Mobile access to Health Documents (MHD)
4.2.4-current - ci-build

Mobile access to Health Documents (MHD), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 4.2.4-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.MHD/ and changes regularly. See the Directory of published versions

## Resource Profile: MHD Folder Comprehensive

Official URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.Folder | Version: 4.2.4-current
Active as of 2026-04-01 | Computable Name: FolderComprehensive

A profile on the List resource for MHD Comprehensive Metadata Folder. Note UnContained has no impact on Folder.

- MHD is based on the IHE Document Sharing model,
- the 3:4.1 Abstract Metadata Model, and
- the use defined here is FHIR List for use as a Folder implementation of the
- ebRIM implementation at 3:4.2.3.4 Folder Attributes.
- with use-cases and constraints found in 3:4.3 Additional Document Sharing Requirements

Usages:

- Examples for this Profile: List/ex-compFolder
- CapabilityStatements using this Profile: Document Responder (server) with Full-Text Search Option and Document Responder (server)

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List | C | 0..* | Folder | A list is a curated collection of resources Constraints: lst-1, lst-2, lst-3
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType | S | 1..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
Slices for identifier |  | 0..* | Identifier | Business identifier Slice: Unordered, Open by value:use
identifier:uniqueId | S | 0..1 | UniqueIdIdentifier | Business identifier
identifier:entryUUID | S | 0..* | EntryUUIDIdentifier | Business identifier
status | ?!Σ | 1..1 | code | current | retired | entered-in-error Binding: ListStatus (required): The current state of the list.
mode | ?!Σ | 1..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this list. Required Pattern: working
title | Σ | 1..1 | string | Descriptive name for the list Example General: Dr. Jane's Patients
code | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://profiles.ihe.net/ITI/MHD/CodeSystem/MHDlistTypes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: folder
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | If all resources have the same subject
note |  | 0..1 | Annotation | Comments about the list
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
List.status | Base | required | ListStatus | 📍4.0.1 | FHIR Std.
List.mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
List.code | Base | required | MHD List Types ValueSet | 📦4.2.4-current | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | List | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | List | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | List | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | List | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | List | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
lst-1 | error | List | A list can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
lst-2 | error | List | The deleted flag can only be used if the mode of the list is "changes" | `mode = 'changes' or entry.deleted.empty()`
lst-3 | error | List | An entry date can only be used if the mode of the list is "working" | `mode = 'working' or entry.date.empty()`

This structure is derived from Folder

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List |  | 0..* | Folder | A list is a curated collection of resources
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:designationType |  | 1..* | DesignationType | Clinical code of the List
title |  | 1..1 | string | Descriptive name for the list
subject |  | 1..1 | Reference(Patient) | If all resources have the same subject
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List | C | 0..* | Folder | A list is a curated collection of resources Constraints: lst-1, lst-2, lst-3
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType | S | 1..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
Slices for identifier |  | 0..* | Identifier | Business identifier Slice: Unordered, Open by value:use
identifier:uniqueId | S | 0..1 | UniqueIdIdentifier | Business identifier
identifier:entryUUID | S | 0..* | EntryUUIDIdentifier | Business identifier
status | ?!Σ | 1..1 | code | current | retired | entered-in-error Binding: ListStatus (required): The current state of the list.
mode | ?!Σ | 1..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this list. Required Pattern: working
title | Σ | 1..1 | string | Descriptive name for the list Example General: Dr. Jane's Patients
code | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://profiles.ihe.net/ITI/MHD/CodeSystem/MHDlistTypes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: folder
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | If all resources have the same subject
date | Σ | 0..1 | dateTime | When the list was prepared
note |  | 0..1 | Annotation | Comments about the list
entry | C | 0..* | BackboneElement | Entries in the list
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
item |  | 1..1 | Reference(DocumentReference) | Actual entry
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
List.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
List.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
List.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
List.status | Base | required | ListStatus | 📍4.0.1 | FHIR Std.
List.mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
List.code | Base | required | MHD List Types ValueSet | 📦4.2.4-current | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | List | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | List | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | List | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | List | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | List | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
lst-1 | error | List | A list can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
lst-2 | error | List | The deleted flag can only be used if the mode of the list is "changes" | `mode = 'changes' or entry.deleted.empty()`
lst-3 | error | List | An entry date can only be used if the mode of the list is "working" | `mode = 'working' or entry.date.empty()`

