Develop an Informative Implementation Guide in the US Realm to specify functional and technical guidance on what constitutes minimal “provenance”. This guidance should inform future implementations of the data class identified in the US Core Data for Interoperability published by the Office of the National Coordinator.
Specifically, the IG will include technical guidance for C-CDA 2.1, and US FHIR Core (based on R4). Guidance will be limited to the set of data classes identified in the US Core Data for Interoperability, and any additional information needed to convey those data classes within C-CDA and FHIR.
The Draft U.S. Core Data for Interoperability and Expansion Process, published by ONC on Jan 5, 2018 indicated 22 “data classes” in the list of Draft USCDI Version 1 Data Classes. While many of those data classes have already been well defined within the C-CDA and FHIR standards, “provenance” has not been. For interoperability to be achieved with this data class, functional and technical guidance are needed regarding what details constitute “provenance”, which data classes should be conveyed including provenance information, and technically how provenance information should be represented in the C-CDA and FHIR standards.
- Security WG (sponsor)
- Historical references and guidance on provenance attributes
- Patient Care WG (co-sponsor)
- Selection of data classes for which provenance is important
- Selection of provenance attributes that should be required
- Structured Documents WG (co-sponsor)
- C-CDA 2.1 technical guidance
- EHR FM (co-sponsor)
- FHIR EHR-LR IG technical guidance
- Legal Medical Record expertiese
- CBCP (co-sponsor)
- Prior CDA Data Provenance IG owner
Develop priority use cases
2019 May WGM
Submit for Informative Ballot(First Ballot Cycle)
2019 Sep Ballot
Complete Informative Reconciliation
2019 November WGM
Request Informative Publication
2020 Jan WGM
Project End Date
Every 2 weeks starting March 25, 2019
3:00 PM - 4:00 PM ET (GMT -5)
Phone: +1 515-604-9567, Participant Code: 880898
Online Meeting Link: https://www.freeconferencecall.com/join/security36
Visit http://www.hl7.org/concalls/CallDetails.aspx?concall=43654 for the full details of this call
Basic Provenance Project Materials
20190719_HL7_Basic_Provenance_Security_Posting.docx - draft of Ballot Content for approval to proceed to ballot
BasicProvenance_20190422_v2 - 201905 WGM ppt
Final Basic Provenance Reconciliation Spreadsheet 20200218_HL7_PROVENANCE_CCDA_FHIR_R1_I1_2019SEP_Amalgamated.xls
This list of references to Provenance is likely to be leveraged by this Implementation Guide.
•HL7 Implementation Guide: Data Segmentation for Privacy (DS4P)
•FHIR Provenance Resource
•FHIR EHR Record Lifecycle Event IG with Provenance Profile directly in FHIR Core R4
•HL7 Version 3 Standard: Privacy and Security Architecture Framework - Volume 3 Provenance, Release 1 (recent ballot)
•IHE set of profiles - mXDE – MHD profiles, QEDM, RECON profile – Provide clear Provenance to support use-case where FHIR Resources have been extracted from Documents.
•ONC Challenge for tracking provenance
•ONC S&I Initiative on Data Provenance (led to CDA IG)
•HL7 CDA R2 Data Provenance (sponsored by CBCP, co-sponsoerd by Security)
•ISO specifications on EHR Lifecycle events – how an EHR manages a record over lifecycle events – focused on CRUD (27 lifecycle events)
ISO 21089:2018 - Trusted End-to-End Information Flows (27 Record Lifecycle Events, including provenance specification where applicable)
• FHIR Record Lifecycle Event Implementation Guide (RLE IG), part of FHIR Core R4 (27 Lifecycle Events, including Provenance Resource Profile as applicable)
• ISO/HL7 10781:2014 - Electronic Health Record System Functional Model, Release 2, Information Infrastructure Section (24 Record Lifecycle Events, including provenance specification as applicable)
• HL7 Electronic Health Record System Functional Model, Release 2.1, passed ballot January 2019, being prepared for publication (27 Record Lifecycle Events, including provenance specification as applicable), will be advanced to ISO as ISO/HL7 10781:2019
• HL7 Personal Health Record System Functional Model, Release 2, passed ballot January 2019, in reconciliation (27 Record Lifecycle Events, including provenance specification as applicable), will be advanced to ISO as ISO/HL7 16527:2019
Basic stepping stone, not comprehensive set of use-cases.
Concurred with prior discussion:
- Who ‘authored’
- Who ‘handed to you’
- Data, and metadata for the purposes for trust, traceability and identification of ‘Who’ and ‘When’
- Capture at least the last system that provided, if not the full chain of provenance. The full chain can be recreated by asking each system that is ‘one-hop’ prior. The system that provided you the data
- It’s not inherently bad to contain the full chain, but that may not be possible
- Likely the CDA Prov already provides sufficient details for CDA. There is a definition of various levels of effort that could be pointed out as minimally acceptable - Basic Provenance - support
- Likely the FHIR EHR-LR Implementation Guide provides sufficient details for FHIR. There are likely a subset of events that could be chosen for minimally acceptable - Basic Provenance - support
- IHE mXDE profile could be promoted as a best case when an externally sourced Document is decomposed into FHIR Resources that are served up. Such as an HIE that provides a FHIR api. The Provenance specified in mXDE binds the FHIR Query results to the source Document from which that data was extracted.
- Are the use-cases explicitly only those involving external (Import/Export) functionality? That is to say, are we considering internally generated data (fully within the EHR control)? This seems to be the focus of the US Core Data for Interoperability.