Generated Narrative: StructureDefinition epa-activity-provenance Name Flags Card. Type Description & Constraints Provenance 0..* Provenance Dieses Profil beschreibt die Verwendung der FHIR-Resource Provenance zur Dokumentation von Änderungen und Aktivitäten im Rahmen der ePA FHIR Data Services. #xD; <a href="StructureDefinition-epa-activity-provenance-definitions.html#Provenance.target" title="Gibt die Ressource(n) an, die im Rahmen der Änderung innerhalb der ePA erstellt oder aktualisiert wurden.#xA;Es muss eine versionierte Referenz (ResourceType/id/_history/vid) verwendet werden, um eindeutig die durch diese Änderung entstandene Version der betroffenen Ressource anzugeben.#xA;Dadurch wird eine eindeutige, nachvollziehbare Zuordnung zwischen einer fachlichen Änderung und dem resultierenden Ressourcenzustand gewährleistet.">target S 1..* Reference(Resource) Gibt die Ressource(n) an, die im Rahmen der Änderung innerhalb der ePA erstellt oder aktualisiert wurden. Es muss eine versionierte Referenz (ResourceType/id/_history/vid) verwendet werden. #xD; reference S 0..1 string Literal reference, Relative, internal or absolute URL #xD; identifier S 0..1 Identifier Logical reference, when literal reference is not known #xD; display S 0..1 string Text alternative for the resource #xD; occurred[x] S 0..1 dateTime Gibt den Zeitraum oder Zeitpunkt an, in dem die Änderung tatsächlich stattgefunden hat - also wann die Aktion inhaltlich durchgeführt wurde, z.B. das Erfassen oder Bearbeiten von Daten. #xD; recorded S 1..1 instant Gibt den technischen Zeitpunkt an, zu dem dieser Provenance-Eintrag im FHIR Data Service erstellt und persistiert wurde. #xD; activity S 1..1 CodeableConcept Beschreibt die Art der Aktivität, die zu der Änderung im FHIR Data Service der ePA geführt hat. Beispiel CREATE | UPDATE Binding: EPA Activity Provenance Type ValueSet (required) #xD; agent S 1..* BackboneElement Gibt den verantwortlichen Leistungserbringer, die Leistungserbringerinstitution oder das System an, das die Änderung im FHIR Data Service der ePA durchgeführt hat. #xD; <a href="StructureDefinition-epa-activity-provenance-definitions.html#Provenance.agent.type" title="Gibt die Rolle oder Funktion an, die der Agent im Rahmen der dokumentierten Änderung eingenommen hat.#xA;Während agent.who beschreibt, wer die Änderung durchgeführt hat (z.B. ein System oder eine Institution), legt agent.type fest, in welcher Eigenschaft oder mit welcher funktionalen Verantwortung diese Aktion erfolgt ist. Im Kontext dieses Profils ist ausschließlich die Rolle author zulässig, da jede Änderung im FHIR Data Service der ePA fachlich verantwortet sein muss.">type S 1..1 CodeableConcept Gibt die Rolle oder Funktion an, die der Agent im Rahmen der dokumentierten Änderung eingenommen hat. Im Kontext dieses Profils ist ausschließlich die Rolle author zulässig, da jede Änderung im FHIR Data Service der ePA fachlich verantwortet sein muss. Binding: EPA Provenance Participant Type ValueSet (required) #xD; coding S 1..1 Coding Code defined by a terminology system #xD; system S 1..1 uri Identity of the terminology system #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; who S 1..1 Reference(Practitioner | Organization | PractitionerRole) Who participated #xD; reference S 0..1 string Literal reference, Relative, internal or absolute URL #xD; identifier S 0..1 IdentifierTelematikId, IdentifierEPAFHIRDataService Logical reference, when literal reference is not known #xD; display S 0..1 string Text alternative for the resource #xD; Documentation for this format
Dieses Profil beschreibt die Verwendung der FHIR-Resource Provenance zur Dokumentation von Änderungen und Aktivitäten im Rahmen ePA FHIR Data Services. Es ermöglicht die strukturierte Nachverfolgung, wer zu welchem Zeitpunkt welche Ressourcen erstellt oder verändert hat. Der ePA Änderungseintrag dient damit als technischer und fachlicher Nachweis über den Ursprung und die Verantwortlichkeit von Einträgen in der ePA.
gematik GmbH / Dieses Artefakt ist lizenziert unter [Apache License](./license.html), Version 2.0.
