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

## : Example of a FHIR-Document Bundle - XML Representation

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    <Bundle xmlns="http://hl7.org/fhir">
      <id value="ex-fhir-document-bundle"/>
      <meta>
        <lastUpdated value="2013-05-28T22:12:21Z"/>
      </meta>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:uuid:0c3151bd-1cbf-4d64-b04d-cd9187a4c6e0"/>
      </identifier>
      <type value="document"/>
      <timestamp value="2013-05-28T22:12:21Z"/>
      <entry>
        <fullUrl
                 value="http://example.org/fhir/Composition/180f219f-97a8-486d-99d9-ed631fe4fc57"/>
        <resource>
          <Composition>
            <id value="180f219f-97a8-486d-99d9-ed631fe4fc57"/>
            <meta>
              <lastUpdated value="2013-05-28T22:12:21Z"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Composition_180f219f-97a8-486d-99d9-ed631fe4fc57"> </a><p class="res-header-id"><b>Generated Narrative: Composition 180f219f-97a8-486d-99d9-ed631fe4fc57</b></p><a name="180f219f-97a8-486d-99d9-ed631fe4fc57"> </a><a name="hc180f219f-97a8-486d-99d9-ed631fe4fc57"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2013-05-28 22:12:21+0000</p></div><p><b>status</b>: Final</p><p><b>type</b>: <span title="Codes:{http://loinc.org 28655-9}">Discharge Summary from Responsible Clinician</span></p><p><b>encounter</b>: <a href="Bundle-ex-fhir-document-bundle.html#Encounter_fdoc-encounter">Encounter: identifier = http://www.example.org/encounters#S100; status = finished; class = inpatient encounter (ActCode#IMP); type = ; period = 2013-01-20 12:30:02+0000 --&gt; 2013-02-01 12:30:02+0000</a></p><p><b>date</b>: 2013-02-01 12:30:02+0000</p><p><b>author</b>: <a href="Bundle-ex-fhir-document-bundle.html#Practitioner_fdoc-practitioner">Practitioner Adam Careful </a></p><p><b>title</b>: Discharge Summary</p></div>
            </text>
            <status value="final"/>
            <type>
              <coding>
                <system value="http://loinc.org"/>
                <code value="28655-9"/>
              </coding>
              <text value="Discharge Summary from Responsible Clinician"/>
            </type>
            <subject>
              <reference value="Patient/fdoc-patient"/>
            </subject>
            <encounter>
              <reference value="Encounter/fdoc-encounter"/>
            </encounter>
            <date value="2013-02-01T12:30:02Z"/>
            <author>
              <reference value="Practitioner/fdoc-practitioner"/>
            </author>
            <title value="Discharge Summary"/>
            <section>
              <title value="Reason for admission"/>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="29299-5"/>
                  <display value="Reason for visit Narrative"/>
                </coding>
              </code>
              <text>
                <status value="additional"/>
                <div xmlns="http://www.w3.org/1999/xhtml"><table><thead><tr><td>Details</td><td/></tr></thead><tbody><tr><td>Acute Asthmatic attack. Was wheezing for days prior to admission.</td><td/></tr></tbody></table></div>
              </text>
              <entry>
                <reference value="Observation/fdoc-observation"/>
              </entry>
            </section>
            <section>
              <title value="Medications on Discharge"/>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="10183-2"/>
                  <display value="Hospital discharge medications Narrative"/>
                </coding>
              </code>
              <text>
                <status value="additional"/>
                <div xmlns="http://www.w3.org/1999/xhtml"><table><thead><tr><td>Medication</td><td>Last Change</td><td>Last ChangeReason</td></tr></thead><tbody><tr><td>Theophylline 200mg BD after meals</td><td>continued</td></tr><tr><td>Ventolin Inhaler</td><td>stopped</td><td>Getting side effect of tremor</td></tr></tbody></table></div>
              </text>
              <entry>
                <reference value="MedicationRequest/fdoc-medicationrequest"/>
              </entry>
              <entry>
                <reference value="MedicationStatement/fdoc-medicationstatement"/>
              </entry>
            </section>
            <section>
              <title value="Known allergies"/>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48765-2"/>
