diff --git a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/plugin/ProcessPluginImpl.java b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/plugin/ProcessPluginImpl.java
index 1dcc2c95f..15cc8c072 100644
--- a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/plugin/ProcessPluginImpl.java
+++ b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/plugin/ProcessPluginImpl.java
@@ -112,7 +112,8 @@ public ProcessPluginImpl(ProcessPluginDefinition processPluginDefinition, int pr
 
 		this.processPluginDefinition = processPluginDefinition;
 
-		variablesFactory = delegateExecution -> new VariablesImpl(delegateExecution, getObjectMapper());
+		variablesFactory = delegateExecution -> new VariablesImpl(delegateExecution, getObjectMapper(),
+				getProcessPluginApi().getDsfClientProvider().getLocalDsfClient());
 		pluginMdc = new PluginMdcImpl(processPluginApiVersion, processPluginDefinition.getName(),
 				processPluginDefinition.getVersion(), jarFile.toString(), serverBaseUrl, variablesFactory);
 	}
diff --git a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/service/StartTaskUpdaterImpl.java b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/service/StartTaskUpdaterImpl.java
new file mode 100644
index 000000000..74cc90f7d
--- /dev/null
+++ b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/service/StartTaskUpdaterImpl.java
@@ -0,0 +1,117 @@
+package dev.dsf.bpe.v2.service;
+
+import java.util.List;
+import java.util.Objects;
+import java.util.Optional;
+import java.util.function.Consumer;
+import java.util.function.Predicate;
+import java.util.function.Supplier;
+
+import org.hl7.fhir.r4.model.Coding;
+import org.hl7.fhir.r4.model.Task;
+import org.hl7.fhir.r4.model.Task.TaskOutputComponent;
+import org.hl7.fhir.r4.model.Type;
+
+import dev.dsf.bpe.v2.client.dsf.DsfClient;
+
+public class StartTaskUpdaterImpl implements StartTaskUpdater
+{
+	private final DsfClient client;
+
+	private final Supplier<Task> getStartTask;
+	private final Consumer<Task> updateTask;
+
+	public StartTaskUpdaterImpl(DsfClient client, Supplier<Task> getStartTask, Consumer<Task> updateTask)
+	{
+		this.client = Objects.requireNonNull(client, "client");
+
+		this.getStartTask = Objects.requireNonNull(getStartTask, "getStartTask");
+		this.updateTask = Objects.requireNonNull(updateTask, "updateTask");
+	}
+
+	@Override
+	public void addOutput(Coding outputType, Type outputValue)
+	{
+		Task task = getStartTask.get();
+		task.addOutput().setValue(outputValue).getType().addCoding(outputType);
+
+		Task updated = client.update(task);
+		updateTask.accept(updated);
+	}
+
+	@Override
+	public Optional<TaskOutputComponent> getOutput(Coding outputType)
+	{
+		checkOutputType(outputType);
+
+		Task task = getStartTask.get();
+		return doGetOutput(task, outputType);
+	}
+
+	private Optional<TaskOutputComponent> doGetOutput(Task task, Coding outputType)
+	{
+		return task.getOutput().stream().filter(matchesSystemAndCodeOptionallyVersion(outputType)).findFirst();
+	}
+
+	private Predicate<TaskOutputComponent> matchesSystemAndCodeOptionallyVersion(Coding outputType)
+	{
+		return o -> o.getType().getCoding().stream()
+				.anyMatch(c -> Objects.equals(c.getSystem(), outputType.getSystem())
+						&& Objects.equals(c.getCode(), outputType.getCode()) && outputType.hasVersion()
+								? Objects.equals(c.getVersion(), outputType.getVersion())
+								: true);
+	}
+
+	@Override
+	public void modifyOutput(Coding outputType, Type outputValue)
+	{
+		checkOutputType(outputType);
+
+		Task task = getStartTask.get();
+
+		doGetOutput(task, outputType)
+				.orElseThrow(() -> new IllegalArgumentException("Output for type " + outputType.getSystem() + "|"
+						+ outputType.getCode()
+						+ (outputType.hasVersion() ? " (version: " + outputType.getVersion() + ") not found" : "")))
+				.setValue(outputValue);
+
+		Task updated = client.update(task);
+		updateTask.accept(updated);
+	}
+
+	@Override
+	public void removeOutput(Coding outputType)
+	{
+		checkOutputType(outputType);
+
+		Task task = getStartTask.get();
+
+		List<TaskOutputComponent> filtered = task.getOutput().stream()
+				.filter(matchesSystemAndCodeOptionallyVersion(outputType).negate()).toList();
+
+		if (task.getOutput().size() == filtered.size())
+			throw new IllegalArgumentException("Output for type " + outputType.getSystem() + "|" + outputType.getCode()
+					+ (outputType.hasVersion() ? " (version: " + outputType.getVersion() + ") not found" : ""));
+
+		task.setOutput(filtered);
+
+		Task updated = client.update(task);
+		updateTask.accept(updated);
+	}
+
+	private void checkOutputType(Coding outputType)
+	{
+		Objects.requireNonNull(outputType, "outputType");
+
+		Objects.requireNonNull(outputType.getSystem(), "outputType.system");
+		Objects.requireNonNull(outputType.getCode(), "outputType.code");
+		Objects.requireNonNull(outputType.getVersion(), "outputType.version");
+
+		if (outputType.getSystem().isBlank())
+			throw new IllegalArgumentException("outputType.system is blank");
+		if (outputType.getCode().isBlank())
+			throw new IllegalArgumentException("outputType.code is blank");
+		if (outputType.getVersion().isBlank())
+			throw new IllegalArgumentException("outputType.version is blank");
+	}
+}
diff --git a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/service/TaskHelperImpl.java b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/service/TaskHelperImpl.java
index 5e2009c07..e8c60ef69 100644
--- a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/service/TaskHelperImpl.java
+++ b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/service/TaskHelperImpl.java
@@ -107,21 +107,9 @@ public ParameterComponent createInput(Type value, Coding coding)
 		return new ParameterComponent(new CodeableConcept(coding), value);
 	}
 
-	@Override
-	public ParameterComponent createInput(Type value, String system, String code)
-	{
-		return createInput(value, new Coding(system, code, null));
-	}
-
 	@Override
 	public TaskOutputComponent createOutput(Type value, Coding coding)
 	{
 		return new TaskOutputComponent(new CodeableConcept(coding), value);
 	}
-
-	@Override
-	public TaskOutputComponent createOutput(Type value, String system, String code)
-	{
-		return createOutput(value, new Coding(system, code, null));
-	}
 }
diff --git a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/spring/ApiServiceConfig.java b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/spring/ApiServiceConfig.java
index ddf598465..a6c5182ee 100644
--- a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/spring/ApiServiceConfig.java
+++ b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/spring/ApiServiceConfig.java
@@ -260,7 +260,7 @@ public JsonHolderSerializer jsonVariableSerializer()
 	@Bean
 	public Function<DelegateExecution, ListenerVariables> listenerVariablesFactory()
 	{
-		return execution -> new VariablesImpl(execution, objectMapper());
+		return execution -> new VariablesImpl(execution, objectMapper(), dsfClientProvider().getLocalDsfClient());
 	}
 
