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    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ImplementationGuide ihe.iti.vhl</b></p><a name="ihe.iti.vhl"> </a><a name="hcihe.iti.vhl"> </a><h2>IHE_ITI_VHL</h2><p>The official URL for this implementation guide is: </p><pre>https://profiles.ihe.net/ITI/VHL/ImplementationGuide/ihe.iti.vhl</pre><div><p>Patient Mediated sharing of their health information using internet accessible verifiable health link.</p>
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      <description value="**Purpose:**  &#xA;Ensure that the VHL Sharer records audit events when health documents are accessed or retrieved using a Verified Health Link (VHL).&#xA;&#xA;**Description:**  &#xA;The [VHL Sharer](ActorDefinition-VHLSharer.html) MAY record audit events for critical events involving document access. These MAY include:&#xA;* A request from a [VHL Holder](ActorDefinition-VHLHolder.html) to generate a VHL&#xA;* A request from a [VHL Receiver](ActorDefinition-VHLReceiver.html) to retrieve one or more health documents using a valid VHL&#xA;* Any access to protected health content triggered by the use of a VHL"/>
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      </reference>
      <name value="Generate a VHL Authorization Mechanism Based on Query Parameters"/>
      <description value="The [VHL Sharer](ActorDefinition-VHLSharer.html) SHALL generate a Verified Health Link (VHL) to be issued to a [VHL Holder](ActorDefinition-VHLHolder.html).&#xA;&#xA;The Sharer SHALL conduct all necessary tasks to prepare the content referenced by the VHL. These tasks MAY be further defined by applicable content profiles or implementation guides, and MAY include:&#xA;* Generation of new documents in real time;&#xA;* Querying for existing documents (e.g., IPS, CDA, FHIR Bundles) associated with the VHL Holder; or&#xA;* Creation of digital signatures on one or more documents.&#xA;&#xA;Once content preparation is complete, the Sharer SHALL construct the VHL payload and sign it to produce a cryptographically verifiable authorization mechanism.&#xA;&#xA;**Optional behaviors:**&#xA;* The Sharer MAY record consent in accordance with the [Record Consent](Requirements-RecordConsent.html) requirement.&#xA;* The Sharer MAY log an audit event describing the VHL issuance, in accordance with the [Audit Event – Accessed Health Data](Requirements-AuditEventAccess.html) requirement."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="OperationDefinition"/>
      </extension>
      <reference>
        <reference value="OperationDefinition/generate-vhl"/>
      </reference>
      <name value="Generate VHL"/>
      <description value="This operation generates a Verifiable Health Link (VHL) for transmission or display. The VHL MAY be returned as a QR code (HCERT/CWT) or, when the VHL Sharer supports the VC Envelope Option, as a signed W3C Verifiable Credential.&#xA;&#xA;Input Parameters:&#xA;- sourceIdentifier: Patient identifier (required)&#xA;- exp: Expiration time in Epoch seconds (optional)&#xA;- flag: Single-character flags in alphabetical order - L (long-term use), P (Passcode required), U (direct file access) (optional)&#xA;- label: Short description up to 80 characters (optional)&#xA;- passcode: User-supplied passcode for passcode-protected VHLs (optional)&#xA;- purposeOfUse: Purpose(s) of use the VHL Holder is authorizing for this share, bound to the HL7 v3 PurposeOfUse value set (optional). Populates Consent.provision.purpose when an IHE PCF Consent is bound to the generated folder.&#xA;- format: Requested output carrier - 'qrcode' (default) or 'vc'. 'vc' requires the VHL Sharer to support the VC Envelope Option.&#xA;&#xA;Output Generation:&#xA;- When format=qrcode: Returns a Binary resource containing the QR code image (PNG or SVG format) that encodes the VHL as an HCERT/CWT structure.&#xA;- When format=vc: Returns a Binary resource (media type application/vc+ld+json) containing a JSON-LD Verifiable Credential whose credentialSubject carries the VHL payload, signed with the VHL Sharer's trust-network key using W3C Data Integrity (DataIntegrityProof, cryptosuite ecdsa-2019).&#xA;- Exactly one of qrcode or verifiableCredential SHALL be populated."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ExampleScenario"/>
      </extension>