                  <display value="Allergies and adverse reactions Document"/>
                </coding>
              </code>
              <text>
                <status value="additional"/>
                <div xmlns="http://www.w3.org/1999/xhtml"><table><thead><tr><td>Allergen</td><td>Reaction</td></tr></thead><tbody><tr><td>Doxycycline</td><td>Hives</td></tr></tbody></table></div>
              </text>
              <entry>
                <reference value="AllergyIntolerance/fdoc-allergyintolerance"/>
              </entry>
            </section>
          </Composition>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Practitioner/fdoc-practitioner"/>
        <resource>
          <Practitioner>
            <id value="fdoc-practitioner"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_fdoc-practitioner"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner fdoc-practitioner</b></p><a name="fdoc-practitioner"> </a><a name="hcfdoc-practitioner"> </a><p><b>identifier</b>: <code>http://www.acme.org/practitioners</code>/23</p><p><b>name</b>: Adam Careful </p></div>
            </text>
            <identifier>
              <system value="http://www.acme.org/practitioners"/>
              <value value="23"/>
            </identifier>
            <name>
              <family value="Careful"/>
              <given value="Adam"/>
              <prefix value="Dr"/>
            </name>
          </Practitioner>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Patient/fdoc-patient"/>
        <resource>
          <Patient>
            <id value="fdoc-patient"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_fdoc-patient"> </a><p class="res-header-id"><b>Generated Narrative: Patient fdoc-patient</b></p><a name="fdoc-patient"> </a><a name="hcfdoc-patient"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Eve Everywoman Female, DoB: 1955-01-06</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td colspan="3">true</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><ul><li>ph: 555-555-2003(Work)</li><li>2222 Home Street (home)</li></ul></td></tr></table></div>
            </text>
            <active value="true"/>
            <name>
              <text value="Eve Everywoman"/>
              <family value="Everywoman1"/>
              <given value="Eve"/>
            </name>
            <telecom>
              <system value="phone"/>
              <value value="555-555-2003"/>
              <use value="work"/>
            </telecom>
            <gender value="female"/>
            <birthDate value="1955-01-06"/>
            <address>
              <use value="home"/>
              <line value="2222 Home Street"/>
            </address>
          </Patient>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Encounter/fdoc-encounter"/>
        <resource>
          <Encounter>
            <id value="fdoc-encounter"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Encounter_fdoc-encounter"> </a><p class="res-header-id"><b>Generated Narrative: Encounter fdoc-encounter</b></p><a name="fdoc-encounter"> </a><a name="hcfdoc-encounter"> </a><p><b>identifier</b>: <code>http://www.example.org/encounters</code>/S100</p><p><b>status</b>: Finished</p><p><b>class</b>: <a href="http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP">ActCode: IMP</a> (inpatient encounter)</p><p><b>type</b>: <span title="Codes:">Orthopedic Admission</span></p><p><b>subject</b>: <a href="Bundle-ex-fhir-document-bundle.html#Patient_fdoc-patient">Eve Everywoman Female, DoB: 1955-01-06</a></p><p><b>period</b>: 2013-01-20 12:30:02+0000 --&gt; 2013-02-01 12:30:02+0000</p><h3>Hospitalizations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Discharged to care of GP</span></td></tr></table></div>
            </text>
            <identifier>
              <system value="http://www.example.org/encounters"/>
              <value value="S100"/>
            </identifier>
            <status value="finished"/>
            <class>
              <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
              <code value="IMP"/>
              <display value="inpatient encounter"/>
            </class>
            <type>
              <text value="Orthopedic Admission"/>
            </type>
            <subject>
              <reference value="Patient/fdoc-patient"/>
            </subject>
            <period>
              <start value="2013-01-20T12:30:02Z"/>
              <end value="2013-02-01T12:30:02Z"/>
