Mobile access to Health Documents (MHD)
4.2.3 - Trial-Implementation

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 4.2.3 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 common List with designationType

Official URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.List | Version: 4.2.3
Active as of 2025-10-30 | Computable Name: MhdList

A profile on the List resource for MHD. Used with both Folder and SubmissionSet.

- MHD adds a codeable Concept to List for use with Folder and SubmissionSet

Usages:

- Derived from this Profile: MHD Folder Minimal and MHD SubmissionSet Minimal
- CapabilityStatements using this Profile: Document Consumer (client) 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..* | List | 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 |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType |  | 0..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
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.
code | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required)
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 | 📦4.2.3 | 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 List

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List |  | 0..* | List | A list is a curated collection of resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType |  | 0..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
modifierExtension |  | 0..0 |  | Extension
code |  | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
List.code | Base | required | MHD List Types ValueSet | 📦4.2.3 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List | C | 0..* | List | 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
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 |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType |  | 0..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
identifier |  | 0..* | Identifier | 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.
title | Σ | 0..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)
subject | Σ | 0..1 | Reference(Patient | Group | Device | Location) | If all resources have the same subject
encounter |  | 0..1 | Reference(Encounter) | Context in which list created
date | Σ | 0..1 | dateTime | When the list was prepared
source | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | Device) | Who and/or what defined the list contents (aka Author)
orderedBy |  | 0..1 | CodeableConcept | What order the list has Binding: ListOrderCodes (preferred): What order applies to the items in a list.
note |  | 0..* | 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
flag |  | 0..1 | CodeableConcept | Status/Workflow information about this item Binding: PatientMedicineChangeTypes (example): Codes that provide further information about the reason and meaning of the item in the list.
deleted | ?!C | 0..1 | boolean | If this item is actually marked as deleted
date |  | 0..1 | dateTime | When item added to list
item |  | 1..1 | Reference(Resource) | Actual entry
emptyReason | C | 0..1 | CodeableConcept | Why list is empty Binding: ListEmptyReasons (preferred): If a list is empty, why it is empty.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
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 | 📦4.2.3 | This IG
List.orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
List.entry.flag | Base | example | Patient Medicine Change Types | 📍4.0.1 | FHIR Std.
List.emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### 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 List

Summary

Mandatory: 1 element
Prohibited: 1 element

Extensions

This structure refers to these extensions:

- https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List | C | 0..* | List | 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 |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType |  | 0..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
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.
code | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required)
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 | 📦4.2.3 | 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 List

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List |  | 0..* | List | A list is a curated collection of resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType |  | 0..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
modifierExtension |  | 0..0 |  | Extension
code |  | 1..1 | CodeableConcept | What the purpose of this list is Binding: MHD List Types ValueSet (required)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
List.code | Base | required | MHD List Types ValueSet | 📦4.2.3 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
List | C | 0..* | List | 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
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 |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:designationType |  | 0..* | CodeableConcept | Clinical code of the List URL: https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType
identifier |  | 0..* | Identifier | 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.
title | Σ | 0..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)
subject | Σ | 0..1 | Reference(Patient | Group | Device | Location) | If all resources have the same subject
encounter |  | 0..1 | Reference(Encounter) | Context in which list created
date | Σ | 0..1 | dateTime | When the list was prepared
source | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | Device) | Who and/or what defined the list contents (aka Author)
orderedBy |  | 0..1 | CodeableConcept | What order the list has Binding: ListOrderCodes (preferred): What order applies to the items in a list.
note |  | 0..* | 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
flag |  | 0..1 | CodeableConcept | Status/Workflow information about this item Binding: PatientMedicineChangeTypes (example): Codes that provide further information about the reason and meaning of the item in the list.
deleted | ?!C | 0..1 | boolean | If this item is actually marked as deleted
date |  | 0..1 | dateTime | When item added to list
item |  | 1..1 | Reference(Resource) | Actual entry
emptyReason | C | 0..1 | CodeableConcept | Why list is empty Binding: ListEmptyReasons (preferred): If a list is empty, why it is empty.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
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 | 📦4.2.3 | This IG
List.orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
List.entry.flag | Base | example | Patient Medicine Change Types | 📍4.0.1 | FHIR Std.
List.emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### 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 List

Summary

Mandatory: 1 element
Prohibited: 1 element

Extensions

This structure refers to these extensions:

- https://profiles.ihe.net/ITI/MHD/StructureDefinition/ihe-designationType

Other representations of profile: CSV, Excel, Schematron