 	@Bean
diff --git a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/variables/VariablesImpl.java b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/variables/VariablesImpl.java
index 7eb2703b2..9ab102fc3 100644
--- a/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/variables/VariablesImpl.java
+++ b/dsf-bpe/dsf-bpe-process-api-v2-impl/src/main/java/dev/dsf/bpe/v2/variables/VariablesImpl.java
@@ -23,8 +23,11 @@
 import com.fasterxml.jackson.databind.ObjectMapper;
 
 import dev.dsf.bpe.api.Constants;
+import dev.dsf.bpe.v2.client.dsf.DsfClient;
 import dev.dsf.bpe.v2.constants.BpmnExecutionVariables;
 import dev.dsf.bpe.v2.listener.ListenerVariables;
+import dev.dsf.bpe.v2.service.StartTaskUpdater;
+import dev.dsf.bpe.v2.service.StartTaskUpdaterImpl;
 import dev.dsf.bpe.v2.variables.FhirResourceValues.FhirResourceValue;
 import dev.dsf.bpe.v2.variables.FhirResourcesListValues.FhirResourcesListValue;
 import dev.dsf.bpe.v2.variables.TargetValues.TargetValue;
@@ -69,16 +72,22 @@ public int hashCode()
 	private final DelegateExecution execution;
 	private final ObjectMapper objectMapper;
 
+	private final StartTaskUpdater startTaskUpdater;
+
 	/**
 	 * @param execution
 	 *            not <code>null</code>
 	 * @param objectMapper
 	 *            not <code>null</code>
+	 * @param client
+	 *            not <code>null</code>
 	 */
-	public VariablesImpl(DelegateExecution execution, ObjectMapper objectMapper)
+	public VariablesImpl(DelegateExecution execution, ObjectMapper objectMapper, DsfClient client)
 	{
 		this.execution = Objects.requireNonNull(execution, "execution");
 		this.objectMapper = Objects.requireNonNull(objectMapper, "objectMapper");
+
+		startTaskUpdater = new StartTaskUpdaterImpl(client, this::getStartTask, this::updateTask);
 	}
 
 	private JsonHolder toJsonHolder(Object json)
@@ -290,6 +299,12 @@ public Task getStartTask()
 		return getFhirResource(START_TASK);
 	}
 
+	@Override
+	public StartTaskUpdater getStartTaskUpdater()
+	{
+		return startTaskUpdater;
+	}
+
 	@Override
 	public Task getLatestTask()
 	{
diff --git a/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/activity/DefaultUserTaskListener.java b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/activity/DefaultUserTaskListener.java
index a66f3dbda..f6313454a 100644
--- a/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/activity/DefaultUserTaskListener.java
+++ b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/activity/DefaultUserTaskListener.java
@@ -16,6 +16,7 @@
 import org.hl7.fhir.r4.model.Reference;
 import org.hl7.fhir.r4.model.ResourceType;
 import org.hl7.fhir.r4.model.StringType;
+import org.hl7.fhir.r4.model.Task;
 import org.hl7.fhir.r4.model.Type;
 import org.slf4j.Logger;
 import org.slf4j.LoggerFactory;
@@ -88,6 +89,10 @@ Coding toCoding()
 	private final Set<KeyAndValue> practitionerRoles = new HashSet<>();
 	private final Set<KeyAndValue> practitioners = new HashSet<>();
 
+	private String taskOutputSystem;
+	private String taskOutputCode;
+	private String taskOutputVersion;
+
 	/**
 	 * @param practitionerRole
 	 *            does nothing if <code>null</code> or blank
@@ -144,6 +149,48 @@ public void setPractitioners(List<String> practitioners)
 		}
 	}
 
+	/**
+	 * If {@link #taskOutputSystem}, {@link #taskOutputCode} and {@link #taskOutputVersion} are set with not blank
+	 * values, an output parameter is added to the start Task with a reference to the created
+	 * {@link QuestionnaireResponse} resource.
+	 *
+	 * @param taskOutputSystem
+	 * @deprecated only for field injection
+	 */
+	@Deprecated
+	public void setTaskOutputSystem(String taskOutputSystem)
+	{
+		this.taskOutputSystem = taskOutputSystem;
+	}
+
+	/**
+	 * If {@link #taskOutputSystem}, {@link #taskOutputCode} and {@link #taskOutputVersion} are set with not blank
+	 * values, an output parameter is added to the start Task with a reference to the created
+	 * {@link QuestionnaireResponse} resource.
+	 *
+	 * @param taskOutputCode
+	 * @deprecated only for field injection
+	 */
+	@Deprecated
+	public void setTaskOutputCode(String taskOutputCode)
+	{
+		this.taskOutputCode = taskOutputCode;
+	}
+
+	/**
+	 * If {@link #taskOutputSystem}, {@link #taskOutputCode} and {@link #taskOutputVersion} are set with not blank
+	 * values, an output parameter is added to the start Task with a reference to the created
+	 * {@link QuestionnaireResponse} resource.
+	 *
+	 * @param taskOutputVersion
+	 * @deprecated only for field injection
+	 */
+	@Deprecated
+	public void setTaskOutputVersion(String taskOutputVersion)
+	{
+		this.taskOutputVersion = taskOutputVersion;
+	}
+
 	@Override
 	public void notify(ProcessPluginApi api, Variables variables,
 			CreateQuestionnaireResponseValues createQuestionnaireResponseValues) throws Exception
@@ -286,7 +333,13 @@ protected void beforeQuestionnaireResponseCreate(ProcessPluginApi api, Variables
 
 	/**
 	 * <i>Override this method to execute code after the {@link QuestionnaireResponse} resource has been created on the
-	 * DSF FHIR server</i>
+	 * DSF FHIR server</i><br>
+	 * <br>
+	 * Default implementation will add an output parameter to the start {@link Task} with a reference to the created
+	 * {@link QuestionnaireResponse} resource if {@link #taskOutputSystem}, {@link #taskOutputCode} and
+	 * {@link #taskOutputVersion} are set with not blank values.<br>
+	 * <br>
+	 * Use field inject in BPMN to set value.
 	 *
 	 * @param api
 	 *            not <code>null</code>
@@ -301,7 +354,12 @@ protected void beforeQuestionnaireResponseCreate(ProcessPluginApi api, Variables
 	protected void afterQuestionnaireResponseCreate(ProcessPluginApi api, Variables variables,
 			CreateQuestionnaireResponseValues createQuestionnaireResponseValues, QuestionnaireResponse afterCreate)
 	{
-		// Nothing to do in default behavior
+		if (taskOutputSystem != null && !taskOutputSystem.isBlank() && taskOutputCode != null
+				&& !taskOutputCode.isBlank() && taskOutputVersion != null && !taskOutputVersion.isBlank())
+		{
+			variables.getStartTaskUpdater().addOutput(taskOutputSystem, taskOutputCode, taskOutputVersion,
+					new Reference(afterCreate.getIdElement().toUnqualifiedVersionless()));
+		}
 	}
 
