No agent field in Provenance for ADT_A01 => R4

[bitcrshr]

The following HL7 message (yanked from the hl7 website) produces invalid FHIR (R4) because the Provenance resource does not contain an agent field.

MSH|^~\&|ADT1|GOOD HEALTH HOSPITAL|GHH LAB, INC.|GOOD HEALTH HOSPITAL|198808181126|SECURITY|ADT^A01^ADT_A01|MSG00001|P|2.8||
EVN|A01|200708181123||
PID|1||PATID1234^5^M11^ADT1^MR^GOOD HEALTH HOSPITAL~123456789^^^USSSA^SS||EVERYMAN^ADAM^A^III||19610615|M||C|2222 HOME STREET^^GREENSBORO^NC^27401-1020|GL|(555) 555-2004|(555)555-2004||S||PATID12345001^2^M10^ADT1^AN^A|444333333|987654^NC|
NK1|1|NUCLEAR^NELDA^W|SPO^SPOUSE||||NK^NEXT OF KIN
PV1|1|I|2000^2012^01||||004777^ATTEND^AARON^A|||SUR||||ADM|A0|

I am unable to insert the generated FHIR into a store, as I get the following error:

{
    "issue": [
        {
            "code": "structure",
            "details": {
                "text": "unparseable_resource"
            },
            "diagnostics": "missing required field \"agent\"",
            "expression": [
                "Bundle.entry[10].resource.provenance"
            ],
            "severity": "error"
        },
        {
            "code": "structure",
            "details": {
                "text": "unparseable_resource"
            },
            "diagnostics": "failed FHIRPath constraint: fhirpath-constraint-violation-Bundle.entry.resource.ofType(Patient).telecom: \"value.empty() or system.exists()\"",
            "expression": [
                "Bundle.entry[3].resource.ofType(Patient).telecom[0]"
            ],
            "severity": "error"
        },
        {
            "code": "structure",
            "details": {
                "text": "unparseable_resource"
            },
            "diagnostics": "failed FHIRPath constraint: fhirpath-constraint-violation-Bundle.entry.resource.ofType(Patient).telecom: \"value.empty() or system.exists()\"",
            "expression": [
                "Bundle.entry[3].resource.ofType(Patient).telecom[1]"
            ],
            "severity": "error"
        }
    ],
    "resourceType": "OperationOutcome"
}

I believe I can fix the telecom issues fairly easily, but from what I can tell, as long as the MSH (present here) or EVN.5 (not present) is present, the agent field should be rendered. Any guidance here would be greatly appreciated!

This is the result from the converter (though type is modified to be transaction):

