OZO FHIR implementation guide
0.5.1 - ci-build

OZO FHIR implementation guide - Local Development build (v0.5.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: OZOAuditEvent - Detailed Descriptions

Active as of 2026-02-19

Definitions for the ozo-auditevent resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. AuditEvent
Definition

A record of an event made for purposes of maintaining a security log. Typical uses include detection of intrusion attempts and monitoring for inappropriate usage.

ShortEvent record kept for security purposes
Comments

Based on IHE-ATNA.

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. AuditEvent.implicitRules
Definition

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.

ShortA set of rules under which this content was created
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.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. AuditEvent.extension:traceId
Slice NametraceId
Definition

W3C Trace Context trace-id for distributed tracing

ShortOZO Trace ID
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(OZO Trace ID) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. AuditEvent.extension:spanId
Slice NamespanId
Definition

W3C Trace Context span-id for distributed tracing

ShortOZO Span ID
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(OZO Span ID) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. AuditEvent.extension:resourceOrigin
Slice NameresourceOrigin
Definition

Device that originally created the resource

ShortOZO Resource Origin
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(OZO Resource Origin) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. AuditEvent.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored
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.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
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.

Alternate Namesextensions, user content
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on AuditEvent.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. AuditEvent.type
    Definition

    Type of audit event - either REST operation or notification transmission


    Identifier for a family of the event. For example, a menu item, program, rule, policy, function code, application name or URL. It identifies the performed function.

    ShortType of event (rest, transmit)Type/identifier of event
    Comments

    Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from OZO AuditEvent Type ValueSethttp://hl7.org/fhir/ValueSet/audit-event-type
    (required to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-type-vs)
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    This identifies the performed function. For "Execute" Event Action Code audit records, this identifies the application function performed.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. AuditEvent.subtype
    Definition

    More specific type of event within the broader category


    Identifier for the category of event.

    ShortSpecific type of event (read, create, update, delete, search, capabilities)More specific type/id for the event
    Comments

    Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

    Control0..*
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Subtype ValueSethttp://hl7.org/fhir/ValueSet/audit-event-sub-type
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-subtype-vs)
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    This field enables queries of messages by implementation-defined event categories.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. AuditEvent.action
    Definition

    Indicator for type of action performed during the event that generated the audit


    Indicator for type of action performed during the event that generated the audit.

    ShortType of action performed (C,R,U,D,E)Type of action performed during the event
    Control10..1
    BindingThe codes SHALL be taken from AuditEventActionhttp://hl7.org/fhir/ValueSet/audit-event-action|4.0.1
    (required to http://hl7.org/fhir/ValueSet/audit-event-action|4.0.1)

    Indicator for type of action performed during the event that generated the event.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    This broadly indicates what kind of action was done on the AuditEvent.entity by the AuditEvent.agent.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. AuditEvent.recorded
    Definition

    The time when the event was recorded


    The time when the event was recorded.

    ShortWhen the event was recordedTime when the event was recorded
    Comments

    In a distributed system, some sort of common time base (e.g. an NTP [RFC1305] server) is a good implementation tactic.

    Control1..1
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    This ties an event to a specific date and time. Security audits typically require a consistent time base (e.g. UTC), to eliminate time-zone issues arising from geographical distribution.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. AuditEvent.outcome
    Definition

    Indicates whether the event succeeded or failed. 0=Success, 4=Minor failure, 8=Major failure


    Indicates whether the event succeeded or failed.

    ShortWhether the event succeeded or failed
    Comments

    In some cases a "success" may be partial, for example, an incomplete or interrupted transfer of a radiological study. For the purpose of establishing accountability, these distinctions are not relevant.

    Control10..1
    BindingThe codes SHALL be taken from AuditEventOutcomehttp://hl7.org/fhir/ValueSet/audit-event-outcome|4.0.1
    (required to http://hl7.org/fhir/ValueSet/audit-event-outcome|4.0.1)

    Indicates whether the event succeeded or failed.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. AuditEvent.outcomeDesc
    Definition

    Text description of the outcome, particularly for failures


    A free text description of the outcome of the event.