      <reference>
        <reference value="ExampleScenario/UseCaseHajjPilgrimage"/>
      </reference>
      <name value="Hajj Pilgrimage VHL Flow"/>
      <description value="Use case describing the sharing of pilgrim health records (International Patient Summary) during Hajj using VHL with WHO GDHCN trust infrastructure for cross-border verification."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/InitiateRetrieveTrustListRequest"/>
      </reference>
      <name value="Initiate Retrieve Trust List Request"/>
      <description value="A [VHL Sharer](ActorDefinition-VHLSharer.html) or [VHL Receiver](ActorDefinition-VHLReceiver.html), as a participant in the trust network, SHALL be capable of retrieving public key infrastructure (PKI) material from a designated [Trust Anchor](ActorDefinition-TrustAnchor.html).&#xA;&#xA;The retrieved material MAY include:&#xA;* Public key certificates and associated trust lists&#xA;* Certificate revocation data (e.g., CRLs, OCSP responses)&#xA;* Metadata used to:&#xA;  - Validate digital signatures on VHLs and related resources&#xA;  - Establish secure connections&#xA;  - Decrypt content protected via asymmetric encryption&#xA;&#xA;Participants SHOULD cache the received trust list to reduce network and server load.&#xA;&#xA;**Preconditions:**&#xA;* The requesting participant knows in advance the endpoint from which to retrieve PKI material, as published or distributed by the Trust Anchor."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/InitiateSubmitPKIMaterialRequest"/>
      </reference>
      <name value="Initiate Submit PKI Material Request"/>
      <description value="When a [VHL Sharer](ActorDefinition-VHLSharer.html) or [VHL Receiver](ActorDefinition-VHLReceiver.html) generates a new public-private key pair for use within the VHL trust network, they SHALL submit the corresponding public key material to the [Trust Anchor](ActorDefinition-TrustAnchor.html) for validation and inclusion in the trust list.&#xA;&#xA;The submission MAY include metadata to support categorization of key usage (e.g., digital signatures, encryption, secure channels) and business or operational context."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="TestPlan"/>
      </extension>
      <reference>
        <reference value="TestPlan/TestPlan-QRCodeFlow"/>
      </reference>
      <name value="Integration Test Plan – QR Code Generation and Validation Flow"/>
      <description value="Integration test plan for the **QR Code Generation and Validation Flow** of the IHE ITI&#xA;Verifiable Health Links (VHL) profile.&#xA;&#xA;Scope: validates multi-actor, cross-transaction scenarios that span ITI-YY3 (Generate VHL),&#xA;ITI-YY4 (Provide VHL), and ITI-YY5 (Retrieve Manifest). Tests verify that the QR code&#xA;generated in YY3 can be decoded in YY4, that the decoded VHL payload's manifest URL is used&#xA;correctly in YY5, and that the full end-to-end pipeline including passcode handling, signature&#xA;verification, and VHL authorization succeeds.&#xA;&#xA;Actors exercised: VHL Holder, VHL Sharer, VHL Receiver."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="TestPlan"/>
      </extension>
      <reference>
        <reference value="TestPlan/TestPlan-TrustEstablishment"/>
      </reference>
      <name value="Integration Test Plan – Trust Establishment"/>
      <description value="Integration test plan for the **Trust Establishment** workflow of the IHE ITI Verifiable Health&#xA;Links (VHL) profile.&#xA;&#xA;Scope: validates multi-actor, cross-transaction scenarios that span ITI-YY1 (Submit PKI Material)&#xA;and ITI-YY2 (Retrieve Trust List) and cannot be covered by unit tests. Tests verify that a DID&#xA;Document submitted in YY1 is subsequently retrievable via YY2 in the same session, that both&#xA;the VHL Sharer and VHL Receiver can retrieve peer keys, that a full round-trip signature&#xA;verification succeeds, and that revocation propagates correctly across actors.&#xA;&#xA;Actors exercised: VHL Sharer, Trust Anchor, VHL Receiver."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ExampleScenario"/>
      </extension>
      <reference>
        <reference value="ExampleScenario/UseCasePH4H"/>
      </reference>
      <name value="Pan-American Highway for Health (PH4H)"/>
