## Profile Comparison between https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference vs https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference

Left: | MHD DocumentReference Comprehensive (https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference)
Right: | MHD DocumentReference Comprehensive (https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference)

### Messages

Error | StructureDefinition.version | Values for version differ: '5.0.0' vs '5.0.1-current'
Information | StructureDefinition.date | Values for date differ: '2025-12-18T09:48:18-06:00' vs '2026-01-13T00:32:19+00:00'

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.UnContained.Comprehensive.DocumentReference |
copyright |  |
date | 2025-12-18T09:48:18-06:00 | 2026-01-13T00:32:19+00:00 | Values Differ
description | A profile on the DocumentReference resource for MHD Comprehensive Option with Contained (not UnContained), compatible with XDS-on-FHIR and XCA use. - MHD is based on the [IHE Document Sharing](https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html) model, - the [3:4.1 Abstract Metadata Model](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.1.html#4.1), and - the use defined here is FHIR DocumentReference implementation of the - ebRIM implementation at [3:4.2.3.2 Document Entry](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.2.html#4.2.3.2). - with use-cases and constraints found in [3:4.3 Additional Document Sharing Requirements](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.3.html#4.3) | A profile on the DocumentReference resource for MHD Comprehensive Option with Contained (not UnContained), compatible with XDS-on-FHIR and XCA use. - MHD is based on the [IHE Document Sharing](https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html) model, - the [3:4.1 Abstract Metadata Model](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.1.html#4.1), and - the use defined here is FHIR DocumentReference implementation of the - ebRIM implementation at [3:4.2.3.2 Document Entry](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.2.html#4.2.3.2). - with use-cases and constraints found in [3:4.3 Additional Document Sharing Requirements](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.3.html#4.3) | Values Differ
experimental |  |
fhirVersion | 5.0.0 |
jurisdiction |  |
jurisdiction[0] | http://unstats.un.org/unsd/methods/m49/m49.htm#001 |
kind | resource |
name | ComprehensiveDocumentReference |
publisher | IHE IT Infrastructure Technical Committee |
purpose |  |
status | active |
title | MHD DocumentReference Comprehensive |
type | DocumentReference |
url | https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference |
version | 5.0.0 | 5.0.1-current | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
DocumentReference | C | 0..* | UnContainedComprehensiveDocumentReference | A reference to a document | C | 0..* | UnContainedComprehensiveDocumentReference | A reference to a document |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
id |  | 0..1 | id | Unique id for inter-element referencing |  | 0..1 | id | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
versionId | Σ | 0..1 | id | Version specific identifier | Σ | 0..1 | id | Version specific identifier |
lastUpdated | Σ | 0..1 | instant | When the resource version last changed | Σ | 0..1 | instant | When the resource version last changed |
source | Σ | 0..1 | uri | Identifies where the resource comes from | Σ | 0..1 | uri | Identifies where the resource comes from |
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to |
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. |
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (required): IETF language tag for a human language
Additional Bindings | Purpose
?? | Starter
|  | 0..1 | code | Language of the resource content Binding: ?? (required): IETF language tag for a human language
Additional Bindings | Purpose
?? | Starter
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 |  | 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 |  | 0..* | Resource | Contained, inline Resources |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
modifierExtension | ?!Σ | 0..0 |  | Extension | ?!Σ | 0..0 |  | Extension |
Slices for identifier | S Σ | 1..* | Identifier | Business identifiers for the document Slice: Unordered, Open by value:use | S Σ | 1..* | Identifier | Business identifiers for the document Slice: Unordered, Open by value:type |
version | Σ | 0..1 | string | An explicitly assigned identifer of a variation of the content in the DocumentReference | Σ | 0..1 | string | An explicitly assigned identifer of a variation of the content in the DocumentReference |
basedOn |  | 0..* | Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription) | Procedure that caused this media to be created |  | 0..* | Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription) | Procedure that caused this media to be created |
status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: ?? (required) | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: ?? (required) |
docStatus | Σ | 0..0 |  | registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: ?? (required): Status of the underlying document. | Σ | 0..0 |  | registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: ?? (required): Status of the underlying document. |
modality | Σ | 0..* | CodeableConcept | Imaging modality used Binding: ?? (extensible): Type of acquired data in the instance. | Σ | 0..* | CodeableConcept | Imaging modality used Binding: ?? (extensible): Type of acquired data in the instance. |
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: ?? (preferred): Precise type of clinical document. | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: ?? (preferred): Precise type of clinical document. |
category | S Σ | 1..1 | CodeableConcept | Categorization of document Binding: ?? (example): High-level kind of document at a macro level. | S Σ | 1..1 | CodeableConcept | Categorization of document Binding: ?? (example): High-level kind of document at a macro level. |
subject | S Σ | 1..1 | Reference(Patient) | Who/what is the subject of the document | S Σ | 1..1 | Reference(Patient) | Who/what is the subject of the document |
context | C | 0..* | Reference(Appointment | Encounter | EpisodeOfCare) | Context of the document content | C | 0..* | Reference(Appointment | Encounter | EpisodeOfCare) | Context of the document content |
event |  | 0..* | CodeableReference() | Main clinical acts documented Binding: ?? (example): This list of codes represents the main clinical acts being documented. |  | 0..* | CodeableReference() | Main clinical acts documented Binding: ?? (example): This list of codes represents the main clinical acts being documented. |
id |  | 0..1 | id | Unique id for inter-element referencing |  | 0..1 | id | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