    ShortDescription of the event outcome
    Comments

    Note that FHIR strings SHALL NOT exceed 1MB in size

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. AuditEvent.agent
    Definition

    An actor taking an active role in the event or activity that is logged


    An actor taking an active role in the event or activity that is logged.

    ShortActor involved in the event
    Comments

    Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

    For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

    Control1..*
    This element is affected by the following invariants: ele-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Requirements

    An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

    Alternate NamesActiveParticipant
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. AuditEvent.agent.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored even if unrecognized
    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.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    28. AuditEvent.agent.type
    Definition

    Specification of the participation type the user plays when performing the event.

    ShortHow agent participated
    Comments

    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

    Control0..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Agent Type ValueSethttp://hl7.org/fhir/ValueSet/participation-role-type
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-agent-type-vs)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. AuditEvent.agent.who
    Definition

    Reference to the resource for the user who performed the action


    Reference to who this agent is that was involved in the event.

    ShortIdentifier of who performed the action
    Comments

    Where a User ID is available it will go into who.identifier.

    Control10..1
    This element is affected by the following invariants: ele-1
    TypeReference(Practitioner, RelatedPerson, Device, PractitionerRole, Organization, Patient)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summarytrue
    Requirements

    This field ties an audit event to a specific resource or identifier.

    Alternate NamesuserId
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    32. AuditEvent.agent.requestor
    Definition

    Indicator that the user is or is not the requestor, or initiator, for the event being audited


    Indicator that the user is or is not the requestor, or initiator, for the event being audited.

    ShortWhether user is initiator
    Comments

    There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

    Control1..1
    Typeboolean
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. AuditEvent.source
    Definition

    The system that is reporting the event.

    ShortAudit Event Reporter
    Comments

    Since multi-tier, distributed, or composite applications make source identification ambiguous, this collection of fields may repeat for each application or process actively involved in the event. For example, multiple value-sets can identify participating web servers, application processes, and database server threads in an n-tier distributed application. Passive event participants (e.g. low-level network transports) need not be identified.

    Control1..1
    This element is affected by the following invariants: ele-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Requirements

    The event is reported by one source.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. AuditEvent.source.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored even if unrecognized
    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.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    38. AuditEvent.source.site
    Definition

    Logical source location within the healthcare enterprise network


    Logical source location within the healthcare enterprise network. For example, a hospital or other provider location within a multi-entity provider group.

    ShortLogical source location within the enterprise
    Comments

    Note that FHIR strings SHALL NOT exceed 1MB in size

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Requirements

    This value differentiates among the sites in a multi-site enterprise health information system.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. AuditEvent.source.observer
    Definition

    Identifier of the source where the event was detected (OZO AAA Proxy)


    Identifier of the source where the event was detected.

    ShortThe identity of source detecting the event
    Comments

    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

    Control1..1
    This element is affected by the following invariants: ele-1
    TypeReference(Device, PractitionerRole, Practitioner, Organization, Patient, RelatedPerson)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    This field ties the event to a specific source system. It may be used to group events for analysis according to where the event was detected.

    Alternate NamesSourceId
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    42. AuditEvent.source.type
    Definition

    Code specifying the type of source where event originated.

    ShortThe type of source where event originated
    Comments

    Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

    Control10..*
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Source Type ValueSethttp://hl7.org/fhir/ValueSet/audit-source-type
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-source-type-vs)
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Requirements

    This field indicates which type of source is identified by the Audit Source ID. It is an optional value that may be used to group events for analysis according to the type of source where the event occurred.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. AuditEvent.entity
    Definition

    Specific instances of data or objects that have been accessed


    Specific instances of data or objects that have been accessed.

    ShortData or objects used
    Comments

    Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Requirements

    The event may have other entities involved.

    Alternate NamesParticipantObject
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
    46. AuditEvent.entity.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored even if unrecognized
    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.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    48. AuditEvent.entity.what
    Definition

    Reference to the specific FHIR resource that was accessed or modified


    Identifies a specific instance of the entity. The reference should be version specific.