      <description value="Use case describing cross-border health record sharing in the Americas using VHL to support continuity of care for internal migrants across overlapping trust networks."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/ProvideVHL"/>
      </reference>
      <name value="Provide VHL"/>
      <description value="The Provide VHL transaction enables a [VHL Holder](ActorDefinition-VHLHolder.html) to transmit a Verified Health Link (VHL) to a [VHL Receiver](ActorDefinition-VHLReceiver.html). The VHL serves as a signed authorization mechanism that allows the Receiver to subsequently retrieve one or more health documents from a VHL Sharer.&#xA;&#xA;Depending on the use case, the VHL MAY be rendered or transmitted using formats such as QR code or deep link (HTTPS URL)."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/ReceiveTrustList"/>
      </reference>
      <name value="Receive Trust List"/>
      <description value="A [VHL Sharer](ActorDefinition-VHLSharer.html) or [VHL Receiver](ActorDefinition-VHLReceiver.html), after receiving PKI material from a [Trust Anchor](ActorDefinition-TrustAnchor.html), SHALL validate and process the trust information for subsequent cryptographic operations.&#xA;&#xA;Participants SHOULD:&#xA;* Cache the received trust list or certificate material to reduce network and server load&#xA;* Validate digital signatures or trust paths before use in VHL validation or secure channel sessions&#xA;* Monitor certificate expiration or revocation status where applicable"/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/RespondtoProvideVHL"/>
      </reference>
      <name value="Receive VHL authorization mechanism"/>
      <description value="The [VHL Receiver](ActorDefinition-VHLReceiver.html) SHALL be capable of receiving a Verified Health Link (VHL) from a [VHL Holder](ActorDefinition-VHLHolder.html) through a supported transport mechanism (e.g., QR code scan, direct URL, or digital message).&#xA;&#xA;Upon receipt, the Receiver SHALL:&#xA;* Parse the VHL&#xA;* Validate its digital signature against a trusted key published by a recognized Trust Anchor&#xA;* Prepare to retrieve the associated health documents&#xA;&#xA;Receipt of the VHL may occur through direct user interaction (e.g., scanning a QR code) or automated channels, depending on the implementation context."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/RecordAccessToHealthData"/>
      </reference>
      <name value="Record Access to Health Data"/>
      <description value="The [VHL Sharer](ActorDefinition-VHLSharer.html) MAY record audit events when health data is accessed through a Verified Health Link (VHL). These events support accountability, traceability, and compliance with applicable security and privacy regulations.&#xA;&#xA;Audit records MAY include the following metadata:&#xA;* Timestamp of the access event&#xA;* Identity of the accessing actor (e.g., person or system)&#xA;* Type and identifier of the accessed resource (e.g., DocumentReference)&#xA;* Purpose of access, where available (e.g., treatment, consent verification)&#xA;* Outcome of the event (e.g., success, failure)&#xA;&#xA;Audit events SHALL be represented using the FHIR `AuditEvent` resource, and SHOULD conform to applicable IHE profiles such as ATNA where appropriate. Implementers MAY define additional audit logging behavior to meet jurisdictional or organizational policies."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/RecordConsent"/>
      </reference>
      <name value="Record Consent"/>
      <description value="The [VHL Sharer](ActorDefinition-VHLSharer.html) SHALL record the consent granted by a [VHL Holder](ActorDefinition-VHLHolder.html) to authorize the sharing of their health data via a Verified Health Link (VHL). This consent confirms that the Holder agrees to the creation of a VHL and its use by authorized [VHL Receivers](ActorDefinition-VHLReceiver.html) to access specific health documents.&#xA;&#xA;In this requirement, the VHL Sharer acts as a Consent Recorder, as defined in the [Privacy Consent on FHIR (PCF)](https://profiles.ihe.net/ITI/PCF/index.html) profile. Specifically, the Sharer SHALL initiate the [Access Consent - ITI-108](https://profiles.ihe.net/ITI/PCF/ITI-108.html) transaction to formally capture the Holder's consent.&#xA;&#xA;The ITI-108 transaction SHOULD be invoked as part of the actions triggered by a Generate VHL request, particularly when legal, jurisdictional, or organizational policy requires explicit, recorded consent prior to enabling document sharing.&#xA;&#xA;This requirement enables lawful, transparent sharing of personal health information across organizations and trust domains."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/InitiateVHLGenerationRequest"/>
