Validation Results for IHE_ITI_MHD

Generated Tue Jun 02 19:10:35 UTC 2026, FHIR version 4.0.1 for ihe.iti.mhd#4.2.4-current (canonical = https://profiles.ihe.net/ITI/MHD (history)). See Full QA Report & IP

Quality Checks

Publisher Version: IG Publisher Version: v2.2.8

Publication Code: n/a . PackageId = ihe.iti.mhd, Canonical = https://profiles.ihe.net/ITI/MHD

Realm Check for n/a:

n/a

Language Info: This IG has no language information

Publication Request:

RelatedIgs

(None Found)

Publication Request is for v'4.2.3' but package version is v4.2.4-current
Publication Request is for version v4.2.3 which is already published

Supressed Messages: 36 Suppressed Issues

Dependency Checks:

Package	Version	FHIR	Canonical	Web Base	Comment
ihe.iti.mhd	4.2.4-current	R4	https://profiles.ihe.net/ITI/MHD
hl7.terminology.r4	7.1.0 M	R4	http://terminology.hl7.org	http://terminology.hl7.org/7.1.0
hl7.fhir.uv.extensions.r4	5.2.0 O	R4	http://hl7.org/fhir/extensions	http://hl7.org/fhir/extensions/5.2.0	Latest Release is 5.3.0
hl7.fhir.uv.extensions.r4	5.3.0 M	R4	http://hl7.org/fhir/extensions	http://hl7.org/fhir/extensions/5.3.0
hl7.terminology.r4	7.1.0 M	R4	http://terminology.hl7.org	http://terminology.hl7.org/7.1.0	(as above)
ihe.iti.balp	1.1.4 M	R4	https://profiles.ihe.net/ITI/BALP	https://profiles.ihe.net/ITI/BALP/1.1.4
hl7.terminology.r4	6.5.0 O	R4	http://terminology.hl7.org	http://terminology.hl7.org/6.5.0	Latest Release is 7.1.0
hl7.fhir.uv.extensions.r4	5.2.0 O	R4	http://hl7.org/fhir/extensions	http://hl7.org/fhir/extensions/5.2.0	(as above). Latest Release is 5.3.0
hl7.fhir.uv.extensions.r4	5.2.0 O	R4	http://hl7.org/fhir/extensions	http://hl7.org/fhir/extensions/5.2.0	(as above). Latest Release is 5.3.0
ihe.formatcode.fhir	1.4.0 O	R4	https://profiles.ihe.net/fhir/ihe.formatcode.fhir	https://profiles.ihe.net/fhir/ihe.formatcode.fhir/1.4.0	Matched to latest patch release (1.4.x->1.4.0). Latest Release is 1.5.0
hl7.terminology.r4	6.3.0 O	R4	http://terminology.hl7.org	http://terminology.hl7.org/6.3.0	Latest Release is 7.1.0
hl7.fhir.uv.extensions.r4	5.2.0 O	R4	http://hl7.org/fhir/extensions	http://hl7.org/fhir/extensions/5.2.0	(as above). Latest Release is 5.3.0
hl7.fhir.uv.extensions.r4	5.2.0 O	R4	http://hl7.org/fhir/extensions	http://hl7.org/fhir/extensions/5.2.0	(as above). Latest Release is 5.3.0
hl7.fhir.uv.tools.r4	1.1.2 M	R4	http://hl7.org/fhir/tools	http://hl7.org/fhir/tools/1.1.2	Internal Dependency

Templates: ihe.fhir.template#1.0.0 -> fhir.base.template#1.0.0

Related IGs: n/a

Dependent IGs: no references

Global Profiles: (none declared)

Terminology Server(s): http://tx.fhir.org/r4, https://tx.fhir.ch/r4, https://tx.fhir.org/r4, https://tx.hl7.org.au/fhir, https://tx.hl7chile.cl/r4, https://tx.hl7europe.eu/r4, https://tx.ontoserver.csiro.au/fhir (details)

HTA Analysis: Non-HL7 Igs are exempt from terminology dependency analysis

R5 Dependencies: (none)

Draft Dependencies:

hl7.fhir.r4.core#4.0.1: GuideParameterCode (14 uses), AuditEventEntityRole (50 uses), CompositionAttestationMode (5 uses), DocumentRelationshipType (7 uses), DoseAndRateType (3 uses), AllergyIntoleranceClinicalStatusCodes (3 uses), AllergyIntoleranceVerificationStatusCodes (3 uses), AllergyIntoleranceType (3 uses), DocumentReferenceStatus (6 uses), CommonTags (11 uses), CommonLanguages (35 uses), CompositionStatus (4 uses), Practitioner (77 uses), PractitionerRole (75 uses), Organization (89 uses), Device (73 uses), RelatedPerson (65 uses), DocumentRelationshipType (4 uses), DocumentReference (19 uses), Encounter (10 uses), EpisodeOfCare (4 uses), List (27 uses), ListStatus (6 uses), ListMode (6 uses), ListOrderCodes (6 uses), PatientMedicineChangeTypes (6 uses), ListEmptyReasons (6 uses), AuditEventAction (12 uses), AuditEventOutcome (12 uses), ParticipationRoleType (42 uses), SecurityRoleType (46 uses), Location (49 uses), AuditEventAgentNetworkType (46 uses), AuditEvent (47 uses), AuditEventEntityType (45 uses), AuditEventEntityRole (39 uses), ObjectLifecycleEvents (45 uses), AuditEventEntityType (27 uses), Group (3 uses), DocumentReferenceStatus (1 uses), _id (8 uses), _lastUpdated (8 uses), category (4 uses), date (4 uses), event (4 uses), facility (4 uses), format (4 uses), identifier (8 uses), patient (8 uses), period (4 uses), related (4 uses), security-label (4 uses), setting (4 uses), status (4 uses), type (4 uses), code (4 uses), date (4 uses), status (4 uses)

Modifier Extensions: (none)

Previous Version Comparison: Comparison with version 5.0.0

IPA Comparison: n/a

IPS Comparison: n/a

Validation Flags: On: autoLoad; Off: hintAboutNonMustSupport, anyExtensionsAllowed, checkAggregation, showReferenceMessages, noExperimentalContent, displayWarnings

Summary: errors = 0, warn = 1, info = 4, broken links = 0, pinned = n/a.

Filename	Errors	Warnings	Hints
Build Errors	0	0	0
/scratch/repo/fsh-generated/resources/ImplementationGuide-ihe.iti.mhd	0	1	0

n/a Show Validation Information

fsh-generated/resources/ImplementationGuide-ihe.iti.mhd.json Show Validation Information (1)

Path

Severity

Message

Validating

ImplementationGuide.dependsOn[3] (l1/c2489)

warning

The ImplementationGuide uses package ihe.formatcode.fhir#1.4.x released on 2025-05-20, but the most recent appropriate version is 1.5.0. This reference is getting old and the more recent version should be considered IG_DEPENDENCY_VERSION_WARNING_OLD

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Suppressed Messages (Warnings, hints, broken links)

FHIR R4 had the valueset setup wrong. We are using the proper system value

The Coding provided (http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode#urn:ihe:iti:xds-sd:text:2008) was not found in the value set 'DocumentReference Format Code Set' (http://hl7.org/fhir/ValueSet/formatcodes|4.0.1), and a code is recommended to come from this value set. (error message = The provided code 'http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode#urn:ihe:iti:xds-sd:text:2008' was not found in the value set 'http://hl7.org/fhir/ValueSet/formatcodes|4.0.1') (10 uses)

IHE code system used but never defined by IHE as a formal codeSystem

A definition for CodeSystem 'urn:ihe:event-type-code' could not be found, so the code cannot be validated (37 uses)

The concept map is from EB-Registry defined values, so we are using rfc3986. not a problem the source checking isn't done

The Source Code System urn:ietf:rfc:3986 is not fully defined and populated, and no sourceScope is specified, so the source code checking will not be performed (1 uses)

The concept map is from a conceptual valueset from IHE, so there is no formal definition. not a problem the source checking isn't done

The Source Code System urn:ihe:iti:2007:AssociationType is not fully defined and populated, and no sourceScope is specified, so the source code checking will not be performed (1 uses)

YES we know some examples use old codes. That old code use is not important to the example use

WARNING: Bundle/FindDocumentReferences: Bundle.entry[0].resource.context.facilityType.coding[0]: The concept '264358009' has a status of inactive and its use should be reviewed (1 uses)
WARNING: Bundle/FindDocumentReferences: Bundle.entry[0].resource/*DocumentReference/50383ae5-49e5-4dea-b0e6-660cb9e7b91f*/.context.facilityType.coding[0]: The concept '264358009' has a status of inactive and its use should be reviewed (0 uses)

YES we want to point informatively at MHDS and NOT to have a dependency.