    ShortSpecific resource accessedSpecific instance of resource
    Comments

    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

    Control10..1
    This element is affected by the following invariants: ele-1
    TypeReference(Resource)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    50. AuditEvent.entity.type
    Definition

    The type of the object that was involved in this audit event.

    ShortType of entity involved
    Comments

    This value is distinct from the user's role or any user relationship to the entity.

    Control0..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Entity Type ValueSethttp://hl7.org/fhir/ValueSet/audit-entity-type
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-entity-type-vs)
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Requirements

    To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. AuditEvent.entity.role
    Definition

    Code representing the role the entity played in the event being audited.

    ShortWhat role the entity played
    Comments

    Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

    Control0..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityRolehttp://hl7.org/fhir/ValueSet/object-role
    (extensible to http://hl7.org/fhir/ValueSet/object-role)

    Code representing the role the entity played in the audit event.

    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Requirements

    For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. AuditEvent.entity.lifecycle
    Definition

    Identifier for the data life-cycle stage for the entity.

    ShortLife-cycle stage for the entity
    Comments

    This can be used to provide an audit trail for data, over time, as it passes through the system.

    Control0..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from ObjectLifecycleEventshttp://hl7.org/fhir/ValueSet/object-lifecycle-events
    (extensible to http://hl7.org/fhir/ValueSet/object-lifecycle-events)

    Identifier for the data life-cycle stage for the entity.

    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Requirements

    Institutional policies for privacy and security may optionally fall under different accountability rules based on data life cycle. This provides a differentiating value for those cases.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. AuditEvent.entity.query
    Definition

    For search operations, the query parameters used


    The query parameters for a query-type entities.

    ShortQuery parameters if applicable
    Comments

    The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example, if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

    Control0..1
    This element is affected by the following invariants: sev-1
    Typebase64Binary
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    For query events, it may be necessary to capture the actual query input to the query process in order to identify the specific event. Because of differences among query implementations and data encoding for them, this is a base 64 encoded data blob. It may be subsequently decoded or interpreted by downstream audit analysis processing.

    Invariantsele-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 foundhere

    0. AuditEvent
    2. AuditEvent.extension:traceId
    Slice NametraceId
    Control0..1
    TypeExtension(OZO Trace ID) (Extension Type: string)
    Must Supporttrue
    4. AuditEvent.extension:spanId
    Slice NamespanId
    Control0..1
    TypeExtension(OZO Span ID) (Extension Type: string)
    Must Supporttrue
    6. AuditEvent.extension:resourceOrigin
    Slice NameresourceOrigin
    Control0..1
    TypeExtension(OZO Resource Origin) (Extension Type: string)
    Must Supporttrue
    8. AuditEvent.type
    Definition

    Type of audit event - either REST operation or notification transmission

    ShortType of event (rest, transmit)
    BindingThe codes SHALL be taken from OZO AuditEvent Type ValueSet
    (required to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-type-vs)
    Must Supporttrue
    10. AuditEvent.subtype
    Definition

    More specific type of event within the broader category

    ShortSpecific type of event (read, create, update, delete, search, capabilities)
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Subtype ValueSet
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-subtype-vs)
    Must Supporttrue
    12. AuditEvent.action
    Definition

    Indicator for type of action performed during the event that generated the audit

    ShortType of action performed (C,R,U,D,E)
    Control1..?
    Must Supporttrue
    14. AuditEvent.recorded
    Definition

    The time when the event was recorded

    ShortWhen the event was recorded
    Must Supporttrue
    16. AuditEvent.outcome
    Definition

    Indicates whether the event succeeded or failed. 0=Success, 4=Minor failure, 8=Major failure

    Control1..?
    Must Supporttrue
    18. AuditEvent.outcomeDesc
    Definition

    Text description of the outcome, particularly for failures

    Must Supporttrue
    20. AuditEvent.agent
    Definition

    An actor taking an active role in the event or activity that is logged

    Must Supporttrue
    22. AuditEvent.agent.type
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Agent Type ValueSet
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-agent-type-vs)
    Must Supporttrue
    24. AuditEvent.agent.who
    Definition

