Comment:

Update the provenance resource to support a digital signature that references the digital certificate resource and only requires the signing of the hash of the xml representation of the object (resource, profile, document) and the remaining elements of provenance resource to reduce the overhead with digital signatures applied to FHIR resources.... (e.g. the balance of the XADES-XL is in the digital certificate resource and may be reused for multiple signed resources as long as the OCSP or singed revocation list verifying the validity of the Certificate is contemporaneous with or post-dates the date of the last signed hash.)