{
  "resourceType": "Bundle",
  "type": "transaction",
  "timestamp": "2024-01-18T04:57:31Z",
  "identifier": {
    "value": "MSG00001"
  },
  "id": "513a3d06-5e87-6fbc-ad1b-170ab430499f",
  "entry": [
    {
      "fullUrl": "urn:uuid:64c2d51b-34a4-e841-fb1c-03f1f7762d1a",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "64c2d51b-34a4-e841-fb1c-03f1f7762d1a",
        "source": {
          "name": "ADT1",
          "_endpoint": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
                "valueCode": "unknown"
              }
            ]
          }
        },
        "destination": [
          {
            "name": "GHH LAB, INC.",
            "_endpoint": {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
                  "valueCode": "unknown"
                }
              ]
            },
            "receiver": {
              "reference": "Organization/2d7d77cd-0ca7-13a5-c9ed-6e70b739adb4"
            }
          }
        ],
        "meta": {
          "security": [
            {
              "display": "SECURITY"
            }
          ],
          "tag": [
            {
              "code": "P",
              "system": "http://terminology.hl7.org/CodeSystem/v2-0103"
            }
          ]
        },
        "eventCoding": {
          "code": "A01",
          "system": "http://terminology.hl7.org/CodeSystem/v2-0003",
          "display": "ADT^A01^ADT_A01"
        },
        "sender": {
          "reference": "Organization/2d7d77cd-0ca7-13a5-c9ed-6e70b739adb4"
        }
      },
      "request": {
        "method": "PUT",
        "url": "MessageHeader/64c2d51b-34a4-e841-fb1c-03f1f7762d1a"
      }
    },
    {
      "fullUrl": "urn:uuid:aaf37d11-5d66-af8d-c286-16b46b7f9ada",
      "resource": {
        "resourceType": "Provenance",
        "id": "aaf37d11-5d66-af8d-c286-16b46b7f9ada",
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><span>Resource bundle generated on 2024-01-18T21:57:32.672Z using Microsoft FHIR Converter.</span><span>Template Version: TEMPLATE_VERSION_PLACEHOLDER.</span><span>Template URL: https://github.com/microsoft/FHIR-Converter/releases/download/vTEMPLATE_VERSION_PLACEHOLDER/Hl7v2DefaultTemplates.tar.gz.</span><span>Root template: ADT_A01.</span></p></div>"
        },
        "occurredDateTime": "2024-01-18T04:57:31Z",
        "recorded": "2024-01-18T04:57:31Z",
        "agent": [
          {
            "type": {
              "coding": [
                {
                  "code": "author",
                  "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type"
                }
              ]
            },
            "who": {
              "reference": "Organization/2d7d77cd-0ca7-13a5-c9ed-6e70b739adb4"
            }
          }
        ],
        "activity": {
          "coding": [
            {
              "display": "ADT^A01^ADT_A01"
            }
          ]
        },
        "target": [
          {
            "reference": "Bundle/513a3d06-5e87-6fbc-ad1b-170ab430499f"
          }
        ]
      },
      "request": {
        "method": "PUT",
        "url": "Provenance/aaf37d11-5d66-af8d-c286-16b46b7f9ada"
      }
    },
    {
      "fullUrl": "urn:uuid:2d7d77cd-0ca7-13a5-c9ed-6e70b739adb4",
      "resource": {
        "resourceType": "Organization",
        "id": "2d7d77cd-0ca7-13a5-c9ed-6e70b739adb4",
        "identifier": [
          {
            "value": "GOOD HEALTH HOSPITAL",
            "system": "http://example.com/v2-to-fhir-converter/Identifier/GOOD-HEALTH-HOSPITAL"
          }
        ]
      },
      "request": {
        "method": "PUT",
        "url": "Organization/2d7d77cd-0ca7-13a5-c9ed-6e70b739adb4"
      }
    },
    {
      "fullUrl": "urn:uuid:d5fe6802-a680-e762-8f43-9659340b00ac",
      "resource": {
        "resourceType": "Patient",
        "id": "d5fe6802-a680-e762-8f43-9659340b00ac",
        "identifier": [
          {
            "value": "PATID1234",
            "type": {
              "coding": [
                {
                  "code": "MR",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "display": "Medical record number"
                }
              ]
            },
            "system": "http://example.com/v2-to-fhir-converter/Identifier/ADT1"
          },
          {
            "value": "123456789",
            "type": {
              "coding": [
                {
                  "code": "SS",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "display": "Social Security number"
                }
              ]
            },
            "system": "http://example.com/v2-to-fhir-converter/Identifier/USSSA"
          },
          {
            "value": "444333333",
            "type": {
              "coding": [