    Reference to the resource for the user who performed the action

    ShortIdentifier of who performed the action
    Control1..?
    TypeReference(Practitioner, RelatedPerson, Device)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    26. AuditEvent.agent.requestor
    Definition

    Indicator that the user is or is not the requestor, or initiator, for the event being audited

    Must Supporttrue
    28. AuditEvent.source
    Must Supporttrue
    30. AuditEvent.source.site
    Definition

    Logical source location within the healthcare enterprise network

    Must Supporttrue
    32. AuditEvent.source.observer
    Definition

    Identifier of the source where the event was detected (OZO AAA Proxy)

    TypeReference(Device)
    Must Supporttrue
    34. AuditEvent.source.type
    Control1..?
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Source Type ValueSet
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-source-type-vs)
    Must Supporttrue
    36. AuditEvent.entity
    Definition

    Specific instances of data or objects that have been accessed

    Must Supporttrue
    38. AuditEvent.entity.what
    Definition

    Reference to the specific FHIR resource that was accessed or modified

    ShortSpecific resource accessed
    Control1..?
    Must Supporttrue
    40. AuditEvent.entity.type
    BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Entity Type ValueSet
    (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-entity-type-vs)
    Must Supporttrue
    42. AuditEvent.entity.role
    Must Supporttrue
    44. AuditEvent.entity.lifecycle
    Must Supporttrue
    46. AuditEvent.entity.query
    Definition

    For search operations, the query parameters used

    ShortQuery parameters if applicable
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be foundhere

    0. AuditEvent
    Definition

    A record of an event made for purposes of maintaining a security log. Typical uses include detection of intrusion attempts and monitoring for inappropriate usage.

    ShortEvent record kept for security purposes
    Comments

    Based on IHE-ATNA.

    Control0..*
    Is Modifierfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. AuditEvent.id
    Definition

    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

    ShortLogical id of this artifact
    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.

    Control0..1
    Typeid
    Is Modifierfalse
    Summarytrue
    4. AuditEvent.meta
    Definition

    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.

    ShortMetadata about the resource
    Control0..1
    TypeMeta
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. AuditEvent.implicitRules
    Definition

    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.

    ShortA set of rules under which this content was created
    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.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. AuditEvent.language
    Definition

    The base language in which the resource is written.

    ShortLanguage of the resource content
    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).

    Control0..1
    BindingThe codes SHOULD be taken from CommonLanguages
    (preferred to http://hl7.org/fhir/ValueSet/languages)

    A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. AuditEvent.text
    Definition

    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.

    ShortText summary of the resource, for human interpretation
    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.

    Control0..1
    TypeNarrative
    Is Modifierfalse
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. AuditEvent.contained
    Definition

    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.

    ShortContained, inline Resources
    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.

    Control0..*
    TypeResource
    Is Modifierfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    14. AuditEvent.extension
    Definition

    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.

    ShortAdditional content defined by implementations
    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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 AuditEvent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 16. AuditEvent.extension:traceId
      Slice NametraceId
      Definition

      W3C Trace Context trace-id for distributed tracing

      ShortOZO Trace ID
      Control0..1
      TypeExtension(OZO Trace ID) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-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())
      18. AuditEvent.extension:spanId
      Slice NamespanId
      Definition

      W3C Trace Context span-id for distributed tracing

      ShortOZO Span ID
      Control0..1
      TypeExtension(OZO Span ID) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-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())
      20. AuditEvent.extension:resourceOrigin
      Slice NameresourceOrigin
      Definition

      Device that originally created the resource

      ShortOZO Resource Origin
      Control0..1
      TypeExtension(OZO Resource Origin) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-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())
      22. AuditEvent.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      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.

