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

## Download and Analysis

You can download:

- this entire guide,
- the definition resources in json, xml, ttl, or csv format, or
- the example resources in json, xml or ttl format.

The source code for this Implementation Guide can be found on IHE ITI.MHD Github Repo.

#### Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (ihe.iti.mhd.r4) and R4B (ihe.iti.mhd.r4b) are available.

#### Dependency Table

IG | Package | FHIR | Comment
--- | --- | --- | ---
Mobile access to Health Documents (MHD) | ihe.iti.mhd#4.2.3 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.5.0 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 |
Basic Audit Log Patterns (BALP) | ihe.iti.balp#1.1.4-current | R4 |
IHE FormatCode Vocabulary | ihe.formatcode.fhir#1.4.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.3.0 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#0.8.0 | R4 | for example references

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package ihe.iti.balp#1.1.4-current The Basic Audit Log Patterns (BALP) Implementation Guide is a Content Profile that defines some basic and reusable AuditEvent patterns. This includes basic audit log profiles for FHIR RESTful operations to be used when there is not a more specific audit event defined. A focus is enabling Privacy centric AuditEvent logs that hold well formed indication of the Patient when they are the subject of the activity being recorded in the log. Where a more specific audit event can be defined it should be derived off of these basic patterns. (built Tue, Oct 7, 2025 16:46+0000+00:00)

Package ihe.formatcode.fhir#1.4.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Tue, May 20, 2025 09:01-0500-05:00)

Package hl7.fhir.uv.tools.r4#0.8.0 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Aug 5, 2025 20:09+1000+10:00)

#### Globals Table

There are no Global profiles defined

#### IP Statements

This publication includes IP covered under the following statements.

