Mobile access to Health Documents (MHD)
The IHE MHD profile and the HL7 FHIR activities are working together to revise and enhance the transactions profiled here. For details on HL7 FHIR See http://hl7.org/fhir
The Mobile access to Health Documents (MHD) profile defines a simple HTTP interface to an XDS like environment. The MHD profile is intended for any system that prefers the simplified HTTP RESTful technology rather than the more robust technology used in XDS. It defines transactions to a) submit a set of documents and metadata from the mobile device to a document receiver, b) find the document submission set metadata based on query parameters; c) find document entries containing metadata based on query parameters, and d) retrieve a copy of a specific document.
Mobile access to Health Documents (MHD) profile defines a simple HTTP interface to an XDS like environment. It defines transactions to a) submit a submission sets, folders, new documents, and document metadata from the mobile device to a document receiver, b) Find submission sets matching query parameters, c) find document entries containing metadata based on query parameters, and d) retrieve a copy of a specific document. These transactions leverage the document content and format agnostic metadata concepts from XDS, but simplify them for access by constrained environments such as mobile devices, or other resource constrained systems. The MHD profile does not replace XDS. It can be used to allow mobile devices, or other resource constrained systems, access to an XDS health information exchange. The following figure shows one possible way to implement MHD with a document sharing environment (that may, but is not necessarily, XDS based). This implementation choice is not mandatory and we recognize other architectures will be implemented. An Implementation Guide is being maintained at MHD Implementation Guide.
RESTful interface to XDS and other Document Sharing environments These transactions leverage the document content and format agnostic metadata concepts from XDS, but simplify them for access by constrained environments such as mobile devices. The MHD profile does not replace XDS. It can be used to allow mobile devices, or other resource constrained systems, access to an XDS health information exchange. The following figure shows one possible way to implement MHD with a document sharing environment (that may, but is not necessarily, XDS based). This implementation choice is not mandatory and we recognize other architectures will be implemented. An Implementation Guide is being maintained at http://wiki.ihe.net/index.php?title=MHD_Implementation_Guide
The XDS profile is specifically designed to support the needs of Cross-Enterprise security, privacy, interoperability, and includes characteristics to support this level of policy and operational needs. The MHD profile has simplified the interactions in ways that are more consistent with a single policy domain use. The MHD transactions are not specifically tied to XDS, and some of the system implementations envisioned would interface directly to an organizational EHR, or a multi-national PHR. The following lists a few examples of the environments which might choose to use the MHD profile instead of the XDS profile. The MHD profile supports a broad set of the XDS use cases and functionality while keeping the technology as simple as possible. The MHD profile is focused on a useful subset of the use-cases that XDS supports and does not try to reproduce the full scalability, flexibility, privacy, or security supported by the more robust XDS infrastructure.
- Medical devices such as those targeted by the Patient Care Devices (PCD) domain or Continua organization, submitting data in the form of documents.
- Kiosks used by patients in hospital registration departments, where it is anticipated that a hospital staff member will review, edit, and approve the document before it is allowed into the hospital system.
- PHR publishing into a staging area for subsequent import into an EHR or HIE.
- Patient or provider application that is configured to securely connect to a PHR in order to submit a medical history document. (For example BlueButton+)
- Electronic measurement device participating in an XDW workflow and pulling medical history documents from an HIE.
- A General Practitioner physician’s office with minimal IT capabilities using a mobile application to connect to an HIE or EHR.
The Mobile access to Health Documents (MHD) profile defines actors and transactions. There is one set of actors and a transaction used to submit or push a new document entry or set of document entries from the mobile device to a receiving system. The other set of actors and transactions is used to get a list of document entries containing metadata, and to retrieve a copy of a specific document. These transactions leverage the metadata concepts from XDS, but simplify the technology requirements for access by mobile devices. The MHD profile defines a Document Dossier that is focused on the Document Entry as defined by XDS with all the related metadata including Submission Sets, Folders, and Associations. The MHD profile does not replace XDS. It enables simplified access by mobile devices to an XDS (or a similar) document management environment containing health information.
Two options are defined
- Comprehensive Metadata -- Indicates that the actors will abide by the XDS definition of metadata cardinality (not minimal metadata)
- XDS on FHIR -- Indicates that the actors are expecting XDS implementation behind the Document Responder and Document Recipient.
One deployment model is to use the MHD as a FHIR based API to XDS, thus more friendly to applications. This is defined as the "XDS on FHIR" Option. In this option the MHD Document Responder is responsible for converting the XDS metadata into MHD metadata. This Document Responder is thus responsible for setting the DocumentReference.content.attachment.url so that a Document Consumer simply requests the document from that URL. This URL is fully in the control of the Document Responder. Thus the Document Responder might choose to encode the XDS Document Repository ID and the Document UniqueID into the URL. It might encode them as query parameters in a URL. The Document Responder might alternatively use UUIDs that it keeps a mapping table. The URL might be rooted at the same or a different server endpoint as the Document Responder. The important point is that the Document Responder is empowered to fill the URL anyway it wants. The URL must simply be used by the Document Consumer, meaning the Document Consumer shall not try to interpret the URL, it should just GET.
Systems involved in this profile are:
- Any application or service that would like to use RESTful interactions for Document Sharing.
Actors & Transactions:
Profile Status: Trial Implementation
Documents: MHD Supplement
Additional Supplements: Appendix Z on HL7 FHIR
- HL7 FHIR STU3 http://hl7.org/fhir/STU3
- RFC2616 IETF Hypertext Transfer Protocol – HTTP/1.1
- RFC3986 IETF Uniform Resource Identifier (URI): Generic Syntax
- RFC6585 IETF Additional HTTP Status Codes
This profile supports the security/privacy model discussed in Health Information Exchange: Enabling Document Sharing Using IHE Profiles white paper.
- PDQm -- provides HTTP (RESTful) equivalent to PDQ and PDQv3; and basis set of FHIR methods and data-types
- IUA -- provides user token security for HTTP (RESTful) transactions
This page is based on the Profile Template
Current: IT Infrastructure Technical Framework.