FHIR version 4 introduced a new pattern in which various participations that were previously named (e.g., recorder, data enterer), are now handled using a Participation class with a role code (e.g., recorder, data enterer) and a pointer to the Actor which is participating in the role of the role code. This actor may be any on of a number of entities, such as a Patient, Practitioner, Organization, PractitionerRole, Device, RelatedPerson, etc. This approach is analogous to the FHIM Participation class, except that in the past, FHIM has used named properties in the clinical classes (e.g., performer, observer), which then pointed to Attribution or directly to participation, depending on whether additional data such as the date recorded, location, or digital signature were typically needed. The FHIM use of Attribution was driven in part by alignment with CIMI. As FHIR adopted some patterns from CIMI, but not others, the FHIM may well use this FHIR pattern in the future over the CIMI Attribution pattern. If so, this would require changing all clinical classes that currently reference named participations (e.g., performer, observer), to reference a bag of participations instead – with said bag being perhaps restricted by the role types allowed, or even the types of actors that may be allowed. It is possible that we may wish to adopt a middle-ground approach, were named properties are derived attributes that may be implemented using the bag of participations approach. Since this is a fundamental design decision, future versions of the FHIM will likely have to make a dogmatic statement concerning the appropriate approach. For now, however, we allow both approaches to intermix, even though they are fundamentally duplicative.

"Indicates who or what performed or participated in the charged service." - HL7 FHIR, Invoice.participant

Attributes
Participation	participant	"A person, entity, or other party responsible for execution of some facet of the activity." - HL7 CIMI, Attribution.participant "Indicates who or what performed or participated in the charged service." - HL7 FHIR, Invoice.participant
«CS» Code	role	"Describes the type of involvement (e.g. transcriptionist, creator etc.). If the invoice has been created automatically, the Participant may be a billing engine or another kind of device." - HL7 FHIR, Invoice.participant.role

 participant

Public Participation participant

"A person, entity, or other party responsible for execution of some facet of the activity." - HL7 CIMI, Attribution.participant
"Indicates who or what performed or participated in the charged service." - HL7 FHIR, Invoice.participant

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	FHIRParticipant
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	participant
Name Expression
Namespace	FHIRParticipant
Opposite
Owner	FHIRParticipant
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Common::FHIRParticipant::participant
Stereotype
Template Parameter
Type	Participation
Upper	*
Upper Value	(*)
Visibility	Public

 role

Public «CS» Code role

"Describes the type of involvement (e.g. transcriptionist, creator etc.). If the invoice has been created automatically, the Participant may be a billing engine or another kind of device." - HL7 FHIR, Invoice.participant.role

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	FHIRParticipant
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	role
Name Expression
Namespace	FHIRParticipant
Opposite
Owner	FHIRParticipant
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Common::FHIRParticipant::role
Stereotype
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

• Important!
  Read the definition of FHIR Participant concerning the use of FHIR Participant, Participation, and Attribution!