      Alternate Namesextensions, user content
      Invariantsele-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 AuditEvent.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 24. AuditEvent.type
        Definition

        Type of audit event - either REST operation or notification transmission

        ShortType of event (rest, transmit)
        Comments

        Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

        Control1..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from OZO AuditEvent Type ValueSet
        (required to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-type-vs)
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        This identifies the performed function. For "Execute" Event Action Code audit records, this identifies the application function performed.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. AuditEvent.subtype
        Definition

        More specific type of event within the broader category

        ShortSpecific type of event (read, create, update, delete, search, capabilities)
        Comments

        Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Subtype ValueSet
        (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-subtype-vs)
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        This field enables queries of messages by implementation-defined event categories.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. AuditEvent.action
        Definition

        Indicator for type of action performed during the event that generated the audit

        ShortType of action performed (C,R,U,D,E)
        Control1..1
        BindingThe codes SHALL be taken from AuditEventAction
        (required to http://hl7.org/fhir/ValueSet/audit-event-action|4.0.1)

        Indicator for type of action performed during the event that generated the event.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        This broadly indicates what kind of action was done on the AuditEvent.entity by the AuditEvent.agent.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. AuditEvent.period
        Definition

        The period during which the activity occurred.

        ShortWhen the activity occurred
        Comments

        The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypePeriod
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
        32. AuditEvent.recorded
        Definition

        The time when the event was recorded

        ShortWhen the event was recorded
        Comments

        In a distributed system, some sort of common time base (e.g. an NTP [RFC1305] server) is a good implementation tactic.

        Control1..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        This ties an event to a specific date and time. Security audits typically require a consistent time base (e.g. UTC), to eliminate time-zone issues arising from geographical distribution.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. AuditEvent.outcome
        Definition

        Indicates whether the event succeeded or failed. 0=Success, 4=Minor failure, 8=Major failure

        ShortWhether the event succeeded or failed
        Comments

        In some cases a "success" may be partial, for example, an incomplete or interrupted transfer of a radiological study. For the purpose of establishing accountability, these distinctions are not relevant.

        Control1..1
        BindingThe codes SHALL be taken from AuditEventOutcome
        (required to http://hl7.org/fhir/ValueSet/audit-event-outcome|4.0.1)

        Indicates whether the event succeeded or failed.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. AuditEvent.outcomeDesc
        Definition

        Text description of the outcome, particularly for failures

        ShortDescription of the event outcome
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. AuditEvent.purposeOfEvent
        Definition

        The purposeOfUse (reason) that was used during the event being recorded.

        ShortThe purposeOfUse of the event
        Comments

        Use AuditEvent.agent.purposeOfUse when you know that it is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
        (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

        The reason the activity took place.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. AuditEvent.agent
        Definition

        An actor taking an active role in the event or activity that is logged

        ShortActor involved in the event
        Comments

        Several agents may be associated (i.e. have some responsibility for an activity) with an event or activity.

        For example, an activity may be initiated by one user for other users or involve more than one user. However, only one user may be the initiator/requestor for the activity.

        Control1..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Requirements

        An agent can be a person, an organization, software, device, or other actors that may be ascribed responsibility.

        Alternate NamesActiveParticipant
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. AuditEvent.agent.id
        Definition

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

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        44. AuditEvent.agent.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.

        ShortAdditional content defined by implementations
        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-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 AuditEvent.agent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 46. AuditEvent.agent.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored even if unrecognized
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          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.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-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())
          48. AuditEvent.agent.type
          Definition

          Specification of the participation type the user plays when performing the event.

          ShortHow agent participated
          Comments

          Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Agent Type ValueSet
          (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-agent-type-vs)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. AuditEvent.agent.role
          Definition

          The security role that the user was acting under, that come from local codes defined by the access control security system (e.g. RBAC, ABAC) used in the local context.

          ShortAgent role in the event
          Comments

          Should be roles relevant to the event. Should not be an exhaustive list of roles.

          Control0..*
          This element is affected by the following invariants: ele-1
          BindingFor example codes, see SecurityRoleType
          (example to http://hl7.org/fhir/ValueSet/security-role-type)

          What security role enabled the agent to participate in the event.

          TypeCodeableConcept
          Is Modifierfalse
          Requirements

          This value ties an audited event to a user's role(s). It is an optional value that might be used to group events for analysis by user functional role categories.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. AuditEvent.agent.who
          Definition

          Reference to the resource for the user who performed the action

          ShortIdentifier of who performed the action
          Comments

          Where a User ID is available it will go into who.identifier.