      </reference>
      <name value="Request that a VHL authorization mechanism be issued"/>
      <description value="A [VHL Holder](ActorDefinition-VHLHolder.html) initiates a request to a [VHL Sharer](ActorDefinition-VHLSharer.html) to generate a Verified Health Link (VHL) that references one or more health documents. The resulting VHL allows the Holder to subsequently share access to those documents with a [VHL Receiver](ActorDefinition-VHLReceiver.html).&#xA;The Holder MAY include optional parameters to constrain or protect the issued VHL-such as defining an expiration period, scoping which documents are included, or requiring a passcode for retrieval. These parameters guide the Sharer's issuance of the VHL and influence the conditions under which the associated documents may be accessed.&#xA;&#xA;**Preconditions:**&#xA;  * The [VHL Holder](ActorDefinition-VHLHolder.html) SHALL trust that the [VHL Sharer](ActorDefinition-VHLSharer.html) has been authorized by its jurisdiction to generate VHLs and to provide access to the corresponding health documents.&#xA;  * Optionally, the [VHL Holder](ActorDefinition-VHLHolder.html) has selected consent directives or selective disclosure preferences, as permitted by the applicable content profile."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/RequestVHLDocument"/>
      </reference>
      <name value="Request VHL Document"/>
      <description value="The [VHL Receiver](ActorDefinition-VHLReceiver.html) SHALL initiate a request to retrieve a single health document from a [VHL Sharer](ActorDefinition-VHLSharer.html), using a previously received and validated Verified Health Link (VHL).&#xA;&#xA;This transaction SHALL be conducted over a secure channel. Both the Receiver and Sharer SHALL validate each other's participation in the trust network using PKI material published by the [Trust Anchor](ActorDefinition-TrustAnchor.html).&#xA;&#xA;**Optional behaviors:**&#xA;* The VHL Receiver MAY verify the digital signature of the returned health document to confirm its authenticity, integrity, and provenance, as defined in the [Verify Document Signature](Requirements-VerifyDocumentSignature.html) requirement.&#xA;* The VHL Sharer MAY record an audit event documenting the access request by the Receiver, in accordance with the [Audit Event – Received Health Data](Requirements-AuditEventReceived.html) requirement."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/RequestVHLDocuments"/>
      </reference>
      <name value="Request VHL Documents"/>
      <description value="The [VHL Receiver](ActorDefinition-VHLReceiver.html) SHALL initiate a request to retrieve a set of health documents from a [VHL Sharer](ActorDefinition-VHLSharer.html), using a previously received and validated Verified Health Link (VHL).&#xA;&#xA;Both the Receiver and Sharer SHALL validate each other's participation in the trust network using PKI material published by the [Trust Anchor](ActorDefinition-TrustAnchor.html).&#xA;&#xA;**Optional behaviors:**&#xA;* The VHL Sharer MAY record an audit event documenting the access request by the Receiver, in accordance with the [Audit Event – Received Health Data](Requirements-AuditEventReceived.html) requirement.&#xA;* This transaction MAY be conducted over a secure channel, as defined in the [Audit Trail and Node Authentication (ATNA)](https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html#9.1) Profile."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/RespondtoSubmitPKIMaterialRequest"/>
      </reference>
      <name value="Respond to Submit PKI Material Request"/>
      <description value="Upon receipt of public key material from a [VHL Sharer](ActorDefinition-VHLSharer.html) or [VHL Receiver](ActorDefinition-VHLReceiver.html), the [Trust Anchor](ActorDefinition-TrustAnchor.html) SHALL validate, organize, sign, and expose the PKI material as part of a trusted, canonical trust list."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/RespondtoRetrieveTrustListRequest"/>