            </period>
            <hospitalization>
              <dischargeDisposition>
                <text value="Discharged to care of GP"/>
              </dischargeDisposition>
            </hospitalization>
          </Encounter>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/fdoc-observation"/>
        <resource>
          <Observation>
            <id value="fdoc-observation"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_fdoc-observation"> </a><p class="res-header-id"><b>Generated Narrative: Observation fdoc-observation</b></p><a name="fdoc-observation"> </a><a name="hcfdoc-observation"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title="Codes:{http://loinc.org 46241-6}">Reason for admission</span></p><p><b>subject</b>: <a href="Bundle-ex-fhir-document-bundle.html#Patient_fdoc-patient">Eve Everywoman Female, DoB: 1955-01-06</a></p><p><b>encounter</b>: <a href="Bundle-ex-fhir-document-bundle.html#Encounter_fdoc-encounter">Encounter: identifier = http://www.example.org/encounters#S100; status = finished; class = inpatient encounter (ActCode#IMP); type = ; period = 2013-01-20 12:30:02+0000 --&gt; 2013-02-01 12:30:02+0000</a></p><p><b>value</b>: Acute Asthmatic attack. Was wheezing for days prior to admission.</p></div>
            </text>
            <status value="final"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="46241-6"/>
              </coding>
              <text value="Reason for admission"/>
            </code>
            <subject>
              <reference value="Patient/fdoc-patient"/>
            </subject>
            <encounter>
              <reference value="Encounter/fdoc-encounter"/>
            </encounter>
            <valueString
                         value="Acute Asthmatic attack. Was wheezing for days prior to admission."/>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://example.org/fhir/MedicationRequest/fdoc-medicationrequest"/>
        <resource>
          <MedicationRequest>
            <id value="fdoc-medicationrequest"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicationRequest_fdoc-medicationrequest"> </a><p class="res-header-id"><b>Generated Narrative: MedicationRequest fdoc-medicationrequest</b></p><a name="fdoc-medicationrequest"> </a><a name="hcfdoc-medicationrequest"> </a><p><b>status</b>: Unknown</p><p><b>intent</b>: Order</p><p><b>medication</b>: <span title="Codes:{http://snomed.info/sct 66493003}">Theophylline 200mg</span></p><p><b>subject</b>: <a href="Bundle-ex-fhir-document-bundle.html#Patient_fdoc-patient">Eve Everywoman Female, DoB: 1955-01-06</a></p><p><b>requester</b>: <a href="Bundle-ex-fhir-document-bundle.html#Practitioner_fdoc-practitioner">Practitioner Adam Careful </a></p><p><b>reasonCode</b>: <span title="Codes:">Management of Asthma</span></p><blockquote><p><b>dosageInstruction</b></p><p><b>additionalInstruction</b>: <span title="Codes:">Take with Food</span></p><p><b>timing</b>: 2 per 1 day</p><p><b>route</b>: <span title="Codes:{http://snomed.info/sct 394899003}">oral administration of treatment</span></p><h3>DoseAndRates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Dose[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/dose-rate-type ordered}">Ordered</span></td><td>1 tablet<span style="background: LightGoldenRodYellow"> (Details: Orderable Drug Form  codeTAB = 'Tablet')</span></td></tr></table></blockquote></div>
            </text>
            <status value="unknown"/>
            <intent value="order"/>
            <medicationCodeableConcept>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="66493003"/>
              </coding>
              <text value="Theophylline 200mg"/>
            </medicationCodeableConcept>
            <subject>
              <reference value="Patient/fdoc-patient"/>
            </subject>
            <requester>
              <reference value="Practitioner/fdoc-practitioner"/>
            </requester>
            <reasonCode>
              <text value="Management of Asthma"/>
            </reasonCode>
            <dosageInstruction>
              <additionalInstruction>
                <text value="Take with Food"/>
              </additionalInstruction>
              <timing>
                <repeat>
                  <frequency value="2"/>
                  <period value="1"/>
                  <periodUnit value="d"/>
                </repeat>
              </timing>
              <route>
                <coding>