The link 'https://profiles.ihe.net/ITI/MHDS' for "MHDS" cannot be resolved (1 uses)
The link 'https://profiles.ihe.net/ITI/MHDS/volume-1.html#150111-document-registry' for "Document Registry" cannot be resolved (1 uses)

borrowed Document Bundle has issues that we don't care about (note removed signature as that threw errors)

All_observations_should_have_a_performer (2 uses)
All_observations_should_have_an_effectiveDateTime_or_an_effectivePeriod (2 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource.entry[4].resource/*Observation/fdoc-observation*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource.entry[5].resource/*MedicationRequest/fdoc-medicationrequest*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource.entry[6].resource/*MedicationStatement/fdoc-medicationstatement*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource.entry[7].resource/*AllergyIntolerance/fdoc-allergyintolerance*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource/*Bundle/ex-fhir-document-bundle*/.entry[1].resource/*Practitioner/fdoc-practitioner*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource/*Bundle/ex-fhir-document-bundle*/.entry[2].resource/*Patient/fdoc-patient*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource/*Bundle/ex-fhir-document-bundle*/.entry[3].resource/*Encounter/fdoc-encounter*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[0].resource/*Composition/180f219f-97a8-486d-99d9-ed631fe4fc57*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[1].resource/*Practitioner/fdoc-practitioner*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[2].resource/*Patient/fdoc-patient*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[3].resource/*Encounter/fdoc-encounter*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[4].resource/*Observation/fdoc-observation*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[4].resource: Best Practice Recommendation: In general, all observations should have a performer (1 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[4].resource: Best Practice Recommendation: In general, all observations should have an effective[x] () (1 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[5].resource/*MedicationRequest/fdoc-medicationrequest*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[6].resource/*MedicationStatement/fdoc-medicationstatement*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)
WARNING: Parameters/ex-input-doc-bundle: Parameters.parameter[0].resource/*Bundle/ex-fhir-document-bundle*/.entry[7].resource/*AllergyIntolerance/fdoc-allergyintolerance*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (0 uses)

comes from core. Not anything we can document

The extension http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet|5.2.0 is deprecated (0 uses)

profile for MHD that is just structural and thus has no examples

WARNING: StructureDefinition.where(url = 'https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.List'): The Implementation Guide contains no examples for this profile (1 uses)

some examples are underpopulated, the full population is not important for the use-case being explained

Constraint failed: dom-6: 'A resource should have narrative for robust management (text.`div`.exists())' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (16 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource.entry[4].resource: Best Practice Recommendation: In general, all observations should have a performer (0 uses)
WARNING: Bundle/ex-comprehensiveProvideDocumentBundleDocument: Bundle.entry[2].resource.entry[4].resource: Best Practice Recommendation: In general, all observations should have an effective[x] () (0 uses)
WARNING: Bundle/ex-fhir-document-bundle: Bundle.entry[4].resource: Best Practice Recommendation: In general, all observations should have a performer (0 uses)
WARNING: Bundle/ex-fhir-document-bundle: Bundle.entry[4].resource: Best Practice Recommendation: In general, all observations should have an effective[x] () (0 uses)

these are all examples that are good enough

Type_Specific_Checks_DT_URL_Resolve (27 uses)

yes we know we are using non normative resources and valuesets

MSG_DRAFT (187 uses)

Errors sorted by type

IG_DEPENDENCY_VERSION_WARNING_OLD

fsh-generated/resources/ImplementationGuide-ihe.iti.mhd.json

The ImplementationGuide uses package ihe.formatcode.fhir#1.4.x released on 2025-05-20, but the most recent appropriate version is 1.5.0. This reference is getting old and the more recent version should be considered

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MSG_DEPENDS_ON_DEPRECATED_NOTE

fsh-generated/resources/StructureDefinition-IHE.MHD.Comprehensive.DocumentReference.json

The extension http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet|5.3.0 is deprecated with the note: 'Use additionalBinding extension or element instead'

StructureDefinition

Terminology_TX_NoValid_14

fsh-generated/resources/Bundle-FindDocumentReferences.json

The Coding provided (http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode#urn:ihe:pharm:pml:2013) was not found in the value set 'DocumentReference Format Code Set' (http://hl7.org/fhir/ValueSet/formatcodes|4.0.1), and a code is recommended to come from this value set. (error message = The provided code 'http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode#urn:ihe:pharm:pml:2013' was not found in the value set 'http://hl7.org/fhir/ValueSet/formatcodes|4.0.1')

fsh-generated/resources/Bundle-ex-comprehensiveProvideDocumentBundleDocument.json

The Coding provided (http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode#urn:ihe:iti:xds:2017:mimeTypeSufficient) was not found in the value set 'DocumentReference Format Code Set' (http://hl7.org/fhir/ValueSet/formatcodes|4.0.1), and a code is recommended to come from this value set. (error message = The provided code 'http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode#urn:ihe:iti:xds:2017:mimeTypeSufficient' was not found in the value set 'http://hl7.org/fhir/ValueSet/formatcodes|4.0.1')

Terminology_TX_NoValid_3_CC

fsh-generated/resources/Bundle-FindDocumentReferences.json

None of the codings provided are in the value set 'Document Type Value Set' (http://hl7.org/fhir/ValueSet/c80-doc-typecodes|4.0.1), and a coding is recommended to come from this value set (codes = http://snomed.info/sct#721912009)