Provenance
Overview
The Provenance resource tracks information about the activity that created, revised, deleted, or signed a version of a resource, describing the entities and agents involved. This information can be used to form assessments about its quality, reliability, trustworthiness, or to provide pointers for where to go to further investigate the origins of the resource and the information in it. While Provenance resources can be retrieved directly from athena's systems by ID, it is generally unlikely for FHIR consumers to know the ID of a provenance resource ahead of time. Typically, Provenance resources are included in bundle reesponses using '_revinclude' to search interactions for 'other' FHIR resources. As an example, to retrieve a patient's Condition resources along with the Provenance resources for those conditions, the user would execute a search like 'GET /Condition?patient={fhir patient id}&_revinclude=Provenance:target'
This profile is used to define the content that will be returned by the API Server in response to requests to access Provenance resources. All elements described in the Definition and Detailed Definitions below are supported, which means that the API Server is capable of supplying these fields from the product database when they have been populated via the product or its APIs.
List of profiles we support:
Definition
The official URL for this profile is:
https://fhir.athena.io/StructureDefinition/ah-provenance
The base definition for this profile is:
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
  Provenance | 0..* | Provenance | Who, What, When for a set of resources | |||||
  id | Σ | 0..1 | id | Logical id of this artifact | ||||
 meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
 extension | 0..* | Extension | Additional content defined by implementations | |||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
 target | Σ | 1..* | Reference(Resource) | Target Reference(s) (usually version specific) | ||||
| recorded | Σ | 1..1 | instant (YYYY-MM-DDThh:mm:ss.sss+zz:zz) | When the activity was recorded / updated | ||||
 agent | 1..* | BackboneElement | Actor involved | |||||
 id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type | Σ | 0..1 | CodeableConcept | How the agent participated Binding: ProvenanceParticipantType (extensible): The type of participation that a provenance agent played with respect to the activity. | ||||
| who | Σ | 1..1 | Reference(Practitioner | Organization) | Who participated | ||||
 onBehalfOf | 0..1 | Reference(Organization) | Who the agent is representing | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Conformance | ValueSet | ||||
| Provenance.language | preferred | CommonLanguages
| ||||
| Provenance.agent.type | extensible | ProvenanceParticipantType | ||||
| Provenance.entity.role | required | ProvenanceEntityRole |
Detailed Definitions
Provenance
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.
| Cardinality | 0..* |
| Type | Root |
| Comments | Some parties may be duplicated between the target resource and its provenance. For instance, the prescriber is usually (but not always) the author of the prescription resource. This resource is defined with close consideration for W3C Provenance. |
Provenance.id
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
| Cardinality | 0..1 |
| Type | id |
| Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Provenance.meta
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.
| Cardinality | 0..1 |
| Type | Meta |
Provenance.implicitRules
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.
| Cardinality | 0..1 |
| Type | uri |
| Comments | 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. |
Provenance.language
The base language in which the resource is written.
| Cardinality | 0..1 |
| Type | code Binding: CommonLanguages (preferred) |
| Comments | 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). |
Provenance.text
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.
| Cardinality | 0..1 |
| Type | Narrative |
| Comments | 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. |
Provenance.contained
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.
| Cardinality | 0..* |
| Type | Resource |
| Comments | 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. |
Provenance.extension
May be used to represent additional information that is not part of the basic definition of the resource. 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.
| Cardinality | 0..* |
| Type | Extension |
| 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. |
Provenance.modifierExtension
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).
| Cardinality | 0..* |
| Type | Extension |
| 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. |
| Requirements | 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. |
Provenance.target
The Reference(s) that were generated or updated by the activity described in this resource. A provenance can point to more than one target if multiple resources were created/updated by the same activity.
| Cardinality | 1..* |
| Type | Reference(Resource) |
| Comments | Target references are usually version specific, but might not be, if a version has not been assigned or if the provenance information is part of the set of resources being maintained (i.e. a document). When using the RESTful API, the identity of the resource might not be known (especially not the version specific one); the client may either submit the resource first, and then the provenance, or it may submit both using a single transaction. See the notes on transaction for further discussion. |
Provenance.recorded
The instant of time at which the activity was recorded.
