Provenance: Implementation Guidance
Usage
The Provenance resource is used to carry the relevant history of the triage journey. The full history of the journey will be available in the GuidanceResponse.outputParameters and the ServiceDefinition.$evaluate.inputData, but the key steps in the journey will be carried as the relevant history. It will be the decision of the CDSS which assertions are most relevant, and only these will be added to the Provenance resource. In general, it is expected that positive statements driving the result will be captured as the relevant history. The CDSS should consider whether a particular assertion has value for another clinical user - only if it does, should it be added to the relevant history (and so to the Provenance resource).
Each assertion which is relevant to the history of the ReferralRequest will be carried as an independent Provenance resource, so the relevantHistory may have multiple Provenance resources, each identifying a key step.
The target of the Provenance will be the assertion. The agent will always be the CDSS, and the entity will be whichever QuestionnaireResponses drove the assertion.
The table below details implementation guidance for this resource in the CDS context:
| Name | Cardinality | Type | FHIR Documentation | CDS Implementation Guidance |
|---|---|---|---|---|
target |
1..* |
Reference(Any) | Target Reference(s) (usually version specific) | This MUST be populated by the CDSS and must carry the logical ID of the assertion (typically Observation) that was generated or updated as a key step in this triage journey. |
period |
0..1 |
Period | When the activity occurred | |
recorded |
1..1 |
instant | When the activity was recorded/updated | This MUST be populated by the CDSS with the time at which the assertion was recorded. |
policy |
0..* |
uri | Policy or plan the activity was defined by | |
location |
0..1 |
Reference (Location) |
Where the activity occurred, if relevant | |
reason |
0..* |
Coding | Reason the activity is occurring PurposeOfUse (Extensible) | This SHOULD be NULL |
activity |
0..1 |
Coding | Activity that occurred ProvenanceActivityType (Extensible) | This SHOULD be NULL |
agent |
1..* |
BackboneElement | Actor involved | This MUST be the CDSS (a software device) |
agent.role |
0..* |
CodeableConcept | What the agent's role was SecurityRoleType (Extensible) | |
agent.who[x] |
1..1 |
whoUri uri whoReference Reference (Practitioner | RelatedPerson | Patient | Device | Organization) |
Who participated | The CDSS MUST populate this with the details of the individual, device or organisation that participated in the event. |
agent.onBehalfOf[x] |
0..1 |
onBehalfOfUri uri onBehalfOfReference Reference (Practitioner | RelatedPerson | Patient | Device | Organization) |
Who participated | The CDSS MUST populate this with the details of the individual, device or organisation that participated in the event. |
agent.relatedAgentType |
0..1 |
CodeableConcept | Type of relationship between agents v3 Code System RoleLinkType (Example) | |
entity |
0..* |
BackboneElement | An entity used in this activity | The QuestionnaireResponse resources which contributed to the creation (or update) of this assertion, where applicable |
entity.role |
1..1 |
code | derivation | revision | quotation | source | removal ProvenanceEntityRole (Required) | This SHOULD be populated with the value 'derivation' |
entity.what[x] |
1..1 |
whatUri uri whatReference Reference(Any) whatIdentifier Identifier |
Identity of entity | Identity of the entity used. MAY be a logical or physical uri and may be absolute or relative. |
entity.agent |
0..* |
see agent | Entity is attributed to this agent | |
signature |
0..* |
Signature | Signature on target | This element carries a digital signature on the target Reference(s). The signer SHOULD match a Provenance.agent. |