Dieses Profil beschreibt die Verwendung der FHIR-Resource Provenance zur Dokumentation von Änderungen und Aktivitäten im Rahmen der ePA FHIR Data Services.
Provenance of a resource is a record that describes entities and processes involved in producing and delivering or otherwise influencing that resource. Provenance provides a critical foundation for assessing authenticity, enabling trust, and allowing reproducibility. Provenance assertions are a form of contextual metadata and can themselves become important records with their own provenance. Provenance statement indicates clinical significance in terms of confidence in authenticity, reliability, and trustworthiness, integrity, and stage in lifecycle (e.g. Document Completion - has the artifact been legally authenticated), all of which may impact security, privacy, and trust policies.
Some parties may be duplicated between the target resource and its provenance. For instance, the prescriber is usually (but not always) the author of the prescription resource. This resource is defined with close consideration for W3C Provenance.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
ControlAct[isNormalAct() and subsumes(CACT, classCode) and moodCode=EVN]
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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).
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Gibt die Ressource(n) an, die im Rahmen der Änderung innerhalb der ePA erstellt oder aktualisiert wurden. Es muss eine versionierte Referenz (ResourceType/id/_history/vid) verwendet werden.
Gibt die Ressource(n) an, die im Rahmen der Änderung innerhalb der ePA erstellt oder aktualisiert wurden. Es muss eine versionierte Referenz (ResourceType/id/_history/vid) verwendet werden, um eindeutig die durch diese Änderung entstandene Version der betroffenen Ressource anzugeben. Dadurch wird eine eindeutige, nachvollziehbare Zuordnung zwischen einer fachlichen Änderung und dem resultierenden Ressourcenzustand gewährleistet.
Target references are usually version specific, but might not be, if a version has not been assigned or if the provenance information is part of the set of resources being maintained (i.e. a document). When using the RESTful API, the identity of the resource might not be known (especially not the version specific one); the client may either submit the resource first, and then the provenance, or it may submit both using a single transaction. See the notes on transaction for further discussion.
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'))
not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])
The target of a resource reference is a RIM entry point (Act, Role, or Entity)
./outboundRelationship[isNormalActRelationship() and typeCode=SUBJ]/target OR ./participation[isNormalParticipation() and typeCode=SBJ]/role OR ./participation[isNormalParticipation() and typeCode=SBJ]/role[isNormalRole()]/player
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
CX / EI (occasionally, more often EI maps to a resource id or a URL)
II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Gibt den Zeitraum oder Zeitpunkt an, in dem die Änderung tatsächlich stattgefunden hat - also wann die Aktion inhaltlich durchgeführt wurde, z.B. das Erfassen oder Bearbeiten von Daten.
The period during which the activity occurred.
The period can be a little arbitrary; where possible, the time should correspond to human assessment of the activity time.
Gibt den technischen Zeitpunkt an, zu dem dieser Provenance-Eintrag im FHIR Data Service erstellt und persistiert wurde.
The instant of time at which the activity was recorded.
This can be a little different from the time stamp on the resource if there is a delay between recording the event and updating the provenance and target resource.
unique(./participation[isNormalParticipation() and typeCode=AUT]/time[type=TS])
Policy or plan the activity was defined by
Policy or plan the activity was defined by. Typically, a single activity may have multiple applicable policy documents, such as patient consent, guarantor funding, etc.
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.
