Mobile access to Health Documents (MHD)
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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 5.0.0-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

3:4.5 FHIR Maps

Editor, please Add Section 4.5

3:4.5 FHIR Representation of Document Sharing Metadata

This section documents the mapping between IHE Document Sharing Metadata and the FHIR Resources.

3:4.5.1 Metadata Object Types mapped to FHIR

For details on FHIR resources and data types see HL7 FHIR FHIR index.html.

Some Document Sharing Metadata attributes must be treated as contained FHIR Resources. These are indicated in with a "Note 1” and the word contained. The details of the FHIR contained mechanism is found at FHIR references.html#contained.

When encoding XDS identifiers into FHIR Resource data elements of type Identifier, the FHIR notation of OIDs and UUIDs uses the system identifier of urn:ietf:rfc:3986. For more details and examples, see ITI TF-2: Appendix E.3 “FHIR Identifier Type”.

3:4.5.1.1 DocumentEntry Metadata Attributes

The documented mapping of the metadata elements associated with a Document Sharing DocumentEntry object attributes.

The mapping in table form

DocumentEntry R4 DocumentReference R5 DocumentReference
limitedMetadata meta.profile meta.profile
uniqueId masterIdentifier identifier (uniqueId)
entryUUID identifier identifier (entryUUID)
availabilityStatus status status
typeCode type type
classCode category category
patientId subject subject
author author author
legalAuthenticator authenticator attester
Associations    
.type relatesTo.code relatesTo.code
.reference relatesTo.target relatesTo.target
comments description description
confidentialityCode securityLabel securityLabel
mimeType content.attachment.contentType content.attachment.contentType
languageCode content.attachment.language content.attachment.language
repositoryUniqueId content.attachment.url content.attachment.url
URI content.attachment.url content.attachment.url
size content.attachment.size content.attachment.size
hash content.attachment.hash content.attachment.hash
title content.attachment.title content.attachment.title
creationTime content.attachment.creation content.attachment.creation
formatCode content.format content.profile.valueCoding
referenceIdList    
type encounterId context.encounter context
procedures context.related basedOn
all other context.related event.reference
eventCodeList context.event event.concept
serviceStartTime context.period.start period.start
serviceStopTime context.period.end period.end
healthcareFacilityTypeCode context.facilityType facilityType
practiceSettingCode context.practiceSettingCode practiceSetting
sourcePatientInfo sourcePatientInfo.reference extension (sourcePatient)
sourcePatientId sourcePatientInfo.identifier extension (sourcePatient)

Note: FHIR contains an informative mapping that is intended to be equivalent and can be found at FHIR documentReference XDS mapping. For the purposes of IHE MHD conformance the mapping documented here (in IHE) are normative.

3:4.5.1.2 DocumentReference StructureDefinition

The conformance requirements are different between a Provide Document Bundle ITI-65 transaction and a Find Document References ITI-67 transaction, and between Minimal Metadata, Comprehensive Metadata, and UnContained References.

The conformance requirements are different between Comprehensive, minimal, and UnContained References. The canonical URI is found as the "Defining URL:":

Resources are not required to carry the meta.profile element and may only carry the profile element defined for the Provide Document Bundle [ITI-65] transaction, as the Receiver is not required to add the profile tags. The value of the meta.profile is a soft indicator of conformance expectation. Receivers may choose to validate actual conformance and fail transactions due to non-conformance.

3:4.5.2 SubmissionSet Metadata Attributes

The documented mapping of the metadata elements associated with a Document Sharing SubmissionSet object attributes.

SubmissionSet R4 List R5 List
limitedMetadata meta.profile meta.profile
contentTypeCode extension (designationType) extension (designationType)
sourceId extension (sourceId) extension (sourceId)
intendedRecipient extension (intendedRecipient) extension (intendedRecipient)
entryUUID identifier identifier
uniqueId identifier identifier
availabilityStatus status status
title title title
patientId subject subject
submissionTime date date
author    
when Organization extension (authorOrg) extension (authorOrg)
when Practitioner source source
comments note note
DocumentEntry(s) entry.item entry.item
Folder(s) entry.item entry.item

3:4.5.2.1 SubmissionSet List StructureDefinition

The conformance requirements are different between Comprehensive, Minimal, and UnContained References. The canonical URI is found as the "Defining URL:":

Resources are not required to carry the meta.profile element and may only carry the profile element defined for the Provide Document Bundle ITI-65 transaction, as the Receiver is not required to add the profile tags. The value of the meta.profile is a soft indicator of conformance expectation. Receivers may choose to validate actual conformance and fail transactions due to non-conformance.

3:4.5.3 Folder Metadata Attributes

The documented mapping of the metadata elements associated with a Document Sharing Folder object attributes.

Note that FHIR List Resource in the FHIR core specification does not include a Mapping to XDS.

Folder R4 List R5 List
limitedMetadata meta.profile meta.profile
contentTypeCode extension (designationType) extension (designationType)
entryUUID identifier identifier
uniqueId identifier identifier
availabilityStatus status status
title title title
patientId subject subject
lastUpdateTime date date
comments note note
DocumentEntry(s) entry.item entry.item

3:4.5.3.1 Folder StructureDefinition

The conformance requirements are different between Comprehensive and Minimal metadata. The canonical URI is found as the "Defining URL:":

Resources are not required to carry the meta.profile element and may only carry the profile element defined for the Provide Document Bundle ITI-65 transaction, as the Receiver is not required to add the profile tags. The value of the meta.profile is a soft indicator of conformance expectation. Receivers may choose to validate actual conformance and fail transactions due to non-conformance.