Mobile access to Health Documents (MHD)
5.0.1-current - ci-build

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 5.0.1-current 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

## 3:4.5 FHIR Maps

Editor, please Add Section 4.5

## 3:4.5 FHIR Representation of Document Sharing Metadata

This section documents the mapping between IHE Document Sharing Metadata and the FHIR Resources.

### 3:4.5.1 Metadata Object Types mapped to FHIR

For details on FHIR resources and data types see HL7 FHIR FHIR index.html.

Some Document Sharing Metadata attributes must be treated as `contained` FHIR Resources. These are indicated in with a "Note 1” and the word `contained`. The details of the FHIR `contained` mechanism is found at FHIR references.html#contained.

When encoding XDS identifiers into FHIR Resource data elements of type Identifier, the FHIR notation of OIDs and UUIDs uses the system identifier of `urn:ietf:rfc:3986`. For more details and examples, see ITI TF-2: Appendix E.3 “FHIR Identifier Type”.

#### 3:4.5.1.1 DocumentEntry Metadata Attributes

The documented mapping of the metadata elements associated with a Document Sharing DocumentEntry object attributes.

The mapping in table form

DocumentEntry | R4 DocumentReference | R5 DocumentReference
--- | --- | ---
limitedMetadata | meta.profile | meta.profile
uniqueId | masterIdentifier | identifier (uniqueId)
entryUUID | identifier | identifier (entryUUID)
availabilityStatus | status | status
typeCode | type | type
classCode | category | category
patientId | subject | subject
author | author | author
legalAuthenticator | authenticator | attester
Associations |  |
.type | relatesTo.code | relatesTo.code
.reference | relatesTo.target | relatesTo.target
comments | description | description
confidentialityCode | securityLabel | securityLabel
mimeType | content.attachment.contentType | content.attachment.contentType
languageCode | content.attachment.language | content.attachment.language
repositoryUniqueId | content.attachment.url | content.attachment.url
URI | content.attachment.url | content.attachment.url
size | content.attachment.size | content.attachment.size
hash | content.attachment.hash | content.attachment.hash
title | content.attachment.title | content.attachment.title
creationTime | content.attachment.creation | content.attachment.creation
formatCode | content.format | content.profile.valueCoding
referenceIdList *type |  |
… encounterId | context.encounter | context
… accession | context.related | basedOn
… referral | context.related | basedOn
… order | context.related | basedOn
… studyInstanceUID | context.related | basedOn
… uniqueId | context.related | extension (referenceId)
… workflowInstanceId | context.related | extension (referenceId)
… all other | context.related | extension (referenceId)
eventCodeList | context.event | event.concept
serviceStartTime | context.period.start | period.start
serviceStopTime | context.period.end | period.end
healthcareFacilityTypeCode | context.facilityType | facilityType
practiceSettingCode | context.practiceSettingCode | practiceSetting
sourcePatientInfo | sourcePatientInfo.reference | extension (sourcePatient)
sourcePatientId | sourcePatientInfo.identifier | extension (sourcePatient)

Note: referenceIdList *type: as encoded in CXi format, is an indication of the type of identifier, see IHE ITI Volume 3 Table 4.2.3.1.7.2: Data Types. Based on that type (CXi.5), the mapping is specific. Where no specific mapping is available the extension for IHE-ReferenceId is used.

Note: FHIR contains an informative mapping that is intended to be equivalent and can be found at FHIR documentReference XDS mapping. For the purposes of IHE MHD conformance the mapping documented here (in IHE) are normative.

#### 3:4.5.1.2 DocumentReference StructureDefinition

The conformance requirements are different between a Provide Document Bundle ITI-65 transaction and a Find Document References ITI-67 transaction, and between Minimal Metadata, Comprehensive Metadata, and UnContained References.

The conformance requirements are different between Comprehensive, minimal, and UnContained References. The canonical URI is found as the "Defining URL:":

- Comprehensive DocumentReference Metadata
- Comprehensive DocumentReference UnContained References
- Minimal DocumentReference Metadata
- Minimal DocumentReference does not include `contained` requirements

Resources are not required to carry the meta.profile element and may only carry the profile element defined for the Provide Document Bundle [ITI-65] transaction, as the Receiver is not required to add the profile tags. The value of the meta.profile is a soft indicator of conformance expectation. Receivers may choose to validate actual conformance and fail transactions due to non-conformance.

### 3:4.5.2 SubmissionSet Metadata Attributes

The documented mapping of the metadata elements associated with a Document Sharing SubmissionSet object attributes.

SubmissionSet | R4 List | R5 List
--- | --- | ---
limitedMetadata | meta.profile | meta.profile
contentTypeCode | extension (designationType) | extension (designationType)
sourceId | extension (sourceId) | extension (sourceId)
intendedRecipient | extension (intendedRecipient) | extension (intendedRecipient)
entryUUID | identifier | identifier
uniqueId | identifier | identifier
availabilityStatus | status | status
title | title | title
patientId | subject | subject
submissionTime | date | date
author |  |
when Organization | extension (authorOrg) | extension (authorOrg)
when Practitioner | source | source
comments | note | note
DocumentEntry(s) | entry.item | entry.item
Folder(s) | entry.item | entry.item

#### 3:4.5.2.1 SubmissionSet List StructureDefinition

The conformance requirements are different between Comprehensive, Minimal, and UnContained References. The canonical URI is found as the "Defining URL:":

- Comprehensive SubmissionSet Metadata
- Comprehensive SubmissionSet UnContained References
- Minimal SubmissionSet Metadata
- Minimal SubmissionSet Metadata does not include `contained` requirements

Resources are not required to carry the meta.profile element and may only carry the profile element defined for the Provide Document Bundle ITI-65 transaction, as the Receiver is not required to add the profile tags. The value of the meta.profile is a soft indicator of conformance expectation. Receivers may choose to validate actual conformance and fail transactions due to non-conformance.

### 3:4.5.3 Folder Metadata Attributes

The documented mapping of the metadata elements associated with a Document Sharing Folder object attributes.

Note that FHIR List Resource in the FHIR core specification does not include a Mapping to XDS.

Folder | R4 List | R5 List
--- | --- | ---
limitedMetadata | meta.profile | meta.profile
contentTypeCode | extension (designationType) | extension (designationType)
entryUUID | identifier | identifier
uniqueId | identifier | identifier
availabilityStatus | status | status
title | title | title
patientId | subject | subject
lastUpdateTime | date | date
comments | note | note
DocumentEntry(s) | entry.item | entry.item

#### 3:4.5.3.1 Folder StructureDefinition

The conformance requirements are different between Comprehensive and Minimal metadata. The canonical URI is found as the "Defining URL:":

- Comprehensive Folder Metadata
- Comprehensive Folder Metadata does not include `contained` requirements
- Minimal Folder Metadata
- Minimal Folder Metadata does not include `contained` requirements

Resources are not required to carry the meta.profile element and may only carry the profile element defined for the Provide Document Bundle ITI-65 transaction, as the Receiver is not required to add the profile tags. The value of the meta.profile is a soft indicator of conformance expectation. Receivers may choose to validate actual conformance and fail transactions due to non-conformance.