CH ATC (R4)
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This page is part of the CH ATC (R4) (v3.3.0-ballot: Draft Ballot 5) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Volume 3 - Content Profiles

There are four different categories of Audit Events in the context of the EPR:

  1. Document management (e.g. a document has been uploaded to the EPR of a patient or a list of document metadata has been retrieved)
  2. Policy management (e.g. a patient has given a healthcare professional access rights to his EPR)
  3. Access Patient Audit Record Repository by a patient or representative (a patient viewed the Audit Trail for the Audit Record Repository)
  4. Notification of the patient about the entry of healthcare professionals into a group

Each category is described as a content profile. These content profiles are based on the AuditEvent Resource, http://hl7.org/fhir/R4/auditevent.html.

The AuditEvent Resource has mapping rules to the DICOM audit message format, which allows to map to ATNA.

Audit Trail Consumption Event Types

The following Audit Trail Consumption Event Types are defined and shall be supported, see EprAuditTrailConsumptionEventTypes from Codesystem 2.16.756.5.30.1.127.3.10.7.

Type Description Profile Ref Opt Community
ATC_DOC_CREATE Document upload Document Audit Event Content Profile R
ATC_DOC_READ Document retrieval Document Audit Event Content Profile R
ATC_DOC_UPDATE Document or Document Metadata update Document Audit Event Content Profile R
ATC_DOC_DELETE Document removal Document Audit Event Content Profile R
ATC_DOC_SEARCH Document search Document Audit Event Content Profile R
ATC_POL_CREATE_AUT_PART_AL Authorize participants to access level/date Policy Audit Event Content Profile R, (NP if not reference community)
ATC_POL_UPDATE_AUT_PART_AL Update access level/date of authorized participants Policy Audit Event Content Profile R, (NP: if not reference community)
ATC_POL_REMOVE_AUT_PART_AL Remove authorization for participants Policy Audit Event Content Profile R, (NP: if not reference community)
ATC_POL_DEF_CONFLEVEL Set or update default Confidentiality Level Policy Audit Event Content Profile R, (NP: if not reference community)
ATC_POL_DIS_EMER_USE Disabling Emergency Access Policy Audit Event Content Profile R, (NP: if not reference community)
ATC_POL_ENA_EMER_USE Enabling Emergency Access Policy Audit Event Content Profile R, (NP: if not reference community)
ATC_POL_INCL_BLACKLIST Assign Healthcare Professional to Blacklist Policy Audit Event Content Profile R, (NP: if not reference community)
ATC_POL_EXL_BLACKLIST Exclude Healthcare Professional from Blacklist Policy Audit Event Content Profile R, (NP: if not reference community)
ATC_LOG_READ Accessing Patient Audit Record Repository Access Audit Trail Content Profile R
ATC_HPD_GROUP_ENTRY_NOTIFY Entry of healthcare professionals into a group HPD Group Entry Audit Event Content Profile R, (NP: if not reference community)

Table 4: Audit Trail Consumption Event Types

Document Audit Event Content Profile

This content profile describes Audit Event related to Document Management. The following Data Elements shall be provided:

Data Element

Description

Property/Value

Event Type

Document upload
Document retrieval
Document or Document Metadata update
Document removal
Document search

Event Date and Time

 

UTC

Participants

 

 

Initiator

Patient

Name

Representative of patient

Name
UAP-ID or EPR-SPID

Authorized Healthcare Professional

Name
GLN

Assistant of a Healthcare Professional

Name
GLN

Technical User

Name
Identifier

Document Administrator

Name
UAP-ID

Responsible[5.1]

Patient

Name

Healthcare Professional

Name
GLN

Groups where Healthcare Professional is member

 

Name of Group
OID

Purpose of Use

 

NORM, EMER, AUTO, DICOM_AUTO

Patient

Involved patient

EPR-SPID

Document[5.2]

type of document

typeCode[5.3] (SNOMED CT code)

reference to document

uniqueId
repositoryUniqueId
homeCommunityID

title of document

title

​[5.1] If different from Initiator (Representative of patient acting on behalf of a patient then patient is responsible).

​[5.2] Required for Document upload, Document retrieval, Document or Document Metadata update and Document removal but not for Document search.

​[5.3] Annex 3 EPRO-FDHA, chapter 2.6 type of document (2.16.756.5.30.1.127.3.10.1.27).

Table 5: Document Audit Event Data Elements

This profile defines the content of the document audit events which a community has to provide for a patient’s audit trail. This profile builds on AuditEvent (http://hl7.org/fhir/R4/auditevent.html).

