Mobile access to Health Documents (MHD)
4.2.0 - Trial-Implementation International flag

This page is part of the IHE Mobile Access to Health Documents (v4.2.0: Publication) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

MHD Home

Official URL: https://profiles.ihe.net/ITI/MHD/ImplementationGuide/ihe.iti.mhd Version: 4.2.0
Active as of 2022-12-07 Computable Name: IHE_ITI_MHD

Applications specific to resource-constrained and mobile devices are an emerging platform for healthcare-enhancing software. The MHD Profile is not limited to mobile devices, using the term “mobile” only as a grouping for mobile applications, mobile devices or any other systems that are resource and platform-constrained. These constraints may drive the implementer to use simpler network interface technology. There are numerous deployed implementations of Document Sharing Health Information Exchange that need a simpler network interface technology, for example those hosted by a Health Information Exchange (HIE), large health provider electronic health record (EHR), or personal health record (PHR).

The Mobile access to Health Documents (MHD) Profile defines one standardized interface to health document sharing (a.k.a. an Application Programming Interface (API)) for use by mobile devices so that deployment of mobile applications is more consistent and reusable. In this context, mobile devices include tablets, smart-phones, and embedded devices including home-health devices. This profile is also applicable to more capable systems where needs are simple, such as pulling the latest summary for display. The critical aspects of the “mobile device” are that it is resource-constrained, has a simple programming environment (e.g., JSON, JavaScript), simple protocol stack (e.g., HTTP), and simple display functionality (e.g., HTML browser). The goal is, in part, to avoid burdening the client with additional libraries such as those that are necessary to process SOAP, WSSE, MIME-Multipart, MTOM/XOP, ebRIM, and multi-depth XML.

The Mobile access to Health Documents (MHD) Profile defines one pair of actors and a transaction to submit or push new “document entries” from the mobile device to a receiving system. Another set of actors and transactions is used to query a list of “document entries” having specific metadata, and to retrieve a document.

The transactions defined here leverage the document content- and format-agnostic metadata concepts that were initially developed for XDS but simplify them for access in constrained environments including mobile devices.

The MHD Profile can be used as an API to a Document Sharing exchange using XDS or XCA. The MHD Profile is used by the MHDS Document Sharing solution. The MHD Profile can be used in push solutions alone or as an API to solutions like XDR or XDM. These are further elaborated in Cross Profile Considerations.

The Mobile Cross-Enterprise Document Data Element Extraction (mXDE) Profile combines MHD with the PCC Query for Existing Data for Mobile (QEDm) Profile to provide element level access to the medical information available in a Document Sharing exchange. More details can be found in the white paper on Document Sharing Health Information Exchange.

MHD is part of IHE – IT-Infrastructure Domain and part of the IHE Document Sharing Health Information Exchange solution.

Significant Changes, Open, and Closed Issues

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Organization of This Guide

This guide is organized into four main sections:

  1. Volume 1: Use-Case analysis
    1. 33.1 MHD Actors and Transactions
    2. 33.2 MHD Actor Options
    3. 33.3 MHD Actor Required Groupings
    4. 33.4 MHD Overview
    5. 33.5 MHD Security Considerations
    6. 33.6 MHD Cross Profile Considerations
  2. Volume 2: Transaction Detail
    1. 3.65 Provide Document Bundle [ITI-65]
    2. 3.66 Find Document Lists [ITI-66]
    3. 3.67 Find Document References [ITI-67]
    4. 3.68 Retrieve Document [ITI-68]
    5. 3.105 Simplified Publish [ITI-105]
    6. 3.106 Generate Metadata [ITI-106]
  3. Volume 3: Metadata
    1. 4.2 XDS Error Codes
    2. 4.5 FHIR Representation
  4. Appendix
    1. Test Plan

Click on any of the links above, see the table of contents, or if you are looking for a specific artifact, check out the index.

Must Support

MHD defines Must Support in StructureDefinition profiles as the element, when the minimal cardionality is zero, is R2 Required if Known, as found in Appendix Z. Must Support when the element minimal cardionality is not zero means R.

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The source code for this Implementation Guide can be found on IHE GitHub https://github.com/IHE/ITI.MHD.

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (ihe.iti.mhd.r4) and R4B (ihe.iti.mhd.r4b) are available.

Dependency Table

Package ihe.iti.balp#1.1.1

The Basic Audit Log Patterns (BALP) Implementation Guide is a Content Profile that defines some basic and reusable AuditEvent patterns. This includes basic audit log profiles for FHIR RESTful operations to be used when there is not a more specific audit event defined. A focus is enabling Privacy centric AuditEvent logs that hold well formed indication of the Patient when they are the subject of the activity being recorded in the log. Where a more specific audit event can be defined it should be derived off of these basic patterns. (built Fri, Oct 21, 2022 08:58-0500-05:00)

Package ihe.formatcode.fhir#1.1.0

Implementation Guide for IHE defined FormatCode vocabulary. (built Thu, Feb 24, 2022 16:55-0600-06:00)

Globals Table

There are no Global profiles defined

IP Statements

This publication includes IP covered under the following statements.