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 - JSON Representation

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    {
      "resourceType" : "Bundle",
      "id" : "ex-fhir-document-bundle",
      "meta" : {
        "lastUpdated" : "2013-05-28T22:12:21Z"
      },
      "identifier" : {
        "system" : "urn:ietf:rfc:3986",
        "value" : "urn:uuid:0c3151bd-1cbf-4d64-b04d-cd9187a4c6e0"
      },
      "type" : "document",
      "timestamp" : "2013-05-28T22:12:21Z",
      "entry" : [
        {
          "fullUrl" : "http://example.org/fhir/Composition/180f219f-97a8-486d-99d9-ed631fe4fc57",
          "resource" : {
            "resourceType" : "Composition",
            "id" : "180f219f-97a8-486d-99d9-ed631fe4fc57",
            "meta" : {
              "lastUpdated" : "2013-05-28T22:12:21Z"
            },
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "status" : "final",
            "type" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "28655-9"
                }
              ],
              "text" : "Discharge Summary from Responsible Clinician"
            },
            "subject" : {
              "reference" : "Patient/fdoc-patient"
            },
            "encounter" : {
              "reference" : "Encounter/fdoc-encounter"
            },
            "date" : "2013-02-01T12:30:02Z",
            "author" : [
              {
                "reference" : "Practitioner/fdoc-practitioner"
              }
            ],
            "title" : "Discharge Summary",
            "section" : [
              {
                "title" : "Reason for admission",
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "29299-5",
                      "display" : "Reason for visit Narrative"
                    }
                  ]
                },
                "text" : {
                  "status" : "additional",
                  "div" : "<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>"
                },
                "entry" : [
                  {
                    "reference" : "Observation/fdoc-observation"
                  }
                ]
              },
              {
                "title" : "Medications on Discharge",
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "10183-2",
                      "display" : "Hospital discharge medications Narrative"
                    }
                  ]
                },
                "text" : {
                  "status" : "additional",
                  "div" : "<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>"
                },
                "entry" : [
                  {
                    "reference" : "MedicationRequest/fdoc-medicationrequest"
                  },
                  {
                    "reference" : "MedicationStatement/fdoc-medicationstatement"
                  }
                ]
              },
              {
                "title" : "Known allergies",
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "48765-2",
                      "display" : "Allergies and adverse reactions Document"
                    }
                  ]
                },
                "text" : {
                  "status" : "additional",
                  "div" : "<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>"
                },
                "entry" : [
                  {
                    "reference" : "AllergyIntolerance/fdoc-allergyintolerance"
                  }
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/Practitioner/fdoc-practitioner",
          "resource" : {
            "resourceType" : "Practitioner",
            "id" : "fdoc-practitioner",
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "identifier" : [
              {
                "system" : "http://www.acme.org/practitioners",
                "value" : "23"
              }
            ],
            "name" : [
              {
                "family" : "Careful",
                "given" : [
                  "Adam"
                ],
                "prefix" : [
                  "Dr"
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/Patient/fdoc-patient",
          "resource" : {
            "resourceType" : "Patient",
            "id" : "fdoc-patient",
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "active" : true,
            "name" : [
              {
                "text" : "Eve Everywoman",
                "family" : "Everywoman1",
                "given" : [
                  "Eve"
                ]
              }
            ],
            "telecom" : [
              {
                "system" : "phone",
                "value" : "555-555-2003",
                "use" : "work"
              }
            ],
            "gender" : "female",
            "birthDate" : "1955-01-06",
            "address" : [
              {
                "use" : "home",
                "line" : [
                  "2222 Home Street"
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/Encounter/fdoc-encounter",
          "resource" : {
            "resourceType" : "Encounter",
            "id" : "fdoc-encounter",
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "identifier" : [
              {
                "system" : "http://www.example.org/encounters",
                "value" : "S100"
              }
            ],
            "status" : "finished",
            "class" : {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code" : "IMP",
              "display" : "inpatient encounter"
            },
            "type" : [
              {
                "text" : "Orthopedic Admission"
              }
            ],
            "subject" : {
              "reference" : "Patient/fdoc-patient"
            },
            "period" : {
              "start" : "2013-01-20T12:30:02Z",
              "end" : "2013-02-01T12:30:02Z"
            },
            "hospitalization" : {
              "dischargeDisposition" : {
                "text" : "Discharged to care of GP"
              }
            }
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/Observation/fdoc-observation",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "fdoc-observation",
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "46241-6"
                }
              ],
              "text" : "Reason for admission"
            },
            "subject" : {
              "reference" : "Patient/fdoc-patient"
            },
            "encounter" : {
              "reference" : "Encounter/fdoc-encounter"
            },
            "valueString" : "Acute Asthmatic attack. Was wheezing for days prior to admission."
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/MedicationRequest/fdoc-medicationrequest",
          "resource" : {
            "resourceType" : "MedicationRequest",
            "id" : "fdoc-medicationrequest",
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "status" : "unknown",
            "intent" : "order",
            "medicationCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "66493003"
                }
              ],
              "text" : "Theophylline 200mg"
            },
            "subject" : {
              "reference" : "Patient/fdoc-patient"
            },
            "requester" : {
              "reference" : "Practitioner/fdoc-practitioner"
            },
            "reasonCode" : [
              {
                "text" : "Management of Asthma"
              }
            ],
            "dosageInstruction" : [
              {
                "additionalInstruction" : [
                  {
                    "text" : "Take with Food"
                  }
                ],
                "timing" : {
                  "repeat" : {
                    "frequency" : 2,
                    "period" : 1,
                    "periodUnit" : "d"
                  }
                },
                "route" : {
                  "coding" : [
                    {
                      "system" : "http://snomed.info/sct",
                      "code" : "394899003",
                      "display" : "oral administration of treatment"
                    }
                  ]
                },
                "doseAndRate" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                          "code" : "ordered",
                          "display" : "Ordered"
                        }
                      ]
                    },
                    "doseQuantity" : {
                      "value" : 1,
                      "unit" : "tablet",
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
                      "code" : "TAB"
                    }
                  }
                ]
              }
            ]
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/MedicationStatement/fdoc-medicationstatement",
          "resource" : {
            "resourceType" : "MedicationStatement",
            "id" : "fdoc-medicationstatement",
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "status" : "active",
            "statusReason" : [
              {
                "text" : "Management of Asthma"
              }
            ],
            "medicationCodeableConcept" : {
              "text" : "Ventolin Inhaler"
            },
            "subject" : {
              "reference" : "Patient/fdoc-patient"
            },
            "dateAsserted" : "2013-05-05T16:13:03Z"
          }
        },
        {
          "fullUrl" : "http://example.org/fhir/AllergyIntolerance/fdoc-allergyintolerance",
          "resource" : {
            "resourceType" : "AllergyIntolerance",
            "id" : "fdoc-allergyintolerance",
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "clinicalStatus" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
                  "code" : "active",
                  "display" : "Active"
                }
              ]
            },
            "verificationStatus" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
                  "code" : "confirmed",
                  "display" : "Confirmed"
                }
              ]
            },
            "type" : "allergy",
            "criticality" : "high",
            "code" : {
              "text" : "Doxycycline"
            },
            "patient" : {
              "reference" : "Patient/fdoc-patient"
            },
            "recordedDate" : "2012-09-17",
            "reaction" : [
              {
                "manifestation" : [
                  {
                    "text" : "Hives"
                  }
                ]
              }
            ]
          }
        }
      ]
    }