./inboundRelationship[isNormalActRelationship() and typeCode="SUBJ"]/source[isNormalAct and subsumes(POLICY, classCode) and moodCode=EVN]/text[typeCode='ED'/tel
Where the activity occurred, if relevant
Where the activity occurred, if relevant.
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.
unique(./participation[isNormalParticipation() and typeCode=LOC]/role[isNormalRole() and subsumes(SDLOC, classCode)]/player[isNormalEntity and classCode="LOC" and determinerCode="INST"]
The reason that the activity was taking place.
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.
fhir:CodeableConcept rdfs:subClassOf dt:CD
Beschreibt die Art der Aktivität, die zu der Änderung im FHIR Data Service der ePA geführt hat. Beispiel CREATE | UPDATE
An activity is something that occurs over a period of time and acts upon or with entities; it may include consuming, processing, transforming, modifying, relocating, using, or generating entities.
Gibt den verantwortlichen Leistungserbringer, die Leistungserbringerinstitution oder das System an, das die Änderung im FHIR Data Service der ePA durchgeführt hat.
An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.
Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa.
An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility.
./participation[isNormalParticipation()] OR ./outboundRelationship[isNormalActRelationship() and typeCode='DRIV']
Extensions that cannot be ignored even if unrecognized
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).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Gibt die Rolle oder Funktion an, die der Agent im Rahmen der dokumentierten Änderung eingenommen hat. Im Kontext dieses Profils ist ausschließlich die Rolle author zulässig, da jede Änderung im FHIR Data Service der ePA fachlich verantwortet sein muss.
Gibt die Rolle oder Funktion an, die der Agent im Rahmen der dokumentierten Änderung eingenommen hat. Während agent.who beschreibt, wer die Änderung durchgeführt hat (z.B. ein System oder eine Institution), legt agent.type fest, in welcher Eigenschaft oder mit welcher funktionalen Verantwortung diese Aktion erfolgt ist. Im Kontext dieses Profils ist ausschließlich die Rolle author zulässig, da jede Änderung im FHIR Data Service der ePA fachlich verantwortet sein muss.
For example: author, performer, enterer, attester, etc.
A reference to a code defined by a terminology system.
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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
A representation of the meaning of the code in the system, following the rules of the system.
Note that FHIR strings SHALL NOT exceed 1MB in size
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
The function of the agent with respect to the activity. The security role enabling the agent with respect to the activity.
The role that a provenance agent played with respect to the activity.
The individual, device or organization that participated in the event.
whoIdentity should be used when the agent is not a Resource type.
The individual, device, or organization for whom the change was made.
onBehalfOfIdentity should be used when the agent is not a Resource type.
Person, Practitioner, Organization, Device :* .role [classCode = RoleClassMutualRelationship; role.code and * .scopes[Role](classCode=IDENT) and *.plays [Role.Code]
derivation | revision | quotation | source | removal
How the entity was used during the activity.
Identity of the Entity used. May be a logical or physical uri and maybe absolute or relative.
whatIdentity should be used for entities that are not a Resource type.
The entity is attributed to an agent to express the agent's responsibility for that entity, possibly along with other agents. This description can be understood as shorthand for saying that the agent was responsible for the activity which generated the entity.
A usecase where one Provenance.entity.agent is used where the Entity that was used in the creation/updating of the Target, is not in the context of the same custodianship as the Target, and thus the meaning of Provenance.entity.agent is to say that the entity referenced is managed elsewhere and that this Agent provided access to it. This would be similar to where the Entity being referenced is managed outside FHIR, such as through HL7 v2, v3, or XDS. This might be where the Entity being referenced is managed in another FHIR resource server. Thus it explains the Provenance of that Entity's use in the context of this Provenance activity.
A digital signature on the target Reference(s). The signer should match a Provenance.agent. The purpose of the signature is indicated.
The elements of the Signature Resource are for ease of access of these elements. For digital signatures (Xml DigSig, JWS), the non-repudiation proof comes from the Signature validation, which includes validation of the referenced objects (e.g. Resources) (a.k.a., Content) in the XML-Signature Detached form.