                {
                  "code": "SB",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                }
              ]
            },
            "system": "http://hl7.org/fhir/sid/us-ssn"
          },
          {
            "value": "987654",
            "type": {
              "coding": [
                {
                  "code": "DL"
                }
              ]
            },
            "system": "http://example.com/v2-to-fhir-converter/CodeSystem/NC"
          }
        ],
        "name": [
          {
            "family": "EVERYMAN",
            "given": [
              "ADAM",
              "A"
            ],
            "suffix": [
              "III"
            ]
          }
        ],
        "birthDate": "1961-06-15",
        "gender": "male",
        "address": [
          {
            "line": [
              "2222 HOME STREET"
            ],
            "city": "GREENSBORO",
            "state": "NC",
            "postalCode": "27401-1020"
          },
          {
            "district": "GL"
          }
        ],
        "telecom": [
          {
            "value": "(555) 555-2004",
            "use": "home"
          },
          {
            "value": "(555)555-2004",
            "use": "work"
          }
        ],
        "maritalStatus": {
          "coding": [
            {
              "code": "S",
              "display": "Never Married",
              "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"
            }
          ]
        },
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "code": "C",
                  "display": "C"
                }
              },
              {
                "url": "text",
                "valueString": "C"
              }
            ]
          }
        ],
        "contact": [
          {
            "name": {
              "family": "NUCLEAR",
              "given": [
                "NELDA",
                "W"
              ]
            },
            "relationship": [
              {
                "coding": [
                  {
                    "code": "NK",
                    "display": "NEXT OF KIN"
                  }
                ]
              }
            ]
          }
        ]
      },
      "request": {
        "method": "PUT",
        "url": "Patient/d5fe6802-a680-e762-8f43-9659340b00ac"
      }
    },
    {
      "fullUrl": "urn:uuid:d8c83ef0-2bbc-591b-4de7-6f284ab60d0b",
      "resource": {
        "resourceType": "Account",
        "id": "d8c83ef0-2bbc-591b-4de7-6f284ab60d0b",
        "identifier": [
          {
            "value": "PATID12345001",
            "type": {
              "coding": [
                {
                  "code": "AN",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "display": "Account number"
                }
              ]
            },
            "system": "http://example.com/v2-to-fhir-converter/Identifier/ADT1"
          }
        ],
        "status": "active",
        "subject": [
          {
            "reference": "Patient/d5fe6802-a680-e762-8f43-9659340b00ac"
          }
        ]
      },
      "request": {
        "method": "PUT",
        "url": "Account/d8c83ef0-2bbc-591b-4de7-6f284ab60d0b"
      }
    },
    {
      "fullUrl": "urn:uuid:15d1e2fd-66ed-373c-919f-8204c9c27ec6",
      "resource": {
        "resourceType": "Practitioner",
        "id": "15d1e2fd-66ed-373c-919f-8204c9c27ec6",
        "identifier": [
          {
            "value": "004777"
          }
        ],
        "name": [
          {
            "family": "ATTEND",
            "given": [
              "AARON",
              "A"
            ]
          }
        ]
      },
      "request": {
        "method": "PUT",
        "url": "Practitioner/15d1e2fd-66ed-373c-919f-8204c9c27ec6"
      }
    },
    {
      "fullUrl": "urn:uuid:fed49117-7114-cc6d-a564-aa500d035ec6",
      "resource": {
        "resourceType": "Location",
        "id": "fed49117-7114-cc6d-a564-aa500d035ec6",
        "name": "2000",
        "mode": "instance",
        "description": "2000--2012--01",
        "physicalType": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/location-physical-type",
              "code": "lvl"
            }
          ]
        }
      },
      "request": {
        "method": "PUT",
        "url": "Location/fed49117-7114-cc6d-a564-aa500d035ec6"
      }
    },
    {
      "fullUrl": "urn:uuid:87cbde24-7a43-2c4d-b0fd-53f7e8617574",
      "resource": {
        "resourceType": "Location",
        "id": "87cbde24-7a43-2c4d-b0fd-53f7e8617574",
        "partOf": {
          "reference": "Location/fed49117-7114-cc6d-a564-aa500d035ec6"
        },
        "name": "2012",
