the episode of care. This, too, is captured in policy.

See create-episode-of-care for further details.

Formal Views of Profile Content

The official URL for this profile is:

http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-provenance

This profile builds on Provenance.

This profile was published on Fri May 22 12:11:22 UTC 2020 as a draft by ehealth.sundhed.dk.

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

 

Terminology Bindings

Path	Conformance	ValueSet
Provenance.language	extensible	Common Languages Max Binding: All Languages
Provenance.policy	required	Policies for provenances
Provenance.reason	extensible	PurposeOfUse
Provenance.activity	extensible	ProvenanceActivityType
Provenance.agent.role	extensible	SecurityRoleType
Provenance.agent.relatedAgentType	example	v3 Code System RoleLinkType
Provenance.entity.role	required	ProvenanceEntityRole

Constraints

Id	Path	Details	Requirements
dom-2	Provenance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-1	Provenance	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-4	Provenance	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3	Provenance	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
ele-1	Provenance.agent	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Provenance.entity	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Provenance.entity.extension:dateTimeOfReusedEntity	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Provenance.entity.extension:dateTimeOfReusedEntity	Must have either extensions or value[x], not both : extension.exists() != value.exists()

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