          Control1..1
          This element is affected by the following invariants: ele-1
          TypeReference(Practitioner, RelatedPerson, Device)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summarytrue
          Requirements

          This field ties an audit event to a specific resource or identifier.

          Alternate NamesuserId
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          54. AuditEvent.agent.altId
          Definition

          Alternative agent Identifier. For a human, this should be a user identifier text string from authentication system. This identifier would be one known to a common authentication system (e.g. single sign-on), if available.

          ShortAlternative User identity
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          In some situations, a human user may authenticate with one identity but, to access a specific application system, may use a synonymous identify. For example, some "single sign on" implementations will do this. The alternative identifier would then be the original identify used for authentication, and the User ID is the one known to and used by the application.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. AuditEvent.agent.name
          Definition

          Human-meaningful name for the agent.

          ShortHuman friendly name for the agent
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          The User ID and Authorization User ID may be internal or otherwise obscure values. This field assists the auditor in identifying the actual user.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. AuditEvent.agent.requestor
          Definition

          Indicator that the user is or is not the requestor, or initiator, for the event being audited

          ShortWhether user is initiator
          Comments

          There can only be one initiator. If the initiator is not clear, then do not choose any one agent as the initiator.

          Control1..1
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          This value is used to distinguish between requestor-users and recipient-users. For example, one person may initiate a report-output to be sent to another user.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. AuditEvent.agent.location
          Definition

          Where the event occurred.

          ShortWhere
          Comments

          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeReference(Location)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          62. AuditEvent.agent.policy
          Definition

          The policy or plan that authorized the activity being recorded. Typically, a single activity may have multiple applicable policies, such as patient consent, guarantor funding, etc. The policy would also indicate the security token used.

          ShortPolicy that authorized event
          Comments

          For example: Where an OAuth token authorizes, the unique identifier from the OAuth token is placed into the policy element Where a policy engine (e.g. XACML) holds policy logic, the unique policy identifier is placed into the policy element.

          Control0..*
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          This value is used retrospectively to determine the authorization policies.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. AuditEvent.agent.media
          Definition

          Type of media involved. Used when the event is about exporting/importing onto media.

          ShortType of media
          Comments

          Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingUnless not suitable, these codes SHALL be taken from MediaTypeCode
          (extensible to http://hl7.org/fhir/ValueSet/dicm-405-mediatype)

          Used when the event is about exporting/importing onto media.

          TypeCoding
          Is Modifierfalse
          Requirements

          Usually, this is used instead of specifying a network address. This field is not used for Media Id (i.e. the serial number of a CD).

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. AuditEvent.agent.network
          Definition

          Logical network location for application activity, if the activity has a network location.

          ShortLogical network location for application activity
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. AuditEvent.agent.network.id
          Definition

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

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          70. AuditEvent.agent.network.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.

          ShortAdditional content defined by implementations
          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-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 AuditEvent.agent.network.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 72. AuditEvent.agent.network.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-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())
            74. AuditEvent.agent.network.address
            Definition

            An identifier for the network access point of the user device for the audit event.

            ShortIdentifier for the network access point of the user device
            Comments

            This could be a device id, IP address or some other identifier associated with a device.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            This datum identifies the user's network access point, which may be distinct from the server that performed the action. It is an optional value that may be used to group events recorded on separate servers for analysis of a specific network access point's data access across all servers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. AuditEvent.agent.network.type
            Definition

            An identifier for the type of network access point that originated the audit event.

            ShortThe type of network access point
            Control0..1
            BindingThe codes SHALL be taken from AuditEventAgentNetworkType
            (required to http://hl7.org/fhir/ValueSet/network-type|4.0.1)

            The type of network access point of this agent in the audit event.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            This datum identifies the type of network access point identifier of the user device for the audit event. It is an optional value that may be used to group events recorded on separate servers for analysis of access according to a network access point's type.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. AuditEvent.agent.purposeOfUse
            Definition

            The reason (purpose of use), specific to this agent, that was used during the event being recorded.

            ShortReason given for this user
            Comments

            Use AuditEvent.agent.purposeOfUse when you know that is specific to the agent, otherwise use AuditEvent.purposeOfEvent. For example, during a machine-to-machine transfer it might not be obvious to the audit system who caused the event, but it does know why.

            Control0..*
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
            (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

            The reason the activity took place.

            TypeCodeableConcept
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. AuditEvent.source
            Definition

            The system that is reporting the event.

            ShortAudit Event Reporter
            Comments

            Since multi-tier, distributed, or composite applications make source identification ambiguous, this collection of fields may repeat for each application or process actively involved in the event. For example, multiple value-sets can identify participating web servers, application processes, and database server threads in an n-tier distributed application. Passive event participants (e.g. low-level network transports) need not be identified.

            Control1..1
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Requirements

            The event is reported by one source.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            82. AuditEvent.source.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            84. AuditEvent.source.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.

            ShortAdditional content defined by implementations
            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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-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 AuditEvent.source.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 86. AuditEvent.source.modifierExtension
              Definition

              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).

              ShortExtensions that cannot be ignored even if unrecognized
              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              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.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-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())
              88. AuditEvent.source.site
              Definition

              Logical source location within the healthcare enterprise network

              ShortLogical source location within the enterprise
              Comments

              Note that FHIR strings SHALL NOT exceed 1MB in size

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              This value differentiates among the sites in a multi-site enterprise health information system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. AuditEvent.source.observer
              Definition

              Identifier of the source where the event was detected (OZO AAA Proxy)

              ShortThe identity of source detecting the event
              Comments

              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

              Control1..1
              This element is affected by the following invariants: ele-1
              TypeReference(Device)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              This field ties the event to a specific source system. It may be used to group events for analysis according to where the event was detected.

              Alternate NamesSourceId
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
              92. AuditEvent.source.type
              Definition

              Code specifying the type of source where event originated.

              ShortThe type of source where event originated
              Comments

              Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

              Control1..*
              This element is affected by the following invariants: ele-1
              BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Source Type ValueSet
              (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-source-type-vs)
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Requirements

              This field indicates which type of source is identified by the Audit Source ID. It is an optional value that may be used to group events for analysis according to the type of source where the event occurred.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              94. AuditEvent.entity
              Definition

              Specific instances of data or objects that have been accessed

              ShortData or objects used
              Comments

              Required unless the values for event identification, agent identification, and audit source identification are sufficient to document the entire auditable event. Because events may have more than one entity, this group can be a repeating set of values.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Requirements

              The event may have other entities involved.

              Alternate NamesParticipantObject
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              sev-1: Either a name or a query (NOT both) (name.empty() or query.empty())
              96. AuditEvent.entity.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              98. AuditEvent.entity.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.

              ShortAdditional content defined by implementations
              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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-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 AuditEvent.entity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 100. AuditEvent.entity.modifierExtension
                Definition

                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).

                ShortExtensions that cannot be ignored even if unrecognized
                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.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                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.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-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())
                102. AuditEvent.entity.what
                Definition

                Reference to the specific FHIR resource that was accessed or modified

                ShortSpecific resource accessed
                Comments

                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                Control1..1
                This element is affected by the following invariants: ele-1
                TypeReference(Resource)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                104. AuditEvent.entity.type
                Definition

                The type of the object that was involved in this audit event.

                ShortType of entity involved
                Comments

                This value is distinct from the user's role or any user relationship to the entity.

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingUnless not suitable, these codes SHALL be taken from OZO AuditEvent Entity Type ValueSet
                (extensible to http://headease.gitlab.io/ozo-refererence-impl/ozo-implementation-guide/ValueSet/ozo-auditevent-entity-type-vs)
                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Requirements

                To describe the object being acted upon. In addition to queries on the subject of the action in an auditable event, it is also important to be able to query on the object type for the action.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. AuditEvent.entity.role
                Definition

                Code representing the role the entity played in the event being audited.