concept | Σ | 1..1 | CodeableConcept | Reference to a concept (by class) | Σ | 1..1 | CodeableConcept | Reference to a concept (by class) |
reference | Σ | 0..1 | Reference() | Reference to a resource (by instance) | Σ | 0..1 | Reference() | Reference to a resource (by instance) |
bodySite | Σ | 0..* | CodeableReference(BodyStructure) | Body part included Binding: ?? (example): SNOMED CT Body site concepts | Σ | 0..* | CodeableReference(BodyStructure) | Body part included Binding: ?? (example): SNOMED CT Body site concepts |
facilityType | S C | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: ?? (example): XDS Facility Type. | S C | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: ?? (example): XDS Facility Type. |
practiceSetting | S C | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: ?? (example): Additional details about where the content was created (e.g. clinical specialty). | S C | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: ?? (example): Additional details about where the content was created (e.g. clinical specialty). |
period | S Σ | 0..1 | Period | Time of service that is being documented | S Σ | 0..1 | Period | Time of service that is being documented |
id |  | 0..1 | id | Unique id for inter-element referencing |  | 0..1 | id | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
start | Σ C | 0..1 | dateTime | Starting time with inclusive boundary | Σ C | 0..1 | dateTime | Starting time with inclusive boundary |
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing |
date | S Σ | 0..1 | instant | When this document reference was created | S Σ | 0..1 | instant | When this document reference was created |
author | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) {c} | Who and/or what authored the document | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) {c} | Who and/or what authored the document |
attester |  | 0..1 | BackboneElement | Attests to accuracy of the document |  | 0..1 | BackboneElement | Attests to accuracy of the document |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
mode |  | 1..1 | CodeableConcept | personal | professional | legal | official Binding: ?? (preferred): The way in which a person authenticated a document. |  | 1..1 | CodeableConcept | personal | professional | legal | official Binding: ?? (preferred): The way in which a person authenticated a document. |
time |  | 0..1 | dateTime | When the document was attested |  | 0..1 | dateTime | When the document was attested |
party |  | 1..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) {c} | Who attested the document |  | 1..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) {c} | Who attested the document |
custodian |  | 0..1 | Reference(Organization) | Organization which maintains the document |  | 0..1 | Reference(Organization) | Organization which maintains the document |
relatesTo | S Σ | 0..* | BackboneElement | Relationships to other documents | S Σ | 0..* | BackboneElement | Relationships to other documents |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | Σ | 1..1 | CodeableConcept | The relationship type with another document Binding: ?? (extensible): The type of relationship between the documents. | Σ | 1..1 | CodeableConcept | The relationship type with another document Binding: ?? (extensible): The type of relationship between the documents. |
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship |
description | Σ | 0..1 | markdown | Human-readable description | Σ | 0..1 | markdown | Human-readable description |
securityLabel | S Σ | 1..* | CodeableConcept | Document security-tags Binding: ?? (example): Example Security Labels from the Healthcare Privacy and Security Classification System. | S Σ | 1..* | CodeableConcept | Document security-tags Binding: ?? (example): Example Security Labels from the Healthcare Privacy and Security Classification System. |
content | Σ | 1..1 | BackboneElement | Document referenced | Σ | 1..1 | BackboneElement | Document referenced |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
attachment | Σ | 1..1 | Attachment | Where to access the document | Σ | 1..1 | Attachment | Where to access the document |
id |  | 0..1 | id | Unique id for inter-element referencing |  | 0..1 | id | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
contentType | Σ C | 1..1 | code | Mime type of the content, with charset etc. Binding: ?? (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Example General: text/plain; charset=UTF-8, image/png | Σ C | 1..1 | code | Mime type of the content, with charset etc. Binding: ?? (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Example General: text/plain; charset=UTF-8, image/png |
language | S Σ | 1..1 | code | Human language of the content (BCP-47) Binding: ?? (required): IETF language tag for a human language.
Additional Bindings | Purpose
?? | Starter
Example General: en-AU | S Σ | 1..1 | code | Human language of the content (BCP-47) Binding: ?? (required): IETF language tag for a human language.
Additional Bindings | Purpose
?? | Starter
Example General: en-AU |
data | C | 0..0 |  | Data inline, base64ed | C | 0..0 |  | Data inline, base64ed |
url | Σ | 1..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png | Σ | 1..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png |
size | Σ | 0..1 | integer64 | Number of bytes of content (if url provided) | Σ | 0..1 | integer64 | Number of bytes of content (if url provided) |
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed) | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed) |
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo |
creation | S Σ | 1..1 | dateTime | Date attachment was first created | S Σ | 1..1 | dateTime | Date attachment was first created |
height |  | 0..1 | positiveInt | Height of the image in pixels (photo/video) |  | 0..1 | positiveInt | Height of the image in pixels (photo/video) |
width |  | 0..1 | positiveInt | Width of the image in pixels (photo/video) |  | 0..1 | positiveInt | Width of the image in pixels (photo/video) |
frames |  | 0..1 | positiveInt | Number of frames if > 1 (photo) |  | 0..1 | positiveInt | Number of frames if > 1 (photo) |
duration |  | 0..1 | decimal | Length in seconds (audio / video) |  | 0..1 | decimal | Length in seconds (audio / video) |
pages |  | 0..1 | positiveInt | Number of printed pages |  | 0..1 | positiveInt | Number of printed pages |
profile | S Σ | 1..1 | BackboneElement | Content profile rules for the document | S Σ | 1..1 | BackboneElement | Content profile rules for the document |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
Slices for value[x] | Σ | 1..1 | Coding | Code|uri|canonical Slice: Unordered, Closed by type:$this Binding: ?? (preferred): Document Format Codes. | Σ | 1..1 | Coding | Code|uri|canonical Slice: Unordered, Closed by type:$this Binding: ?? (preferred): Document Format Codes. |
Documentation for this format