 	/**
diff --git a/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/service/StartTaskUpdater.java b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/service/StartTaskUpdater.java
new file mode 100644
index 000000000..028e0ba55
--- /dev/null
+++ b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/service/StartTaskUpdater.java
@@ -0,0 +1,206 @@
+package dev.dsf.bpe.v2.service;
+
+import java.util.Objects;
+import java.util.Optional;
+
+import org.hl7.fhir.r4.model.Coding;
+import org.hl7.fhir.r4.model.Task;
+import org.hl7.fhir.r4.model.Task.TaskOutputComponent;
+import org.hl7.fhir.r4.model.Type;
+
+import jakarta.ws.rs.WebApplicationException;
+
+public interface StartTaskUpdater
+{
+	/**
+	 * Adds an output parameter to the start task, updates the {@link Task} on the DSF FHIR server and updates the
+	 * process variable.
+	 *
+	 * @param outputType
+	 *            not <code>null</code>, must have system, code and version
+	 * @param outputValue
+	 *            may be <code>null</code>
+	 * @throws WebApplicationException
+	 *             if start task can not be update at the DSF FHIR server
+	 * @throws IllegalArgumentException
+	 *             if system, code or version of the given <b>outputType</b> is blank
+	 */
+	void addOutput(Coding outputType, Type outputValue) throws WebApplicationException;
+
+	/**
+	 * Adds an output parameter to the start task, updates the {@link Task} on the DSF FHIR server and updates the
+	 * process variable.
+	 *
+	 * @param outputTypeSystem
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeCode
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeVersion
+	 *            not <code>null</code>, not blank
+	 * @param outputValue
+	 *            may be <code>null</code>
+	 * @throws WebApplicationException
+	 *             if start task can not be update at the DSF FHIR server
+	 * @throws IllegalArgumentException
+	 *             if <b>outputTypeSystem</b>, <b>outputTypeCode</b> or <b>outputTypeVersion</b> is blank
+	 */
+	default void addOutput(String outputTypeSystem, String outputTypeCode, String outputTypeVersion, Type outputValue)
+			throws WebApplicationException
+	{
+		Objects.requireNonNull(outputTypeSystem, "outputTypeSystem");
+		Objects.requireNonNull(outputTypeCode, "outputTypeCode");
+		Objects.requireNonNull(outputTypeVersion, "outputTypeVersion");
+
+		if (outputTypeSystem.isBlank())
+			throw new IllegalArgumentException("outputTypeSystem is blank");
+		if (outputTypeCode.isBlank())
+			throw new IllegalArgumentException("outputTypeCode is blank");
+		if (outputTypeVersion.isBlank())
+			throw new IllegalArgumentException("outputTypeVersion is blank");
+
+		addOutput(new Coding(outputTypeSystem, outputTypeCode, null).setVersion(outputTypeVersion), outputValue);
+	}
+
+	/**
+	 * @param outputType
+	 *            not <code>null</code>, must have system and code and version
+	 * @return Output with the given <b>outputType</b> from the start task if present
+	 */
+	Optional<TaskOutputComponent> getOutput(Coding outputType);
+
+	/**
+	 * @param outputTypeSystem
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeCode
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeVersion
+	 *            not <code>null</code>, not blank
+	 * @return Output with the given <b>outputType</b> from the start task if present
+	 * @throws IllegalArgumentException
+	 *             if <b>outputTypeSystem</b>, <b>outputTypeCode</b> or <b>outputTypeVersion</b> is blank
+	 */
+	default Optional<TaskOutputComponent> getOutput(String outputTypeSystem, String outputTypeCode,
+			String outputTypeVersion)
+	{
+		Objects.requireNonNull(outputTypeSystem, "outputTypeSystem");
+		Objects.requireNonNull(outputTypeCode, "outputTypeCode");
+		Objects.requireNonNull(outputTypeVersion, "outputTypeVersion");
+
+		if (outputTypeSystem.isBlank())
+			throw new IllegalArgumentException("outputTypeSystem is blank");
+		if (outputTypeCode.isBlank())
+			throw new IllegalArgumentException("outputTypeCode is blank");
+		if (outputTypeVersion.isBlank())
+			throw new IllegalArgumentException("outputTypeVersion is blank");
+
+		return getOutput(new Coding(outputTypeSystem, outputTypeCode, null).setVersion(outputTypeVersion));
+	}
+
+	/**
+	 * @param outputType
+	 *            not <code>null</code>, must have system and code and version
+	 * @return <code>true</code> if the start task has output parameter with the given <b>outputType</b>
+	 */
+	default boolean hasOuput(Coding outputType)
+	{
+		return getOutput(outputType).isPresent();
+	}
+
+	/**
+	 * Set the given <b>outputValue</b> for an output parameter of the start task with the given <b>outputType</b>,
+	 * updates the {@link Task} on the DSF FHIR server and updates the process variable.
+	 *
+	 * @param outputTypeSystem
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeCode
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeVersion
+	 *            not <code>null</code>, not blank
+	 * @param outputValue
+	 *            may be <code>null</code>
+	 * @throws WebApplicationException
+	 *             if start task can not be update at the DSF FHIR server
+	 * @throws IllegalArgumentException
+	 *             if the start task has no output parameter with the given outputType parameters or if
+	 *             <b>outputTypeSystem</b>, <b>outputTypeCode</b> or <b>outputTypeVersion</b> is blank
+	 */
+	default void modifyOutput(String outputTypeSystem, String outputTypeCode, String outputTypeVersion,
+			Type outputValue) throws WebApplicationException
+	{
+		Objects.requireNonNull(outputTypeSystem, "outputTypeSystem");
+		Objects.requireNonNull(outputTypeCode, "outputTypeCode");
+		Objects.requireNonNull(outputTypeVersion, "outputTypeVersion");
+
+		if (outputTypeSystem.isBlank())
+			throw new IllegalArgumentException("outputTypeSystem is blank");
+		if (outputTypeCode.isBlank())
+			throw new IllegalArgumentException("outputTypeCode is blank");
+		if (outputTypeVersion.isBlank())
+			throw new IllegalArgumentException("outputTypeVersion is blank");
+
+		modifyOutput(new Coding(outputTypeSystem, outputTypeCode, null).setVersion(outputTypeVersion), outputValue);
+	}
+
+	/**
+	 * Set the given <b>outputValue</b> for an output parameter of the start task with the given <b>outputType</b>,
+	 * updates the {@link Task} on the DSF FHIR server and updates the process variable.
+	 *
+	 * @param outputType
+	 *            not <code>null</code>, must have system, code and version
+	 * @param outputValue
+	 *            may be <code>null</code>
+	 * @throws WebApplicationException
+	 *             if start task can not be update at the DSF FHIR server
+	 * @throws IllegalArgumentException
+	 *             if the start task has no output parameter with the given <b>outputType</b> or if system, code or
+	 *             version of the given <b>outputType</b> is blank
+	 */
+	void modifyOutput(Coding outputType, Type outputValue) throws WebApplicationException;
+
+	/**
+	 * Removes an output parameter of the start task with the given <b>outputType</b>, updates the {@link Task} on the
+	 * DSF FHIR server and updates the process variable.
+	 *
+	 * @param outputType
+	 *            not <code>null</code>, must have system and code and version
+	 * @throws WebApplicationException
+	 *             if start task can not be update at the DSF FHIR server
+	 * @throws IllegalArgumentException
+	 *             if the start task has no output parameter with the given <b>outputType</b> or if system, code or
+	 *             version of the given <b>outputType</b> is blank
+	 */
+	void removeOutput(Coding outputType) throws WebApplicationException;
+
+	/**
+	 * Removes an output parameter of the start task with the given <b>outputType</b>, updates the {@link Task} on the
+	 * DSF FHIR server and updates the process variable.
+	 *
+	 * @param outputTypeSystem
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeCode
+	 *            not <code>null</code>, not blank
+	 * @param outputTypeVersion
+	 *            not <code>null</code>, not blank
+	 * @throws WebApplicationException
+	 *             if start task can not be update at the DSF FHIR server
+	 * @throws IllegalArgumentException
+	 *             if the start task has no output parameter with the given <b>outputType</b> or if system, code or
+	 *             version of the given <b>outputType</b> is blank
+	 */
+	default void removeOutput(String outputTypeSystem, String outputTypeCode, String outputTypeVersion)
+			throws WebApplicationException
+	{
+		Objects.requireNonNull(outputTypeSystem, "outputTypeSystem");
+		Objects.requireNonNull(outputTypeCode, "outputTypeCode");
+		Objects.requireNonNull(outputTypeVersion, "outputTypeVersion");
+
+		if (outputTypeSystem.isBlank())
+			throw new IllegalArgumentException("outputTypeSystem is blank");
+		if (outputTypeCode.isBlank())
+			throw new IllegalArgumentException("outputTypeCode is blank");
+		if (outputTypeVersion.isBlank())
+			throw new IllegalArgumentException("outputTypeVersion is blank");
+
+		removeOutput(new Coding(outputTypeSystem, outputTypeCode, null).setVersion(outputTypeVersion));
+	}
+}
diff --git a/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/service/TaskHelper.java b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/service/TaskHelper.java
index 0b8693e97..1cd198af9 100644
--- a/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/service/TaskHelper.java
+++ b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/service/TaskHelper.java
@@ -387,11 +387,16 @@ Stream<ParameterComponent> getInputParameters(Task task, String system, String c
 	 *            may be <code>null</code>
 	 * @param code
 	 *            may be <code>null</code>
+	 * @param version
+	 *            may be <code>null</code>
 	 * @return not <code>null</code>
 	 * @see ParameterComponent#setType(org.hl7.fhir.r4.model.CodeableConcept)
 	 * @see ParameterComponent#setValue(Type)
 	 */
-	ParameterComponent createInput(Type value, String system, String code);
+	default ParameterComponent createInput(Type value, String system, String code, String version)
+	{
+		return createInput(value, new Coding(system, code, null).setVersion(version));
+	}
 