      </reference>
      <name value="Retrieve Trust List Response"/>
      <description value="Upon receipt of Retrieve Trust List Request from a [VHL Sharer](ActorDefinition-VHLSharer.html) or [VHL Receiver](ActorDefinition-VHLReceiver.html), the [Trust Anchor](ActorDefinition-TrustAnchor.html) SHALL organize, sign, and expose the PKI material as part of a trusted, canonical trust list.&#xA;&#xA;This MAY include:&#xA;* Public key certificates, trust chains, or JWKS structures&#xA;* Revocation data (CRL or OCSP)&#xA;* Usage metadata (e.g., key type, scope, intended usage)&#xA;&#xA;The Trust Anchor SHALL only respond with validated and trustworthy material in accordance with the governance policies of the VHL trust framework. This signed trust list enables all participants in the VHL trust network to verify digital signatures and establish secure connections in accordance with the governance policies of the Trust Anchor.&#xA;&#xA;Upon receipt of this response, participants SHALL process the trust list as described in [Receive Trust List](Requirements-ReceiveTrustList.html)."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ExampleScenario"/>
      </extension>
      <reference>
        <reference value="ExampleScenario/UseCaseTEFCA"/>
      </reference>
      <name value="TEFCA Health Information Exchange"/>
      <description value="Use case describing how US TEFCA participants (QHINs, providers, payers) can act as VHL Sharers and Receivers using existing TEFCA certificate infrastructure as a trust anchor for VHL exchanges."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="TestPlan"/>
      </extension>
      <reference>
        <reference value="TestPlan/TestPlan-TrustAnchor"/>
      </reference>
      <name value="Test Plan – Trust Anchor"/>
      <description value="Unit test plan for the **Trust Anchor** actor of the IHE ITI Verifiable Health Links (VHL) profile.&#xA;&#xA;Scope: validates all behaviour expected of a Trust Anchor as described in ITI-YY1 (responder)&#xA;and ITI-YY2 (responder). Each test suite (testCase) corresponds to one transaction and exercises&#xA;three atomic feature files: message semantics (shared), responder expected actions, and security&#xA;considerations."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="TestPlan"/>
      </extension>
      <reference>
        <reference value="TestPlan/TestPlan-VHLReceiver"/>
      </reference>
      <name value="Test Plan – VHL Receiver"/>
      <description value="Unit test plan for the **VHL Receiver** actor of the IHE ITI Verifiable Health Links (VHL) profile.&#xA;&#xA;Scope: validates all behaviour expected of a VHL Receiver across its four transactions:&#xA;submitting its own PKI material (ITI-YY1 initiator), retrieving the trust list (ITI-YY2&#xA;initiator), decoding and validating a VHL QR code (ITI-YY4 responder), and requesting the&#xA;document manifest (ITI-YY5 initiator). Each test suite exercises three atomic feature files."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="TestPlan"/>
      </extension>
      <reference>
        <reference value="TestPlan/TestPlan-VHLSharer"/>
      </reference>
      <name value="Test Plan – VHL Sharer"/>
      <description value="Unit test plan for the **VHL Sharer** actor of the IHE ITI Verifiable Health Links (VHL) profile.&#xA;&#xA;Scope: validates all behaviour expected of a VHL Sharer across its four transactions:&#xA;submitting its own PKI material (ITI-YY1 initiator), retrieving the trust list to obtain peer&#xA;keys (ITI-YY2 initiator), generating VHLs on demand (ITI-YY3 responder), and serving document&#xA;manifests to authorised VHL Receivers (ITI-YY5 responder). Each test suite corresponds to one&#xA;transaction and exercises three atomic feature files."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ActorDefinition"/>
      </extension>
      <reference>
        <reference value="ActorDefinition/TrustAnchor"/>
      </reference>
      <name value="Trust Anchor"/>
      <description value="An authorized organization in the trust framework that manages and distributes PKI material—such as public key certificates and revocation lists—to participants in the network."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="CapabilityStatement"/>
      </extension>