- Some content from IHE® Copyright © 2015 IHE International, Inc .
  Show Usage
  - IHE Format Code set for use with Document Sharing: Bundle/FindDocumentReferences, Bundle/ex-ProvideDocumentBundle-addToFolder... Show 16 more, Bundle/ex-comprehensiveProvideDocumentBundleComplete, Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-comprehensiveProvideDocumentBundleMultiple, Bundle/ex-comprehensiveProvideDocumentBundleReplace, Bundle/ex-comprehensiveProvideDocumentBundleSimple, Bundle/ex-dummyBundleDocAndBinary, Bundle/ex-minimalProvideDocumentBundleSimple, Bundle/ex-minimalProvideDocumentBundleSimpleContained, Bundle/ex-unContainedComprehensiveProvideDocumentBundleComplete, DocumentReference/ex-DocumentReferenceComprehensive, DocumentReference/ex-DocumentReferenceComprehensiveDelayedAssembly, DocumentReference/ex-DocumentReferenceComprehensiveOnDemand, DocumentReference/ex-DocumentReferenceComprehensiveWithBinary, DocumentReference/ex-DocumentReferenceUnContained, DocumentReference/ex-DocumentReferenceUnContainedFully and MinimalDocumentReference
- These codes are excerpted from Digital Imaging and Communications in Medicine (DICOM) Standard, Part 16: Content Mapping Resource, Copyright © 2011 by the National Electrical Manufacturers Association.
  Show Usage
  - DICOM Controlled Terminology Definitions: AuditEvent/ex-auditFindDocumentLists-consumer, AuditEvent/ex-auditFindDocumentLists-responder... Show 23 more, AuditEvent/ex-auditFindDocumentReferences-consumer, AuditEvent/ex-auditFindDocumentReferences-post-responder, AuditEvent/ex-auditFindDocumentReferences-responder, AuditEvent/ex-auditGenerateMetadata-recipient, AuditEvent/ex-auditGenerateMetadata-source, AuditEvent/ex-auditProvideBundle-recipient, AuditEvent/ex-auditProvideBundle-source, AuditEvent/ex-auditRetrieveDocument-consumer, AuditEvent/ex-auditRetrieveDocument-responder, AuditEvent/ex-auditSimplifiedPublish-recipient, AuditEvent/ex-auditSimplifiedPublish-source, AuditFindDocumentListsConsumer, AuditFindDocumentListsResponder, AuditFindDocumentReferencesConsumer, AuditFindDocumentReferencesResponder, AuditGenerateMetadataRecipient, AuditGenerateMetadataSource, AuditProvideBundleRecipient, AuditProvideBundleSource, AuditRetrieveDocumentConsumer, AuditRetrieveDocumentResponder, AuditSimplifiedPublishRecipient and AuditSimplifiedPublishSource
  - Audit Event ID: AuditEvent/ex-auditFindDocumentLists-consumer, AuditEvent/ex-auditFindDocumentLists-responder... Show 19 more, AuditEvent/ex-auditFindDocumentReferences-consumer, AuditEvent/ex-auditFindDocumentReferences-post-responder, AuditEvent/ex-auditFindDocumentReferences-responder, AuditEvent/ex-auditGenerateMetadata-recipient, AuditEvent/ex-auditGenerateMetadata-source, AuditEvent/ex-auditRetrieveDocument-consumer, AuditEvent/ex-auditRetrieveDocument-responder, AuditEvent/ex-auditSimplifiedPublish-recipient, AuditEvent/ex-auditSimplifiedPublish-source, AuditFindDocumentListsConsumer, AuditFindDocumentListsResponder, AuditFindDocumentReferencesConsumer, AuditFindDocumentReferencesResponder, AuditGenerateMetadataRecipient, AuditGenerateMetadataSource, AuditRetrieveDocumentConsumer, AuditRetrieveDocumentResponder, AuditSimplifiedPublishRecipient and AuditSimplifiedPublishSource
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  - LOINC: Bundle/ex-ProvideDocumentBundle-addToFolder, Bundle/ex-comprehensiveProvideDocumentBundleComplete... Show 14 more, Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-comprehensiveProvideDocumentBundleMultiple, Bundle/ex-comprehensiveProvideDocumentBundleReplace, Bundle/ex-comprehensiveProvideDocumentBundleSimple, Bundle/ex-dummyBundleDocAndBinary, Bundle/ex-fhir-document-bundle, Bundle/ex-unContainedComprehensiveProvideDocumentBundleComplete, DocumentReference/ex-DocumentReferenceComprehensive, DocumentReference/ex-DocumentReferenceComprehensiveDelayedAssembly, DocumentReference/ex-DocumentReferenceComprehensiveOnDemand, DocumentReference/ex-DocumentReferenceComprehensiveWithBinary, DocumentReference/ex-DocumentReferenceUnContained, DocumentReference/ex-DocumentReferenceUnContainedFully and Parameters/ex-input-doc-bundle
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
  Show Usage