| Cardinality | 1..1 |
| Type | instant (YYYY-MM-DDThh:mm:ss.sss+zz:zz) |
| Comments | This can be a little different from the time stamp on the resource if there is a delay between recording the event and updating the provenance and target resource. |
Provenance.agent
An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.
| Cardinality | 1..* |
| Type | BackboneElement |
| Comments | Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa. |
| Requirements | An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility. |
Provenance.agent.id
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| Cardinality | 0..1 |
| Type | string |
Provenance.agent.extension
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.
| Cardinality | 0..* |
| Type | Extension |
| 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. |
Provenance.agent.modifierExtension
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).
| Cardinality | 0..* |
| Type | Extension |
| 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. |
| Requirements | 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. |
Provenance.agent.type
The participation the agent had with respect to the activity.
| Cardinality | 0..1 |
| Type | CodeableConcept Binding: ProvenanceParticipantType (extensible) |
| Comments | For example: author, performer, enterer, attester, etc. |
Provenance.agent.who
The individual, device or organization that participated in the event.
| Cardinality | 1..1 |
| Type | Reference(Practitioner | Organization) |
| Comments | whoIdentity should be used when the agent is not a Resource type. |
Provenance.agent.onBehalfOf
The individual, device, or organization for whom the change was made.
| Cardinality | 0..1 |
| Type | Reference(Organization) |
| Comments | onBehalfOfIdentity should be used when the agent is not a Resource type. |
Interactions
READ
Read interactions are executed as specified in the HL7 FHIR RESTful API read specification. To read Provenance resources, an application will perform an HTTP GET specifying the logical ID of the Provenance being retrieved.
The [patient|user|system]/Provenance.read authorization scope is required.
Parameters
❙ required
❙ conditional required
| Name | Type | Description |
| logicalId | string | (REQUIRED) The logical ID of the resource (alias: Resource.id). It is specified in the URL path and not as a query parameter. |
Response Codes
| Response code | Description |
| 200 OK | The requested Provenance resource was found and is contained within the body of the HTTP response. |
| 400 Bad Request | The server could not understand the request due to invalid syntax. The body of the HTTP response will contain an OperationOutcome resource that indicates the invalid request could not be processed. |
| 404 Not Found | The requested resource does not exist. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found. |
| 410 Gone | The requested resource has been permanently deleted from server with no forwarding address. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found. |
| 500 Internal Server Error | The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
| 5xx Server Error | The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
GET SEARCH
Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for Provenance resources using the HTTP GET method, an application will perform the HTTP GET specifying the query parameters associated with the Provenance in the URL.
The [patient|user|system]/Provenance.read authorization scope is required.
The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:
- [patient|user|system]/Provenance.read
Parameters
❙ required
❙ conditional required
| Name | Type | Description |
| ah-practice | reference | Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]') |
| target | reference | (REQUIRED) Provenance.target search parameter for Provenance resource |
| _include | string | Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
|
Response Codes
| Response code | Description |
| 200 OK | The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search. |
| 403 Forbidden | The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters. |
| 500 Internal Server Error | The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
| 5xx Server Error | The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
POST SEARCH
Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for Provenance resources using the HTTP POST method, an application will perform the HTTP POST specifying the query parameters associated with the Provenance in the request body.
The [patient|user|system]/Provenance.read authorization scope is required.
The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:
- [patient|user|system]/Provenance.read
Request Header
Content-Type: application/x-www-form-urlencoded
Request Body
param1=value1¶m2=value2...
Parameters
❙ required
❙ conditional required
| Name | Type | Description |
| ah-practice | reference | Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]') |
| target | reference | (REQUIRED) Provenance.target search parameter for Provenance resource |
| _include | string | Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
|
Response Codes
| Response code | Description |
| 200 OK | The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search. |
| 403 Forbidden | The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters. |
| 500 Internal Server Error | The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
| 5xx Server Error | The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |