Provenance Profile

Canonical	../StructureDefinition/nexus-emr-core-provenance
Status	draft · 1.26.0
Base	Provenance (constraint)
Source	FSH · JSON

Attribution for AI-mediated and cross-boundary writes: what was produced, when, by which agent (human or non-human), from what inputs, and -- for generated text -- which verbatim source passage each statement rests on. Used standalone against a produced resource, and contained in an AI-suggestion review Task against the suggestion contained alongside it.

Examples

AI-Drafted Note Accepted by a Clinician · AI-Generated Summary With Per-Fact Citations

AI-Drafted Note Accepted by a Clinician

Provenance for an AI-generated encounter note -- two agents distinguished by agent.type (Device author, Practitioner attester) plus the entity list naming the inputs the draft derived from

Provenance/prov-avery-ai-drafted-note-20250408 — claims conformance to Provenance Profile

{
  "resourceType": "Provenance",
  "id": "prov-avery-ai-drafted-note-20250408",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-provenance"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns='http://www.w3.org/1999/xhtml'><p>Provenance for an AI-drafted encounter note: the SmartDocs AI Scribe generated the DocumentReference from the visit's record context, and Dr. Emil Navarro reviewed and accepted it.</p><p>The shape this profile exists to demonstrate: TWO agents, distinguished by agent.type -- the non-human author (Device) and the human attester (Practitioner). Recording only the human would make AI-drafted content indistinguishable from human-authored content. The entity list names the inputs the draft was derived from, which is what makes the output auditable rather than merely attributable.</p></div>"
  },
  "target": [
    {
      "reference": "DocumentReference/anemia-consult-20250408",
      "display": "Encounter note, annual wellness visit 2025-04-08"
    }
  ],
  "occurredDateTime": "2025-04-08T09:47:00-06:00",
  "recorded": "2025-04-08T09:47:12-06:00",
  "activity": {
    "text": "AI-generated draft accepted by the responsible clinician"
  },
  "agent": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
            "code": "author",
            "display": "Author"
          }
        ],
        "text": "Generating agent (non-human)"
      },
      "who": {
        "type": "Device",
        "identifier": {
          "system": "../NamingSystem/nexus-emr-appdevice-identifier",
          "value": "smartdocs-ai-scribe"
        },
        "display": "SmartDocs AI Scribe"
      },
      "onBehalfOf": {
        "reference": "Practitioner/dr-emil-navarro",
        "display": "Dr. Emil Navarro"
      }
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
            "code": "attester",
            "display": "Attester"
          }
        ],
        "text": "Reviewing clinician who accepted the draft"
      },
      "who": {
        "reference": "Practitioner/dr-emil-navarro",
        "display": "Dr. Emil Navarro"
      }
    }
  ],
  "entity": [
    {
      "role": "source",
      "what": {
        "reference": "Encounter/enc-avery-20250408-01rc",
        "display": "Annual wellness visit, 2025-04-08"
      }
    },
    {
      "role": "source",
      "what": {
        "reference": "QuestionnaireResponse/qr-avery-intake-2025-04-08",
        "display": "Pre-visit intake questionnaire, 2025-04-08"
      }
    },
    {
      "role": "source",
      "what": {
        "reference": "DetectedIssue/di-avery-warfarin-nsaid-override",
        "display": "Warfarin/naproxen interaction and override"
      }
    }
  ]
}