                ShortWhat role the entity played
                Comments

                Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingUnless not suitable, these codes SHALL be taken from AuditEventEntityRole
                (extensible to http://hl7.org/fhir/ValueSet/object-role)

                Code representing the role the entity played in the audit event.

                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Requirements

                For some detailed audit analysis it may be necessary to indicate a more granular type of entity, based on the application role it serves.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                108. AuditEvent.entity.lifecycle
                Definition

                Identifier for the data life-cycle stage for the entity.

                ShortLife-cycle stage for the entity
                Comments

                This can be used to provide an audit trail for data, over time, as it passes through the system.

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingUnless not suitable, these codes SHALL be taken from ObjectLifecycleEvents
                (extensible to http://hl7.org/fhir/ValueSet/object-lifecycle-events)

                Identifier for the data life-cycle stage for the entity.

                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Requirements

                Institutional policies for privacy and security may optionally fall under different accountability rules based on data life cycle. This provides a differentiating value for those cases.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                110. AuditEvent.entity.securityLabel
                Definition

                Security labels for the identified entity.

                ShortSecurity labels on the entity
                Comments

                Copied from entity meta security tags.

                Control0..*
                This element is affected by the following invariants: ele-1
                BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                Security Labels from the Healthcare Privacy and Security Classification System.

                TypeCoding
                Is Modifierfalse
                Requirements

                This field identifies the security labels for a specific instance of an object, such as a patient, to detect/track privacy and security issues.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                112. AuditEvent.entity.name
                Definition

                A name of the entity in the audit event.

                ShortDescriptor for entity
                Comments

                This field may be used in a query/report to identify audit events for a specific person. For example, where multiple synonymous entity identifiers (patient number, medical record number, encounter number, etc.) have been used.

                Control0..1
                This element is affected by the following invariants: sev-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Use only where entity can't be identified with an identifier.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                114. AuditEvent.entity.description
                Definition

                Text that describes the entity in more detail.

                ShortDescriptive text
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Use only where entity can't be identified with an identifier.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                116. AuditEvent.entity.query
                Definition

                For search operations, the query parameters used

                ShortQuery parameters if applicable
                Comments

                The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example, if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                Control0..1
                This element is affected by the following invariants: sev-1
                Typebase64Binary
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                For query events, it may be necessary to capture the actual query input to the query process in order to identify the specific event. Because of differences among query implementations and data encoding for them, this is a base 64 encoded data blob. It may be subsequently decoded or interpreted by downstream audit analysis processing.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. AuditEvent.entity.detail
                Definition

                Tagged value pairs for conveying additional information about the entity.

                ShortAdditional Information about the entity
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeBackboneElement
                Is Modifierfalse
                Requirements

                Implementation-defined data about specific details of the object accessed or used.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. AuditEvent.entity.detail.id
                Definition

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

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                122. AuditEvent.entity.detail.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.

                ShortAdditional content defined by implementations
                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-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 AuditEvent.entity.detail.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 124. AuditEvent.entity.detail.modifierExtension
                  Definition

                  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).

                  ShortExtensions that cannot be ignored even if unrecognized
                  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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  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.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-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())
                  126. AuditEvent.entity.detail.type
                  Definition

                  The type of extra detail provided in the value.

                  ShortName of the property
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  128. AuditEvent.entity.detail.value[x]
                  Definition

                  The value of the extra detail.

                  ShortProperty value
                  Comments

                  The value can be string when known to be a string, else base64 encoding should be used to protect binary or undefined content. The meaning and secondary-encoding of the content of base64 encoded blob is specific to the AuditEvent.type, AuditEvent.subtype, AuditEvent.entity.type, and AuditEvent.entity.role. The base64 is a general-use and safe container for event specific data blobs regardless of the encoding used by the transaction being recorded. An AuditEvent consuming application must understand the event it is consuming and the formats used by the event. For example if auditing an Oracle network database access, the Oracle formats must be understood as they will be simply encoded in the base64binary blob.

                  Control1..1
                  This element is affected by the following invariants: ele-1
                  TypeChoice of: string, base64Binary
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Requirements

                  Should not duplicate the entity value unless absolutely necessary.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))