 
 	/**
@@ -416,9 +421,14 @@ Stream<ParameterComponent> getInputParameters(Task task, String system, String c
 	 *            may be <code>null</code>
 	 * @param code
 	 *            may be <code>null</code>
+	 * @param version
+	 *            may be <code>null</code>
 	 * @return not <code>null</code>
 	 * @see TaskOutputComponent#setType(org.hl7.fhir.r4.model.CodeableConcept)
 	 * @see TaskOutputComponent#setValue(Type)
 	 */
-	TaskOutputComponent createOutput(Type value, String system, String code);
+	default TaskOutputComponent createOutput(Type value, String system, String code, String version)
+	{
+		return createOutput(value, new Coding(system, code, null).setVersion(version));
+	}
 }
diff --git a/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/variables/Variables.java b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/variables/Variables.java
index 9367cdcdd..dfced4a89 100644
--- a/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/variables/Variables.java
+++ b/dsf-bpe/dsf-bpe-process-api-v2/src/main/java/dev/dsf/bpe/v2/variables/Variables.java
@@ -15,6 +15,7 @@
 
 import dev.dsf.bpe.v2.activity.task.BusinessKeyStrategies;
 import dev.dsf.bpe.v2.constants.BpmnExecutionVariables;
+import dev.dsf.bpe.v2.service.StartTaskUpdater;
 
 /**
  * Gives access to process execution variables. Includes factory methods for {@link Target} and {@link Targets} values.
@@ -248,6 +249,14 @@ default Targets createTargets(Target... targets)
 	 */
 	Task getStartTask();
 
+	/**
+	 * Returns a {@link StartTaskUpdater} to modify the start task during process execution and propagate modified
+	 * output parameters to the local DSF FHIR server.
+	 *
+	 * @return service to update the start task
+	 */
+	StartTaskUpdater getStartTaskUpdater();
+
 	/**
 	 * Returns the latest {@link Task} received by this process or subprocess via a intermediate message catch event or
 	 * message receive task.
diff --git a/dsf-bpe/dsf-bpe-test-plugin-v2/src/main/java/dev/dsf/bpe/test/AbstractTest.java b/dsf-bpe/dsf-bpe-test-plugin-v2/src/main/java/dev/dsf/bpe/test/AbstractTest.java
index d3c9b22d9..70bd16468 100644
--- a/dsf-bpe/dsf-bpe-test-plugin-v2/src/main/java/dev/dsf/bpe/test/AbstractTest.java
+++ b/dsf-bpe/dsf-bpe-test-plugin-v2/src/main/java/dev/dsf/bpe/test/AbstractTest.java
@@ -32,7 +32,7 @@ protected void executeTests(ProcessPluginApi api, Variables variables, Function<
 
 	private Consumer<String> output(ProcessPluginApi api, Variables variables, String code)
 	{
-		return t -> variables.getStartTask().addOutput(
-				api.getTaskHelper().createOutput(new StringType(t), "http://dsf.dev/fhir/CodeSystem/test", code));
+		return t -> variables.getStartTask().addOutput(api.getTaskHelper().createOutput(new StringType(t),
+				"http://dsf.dev/fhir/CodeSystem/test", code, api.getProcessPluginDefinition().getResourceVersion()));
 	}
 }
diff --git a/dsf-fhir/dsf-fhir-server/src/main/java/dev/dsf/fhir/authorization/TaskAuthorizationRule.java b/dsf-fhir/dsf-fhir-server/src/main/java/dev/dsf/fhir/authorization/TaskAuthorizationRule.java
index 316abb3b4..7bbb1a927 100644
--- a/dsf-fhir/dsf-fhir-server/src/main/java/dev/dsf/fhir/authorization/TaskAuthorizationRule.java
+++ b/dsf-fhir/dsf-fhir-server/src/main/java/dev/dsf/fhir/authorization/TaskAuthorizationRule.java
@@ -871,12 +871,50 @@ else if (TaskStatus.REQUESTED.equals(oldResource.getStatus())
 					}
 				}
 
