CH MHD DocumentReference Comprehensive - CH EPR FHIR (R4) v5.0.0-ci-build

CH EPR FHIR (R4)
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CH EPR FHIR (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 5.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-epr-fhir/ and changes regularly. See the Directory of published versions

Resource Profile: CH MHD DocumentReference Comprehensive

Official URL: http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-mhd-documentreference-comprehensive				Version: 5.0.0-ci-build
Active as of 2025-08-05				Computable Name: CHMhdDocumentReferenceComprehensive
Copyright/Legal: CC0-1.0

CH MHD Profile on CH Core DocumentReference

Usages:

Use this Profile: CH MHD Find Document References Comprehensive Response message and CH MHD Provide Document Bundle Comprehensive
Refer to this Profile: CH MHD SubmissionSet Comprehensive
Examples for this Profile: DocumentReference/2-7-DocRefMedicationCard
CapabilityStatements using this Profile: MHD Document Consumer (client) and MHD Document Responder (server)

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	CHCoreDocumentReference	CH Core DocumentReference Constraints: ch-mhd
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:deletionStatus	S	0..1	Coding	Deletion status of the document URL: http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-ext-deletionstatus Binding: DocumentEntry.Ext.EprDeletionStatus (required)
extension:originalProviderRole	S	1..1	Coding	Original ProviderRole: This extra metadata attribute SHALL be set by the Document Source actor to the role value of the current user and SHALL NOT be updated by Update Initiator or Document Administrator actors. URL: http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-ext-author-authorrole Binding: DocumentEntry.originalProviderRole (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	SΣ	1..1	UniqueIdIdentifier	Master Version Specific Identifier
identifier	SΣ	0..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current \| superseded Binding: DocumentReferenceStatus (required): The status of the document reference.
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: DocumentEntry.typeCode (required)
category	SΣ	1..1	CodeableConcept	Categorization of document Binding: DocumentEntry.classCode (required)
subject	SΣ	1..1	Reference(CH Core Patient \| CH Core Practitioner \| Group \| Device)	Who/what is the subject of the document
identifier	Σ	1..1	EPRSPIDIdentifier	Logical reference, when literal reference is not known
author	SΣ	0..*	Reference(CH Core Practitioner \| CH Core PractitionerRole \| CH Core Organization \| Device \| CH Core Patient \| CH Core RelatedPerson) {c }	Who and/or what authored the document
authenticator		0..1	Reference(CH Core Practitioner \| CH Core PractitionerRole \| CH Core Organization) {c }	Who/what authenticated the document
relatesTo	SΣ	0..*	BackboneElement	Relationships to other documents
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	code	replaces \| transforms \| signs \| appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(CH Core DocumentReference)	Target of the relationship
description	SΣ	0..1	string	Human-readable description
securityLabel	SΣ	1..*	CodeableConcept	Document security-tags Binding: DocumentEntry.confidentialityCode (required)
content	Σ	1..1	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	SΣ	1..1	Attachment	Where to access the document
contentType	SΣC	1..1	code	Mime type of the content, with charset etc. Binding: DocumentEntry.mimeType (required) Constraints: ch-docref-1 Example General: text/plain; charset=UTF-8, image/png
language	SΣ	1..1	code	Human language of the content (BCP-47) Binding: DocumentEntry.languageCode (required) Example General: en-AU
url	SΣ	1..1	url	The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle. Example General: http://www.acme.com/logo-small.png
size	SΣ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	SΣ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	Date attachment was first created
format	SΣ	1..1	Coding	Format/content rules for the document Binding: DocumentEntry.formatCode (required): Document Format Codes.
context	Σ	1..1	BackboneElement	Clinical context of document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
event	S	0..*	CodeableConcept	Main clinical acts documented Binding: DocumentEntry.eventCodeList (required)
period	SΣ	0..1	Period	Time of service that is being documented
facilityType	S	1..1	CodeableConcept	Kind of facility where patient was seen Binding: DocumentEntry.healthcareFacilityTypeCode (required): XDS Facility Type.
practiceSetting	S	1..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: DocumentEntry.practiceSettingCode (required): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo	S	1..1	Reference(CH Core Patient) {c }	Patient demographics from source
Slices for related		0..*	Reference(Resource)	Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID	S	0..1	Reference(Resource)	Related identifiers or resources
identifier	SΣ	0..1	DicomStudyInstanceUidIdentifier	Requirements on XDS-I.b (Swiss context): When a Imaging Document Source provides a document to the Document Repository, it must provide the StudyInstanceUID, found in the to be registered KOS object, in the referenceIdList (urn:ihe:iti:xds:2013:referenceIdList) attribute of the documentEntry metadata.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.status	required	DocumentReferenceStatus `http://hl7.org/fhir/ValueSet/document-reference-status\|4.0.1` From the FHIR Standard
DocumentReference.type	required	DocumentEntryTypeCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.typeCode`
DocumentReference.category	required	DocumentEntryClassCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.classCode`
DocumentReference.relatesTo.code	required	DocumentRelationshipType `http://hl7.org/fhir/ValueSet/document-relationship-type\|4.0.1` From the FHIR Standard
DocumentReference.securityLabel	required	DocumentEntryConfidentialityCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.confidentialityCode`
DocumentReference.content.attachment.contentType	required	DocumentEntryMimeType `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.mimeType`
DocumentReference.content.attachment.language	required	DocumentEntryLanguageCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.languageCode`
DocumentReference.content.format	required	DocumentEntryFormatCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.formatCode`
DocumentReference.context.event	required	DocumentEntryEventCodeList `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.eventCodeList`
DocumentReference.context.facilityType	required	DocumentEntryHealthcareFacilityTypeCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.healthcareFacilityTypeCode`
DocumentReference.context.practiceSetting	required	DocumentEntryPracticeSettingCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.practiceSettingCode`

