Comment:

In FHIR, attribution information varies significantly across resources. For instance, in Procedure, when an action was performed is represented as performed[x]. For medication administration, the performance time is represented as effective[x]. In communication, it is represented using the attribute 'sent'. Information about the performer is also represented fairly heterogeneously. For instance, in Procedure it is captured with the structure Performer which contains role, actor, and on behalf of. In MedicationAdministration, there is also a performer structure but it lacks role. In Communication, there is a 'sender' even though it is also an action which could be performed by a role, onBehalfOf. In Procedure, there is a location field which is missing for MedicationAdministration and Communication. In order to ensure better cross-resource consistency, I would strongly recommend that FHIR consider an attribution model or discusses the attribution model currently considered by the CIMI group and align on a consistent approach for representing this information. This lack of consistency will impose a cost on implementers who will need to define different transformations for each resource when such variability does not confer significant benefits.

Summary:

Introduce an attribution model for FHIR