+				// INPROGRESS -> INPROGRESS
+				else if (TaskStatus.INPROGRESS.equals(oldResource.getStatus())
+						&& TaskStatus.INPROGRESS.equals(newResource.getStatus()))
+				{
+					final Optional<String> notSame = reasonNotSame(oldResource, newResource);
+					if (notSame.isEmpty())
+					{
+						if (taskAllowedForRecipient(connection, newResource))
+						{
+							logger.info(
+									"Update of Task/{}/_history/{} ({} -> {}) authorized for local identity '{}', old Task.status in-progress, new Task.status in-progress, process allowed for current identity",
+									oldResourceId, oldResourceVersion, TaskStatus.INPROGRESS.toCode(),
+									TaskStatus.INPROGRESS.toCode(), identity.getName());
+
+							return Optional.of(
+									"Local identity, Task.status in-progress, Task.restriction.recipient local organization, process with instantiatesCanonical and message-name allowed for current identity"
+											+ ", Task defines needed profile, Task.instantiatesCanonical not modified, Task.requester not modified, Task.restriction not modified, Task.input not modified");
+						}
+						else
+						{
+							logger.warn(
+									"Update of Task/{}/_history/{} ({} -> {}) unauthorized for local identity '{}', process with instantiatesCanonical, message-name, requester or recipient not allowed",
+									oldResourceId, oldResourceVersion, TaskStatus.INPROGRESS.toCode(),
+									TaskStatus.INPROGRESS.toCode(), identity.getName());
+
+							return Optional.empty();
+						}
+					}
+					else
+					{
+						logger.warn(
+								"Update of Task/{}/_history/{} ({} -> {}) unauthorized for local identity '{}', modification of Task properties {} not allowed",
+								oldResourceId, oldResourceVersion, TaskStatus.INPROGRESS.toCode(),
+								TaskStatus.INPROGRESS.toCode(), identity.getName(), notSame.get());
+
+						return Optional.empty();
+					}
+				}
 				// INPROGRESS -> COMPLETED
 				else if (TaskStatus.INPROGRESS.equals(oldResource.getStatus())
 						&& TaskStatus.COMPLETED.equals(newResource.getStatus()))
 				{
-					final Optional<String> same = reasonNotSame(oldResource, newResource);
-					if (same.isEmpty())
+					final Optional<String> notSame = reasonNotSame(oldResource, newResource);
+					if (notSame.isEmpty())
 					{
 						if (taskAllowedForRecipient(connection, newResource))
 						{
@@ -904,7 +942,7 @@ else if (TaskStatus.INPROGRESS.equals(oldResource.getStatus())
 						logger.warn(
 								"Update of Task/{}/_history/{} ({} -> {}) unauthorized for local identity '{}', modification of Task properties {} not allowed",
 								oldResourceId, oldResourceVersion, TaskStatus.INPROGRESS.toCode(),
-								TaskStatus.COMPLETED.toCode(), identity.getName(), same.get());
+								TaskStatus.COMPLETED.toCode(), identity.getName(), notSame.get());
 
 						return Optional.empty();
 					}
@@ -914,8 +952,8 @@ else if (TaskStatus.INPROGRESS.equals(oldResource.getStatus())
 				else if (TaskStatus.REQUESTED.equals(oldResource.getStatus())
 						&& TaskStatus.FAILED.equals(newResource.getStatus()))
 				{
-					final Optional<String> same = reasonNotSame(oldResource, newResource);
-					if (same.isEmpty())
+					final Optional<String> notSame = reasonNotSame(oldResource, newResource);
+					if (notSame.isEmpty())
 					{
 						logger.info(
 								"Update of Task/{}/_history/{} ({} -> {}) authorized for local identity '{}', old Task.status requested, new Task.status failed",
@@ -931,7 +969,7 @@ else if (TaskStatus.REQUESTED.equals(oldResource.getStatus())
 						logger.warn(
 								"Update of Task/{}/_history/{} ({} -> {}) unauthorized for local identity '{}', modification of Task properties {} not allowed",
 								oldResourceId, oldResourceVersion, TaskStatus.REQUESTED.toCode(),
-								TaskStatus.FAILED.toCode(), identity.getName(), same.get());
+								TaskStatus.FAILED.toCode(), identity.getName(), notSame.get());
 
 						return Optional.empty();
 					}
@@ -940,8 +978,8 @@ else if (TaskStatus.REQUESTED.equals(oldResource.getStatus())
 				else if (TaskStatus.INPROGRESS.equals(oldResource.getStatus())
 						&& TaskStatus.FAILED.equals(newResource.getStatus()))
 				{
-					final Optional<String> same = reasonNotSame(oldResource, newResource);
-					if (same.isEmpty())
+					final Optional<String> notSame = reasonNotSame(oldResource, newResource);
+					if (notSame.isEmpty())
 					{
 						if (taskAllowedForRecipient(connection, newResource))
 						{
@@ -969,7 +1007,7 @@ else if (TaskStatus.INPROGRESS.equals(oldResource.getStatus())
 						logger.warn(
 								"Update of Task/{}/_history/{} ({} -> {}) unauthorized for local identity '{}', modification of Task properties {} not allowed",
 								oldResourceId, oldResourceVersion, TaskStatus.INPROGRESS.toCode(),
-								TaskStatus.FAILED.toCode(), identity.getName(), same.get());
+								TaskStatus.FAILED.toCode(), identity.getName(), notSame.get());
 
 						return Optional.empty();
 					}
@@ -985,6 +1023,7 @@ else if (TaskStatus.INPROGRESS.equals(oldResource.getStatus())
 							identity.getName(),
 							Stream.of(Stream.of(TaskStatus.DRAFT, TaskStatus.DRAFT),
 									Stream.of(TaskStatus.REQUESTED, TaskStatus.INPROGRESS),
+									Stream.of(TaskStatus.INPROGRESS, TaskStatus.INPROGRESS),
 									Stream.of(TaskStatus.INPROGRESS, TaskStatus.COMPLETED),
 									Stream.of(TaskStatus.INPROGRESS, TaskStatus.FAILED))
 									.map(s -> s.map(TaskStatus::toCode).collect(Collectors.joining("->")))
diff --git a/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/static/form.css b/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/static/form.css
index 25d8eb123..ab99ca6fa 100644
--- a/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/static/form.css
+++ b/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/static/form.css
@@ -201,6 +201,15 @@ input[type=number] {
 	display: none;
 }
 
+.open {
+	align-self: center;
+	margin-left: 0.5em;
+}
+
+.open svg {
+	margin-top: 0.2em;
+}
+
 .copy {
 	align-self: center;
 	margin-left: 0.5em;
@@ -218,14 +227,6 @@ input.identifier-coding-code {
 	margin-top: 6px;
 }
 