      <reference>
        <reference value="CapabilityStatement/IHE.VHL.TrustAnchor"/>
      </reference>
      <name value="Trust Anchor"/>
      <description value="CapabilityStatement for Trust Anchor Actor in the IHE IT Infrastructure Technical Framework Supplement IHE VHL. An authorized organization in the trust framework that manages and distributes PKI material—such as public key certificates and revocation lists—to participants in the network. It ensures that this material is trustworthy and available, enabling VHL Sharers and VHL Receivers to verify digital signatures and authenticate the origin of shared data."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="Requirements"/>
      </extension>
      <reference>
        <reference value="Requirements/VerifyDocumentSignature"/>
      </reference>
      <name value="Verify Document Signature"/>
      <description value="The [VHL Receiver](ActorDefinition-VHLReceiver.html), upon receiving a digitally signed health document from a [VHL Sharer](ActorDefinition-VHLSharer.html), MAY verify the document's digital signature using previously retrieved PKI material.&#xA;&#xA;This verification process confirms the authenticity, integrity, and provenance of the document independently of the Verified Health Link (VHL) itself.&#xA;&#xA;The public key used for this verification MAY:&#xA;* Originate from a different trust network than the one used to validate the VHL&#xA;* Be unrelated to the key used to validate the VHL signature&#xA;&#xA;Implementers SHOULD consult cross-profile guidance regarding interoperability with the [IHE Document Digital Signature (DSG) profile](https://profiles.ihe.net/ITI/TF/Volume1/ch-37.html), particularly in cases where additional attestation, long-term non-repudiation, or multi-party signatures are involved."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ActorDefinition"/>
      </extension>
      <reference>
        <reference value="ActorDefinition/VHLHolder"/>
      </reference>
      <name value="VHL Holder"/>
      <description value="An individual—typically the patient or their delegate—who possesses a Verified Health Link (VHL) and presents it to a VHL Receiver."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ActorDefinition"/>
      </extension>
      <reference>
        <reference value="ActorDefinition/VHLReceiver"/>
      </reference>
      <name value="VHL Receiver"/>
      <description value="A system or organization that receives a VHL from a VHL Holder and uses it to retrieve health documents from a VHL Sharer, after verifying the authenticity and integrity of the VHL."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="CapabilityStatement"/>
      </extension>
      <reference>
        <reference value="CapabilityStatement/VHLReceiverCapabilityStatement"/>
      </reference>
      <name value="VHL Receiver Client Capability Statement"/>
      <description value="Capability Statement for a VHL Receiver implementing the Retrieve Manifest [ITI-YY5] transaction as a client. This client searches for List resources using VHL-authorized manifest URLs and can request inclusion of DocumentReference resources via the _include parameter."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ActorDefinition"/>
      </extension>
      <reference>
        <reference value="ActorDefinition/VHLSharer"/>
      </reference>
      <name value="VHL Sharer"/>
      <description value="A system that generates VHLs, provides them to a VHL Holder, and responds to requests from a VHL Receiver to retrieve document manifests authorized by the VHL."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="CapabilityStatement"/>
      </extension>
      <reference>
        <reference value="CapabilityStatement/VHLSharerCapabilityStatement"/>
      </reference>
      <name value="VHL Sharer Server Capability Statement"/>
      <description value="Capability Statement for a VHL Sharer implementing the Retrieve Manifest [ITI-YY5] transaction as a server. This server supports FHIR search on List resources with _include parameter to retrieve document manifests authorized by Verified Health Links."/>
      <exampleBoolean value="false"/>
    </resource>
    <resource>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/resource-information">
        <valueString value="ExampleScenario"/>
      </extension>
