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

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

### Messages

Error | StructureDefinition.version | Values for version differ: '5.0.0' vs '4.2.4-current'
Information | StructureDefinition.date | Values for date differ: '2025-12-18T09:48:18-06:00' vs '2026-01-13T00:00:58+00:00'
Warning | StructureDefinition.fhirVersion | Values for fhirVersion differ: '5.0.0' vs '4.0.1'
Information | StructureDefinition.definition | Values for definition differ: 'A List is a curated collection of resources, for things such as problem lists, allergy lists, facility list, organization list, etc.' vs 'A list is a curated collection of resources.'
Information | StructureDefinition.comment | Values for comment differ: 'Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.' vs 'The only time that a resource does not have an id is when it is being submitted to the server using a create operation.'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.'
Information | StructureDefinition.comment | Values for comment differ: 'This element is generally omitted in instances submitted in a PUT or POST. Instead, it is populated in the response instance and when retrieving information using a GET. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R5/http.html#read) interaction.' vs 'This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction.'
Information | StructureDefinition.definition | Values for definition differ: 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R5/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.' vs 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.'
Information | StructureDefinition.comment | Values for comment differ: 'The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.' vs 'In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.'
Information | StructureDefinition.definition | Values for definition differ: 'A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R5/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R5/structuredefinition-definitions.html#StructureDefinition.url).' vs 'A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).'
Information | StructureDefinition.comment | Values for comment differ: 'Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.' vs 'Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.'
Information | StructureDefinition.comment | Values for comment differ: 'Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a 'text blob' or where text is additionally entered raw or narrated and encoded information is added later.' vs 'Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a 'text blob' or where text is additionally entered raw or narrated and encoded information is added later.'
Information | StructureDefinition.definition | Values for definition differ: 'These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.' vs 'These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.'
Information | StructureDefinition.comment | Values for comment differ: 'This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.' vs 'This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.'
Information | StructureDefinition.short | Values for short differ: 'If all resources have the same subject(s)' vs 'If all resources have the same subject'
Information | StructureDefinition.definition | Values for definition differ: 'The common subject(s) (or patient(s)) of the resources that are in the list if there is one (or a set of subjects).' vs 'The common subject (or patient) of the resources that are in the list if there is one.'
Information | StructureDefinition.comment | Values for comment differ: 'Some purely arbitrary lists do not have a common subject, so this is optional. Lists having multiple subjects may raise challenges for systems that base access control or other security considerations on linkages to 'subject'. E.g. if a List is associated with multiple Patient subjects, then it would be nominally part of multiple patient compartments, which might drive access rights.' vs 'Some purely arbitrary lists do not have a common subject, so this is optional.'
Information | StructureDefinition.definition | Values for definition differ: 'Date list was last reviewed/revised and determined to be 'current'.' vs 'The date that the list was prepared.'
Information | List.orderedBy | Example/preferred bindings differ at List.orderedBy using binding from FolderComprehensive
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).' vs 'May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).'
Information | StructureDefinition.requirements | Values for requirements differ: 'Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).' vs 'Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).'
Information | StructureDefinition.comment | Values for comment differ: 'The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true' vs 'The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is 'changes'.'
Information | StructureDefinition.comment | Values for comment differ: 'If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.' vs 'If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is 'changes'. A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.'
Information | List.emptyReason | Example/preferred bindings differ at List.emptyReason using binding from FolderComprehensive

