CH Health Dossier (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 1.0.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-health-dossier/ and changes regularly. See the Directory of published versions

Mobile Access to Health Documents (MHD)

This section specifies Swiss national extensions to the Mobile Access to Health Documents (MHD), which is published as an IHE ITI Trial Implementation profile.

The national extensions adds an additional transaction from the Document Source to the Document Recipient.

Scope

An EPR App can query, retrieve or publish data to/from an EPR community using the transaction of the MHD profile. An EPR App can Update Document Metadata for a published document with this national extension.

Use Cases

In addition to the Document Sharing Use Case for MHD the national extension defines the following Use Cases:

Document Metadata update from a Health Care professional with a primary system

A Healthcare professional has published a document in his own community for the patient but needs to update the metadata of the document. The healthcare professional updates the metadata (e.g. title) in the primary systems and submits the updated metadata to the community. The metadata which is allowed to be updated is defined in Annex 5.1 1.12.

Patient changes confidentiality code of a document

A patient wants to change the confidentiality code of one of his documents. The patient updates the confidentiality code in the portal and the portal submits the updated metadata to the community where the document is stored (could be another community as where the patient has his reference community).

Actors and Transactions

This figure shows the actors directly involved in the Mobile Access to Health Documents Profile and the relevant transactions between them.

The Find Document Lists [ITI-66] transaction defined in MHD SHALL not be made available in this context.

Actor options

Options that can be selected for each actor in this profile, are listed in the table below.

Actor	Option Name	Optionality
Document Source	Comprehensive Metadata	R
Document Recipient	Comprehensive Metadata	R
Document Consumer	Comprehensive Metadata	R
Document Responder	Comprehensive Metadata	R

Comprehensive Metadata Option

Comprehensive Metadata as defined in 1:33.2.1. For all actors the Metadata as defined in Annex 3 SHALL be supported.

Required Actor Groupings

This national extension enforces authentication and authorization for access control. Therefore actors of this profile SHALL be grouped with actors of other profiles according to the following table:

Actor	Required Grouping	Optionality	Remark
Document Recipient	IUA Resource Server	R	-
Document Responder	IUA Authorization Client	R	-
Document Source	IUA Authorization Client	R	Workflow Initiator Option or Technical User Option
Document Consumer	IUA Authorization Client	R	Workflow Initiator Option

Process Flow

For the process flow of this profile and its interplay with the other profiles see sequence diagrams.

Security Consideration

This national extension enforces authentication and authorization of access to the Document Recipient and Document Responder using the IUA profile as described in IUA.