This structure is derived from Folder

Summary

Mandatory: 4 elements

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List | C | 0..* | Folder | A list is a curated collection of resources Constraints: lst-1, lst-2, lst-3
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType | S | 1..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
Slices for identifier |  | 0..* | Identifier | Business identifier Slice: Unordered, Open by value:use
identifier:uniqueId | S | 0..1 | UniqueIdIdentifier | Business identifier
identifier:entryUUID | S | 0..* | EntryUUIDIdentifier | Business identifier
status | ?!Σ | 1..1 | code | current | retired | entered-in-error Binding: ListStatus (required): The current state of the list.
mode | ?!Σ | 1..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this list. Required Pattern: working
title | Σ | 1..1 | string | Descriptive name for the list Example General: Dr. Jane's Patients
code | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://profiles.ihe.net/ITI/MHD/CodeSystem/MHDlistTypes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: folder
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | If all resources have the same subject
note |  | 0..1 | Annotation | Comments about the list
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
List.status | Base | required | ListStatus | 📍4.0.1 | FHIR Std.
List.mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
List.code | Base | required | MHD List Types ValueSet | 📦4.2.4-current | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | List | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | List | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | List | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | List | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | List | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
lst-1 | error | List | A list can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
lst-2 | error | List | The deleted flag can only be used if the mode of the list is "changes" | `mode = 'changes' or entry.deleted.empty()`
lst-3 | error | List | An entry date can only be used if the mode of the list is "working" | `mode = 'working' or entry.date.empty()`

Differential View

This structure is derived from Folder

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List |  | 0..* | Folder | A list is a curated collection of resources
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:designationType |  | 1..* | DesignationType | Clinical code of the List
title |  | 1..1 | string | Descriptive name for the list
subject |  | 1..1 | Reference(Patient) | If all resources have the same subject
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List | C | 0..* | Folder | A list is a curated collection of resources Constraints: lst-1, lst-2, lst-3
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType | S | 1..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
Slices for identifier |  | 0..* | Identifier | Business identifier Slice: Unordered, Open by value:use
identifier:uniqueId | S | 0..1 | UniqueIdIdentifier | Business identifier
identifier:entryUUID | S | 0..* | EntryUUIDIdentifier | Business identifier
status | ?!Σ | 1..1 | code | current | retired | entered-in-error Binding: ListStatus (required): The current state of the list.
mode | ?!Σ | 1..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this list. Required Pattern: working
title | Σ | 1..1 | string | Descriptive name for the list Example General: Dr. Jane's Patients
code | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: https://profiles.ihe.net/ITI/MHD/CodeSystem/MHDlistTypes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: folder
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | If all resources have the same subject
date | Σ | 0..1 | dateTime | When the list was prepared
note |  | 0..1 | Annotation | Comments about the list
entry | C | 0..* | BackboneElement | Entries in the list
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
item |  | 1..1 | Reference(DocumentReference) | Actual entry
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
List.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
List.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
List.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
List.status | Base | required | ListStatus | 📍4.0.1 | FHIR Std.
List.mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
List.code | Base | required | MHD List Types ValueSet | 📦4.2.4-current | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | List | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | List | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | List | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | List | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | List | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
lst-1 | error | List | A list can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
lst-2 | error | List | The deleted flag can only be used if the mode of the list is "changes" | `mode = 'changes' or entry.deleted.empty()`
lst-3 | error | List | An entry date can only be used if the mode of the list is "working" | `mode = 'working' or entry.date.empty()`

This structure is derived from Folder

Summary

Mandatory: 4 elements

Other representations of profile: CSV, Excel, Schematron