-/* .input-output-header {
-	font-family: monospace;
-	font-size: 1.75em;
-	color: #326F95;
-	padding-left: 5px;
-	margin-bottom: 12px;
-} */
-
 .invisible {
 	display: none;
 }
diff --git a/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/template/resourceTask.html b/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/template/resourceTask.html
index c3b52b4af..d518e9aa3 100644
--- a/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/template/resourceTask.html
+++ b/dsf-fhir/dsf-fhir-server/src/main/resources/fhir/template/resourceTask.html
@@ -30,6 +30,9 @@ <h3 th:if="${not #lists.isEmpty(task.input)}">Input</h3>
 							<div class="input-group">
 								<input th:type="${i.type}" placeholder="string" th:id="${i.id}" th:attr="${resource.status == 'draft' ? 'placeholder' : 'value'} = ${i.stringValue} ?: ${i.type}, fhir-type = ${i.fhirType}">
 								<svg class="insert" height="22" width="22" viewBox="0 -960 960 960" th:disabled="${i.stringValue} == null" th:if="${resource.status == 'draft'}"><title>Insert Placeholder Value</title><path d="M140-160q-24 0-42-18t-18-42v-169h60v169h680v-520H140v171H80v-171q0-24 18-42t42-18h680q24 0 42 18t18 42v520q0 24-18 42t-42 18H140Zm319-143-43-43 103-103H80v-60h439L416-612l43-43 176 176-176 176Z"></path></svg>
+								<a class="open" th:href="${i.stringValue}" th:if="${resource.status != 'draft' and i.type == 'url'}">
+									<svg height="22" width="22" viewBox="0 -960 960 960"><title>Open Resource</title><path d="M180-120q-24 0-42-18t-18-42v-600q0-24 18-42t42-18h600q24 0 42 18t18 42v600q0 24-18 42t-42 18H570v-60h210v-540H180v540h210v60H180Zm270 0v-284l-83 83-43-43 156-156 156 156-43 43-83-83v284h-60Z"/></svg>
+								</a>
 								<svg class="copy" height="22" width="22" viewBox="0 -960 960 960" th:if="${resource.status != 'draft'}"><title>Copy to Clipboard</title><path d="M362.308-260.001q-30.308 0-51.307-21-21-21-21-51.308v-455.382q0-30.308 21-51.308 20.999-21 51.307-21h335.383q30.307 0 51.307 21 21 21 21 51.308v455.382q0 30.308-21 51.308t-51.307 21H362.308Zm0-59.999h335.383q4.615 0 8.462-3.846 3.846-3.847 3.846-8.463v-455.382q0-4.616-3.846-8.463-3.847-3.846-8.462-3.846H362.308q-4.616 0-8.462 3.846-3.847 3.847-3.847 8.463v455.382q0 4.616 3.847 8.463 3.846 3.846 8.462 3.846ZM222.309-120.003q-30.307 0-51.307-21-21-21-21-51.307v-515.381h59.999v515.381q0 4.616 3.846 8.462 3.847 3.847 8.462 3.847h395.382v59.998H222.309ZM349.999-320V-800-320Z"/></svg>
 							</div>								
 						</th:block>
@@ -79,7 +82,7 @@ <h3 th:if="${not #lists.isEmpty(task.input)}">Input</h3>
 				</fieldset>
 			</form>
 			<h3 th:if="${not #lists.isEmpty(task.output)}">Output</h3>
-			<form th:if="${(resource.status == 'failed' or resource.status == 'completed') and not #lists.isEmpty(task.output)}">
+			<form th:if="${(resource.status == 'in-progress' or resource.status == 'failed' or resource.status == 'completed') and not #lists.isEmpty(task.output)}">
 				<fieldset id="form-fieldset" disabled>
 					<div class="row" th:each="o : ${task.output}" th:if="${task.output}" th:classappend="${o.type == null ? 'row-display' : ''}" th:attr="for = ${o.id}">
 						<th:block th:if="${o.type == null}">
@@ -89,6 +92,9 @@ <h3 th:if="${not #lists.isEmpty(task.output)}">Output</h3>
 							<label class="row-label" th:if="${o.label}" th:for="${o.id}" th:title="${o.labelTitle}" th:text="${o.label}">label</label>
 							<div class="input-group">
 								<input th:type="${o.type}" th:id="${o.id}" th:value="${o.stringValue}">
+								<a class="open" th:href="${o.stringValue}" th:if="${resource.status != 'draft' and o.type == 'url'}">
+									<svg height="22" width="22" viewBox="0 -960 960 960"><title>Open Resource</title><path d="M180-120q-24 0-42-18t-18-42v-600q0-24 18-42t42-18h600q24 0 42 18t18 42v600q0 24-18 42t-42 18H570v-60h210v-540H180v540h210v60H180Zm270 0v-284l-83 83-43-43 156-156 156 156-43 43-83-83v284h-60Z"/></svg>
+								</a>
 								<svg class="copy" height="22" width="22" viewBox="0 -960 960 960" th:if="${resource.status != 'draft'}"><title>Copy to Clipboard</title><path d="M362.308-260.001q-30.308 0-51.307-21-21-21-21-51.308v-455.382q0-30.308 21-51.308 20.999-21 51.307-21h335.383q30.307 0 51.307 21 21 21 21 51.308v455.382q0 30.308-21 51.308t-51.307 21H362.308Zm0-59.999h335.383q4.615 0 8.462-3.846 3.846-3.847 3.846-8.463v-455.382q0-4.616-3.846-8.463-3.847-3.846-8.462-3.846H362.308q-4.616 0-8.462 3.846-3.847 3.847-3.847 8.463v455.382q0 4.616 3.847 8.463 3.846 3.846 8.462 3.846ZM222.309-120.003q-30.307 0-51.307-21-21-21-21-51.307v-515.381h59.999v515.381q0 4.616 3.846 8.462 3.847 3.847 8.462 3.847h395.382v59.998H222.309ZM349.999-320V-800-320Z"/></svg>
 							</div>								
 						</th:block>
@@ -131,6 +137,9 @@ <h3 th:if="${not #lists.isEmpty(task.output)}">Output</h3>
 									<label class="extension-label" th:if="${e.url}" th:for="${e.id}" th:title="${e.url}" th:text="${e.url}">url</label>
 									<div class="input-group">
 										<input th:type="${e.type}" th:id="${e.id}" th:value="${e.stringValue}">
+										<a class="open" th:href="${e.stringValue}" th:if="${resource.status != 'draft' and e.type == 'url'}">
+											<svg height="22" width="22" viewBox="0 -960 960 960"><title>Open Resource</title><path d="M180-120q-24 0-42-18t-18-42v-600q0-24 18-42t42-18h600q24 0 42 18t18 42v600q0 24-18 42t-42 18H570v-60h210v-540H180v540h210v60H180Zm270 0v-284l-83 83-43-43 156-156 156 156-43 43-83-83v284h-60Z"/></svg>
+										</a>
 										<svg class="copy" height="22" width="22" viewBox="0 -960 960 960" th:if="${resource.status != 'draft'}"><title>Copy to Clipboard</title><path d="M362.308-260.001q-30.308 0-51.307-21-21-21-21-51.308v-455.382q0-30.308 21-51.308 20.999-21 51.307-21h335.383q30.307 0 51.307 21 21 21 21 51.308v455.382q0 30.308-21 51.308t-51.307 21H362.308Zm0-59.999h335.383q4.615 0 8.462-3.846 3.846-3.847 3.846-8.463v-455.382q0-4.616-3.846-8.463-3.847-3.846-8.462-3.846H362.308q-4.616 0-8.462 3.846-3.847 3.847-3.847 8.463v455.382q0 4.616 3.847 8.463 3.846 3.846 8.462 3.846ZM222.309-120.003q-30.307 0-51.307-21-21-21-21-51.307v-515.381h59.999v515.381q0 4.616 3.846 8.462 3.847 3.847 8.462 3.847h395.382v59.998H222.309ZM349.999-320V-800-320Z"/></svg>
 									</div>								
 								</th:block>
diff --git a/dsf-fhir/dsf-fhir-server/src/test/java/dev/dsf/fhir/integration/TaskIntegrationTest.java b/dsf-fhir/dsf-fhir-server/src/test/java/dev/dsf/fhir/integration/TaskIntegrationTest.java
index bb3c470cb..23332c2cc 100755
--- a/dsf-fhir/dsf-fhir-server/src/test/java/dev/dsf/fhir/integration/TaskIntegrationTest.java
+++ b/dsf-fhir/dsf-fhir-server/src/test/java/dev/dsf/fhir/integration/TaskIntegrationTest.java
@@ -8,10 +8,12 @@
 
 import java.io.IOException;
 import java.io.InputStream;
+import java.nio.charset.StandardCharsets;
 import java.nio.file.Files;
 import java.nio.file.Paths;
 import java.sql.Connection;
 import java.sql.SQLException;
+import java.util.Base64;
 import java.util.Date;
 import java.util.EnumSet;
 import java.util.List;
@@ -22,6 +24,7 @@
 import javax.sql.DataSource;
 
 import org.hl7.fhir.r4.model.ActivityDefinition;
+import org.hl7.fhir.r4.model.Binary;
 import org.hl7.fhir.r4.model.Bundle;
 import org.hl7.fhir.r4.model.Bundle.BundleEntryComponent;
 import org.hl7.fhir.r4.model.Bundle.BundleType;
@@ -1381,7 +1384,8 @@ public void testSearchByProfile() throws Exception
 		assertEquals(0, result6.getTotal());
 	}
 
