Mobile Health Document Sharing, published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 2.3.2-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.MHDS/ and changes regularly. See the Directory of published versions

Open and Closed issues

Significant changes

Changes in 2.3.1

• Quality improvements
• Merge in approved CP-ITI-1238
• add requirement for PMIR
• Cleanup CapabilityStatements
• update to pull in latest dependent IGs

Changes in 2.3.0

• no public-comments were received
• add google analytics
• set depends-on to formally PIXm, PDQm, mCSD, and MHD IGs

Changes in 2.2.0

Version 2.2.0 is intended to be changes to the publication mechanism from WORD/PDF to an Implementation Guide published using the IG-Publisher. However, some other changes have been necessary due to the passing of time.

• Mentions of DocumentManifest are now List.source due to the change in MHD.
• Mentions of the PMIR Patient Identity Manager are changed to Patient Identity Registry due to change in PMIR.
• This version has a CapabilityStatement that was not previously published.
• Updates due to changes in the IUA profile, such as the additional leverage of the Authorization Server Metadata Option.
• Removed section 50.7 as the current HIE-Whitepaper contains MHD and MHDS now.
• Diagrams have been changed to support the above changes.

Open Issues

• Now that IUA has defined OAuth scopes differently than SMART, MHDS needs to adjust. Should it switch to IUA, or show both? It is unclear that the PurposeOfUse mechanism discussed here is consistent with SMART v2.0 published spec.

Closed Issues

1. This profile was renamed from MHD-HIE to Mobile Health Document Sharing (MHDS). This name leverages the concept of “Document Sharing” as defined in the HIE White Paper and includes the original MHD acronym while removing the word “access” which is important in MHD to define it as an API and inserting the word “Sharing” which indicates persistence.

2. There is no action defined for the Document Registry when the PMIR feed transaction indicated a Delete action on a Patient that the Document Registry has records for. The concern is that this action is not clear outside of a policy. It is reasonable that policy may choose to ignore Delete, may choose to mark the affected Resources inactive, or may choose to delete the affected Resources. Thus, we have left this action undefined. It is expected that a Delete action is unusual, and that administrative user interface may be the better solution.

3. Where XDS/XCA is used, the MHDS Profile does not apply, as the MHD Profile provides the API functionality to XDS/XCA

4. MHDS defines an OAuth scope for use with MHDS and IUA to support Patient Privacy Disclosure Consent functionality. This scope is crafted to minimally impact uses of IUA and SMART-on-FHIR. See the “Consent Management Option” for details.

5. In this profile, there is no formal Document Repository, although the functionality is provided virtually when a Document Source chooses to not include the document as a Binary resource, but rather include a URL to a repository that is recognized as part of the trust domain. This distinction is available in MHD today, although it is not pointed out as such and thus not well known. There is a description of this virtual Document Repository functionality.

6. The MHDS environment allows for some normally contained Resources to be recorded as a link to data in the mCSD managed Directory or PMIR Patient Identity Registry. This is defined in the “UnContained Reference Option”. The necessary change to MHD has not been done yet in order to get feedback from Public Comment. CP-ITI-1200 has updated MHD to add an UnContained Reference Option for this support.