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Minimal.Folder |
copyright |  |
date | 2025-12-18T09:48:18-06:00 | 2026-01-13T00:00:58+00:00 | Values Differ
description | A profile on the List resource for MHD Comprehensive Metadata Folder. Note UnContained has no impact on Folder. - 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 List for use as a Folder implementation of the - ebRIM implementation at [3:4.2.3.4 Folder Attributes](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.2.html#4.2.3.4). - 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 List resource for MHD Comprehensive Metadata Folder. Note UnContained has no impact on Folder. - 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 List for use as a Folder implementation of the - ebRIM implementation at [3:4.2.3.4 Folder Attributes](https://profiles.ihe.net/ITI/TF/Volume3/ch-4.2.html#4.2.3.4). - 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 | 4.0.1 | Values Differ
jurisdiction |  |
jurisdiction[0] | http://unstats.un.org/unsd/methods/m49/m49.htm#001 |
kind | resource |
name | FolderComprehensive |
publisher | IHE IT Infrastructure Technical Committee |
purpose |  |
status | active |
title | MHD Folder Comprehensive |
type | List |
url | https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.Folder |
version | 5.0.0 | 4.2.4-current | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
List | C | 0..* | Folder | A list is a curated collection of resources | C | 0..* | Folder | A list is a curated collection of resources |
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 | string | 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: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url |
modifierExtension | ?!Σ | 0..0 |  | Extension | ?! | 0..0 |  | Extension |
Slices for identifier |  | 0..* | Identifier | Business identifier Slice: Unordered, Open by value:use |  | 0..* | Identifier | Business identifier Slice: Unordered, Open by value:type |
status | ?!Σ | 1..1 | code | current | retired | entered-in-error Binding: ?? (required): The current state of the list. | ?!Σ | 1..1 | code | current | retired | entered-in-error Binding: ?? (required): The current state of the list. |
mode | ?!Σ | 1..1 | code | working | snapshot | changes Binding: ?? (required): The processing mode that applies to this list. Required Pattern: working | ?!Σ | 1..1 | code | working | snapshot | changes Binding: ?? (required): The processing mode that applies to this list. Required Pattern: working |
title | Σ | 1..1 | string | Descriptive name for the list Example General: Dr. Jane's Patients | Σ | 1..1 | string | Descriptive name for the list Example General: Dr. Jane's Patients |
code | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: ?? (required) Required Pattern: {"coding":[{"system":"https://profiles.ihe.net/ITI/MHD/CodeSystem/MHDlistTypes","code":"folder"}]} | Σ | 1..1 | CodeableConcept | What the purpose of this list is Binding: ?? (required) Required Pattern: {"coding":[{"system":"https://profiles.ihe.net/ITI/MHD/CodeSystem/MHDlistTypes","code":"folder"}]} |
subject | S Σ | 1..1 | Reference(Patient) | If all resources have the same subject(s) | S Σ | 1..1 | Reference(Patient) | If all resources have the same subject |
encounter |  | 0..0 |  | Context in which list created |  | 0..0 |  | Context in which list created |
date | Σ | 0..1 | dateTime | When the list was prepared | Σ | 0..1 | dateTime | When the list was prepared |
source | Σ | 0..0 |  | Who and/or what defined the list contents (aka Author) | Σ | 0..0 |  | Who and/or what defined the list contents (aka Author) |
orderedBy |  | 0..0 |  | What order the list has Binding: ?? (preferred): What order applies to the items in a list. |  | 0..0 |  | What order the list has Binding: ?? (preferred): What order applies to the items in a list. | Example/preferred bindings differ at List.orderedBy using binding from FolderComprehensive
note |  | 0..1 | Annotation | Comments about the list |  | 0..1 | Annotation | Comments about the list |
entry | C | 0..* | BackboneElement | Entries in the list This repeating element order: Order has no meaning unless specifically asserted by List.orderedBy, in which case the List SHALL be interpreted as being ordered as specified by List.orderedBy. | C | 0..* | BackboneElement | Entries in the list |
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 |
flag |  | 0..0 |  | Status/Workflow information about this item Binding: ?? (example): Codes that provide further information about the reason and meaning of the item in the list. |  | 0..0 |  | Status/Workflow information about this item Binding: ?? (example): Codes that provide further information about the reason and meaning of the item in the list. |
deleted | ?! | 0..0 |  | If this item is actually marked as deleted | ?!C | 0..0 |  | If this item is actually marked as deleted |
date |  | 0..0 |  | When item added to list |  | 0..0 |  | When item added to list |
item |  | 1..1 | Reference(DocumentReference) | Actual entry |  | 1..1 | Reference(DocumentReference) | Actual entry |
emptyReason | C | 0..0 |  | Why list is empty Binding: ?? (preferred): If a list is empty, why it is empty. | C | 0..0 |  | Why list is empty Binding: ?? (preferred): If a list is empty, why it is empty. | Example/preferred bindings differ at List.emptyReason using binding from FolderComprehensive
Documentation for this format