The mapping from the Document Audit Event Resource to the Data Elements is as follows:

Example of a Document Audit Event: Document upload

Event Upload
Resource title of Document Austrittsbericht von Julia Helfe-Gern
Resource: type of Document Nicht näher bezeichnetes Dokument (SNOMED CT: 419891008)
Resource: reference to Document uniqueID
Event Date and Time 10.10.2020 18:29
Participant, Initiator Julia Helfe-Gern
Participant, Responsible representing Jakob Wieder-Gesund

Table 6: Uploading a Record Artifact by a patient representative (atc-doc-create-rep-pat)

  • Example for Document Audit Event Profile: XML, JSON
Event Search for documents
Event Date and Time 10.10.2020 18:49
Participant, Initiator David Mustermann
Participant, Responsible representing Dr. med. Sabine Musterfrau
Participant, Group Kardiologie Universitätsspital Musterstadt
Purpose of event Emergency Access

Table 7: Example of a Document Audit Event: Document search

  • Example for Document Audit Event Profile: XML, JSON

Policy Audit Event Content Profile

This content profile describes Audit Events related to Policy Management. The following Data Elements shall be provided:

Data Element

Description

Property/Value

Event Type

Authorize participants to access level/date

Update access level/date of authorized participants

Remove authorization for participants to access level/date

Set or update the default Confidentiality Level for new documents

Disabling Emergency Access

Enabling Emergency Access

Exclude a Healthcare Professional from accessing the EPR

Revoke the exclusion of a Healthcare Professional from accessing the EPR

Event Date Time

  

UTC

Participants

    

Initiator

Patient

Name

Representative of patient

Name
UAP-ID or EPR-SPID

Authorized Healthcare Professional[8.1]

Name
GLN

Assistant of a Healthcare Professional

Name
GLN

Policy Administrator

Name
UAP-ID

Responsible

Patient

Name

Healthcare Professional

Name
GLN

Patient

Involved patient

EPR-SPID

Resource

Resource Role

HCP, GRP or REP

Healthcare Professional

Name
GLN

Group of Healthcare Professional

Name of Group
OID

Representative of patient

Name
UAP-ID or EPR-SPID

AccessLevel[8.2]

one of urn:e-health-suisse:2015:policies:access-level:
normal, restricted, delegation-and-restricted, delegation-and-normal, full

AccessLimitedToDate8

Date

ProvideLevel[8.3]

one of urn:e-health-suisse:2015:policies:provide-level:
normal, restricted, secret

[8.1] Healthcare Professional or Assistant of Healthcare Professional can only be a participant for the first Event Type (Authorize participants to access level).

[8.2] Access Level and the date if the access is limited (AccessLimitedToDate) are required for the first two Event Types (Authorize, update Authorization participants to access level/date), for the other Event Types these parameters do not need to be specified.

[8.3] Provide Level is only relevant for the Event Type Default Confidentiality Level for new Documents.

Table 8: Policy Audit Event Data Elements

This content profile defines the document audit events which a community has to provide for a patients audit trail. This profile builds on AuditEvent (http://hl7.org/fhir/R4/auditevent.html).

The mapping from the Document Audit Event Resource to the Data Elements is as follows:

Examples

Event Create
Resource: HCP EPR-Access Level “delegation-and-restricted”
till 31.12.2020 08:00 to
Dr. med. Hans Allzeitbereit
Event Date and Time 22.09.2020 09:47
Participant Initiator Jakob Wieder-Gesund

Table 9: Example Create Delegation and Restricted access for a healthcare professional (atc-pol-create-acc-right)

  • Example for Policy Audit Event Profile: XML, JSON
Event Create
Resource: Representative Julia Helfe-Gern
Event Date and Time 22.09.2020 09:48
Participant Initiator Jakob Wieder-Gesund

Table 10: Example Create for a representative (atc-pol-create-rep)

  • Example for Policy Audit Event Profile: XML, JSON

Access Audit Trail Content Profile

This content profile describes Audit Event related to Accessing the Audit Trail of a Patient from a Patient Audit Record Repository. The following Data Elements shall be provided:

Data Element

Description

Property/Value

Event Type

 

Access Audit Trail

Event Date and Time

 

UTC

Participants

 

 

Initiator

Patient

Name

Representative of patient

Name
UAP-ID or EPR-SPID

Responsible

Patient

Name

Patient

Involved patient

EPR-SPID

Table 11: Access Audit Trail Data Elements

This content profile defines the access audit trail event, which a community has to provide for a patient’s audit trail. This profile builds on AuditEvent (http://hl7.org/fhir/R4/auditevent.html).

The mapping from the Access Audit Trail Event Resource to the Data Elements is as follows:

Example

Event Access Audit Trail
Patient Jakob Wieder-Gesund
Timestamp 22.09.2020 10:47
Participant Jakob Wieder-Gesund

Table 12: Example Log Access (atc-log-read)

  • Example for Access Audit Trail Event Profile: XML, JSON

HPD Group Entry Audit Event Content Profile

This content profile describe the Audit Event related to the entry of a healthcare professional into a HPD group for which the patient is notified. The following Data Elements shall be provided:

Data Element

Description

Property/Value

Event Type

Patient notified of Healthcare Professionals added to a group

Event Date and Time

 

UTC

Notification Service

 

Name

Patient

Notified patient

EPR-SPID

Healthcare Professionals

Healthcare professionals

Name
GLN

Group

Group where Healthcare Professionals are added as members

Name of Group
OID

Table 13: HPD Group Entry Audit Event Elements

This profile defines the content of the HPD group entry audit event. This profile builds on AuditEvent (http://hl7.org/fhir/R4/auditevent.html).

The mapping from the HPD Group Entry Audit Event Resource to the Data Elements is as follows:

Example

Event Group entry of healthcare professional:
Healthcare professionals Dr. med. Sabine Musterfrau
Timestamp 10.10.2020 10:05
Participant, Group Kardiologie Universitätsspital Musterstadt
Patient Jakob Wieder-Gesund

Table 14: Example group entry of healthcare professionals

  • Example for HPD Group Entry Audit Event Profile: XML, JSON