-	private Task createTask(TaskStatus createStatus, boolean createPluginResources) throws IOException, SQLException
+	private Task createTaskBinary(Task task, TaskStatus createStatus, boolean createPluginResources)
+			throws IOException, SQLException
 	{
 		if (createPluginResources)
 		{
@@ -1403,7 +1407,6 @@ private Task createTask(TaskStatus createStatus, boolean createPluginResources)
 			assertNotNull(sd.getIdElement().getIdPart());
 		}
 
-		Task task = readTestTaskBinary("External_Test_Organization", "Test_Organization");
 		task.setStatus(createStatus);
 		TaskDao taskDao = getSpringWebApplicationContext().getBean(TaskDao.class);
 		Task created = taskDao.create(task);
@@ -1417,7 +1420,8 @@ private Task createTask(TaskStatus createStatus, boolean createPluginResources)
 	@Test
 	public void testUpdateTaskFromInProgressToCompletedWithNonExistingInputReferenceToExternalBinary() throws Exception
 	{
-		Task created = createTask(TaskStatus.INPROGRESS, true);
+		Task read = readTestTaskBinary("External_Test_Organization", "Test_Organization");
+		Task created = createTaskBinary(read, TaskStatus.INPROGRESS, true);
 		created.setStatus(TaskStatus.COMPLETED);
 
 		Task updatedTask = getWebserviceClient().update(created);
@@ -1425,10 +1429,93 @@ public void testUpdateTaskFromInProgressToCompletedWithNonExistingInputReference
 		assertNotNull(updatedTask.getIdElement().getIdPart());
 	}
 
+	@Test
+	public void testUpdateTaskFromInProgressToInProgressWithNonExistingInputReferenceToBinaryNotAllowed()
+			throws Exception
+	{
+		Task created = createTaskInProgress();
+
+		created.addOutput().setValue(new Reference().setReference("Binary/" + UUID.randomUUID().toString())).getType()
+				.getCodingFirstRep().setSystem("http://dsf.dev/fhir/CodeSystem/test").setCode("binary-ref")
+				.setVersion("1.7");
+
+		expectForbidden(() -> getWebserviceClient().update(created));
+	}
+
+	@Test
+	public void testUpdateTaskFromInProgressToInProgressWithExistingInputReferencesToBinaryAllowed() throws Exception
+	{
+		Binary binary = new Binary();
+		getReadAccessHelper().addLocal(binary);
+		binary.setContent(Base64.getDecoder().decode(
+				("fCAgXyBcICAvIFx8XyAgIF98LyBcICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgICANCnwgfCB8IHwvIF8gXCB8IHwgLyBfIFwgICAgICAgICAg"
+						+ "ICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgDQp8IHxffCAvIF9fXyBcfCB8LyBfX18gXCAgICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgICAgIA0K"
+						+ "fF9fX18vXy8gICBcX1xfL18vICAgXF9cXyAgX19fIF8gICBfICBfX19fICAgICAgICAgICAgICAgICAgICANCi8gX19ffHwgfCB8IHwgIC8gXCAgfCAgXyBcfF8gX3wg"
+						+ "XCB8IHwvIF9fX3wgICAgICAgICAgICAgICAgICAgDQpcX19fIFx8IHxffCB8IC8gXyBcIHwgfF8pIHx8IHx8ICBcfCB8IHwgIF8gICAgICAgICAgICAgICAgICAgIA0K"
+						+ "IF9fXykgfCAgXyAgfC8gX19fIFx8ICBfIDwgfCB8fCB8XCAgfCB8X3wgfCAgICAgICAgICAgICAgICAgICANCnxfX19fL3xffF98Xy9fLyAgX1xfXF98X1xfXF9fX3xf"
+						+ "fF9cX3xcX19fX3wgX19fX18gIF9fX18gIF8gIF9fDQp8ICBfX198ICBfIFwgICAgLyBcICB8ICBcLyAgfCBfX19fXCBcICAgICAgLyAvIF8gXHwgIF8gXHwgfC8gLw0K"
+						+ "fCB8XyAgfCB8XykgfCAgLyBfIFwgfCB8XC98IHwgIF98ICBcIFwgL1wgLyAvIHwgfCB8IHxfKSB8ICcgLyANCnwgIF98IHwgIF8gPCAgLyBfX18gXHwgfCAgfCB8IHxf"
+						+ "X18gIFwgViAgViAvfCB8X3wgfCAgXyA8fCAuIFwgDQp8X3wgICB8X3wgXF9cL18vICAgXF9cX3wgIHxffF9fX19ffCAgXF8vXF8vICBcX19fL3xffCBcX1xffFxfXA")
+						.getBytes(StandardCharsets.UTF_8)));
+		binary.setContentType("text/plain");
+
+		Binary createdBinary = getWebserviceClient().create(binary);
+
+		Task created = createTaskInProgress();
+		created.addOutput()
+				.setValue(new Reference()
+						.setReference(createdBinary.getIdElement().toUnqualifiedVersionless().toString()))
+				.getType().getCodingFirstRep().setSystem("http://dsf.dev/fhir/CodeSystem/test").setCode("binary-ref")
+				.setVersion("1.7");
+
+		Task updatedTask1 = getWebserviceClient().update(created);
+		assertNotNull(updatedTask1);
+		assertNotNull(updatedTask1.getIdElement().getIdPart());
+
+		updatedTask1.setOutput(null);
+
+		Task updatedTask2 = getWebserviceClient().update(updatedTask1);
+		assertNotNull(updatedTask2);
+		assertNotNull(updatedTask2.getIdElement().getIdPart());
+	}
+
+	private Task createTaskInProgress() throws IOException, SQLException
+	{
+		ActivityDefinition ad = getWebserviceClient()
+				.create(readActivityDefinition("dsf-test-activity-definition1-1.0.xml"));
+		assertNotNull(ad);
+		assertNotNull(ad.getIdElement().getIdPart());
+
+		CodeSystem cs = getWebserviceClient().create(readTestCodeSystem());
+		assertNotNull(cs);
+		assertNotNull(cs.getIdElement().getIdPart());
+
+		ValueSet vs = getWebserviceClient().create(readTestValueSet());
+		assertNotNull(vs);
+		assertNotNull(vs.getIdElement().getIdPart());
+
+		StructureDefinition sd = getWebserviceClient().create(readTestTaskProfile());
+		assertNotNull(sd);
+		assertNotNull(sd.getIdElement().getIdPart());
+
+		Task read = readTestTask("Test_Organization", null, "Test_Organization");
+		read.setStatus(TaskStatus.INPROGRESS);
+		read.addInput().setValue(new StringType(UUID.randomUUID().toString())).getType().getCodingFirstRep()
+				.setSystem("http://dsf.dev/fhir/CodeSystem/bpmn-message").setCode("business-key");
+
+		TaskDao taskDao = getSpringWebApplicationContext().getBean(TaskDao.class);
+		Task created = taskDao.create(read);
+
+		ReferenceCleaner cleaner = getSpringWebApplicationContext().getBean(ReferenceCleaner.class);
+		cleaner.cleanLiteralReferences(created);
+		return created;
+	}
+
 	@Test
 	public void testUpdateTaskFromRequestedToInProgressWithNonExistingInputReferenceToExternalBinary() throws Exception
 	{
-		Task created = createTask(TaskStatus.REQUESTED, true);
+		Task read = readTestTaskBinary("External_Test_Organization", "Test_Organization");
+		Task created = createTaskBinary(read, TaskStatus.REQUESTED, true);
 		created.setStatus(TaskStatus.INPROGRESS);
 