  - SNOMED Clinical Terms&reg; (SNOMED CT&reg;): Bundle/FindDocumentReferences, Bundle/ex-ProvideDocumentBundle-addToFolder... Show 19 more, Bundle/ex-comprehensiveProvideDocumentBundleComplete, Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-comprehensiveProvideDocumentBundleMultiple, Bundle/ex-comprehensiveProvideDocumentBundleReplace, Bundle/ex-comprehensiveProvideDocumentBundleSimple, Bundle/ex-fhir-document-bundle, Bundle/ex-unContainedComprehensiveProvideDocumentBundleComplete, DocumentReference/ex-DocumentReferenceComprehensive, DocumentReference/ex-DocumentReferenceComprehensiveDelayedAssembly, DocumentReference/ex-DocumentReferenceComprehensiveOnDemand, DocumentReference/ex-DocumentReferenceComprehensiveWithBinary, DocumentReference/ex-DocumentReferenceUnContained, DocumentReference/ex-DocumentReferenceUnContainedFully, List/ex-compEmailPackage, List/ex-compFolder, List/ex-compSubmissionSetFull, List/ex-compSubmissionSetFullUnContained, List/ex-compSubmissionSetList and Parameters/ex-input-doc-bundle
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  Show Usage
  - AllergyIntolerance Clinical Status Codes: Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-fhir-document-bundle and Parameters/ex-input-doc-bundle
  - AllergyIntolerance Verification Status: Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-fhir-document-bundle and Parameters/ex-input-doc-bundle
  - Audit event entity type: AuditEvent/ex-auditFindDocumentLists-consumer, AuditEvent/ex-auditFindDocumentLists-responder... Show 23 more, AuditEvent/ex-auditFindDocumentReferences-consumer, AuditEvent/ex-auditFindDocumentReferences-post-responder, AuditEvent/ex-auditFindDocumentReferences-responder, AuditEvent/ex-auditGenerateMetadata-recipient, AuditEvent/ex-auditGenerateMetadata-source, AuditEvent/ex-auditProvideBundle-recipient, AuditEvent/ex-auditProvideBundle-source, AuditEvent/ex-auditRetrieveDocument-consumer, AuditEvent/ex-auditRetrieveDocument-responder, AuditEvent/ex-auditSimplifiedPublish-recipient, AuditEvent/ex-auditSimplifiedPublish-source, AuditFindDocumentListsConsumer, AuditFindDocumentListsResponder, AuditFindDocumentReferencesConsumer, AuditFindDocumentReferencesResponder, AuditGenerateMetadataRecipient, AuditGenerateMetadataSource, AuditProvideBundleRecipient, AuditProvideBundleSource, AuditRetrieveDocumentConsumer, AuditRetrieveDocumentResponder, AuditSimplifiedPublishRecipient and AuditSimplifiedPublishSource
  - DoseAndRateType: Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-fhir-document-bundle and Parameters/ex-input-doc-bundle
  - AuditEventEntityRole: AuditEvent/ex-auditFindDocumentLists-consumer, AuditEvent/ex-auditFindDocumentLists-responder... Show 22 more, AuditEvent/ex-auditFindDocumentReferences-consumer, AuditEvent/ex-auditFindDocumentReferences-post-responder, AuditEvent/ex-auditFindDocumentReferences-responder, AuditEvent/ex-auditGenerateMetadata-recipient, AuditEvent/ex-auditGenerateMetadata-source, AuditEvent/ex-auditProvideBundle-recipient, AuditEvent/ex-auditProvideBundle-source, AuditEvent/ex-auditRetrieveDocument-consumer, AuditEvent/ex-auditRetrieveDocument-responder, AuditEvent/ex-auditSimplifiedPublish-recipient, AuditEvent/ex-auditSimplifiedPublish-source, AuditFindDocumentListsConsumer, AuditFindDocumentListsResponder, AuditFindDocumentReferencesConsumer, AuditFindDocumentReferencesResponder, AuditGenerateMetadataRecipient, AuditProvideBundleRecipient, AuditProvideBundleSource, AuditRetrieveDocumentConsumer, AuditRetrieveDocumentResponder, AuditSimplifiedPublishRecipient and AuditSimplifiedPublishSource
  - Audit Event Source Type: AuditEvent/ex-auditFindDocumentLists-consumer, AuditEvent/ex-auditFindDocumentLists-responder... Show 11 more, AuditEvent/ex-auditFindDocumentReferences-consumer, AuditEvent/ex-auditFindDocumentReferences-post-responder, AuditEvent/ex-auditFindDocumentReferences-responder, AuditEvent/ex-auditGenerateMetadata-recipient, AuditEvent/ex-auditGenerateMetadata-source, AuditEvent/ex-auditProvideBundle-recipient, AuditEvent/ex-auditProvideBundle-source, AuditEvent/ex-auditRetrieveDocument-consumer, AuditEvent/ex-auditRetrieveDocument-responder, AuditEvent/ex-auditSimplifiedPublish-recipient and AuditEvent/ex-auditSimplifiedPublish-source
  - identifierType: Bundle/FindDocumentReferences