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-docref-1	warning	DocumentReference.content.attachment.contentType	The codes from the following ValueSet are 'preferred': http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.mimeType : memberOf('http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.mimeType')
ch-mhd	error	DocumentReference	The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference : conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CHCoreDocumentReference

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	CHCoreDocumentReference	CH Core DocumentReference Constraints: ch-mhd
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:deletionStatus	S	0..1	Coding	Deletion status of the document URL: http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-ext-deletionstatus Binding: DocumentEntry.Ext.EprDeletionStatus (required)
extension:originalProviderRole	S	1..1	Coding	Original ProviderRole: This extra metadata attribute SHALL be set by the Document Source actor to the role value of the current user and SHALL NOT be updated by Update Initiator or Document Administrator actors. URL: http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-ext-author-authorrole Binding: DocumentEntry.originalProviderRole (required)
masterIdentifier	S	1..1	UniqueIdIdentifier	Master Version Specific Identifier
identifier	S	0..*	Identifier	Other identifiers for the document
status	S	1..1	code	current \| superseded
docStatus		0..0
type	S	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: DocumentEntry.typeCode (required)
category	S	1..1	CodeableConcept	Categorization of document Binding: DocumentEntry.classCode (required)
subject	S	1..1	Reference(CH Core Patient \| CH Core Practitioner \| Group \| Device)	Who/what is the subject of the document
identifier		1..1	EPRSPIDIdentifier	Logical reference, when literal reference is not known
author	S	0..*	Reference(CH Core Practitioner \| CH Core PractitionerRole \| CH Core Organization \| Device \| CH Core Patient \| CH Core RelatedPerson) {c }	Who and/or what authored the document
authenticator		0..1	Reference(CH Core Practitioner \| CH Core PractitionerRole \| CH Core Organization) {c }	Who/what authenticated the document
custodian		0..0
relatesTo	S	0..*	BackboneElement	Relationships to other documents
description	S	0..1	string	Human-readable description
securityLabel	S	1..*	CodeableConcept	Document security-tags Binding: DocumentEntry.confidentialityCode (required)
content		1..1	BackboneElement	Document referenced
attachment	S	1..1	Attachment	Where to access the document
contentType	S	1..1	code	Mime type of the content, with charset etc. Binding: DocumentEntry.mimeType (required)
language	S	1..1	code	Human language of the content (BCP-47) Binding: DocumentEntry.languageCode (required)
data		0..0
url	S	1..1	url	The ITI-68 endpoint to use, or a reference to the Binary resource in the Bundle.
size	S	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	S	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	S	1..1	string	Label to display in place of the data
creation	S	1..1	dateTime	Date attachment was first created
format	S	1..1	Coding	Format/content rules for the document Binding: DocumentEntry.formatCode (required): Document Format Codes.
context		1..1	BackboneElement	Clinical context of document
event	S	0..*	CodeableConcept	Main clinical acts documented Binding: DocumentEntry.eventCodeList (required)
period	S	0..1	Period	Time of service that is being documented
facilityType	S	1..1	CodeableConcept	Kind of facility where patient was seen Binding: DocumentEntry.healthcareFacilityTypeCode (required): XDS Facility Type.
practiceSetting	S	1..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: DocumentEntry.practiceSettingCode (required): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo	S	1..1	Reference(CH Core Patient) {c }	Patient demographics from source
Slices for related		0..*	Reference(Resource)	Related identifiers or resources Slice: Unordered, Open by value:identifier
related:StudyInstanceUID	S	0..1	Reference(Resource)	Related identifiers or resources
identifier	S	0..1	DicomStudyInstanceUidIdentifier	Requirements on XDS-I.b (Swiss context): When a Imaging Document Source provides a document to the Document Repository, it must provide the StudyInstanceUID, found in the to be registered KOS object, in the referenceIdList (urn:ihe:iti:xds:2013:referenceIdList) attribute of the documentEntry metadata.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.type	required	DocumentEntryTypeCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.typeCode`
DocumentReference.category	required	DocumentEntryClassCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.classCode`
DocumentReference.securityLabel	required	DocumentEntryConfidentialityCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.confidentialityCode`
DocumentReference.content.attachment.contentType	required	DocumentEntryMimeType `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.mimeType`
DocumentReference.content.attachment.language	required	DocumentEntryLanguageCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.languageCode`
DocumentReference.content.format	required	DocumentEntryFormatCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.formatCode`
DocumentReference.context.event	required	DocumentEntryEventCodeList `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.eventCodeList`
DocumentReference.context.facilityType	required	DocumentEntryHealthcareFacilityTypeCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.healthcareFacilityTypeCode`
DocumentReference.context.practiceSetting	required	DocumentEntryPracticeSettingCode `http://fhir.ch/ig/ch-term/ValueSet/DocumentEntry.practiceSettingCode`

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-mhd	error	DocumentReference	The DocumentReference needs to conform to IHE.MHD.Comprehensive.DocumentReference : conformsTo('https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.DocumentReference')