 		expectForbidden(() -> getWebserviceClient().update(created));
@@ -1437,7 +1524,8 @@ public void testUpdateTaskFromRequestedToInProgressWithNonExistingInputReference
 	@Test
 	public void testUpdateTaskFromRequestedToFailedWithNonExistingInputReferenceToExternalBinary() throws Exception
 	{
-		Task created = createTask(TaskStatus.REQUESTED, true);
+		Task read = readTestTaskBinary("External_Test_Organization", "Test_Organization");
+		Task created = createTaskBinary(read, TaskStatus.REQUESTED, true);
 		created.setStatus(TaskStatus.FAILED);
 
 		Task updatedTask = getWebserviceClient().update(created);
@@ -1449,7 +1537,8 @@ public void testUpdateTaskFromRequestedToFailedWithNonExistingInputReferenceToEx
 	public void testUpdateTaskFromRequestedToFailedWithNonExistingInputReferenceToExternalBinaryAndNonExistingPluginValidationResource()
 			throws Exception
 	{
-		Task created = createTask(TaskStatus.REQUESTED, false);
+		Task read = readTestTaskBinary("External_Test_Organization", "Test_Organization");
+		Task created = createTaskBinary(read, TaskStatus.REQUESTED, false);
 		created.setStatus(TaskStatus.FAILED);
 
 		Task updatedTask = getWebserviceClient().update(created);
@@ -2265,7 +2354,6 @@ public void testSerachTaskWithPractitionerUserByRequester() throws Exception
 		assertNotNull(createdTask);
 		assertNotNull(createdTask.getIdElement().getIdPart());
 
-
 		Bundle searchResult = getPractitionerWebserviceClient().search(Task.class, Map.of("requester:identifier",
 				List.of("http://dsf.dev/sid/practitioner-identifier|" + X509Certificates.PRACTITIONER_CLIENT_MAIL)));
 		assertNotNull(searchResult);
diff --git a/dsf-fhir/dsf-fhir-server/src/test/resources/integration/task/dsf-test-task-profile-1.0.xml b/dsf-fhir/dsf-fhir-server/src/test/resources/integration/task/dsf-test-task-profile-1.0.xml
index 7bca78f7e..950b3bdc3 100644
--- a/dsf-fhir/dsf-fhir-server/src/test/resources/integration/task/dsf-test-task-profile-1.0.xml
+++ b/dsf-fhir/dsf-fhir-server/src/test/resources/integration/task/dsf-test-task-profile-1.0.xml
@@ -1,36 +1,82 @@
-<StructureDefinition xmlns="http://hl7.org/fhir"
-	xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
+<StructureDefinition xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
 	xsi:schemaLocation="http://hl7.org/fhir http://hl7.org/fhir/R4/fhir-single.xsd">
-  <meta>
-    <tag>
-      <system value="http://dsf.dev/fhir/CodeSystem/read-access-tag" />
-      <code value="ALL" />
-    </tag>
-  </meta>
-  <url value="http://dsf.dev/fhir/StructureDefinition/test-task" />
-  <version value="1.0" />
-  <name value="TestTask" />
-  <status value="active" />
-  <experimental value="false" />
-  <date value="2021-05-17" />
-  <fhirVersion value="4.0.1" />
-  <kind value="resource" />
-  <abstract value="false" />
-  <type value="Task" />
-  <baseDefinition value="http://dsf.dev/fhir/StructureDefinition/task-base" />
-  <derivation value="constraint" />
-  <differential>
-    <element id="Task.instantiatesCanonical">
-      <path value="Task.instantiatesCanonical" />
-      <fixedCanonical value="http://dsf.dev/bpe/Process/test|1.0" />
-    </element>
-    <element id="Task.input:message-name">
-      <path value="Task.input" />
-      <sliceName value="message-name" />
-    </element>
-    <element id="Task.input:message-name.value[x]">
-      <path value="Task.input.value[x]" />
-      <fixedString value="test-message" />
-    </element>
-  </differential>
+	<meta>
+		<tag>
+			<system value="http://dsf.dev/fhir/CodeSystem/read-access-tag" />
+			<code value="ALL" />
+		</tag>
+	</meta>
+	<url value="http://dsf.dev/fhir/StructureDefinition/test-task" />
+	<version value="1.0" />
+	<name value="TestTask" />
+	<status value="active" />
+	<experimental value="false" />
+	<date value="2021-05-17" />
+	<fhirVersion value="4.0.1" />
+	<kind value="resource" />
+	<abstract value="false" />
+	<type value="Task" />
+	<baseDefinition value="http://dsf.dev/fhir/StructureDefinition/task-base" />
+	<derivation value="constraint" />
+	<differential>
+		<element id="Task.instantiatesCanonical">
+			<path value="Task.instantiatesCanonical" />
+			<fixedCanonical value="http://dsf.dev/bpe/Process/test|1.0" />
+		</element>
+		<element id="Task.input:message-name">
+			<path value="Task.input" />
+			<sliceName value="message-name" />
+		</element>
+		<element id="Task.input:message-name.value[x]">
+			<path value="Task.input.value[x]" />
+			<fixedString value="test-message" />
+		</element>
+		<element id="Task.output:binary-ref">
+			<path value="Task.output" />
+			<sliceName value="binary-ref" />
+			<min value="0" />
+			<max value="1" />
+		</element>
+		<element id="Task.output:binary-ref.type">
+			<path value="Task.output.type" />
+			<binding>
+				<strength value="required" />
+				<valueSet value="http://dsf.dev/fhir/ValueSet/test|1.7" />
+			</binding>
+		</element>
+		<element id="Task.output:binary-ref.type.coding">
+			<path value="Task.output.type.coding" />
+			<min value="1" />
+			<max value="1" />
+		</element>
+		<element id="Task.output:binary-ref.type.coding.system">
+			<path value="Task.output.type.coding.system" />
+			<min value="1" />
+			<fixedUri value="http://dsf.dev/fhir/CodeSystem/test" />
+		</element>
+		<element id="Task.output:binary-ref.type.coding.version">
+			<path value="Task.output.type.coding.version" />
+			<min value="1" />
+			<fixedString value="1.7" />
+		</element>
+		<element id="Task.output:binary-ref.type.coding.code">
+			<path value="Task.output.type.coding.code" />
+			<min value="1" />
+			<fixedCode value="binary-ref" />
+		</element>
+		<element id="Task.output:binary-ref.value[x]">
+			<path value="Task.output.value[x]" />
+			<type>
+				<code value="Reference" />
+			</type>
+		</element>
+		<element id="Task.output:binary-ref.value[x].reference">
+			<path value="Task.output.value[x].reference" />
+			<min value="1" />
+		</element>
+		<element id="Task.output:binary-ref.value[x].identifier">
+			<path value="Task.output.value[x].identifier" />
+			<max value="0" />
+		</element>
+	</differential>
 </StructureDefinition>
\ No newline at end of file