                  <system value="http://snomed.info/sct"/>
                  <code value="394899003"/>
                  <display value="oral administration of treatment"/>
                </coding>
              </route>
              <doseAndRate>
                <type>
                  <coding>
                    <system
                            value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
                    <code value="ordered"/>
                    <display value="Ordered"/>
                  </coding>
                </type>
                <doseQuantity>
                  <value value="1"/>
                  <unit value="tablet"/>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/>
                  <code value="TAB"/>
                </doseQuantity>
              </doseAndRate>
            </dosageInstruction>
          </MedicationRequest>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://example.org/fhir/MedicationStatement/fdoc-medicationstatement"/>
        <resource>
          <MedicationStatement>
            <id value="fdoc-medicationstatement"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicationStatement_fdoc-medicationstatement"> </a><p class="res-header-id"><b>Generated Narrative: MedicationStatement fdoc-medicationstatement</b></p><a name="fdoc-medicationstatement"> </a><a name="hcfdoc-medicationstatement"> </a><p><b>status</b>: Active</p><p><b>statusReason</b>: <span title="Codes:">Management of Asthma</span></p><p><b>medication</b>: <span title="Codes:">Ventolin Inhaler</span></p><p><b>subject</b>: <a href="Bundle-ex-fhir-document-bundle.html#Patient_fdoc-patient">Eve Everywoman Female, DoB: 1955-01-06</a></p><p><b>dateAsserted</b>: 2013-05-05 16:13:03+0000</p></div>
            </text>
            <status value="active"/>
            <statusReason>
              <text value="Management of Asthma"/>
            </statusReason>
            <medicationCodeableConcept>
              <text value="Ventolin Inhaler"/>
            </medicationCodeableConcept>
            <subject>
              <reference value="Patient/fdoc-patient"/>
            </subject>
            <dateAsserted value="2013-05-05T16:13:03Z"/>
          </MedicationStatement>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://example.org/fhir/AllergyIntolerance/fdoc-allergyintolerance"/>
        <resource>
          <AllergyIntolerance>
            <id value="fdoc-allergyintolerance"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="AllergyIntolerance_fdoc-allergyintolerance"> </a><p class="res-header-id"><b>Generated Narrative: AllergyIntolerance fdoc-allergyintolerance</b></p><a name="fdoc-allergyintolerance"> </a><a name="hcfdoc-allergyintolerance"> </a><p><b>clinicalStatus</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical active}">Active</span></p><p><b>verificationStatus</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/allergyintolerance-verification confirmed}">Confirmed</span></p><p><b>type</b>: Allergy</p><p><b>criticality</b>: High Risk</p><p><b>code</b>: <span title="Codes:">Doxycycline</span></p><p><b>patient</b>: <a href="Bundle-ex-fhir-document-bundle.html#Patient_fdoc-patient">Eve Everywoman Female, DoB: 1955-01-06</a></p><p><b>recordedDate</b>: 2012-09-17</p><h3>Reactions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Manifestation</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Hives</span></td></tr></table></div>
            </text>
            <clinicalStatus>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"/>
                <code value="active"/>
                <display value="Active"/>
              </coding>
            </clinicalStatus>
            <verificationStatus>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"/>
                <code value="confirmed"/>
                <display value="Confirmed"/>
              </coding>
            </verificationStatus>
            <type value="allergy"/>
            <criticality value="high"/>
            <code>
              <text value="Doxycycline"/>
            </code>
            <patient>
              <reference value="Patient/fdoc-patient"/>
            </patient>
            <recordedDate value="2012-09-17"/>
            <reaction>
              <manifestation>
                <text value="Hives"/>
              </manifestation>
            </reaction>
          </AllergyIntolerance>
        </resource>
      </entry>
    </Bundle>