      <reference>
        <reference value="ExampleScenario/UseCaseGDHCN"/>
      </reference>
      <name value="WHO GDHCN Trust Establishment"/>
      <description value="Use case describing how participating jurisdictions establish trust within the WHO Global Digital Health Certification Network (GDHCN) through PKI material submission and trust list distribution."/>
      <exampleBoolean value="false"/>
    </resource>
    <page>
      <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
        <valueUrl value="toc.html"/>
      </extension>
      <nameUrl value="toc.html"/>
      <title value="Table of Contents"/>
      <generation value="html"/>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="index.html"/>
        </extension>
        <nameUrl value="index.html"/>
        <title value="Verifiable Health Links (VHL) Home"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="volume-1.html"/>
        </extension>
        <nameUrl value="volume-1.html"/>
        <title value="1:XX Verifiable Health Links (VHL) - Volume 1"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="ITI-YY1.html"/>
        </extension>
        <nameUrl value="ITI-YY1.html"/>
        <title value="2:3.YY1 Submit PKI Material with DID"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="ITI-YY2.html"/>
        </extension>
        <nameUrl value="ITI-YY2.html"/>
        <title value="2:3.YY2 Retrieve Trust List with DID"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="ITI-YY3.html"/>
        </extension>
        <nameUrl value="ITI-YY3.html"/>
        <title value="2:3.YY3 Generate VHL"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="ITI-YY4.html"/>
        </extension>
        <nameUrl value="ITI-YY4.html"/>
        <title value="2:3.YY4 Provide VHL"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="ITI-YY5.html"/>
        </extension>
        <nameUrl value="ITI-YY5.html"/>
        <title value="2:3.YY5 Retrieve Manifest"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="testplan.html"/>
        </extension>
        <nameUrl value="testplan.html"/>
        <title value="Test Plan"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="other.html"/>
        </extension>
        <nameUrl value="other.html"/>
        <title value="Changes to Other IHE Specifications"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="vhl_vs_shl.html"/>
        </extension>
        <nameUrl value="vhl_vs_shl.html"/>
        <title value="Appendix A: Comparison of health links"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="download.html"/>
        </extension>
        <nameUrl value="download.html"/>
        <title value="Download and Analysis"/>
        <generation value="markdown"/>
      </page>
      <page>
        <extension url="http://hl7.org/fhir/tools/StructureDefinition/ig-page-name">
          <valueUrl value="issues.html"/>
        </extension>
        <nameUrl value="issues.html"/>
        <title value="Significant Changes and Issues"/>
        <generation value="markdown"/>
      </page>
    </page>
    <parameter>
      <code value="path-resource"/>
      <value value="input/resources"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="fsh-generated/resources"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/examples"/>
    </parameter>
    <parameter>
      <code value="path-pages"/>
      <value value="input/tests/features"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/capabilities"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/extensions"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/models"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/operations"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/profiles"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/vocabulary"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/testing"/>
    </parameter>
    <parameter>
      <code value="path-resource"/>
      <value value="input/history"/>
    </parameter>
    <parameter>
      <code value="path-pages"/>
      <value value="template/config"/>
    </parameter>
    <parameter>
      <code value="path-pages"/>
      <value value="input/images"/>
    </parameter>
    <parameter>
      <code value="path-tx-cache"/>
      <value value="input-cache/txcache"/>
    </parameter>
  </definition>
</ImplementationGuide>