  - ActCode: Bundle/ex-comprehensiveProvideDocumentBundleComplete, Bundle/ex-comprehensiveProvideDocumentBundleDocument... Show 7 more, Bundle/ex-fhir-document-bundle, Bundle/ex-unContainedComprehensiveProvideDocumentBundleComplete, DocumentReference/ex-DocumentReferenceComprehensive, DocumentReference/ex-DocumentReferenceComprehensiveDelayedAssembly, DocumentReference/ex-DocumentReferenceUnContainedFully, Encounter/ex-encounter and Parameters/ex-input-doc-bundle
  - ActReason: AuditEvent/ex-auditFindDocumentLists-consumer, AuditEvent/ex-auditFindDocumentLists-responder... Show 56 more, AuditEvent/ex-auditFindDocumentReferences-consumer, AuditEvent/ex-auditFindDocumentReferences-post-responder, AuditEvent/ex-auditFindDocumentReferences-responder, AuditEvent/ex-auditGenerateMetadata-recipient, AuditEvent/ex-auditGenerateMetadata-source, AuditEvent/ex-auditProvideBundle-recipient, AuditEvent/ex-auditProvideBundle-source, AuditEvent/ex-auditRetrieveDocument-consumer, AuditEvent/ex-auditRetrieveDocument-responder, AuditEvent/ex-auditSimplifiedPublish-recipient, AuditEvent/ex-auditSimplifiedPublish-source, Binary/ex-b-binary, Binary/ex-binary, Bundle/ex-ProvideDocumentBundle-addToFolder, Bundle/ex-comprehensiveProvideDocumentBundleComplete, Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-comprehensiveProvideDocumentBundleMultiple, Bundle/ex-comprehensiveProvideDocumentBundleReplace, Bundle/ex-comprehensiveProvideDocumentBundleSimple, Bundle/ex-dummyBundleDocAndBinary, Bundle/ex-findDocumentListsResponse, Bundle/ex-findDocumentReferencesResponse, Bundle/ex-minimalProvideDocumentBundleSimple, Bundle/ex-minimalProvideDocumentBundleSimpleContained, Bundle/ex-response-comprehensiveProvideDocumentBundleComplete, Bundle/ex-response-comprehensiveProvideDocumentBundleMultiple, Bundle/ex-response-comprehensiveProvideDocumentBundleSimple, Bundle/ex-response-minimalProvideDocumentBundleSimple, Bundle/ex-response-minimalProvideDocumentBundleSimpleContained, Bundle/ex-response-unContainedComprehensiveProvideDocumentBundleCompt, Bundle/ex-unContainedComprehensiveProvideDocumentBundleComplete, Device/ex-device, DocumentReference/ex-DocumentReferenceComprehensive, DocumentReference/ex-DocumentReferenceComprehensiveDelayedAssembly, DocumentReference/ex-DocumentReferenceComprehensiveOnDemand, DocumentReference/ex-DocumentReferenceComprehensiveWithBinary, DocumentReference/ex-DocumentReferenceMinimal, DocumentReference/ex-DocumentReferenceMinimalEncounter, DocumentReference/ex-DocumentReferenceSimplifiedPublish, DocumentReference/ex-DocumentReferenceUnContained, DocumentReference/ex-DocumentReferenceUnContainedFully, DocumentReference/ex-documentreference, DocumentReference/ex-documentreference2, Encounter/ex-encounter, List/ex-compEmailPackage, List/ex-compFolder, List/ex-compSubmissionSetFull, List/ex-compSubmissionSetFullUnContained, List/ex-compSubmissionSetList, List/ex-list, List/ex-minimalFolder, List/ex-minimalSubmissionSet, Parameters/ex-input-binary, Patient/ex-patient, Practitioner/ex-practitioner and nowhere
  - Confidentiality: Bundle/FindDocumentReferences, Bundle/ex-ProvideDocumentBundle-addToFolder... Show 12 more, Bundle/ex-comprehensiveProvideDocumentBundleComplete, Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-comprehensiveProvideDocumentBundleMultiple, Bundle/ex-comprehensiveProvideDocumentBundleReplace, Bundle/ex-comprehensiveProvideDocumentBundleSimple, Bundle/ex-unContainedComprehensiveProvideDocumentBundleComplete, DocumentReference/ex-DocumentReferenceComprehensive, DocumentReference/ex-DocumentReferenceComprehensiveDelayedAssembly, DocumentReference/ex-DocumentReferenceComprehensiveOnDemand, DocumentReference/ex-DocumentReferenceComprehensiveWithBinary, DocumentReference/ex-DocumentReferenceUnContained and DocumentReference/ex-DocumentReferenceUnContainedFully
  - HL7 Document Format Codes: MinimalDocumentReference
  - ParticipationType: AuditFindDocumentListsConsumer, AuditFindDocumentListsResponder... Show 4 more, AuditFindDocumentReferencesConsumer, AuditFindDocumentReferencesResponder, AuditRetrieveDocumentConsumer and AuditRetrieveDocumentResponder
  - Orderable Drug Form: Bundle/ex-comprehensiveProvideDocumentBundleDocument, Bundle/ex-fhir-document-bundle and Parameters/ex-input-doc-bundle