This page is part of the Verifiable Health Links (v1.0.0-comment: Publication Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Significant Changes and Issues

Significant Changes

Significant Changes from Revision x.x

• NA, initial public comment release

Issues

Submit an Issue

IHE welcomes New Issues from the GitHub community. For those without GitHub access, issues may be submitted to the ITI Public Comment form.

As issues are submitted they will be managed at ITI.VHL GitHub Issues, where discussion and workarounds may be found. These issues, when critical, will be processed using the normal IHE Change Proposal management and balloting. It is important to note that as soon as a Change Proposal is approved, it carries the same weight as a published Implementation Guide (i.e., it is testable at an IHE Connectathon from the time it is approved, even if it will not be integrated until a leter date).

Open Issues

• ToDo_001: Should we introduce a Trust Network Participant (TNP) actor that does the retrieve and publish of keys and then make the VHL Sharer and VHL Receiver grouped actor with the TNP?

• ToDo_004: Some of the language has the QR code as synonymous with the VHL. Should be careful in Vol 1 that QR is only an example of a type of a VHL that is used for low-bandwidth/contactless/access. May be other access mechanisms - bluetooth or NFC modalities are used in the future for the providing of a VHL by a VHL Holder to a VHL Receiver.

• ToDo_007: ITI-YY5 Retrieve Manifest Message Semantics alignment with SHL — The current message semantics in ITI-YY5 (Section 2:3.YY5.4.1.2) may diverge from the SMART Health Links retrieve manifest specification. Liaise with the SHL team to identify gaps and request updates to the SHL Manifest logical model

Closed Issues

• ToDo_002: Can we use the same transaction to retrieve a single doc VHL as well as retrieve the docs in a folder VHL?
  • Resolution: The specification defines a _include option in the ITI-YY5 transaction that supports both single document and folder-based VHL retrieval using the same transaction.
• ToDo_003: Do we want to talk about the general notion of a health link, and then both the verifiable and shared health links? The SHL model has a different trust network assumption (no pre-coordination of sharer and receiver) so it may be cumbersome to take on in the first pass as the workflow is different?
  • Resolution: The current scope focuses exclusively on Verifiable Health Links (VHL), deferring Shared Health Links (SHL) to a future revision due to the differing trust network assumptions and workflow complexity. This approach allows the specification to establish a solid foundation for pre-coordinated trust models before addressing the more open trust model of SHL.
• ToDo_005: Should we specify an API mechanism for the Publish PKI Material transaction? It may be enough to treat them as Content Creator/Consumer pairs where the content is the location of a trustlist (as a DID).
  • Resolution: The specification treats the Publish PKI Material transaction as a Content Creator/Consumer interaction where the published content is a DID-referenced trustlist, rather than defining a separate API mechanism. This approach leverages existing IHE content sharing patterns and avoids introducing unnecessary complexity for PKI material distribution.
• ToDo_006: ITI-YY5 Receiver Authentication for Sharer using Embedded JWS/VC as an option.
  • Resolution: Addressed by the addition of the Verifiable Credential Option in ITI-YY5 (Section 2:3.YY5.4.1.5). In this option the VHL Receiver self-issues a JSON-LD LDP-VC (W3C Verifiable Credentials Data Model v2) whose credentialSubject contains the manifest decoded from the QR code. An embedded DataIntegrityProof is computed with the VHL Receiver's key from the trust network. The signed VC is sent directly as the HTTP POST body (Content-Type: application/vc+ld+json) with FHIR search parameters in the URL. The VHL Sharer verifies proof.proofValue using the receiver's public key retrieved from the trust network. The option is also reflected in the Actor Options table (Volume 1 Section XX.2.5), the sequence diagram (ITI-YY5.plantuml), and the test plan (testplan.md).
• ToDo_008: ITI-YY5 — clarify document retrieval transaction and document encryption convention.
  • Resolution: ITI-YY5 now explicitly binds binary document retrieval to the IHE MHD Retrieve Document [ITI-68] transaction (HTTP GET on DocumentReference.content.attachment.url), and aligns document encryption with the SMART Health Links convention: each binary is a JWE Compact Serialization using alg=dir and enc=A256GCM with the 32-byte SHL key carried in the SHL payload (generated in ITI-YY3, decoded in ITI-YY4). Two response examples were added (with and without the Include DocumentReference Option), and Required Actor Groupings in Volume 1 now requires VHL Sharer ↔ MHD Document Responder and VHL Receiver ↔ MHD Document Consumer groupings. See ITI-YY5 sections 2:3.YY5.4.2.4 (Document Content Retrieval) and 2:3.YY5.4.2.5 (Document Encryption).