        "mode": "instance",
        "description": "2000--2012--01",
        "physicalType": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/location-physical-type",
              "code": "ro"
            }
          ]
        }
      },
      "request": {
        "method": "PUT",
        "url": "Location/87cbde24-7a43-2c4d-b0fd-53f7e8617574"
      }
    },
    {
      "fullUrl": "urn:uuid:7eda07b5-b256-87e5-1e3d-c2f69a17ecd3",
      "resource": {
        "resourceType": "Location",
        "id": "7eda07b5-b256-87e5-1e3d-c2f69a17ecd3",
        "partOf": {
          "reference": "Location/87cbde24-7a43-2c4d-b0fd-53f7e8617574"
        },
        "name": "01",
        "mode": "instance",
        "description": "2000--2012--01",
        "physicalType": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/location-physical-type",
              "code": "bd"
            }
          ]
        }
      },
      "request": {
        "method": "PUT",
        "url": "Location/7eda07b5-b256-87e5-1e3d-c2f69a17ecd3"
      }
    },
    {
      "fullUrl": "urn:uuid:8add615d-1d8a-1bf3-bffc-9bd789bee0a3",
      "resource": {
        "resourceType": "Encounter",
        "id": "8add615d-1d8a-1bf3-bffc-9bd789bee0a3",
        "class": {
          "code": "IMP",
          "display": "inpatient encounter",
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode"
        },
        "status": "in-progress",
        "location": [
          {
            "status": "active",
            "location": {
              "reference": "Location/fed49117-7114-cc6d-a564-aa500d035ec6"
            }
          }
        ],
        "hospitalization": {
          "admitSource": {
            "coding": [
              {
                "code": "ADM"
              }
            ]
          }
        },
        "participant": [
          {
            "type": [
              {
                "coding": [
                  {
                    "code": "ATND",
                    "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                    "display": "attender"
                  }
                ]
              }
            ],
            "individual": {
              "reference": "Practitioner/15d1e2fd-66ed-373c-919f-8204c9c27ec6"
            }
          }
        ],
        "serviceType": {
          "coding": [
            {
              "code": "SUR"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><span>Visit Description: </span></p></div>"
        },
        "account": [
          {
            "reference": "Account/d8c83ef0-2bbc-591b-4de7-6f284ab60d0b"
          }
        ],
        "subject": {
          "reference": "Patient/d5fe6802-a680-e762-8f43-9659340b00ac"
        }
      },
      "request": {
        "method": "PUT",
        "url": "Encounter/8add615d-1d8a-1bf3-bffc-9bd789bee0a3"
      }
    },
    {
      "fullUrl": "urn:uuid:c6a03972-34d3-7649-0b8f-004e4d442eca",
      "resource": {
        "resourceType": "Provenance",
        "id": "c6a03972-34d3-7649-0b8f-004e4d442eca",
        "recorded": "2007-08-18T11:23:00Z",
        "activity": {
          "text": "ADT^A01^ADT_A01"
        },
        "target": [
          {
            "reference": "Bundle/513a3d06-5e87-6fbc-ad1b-170ab430499f"
          }
        ]
      },
      "request": {
        "method": "PUT",
        "url": "Provenance/c6a03972-34d3-7649-0b8f-004e4d442eca"
      }
    },
    {
      "fullUrl": "urn:uuid:b3a71bad-ca58-a43e-78c3-228806a2f316",
      "resource": {
        "resourceType": "RelatedPerson",
        "id": "b3a71bad-ca58-a43e-78c3-228806a2f316",
        "relationship": [
          {
            "coding": [
              {
                "code": "SPS",
                "display": "spouse",
                "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode"
              }
            ]
          },
          {
            "coding": [
              {
                "code": "NK",
                "display": "NEXT OF KIN"
              }
            ]
          }
        ],
        "name": [
          {
            "family": "NUCLEAR",
            "given": [
              "NELDA",
              "W"
            ]
          }
        ],
        "patient": {
          "reference": "Patient/d5fe6802-a680-e762-8f43-9659340b00ac"
        }
      },
      "request": {
        "method": "PUT",
        "url": "RelatedPerson/b3a71bad-ca58-a43e-78c3-228806a2f316"
      }
    }
  ]
}

[ms-teli]

Verified our default template HL7v2 > FHIR R4 generates the result like described. The "Provenance" resource in R4 should have the "Agent" field as the cardinality is 1..*: https://fhir-ru.github.io/provenance-definitions.html#Provenance.agent

The issue needs to be fixed.