MHD Implementation Guide

Examples

These examples are of MHD objects, objects that conform to both the FHIR spec and the semantic requirements of Document Sharing, basically XDS encoded in FHIR. Since they obey both sets of rules it seemed they needed a name so for now that name is MHD objects.

Sorry for the horrible use of codes but remember that famous quote from Star Trek (with apologies): Darn-it Jim, I'm an engineer, not a doctor.

Minimal DocumentReference

This is the most basic MHD DocumentReference object. It contains the attributes required by XDS and by FHIR and includes nothing extra. This has been validated with the FHIR schema but not yet tested against any of the FHIR test servers.

<?xml version="1.0" encoding="UTF-8"?>

<!-- DocumentReference
    This is the absolute minimalistic coding of an MHD DocumentReference with
    requirements coming from both FHIR and XDS.
-->
<DocumentReference xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
    xsi:schemaLocation="http://hl7.org/fhir file:/Users/bmajur/Documents/HL7/FHIR/Schema/fhir-all-xsd/fhir-all.xsd"
    xmlns="http://hl7.org/fhir">
    <!-- DocumentEntry.sourcePatientId and DocumentEntry.sourcePatientInfo
         coded as extension with a reference from the Patient resource representing
         the sourcePatient (information stored outside XDS environment on the patient -->
    <extension url="http://ihe.net/fhir/Profile/XDS/extensions#sourcePatient">
        <valueResource>
            <reference value="#sourcepatient"/>
        </valueResource>
    </extension>
    <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"/>
    </text>
    <contained>
        <!-- only detail is Patient ID 
             referenced by <subject/> DocumentEntry.patientId 
             this is the Affinity Domain patientID -->
        <Patient id="patient">
            <identifier>
                <system value="urn:oid:1.3.6.1.4.1.21367.2005.3.7"/>
                <value value="1234"/>
            </identifier>
        </Patient>
    </contained>
    <contained>
        <!-- this could contain the full sourcePatientInfo detail 
             referenced by <subject/> DocumentEntry.patientId 
             this is the Source patientID -->
        <Patient id="sourcepatient">
            <identifier>
                <value value="DTG1234"/>
            </identifier>
        </Patient>
    </contained>
    <contained>
        <!-- DocumentEntry.author.authorPerson -->
        <Practitioner id="docdave">
            <name>
                <family value="Careful"/>
                <given value="Dave"/>
                <prefix value="Dr"/>
            </name>
        </Practitioner>
    </contained>
    <!-- DocumentEntry.uniqueId -->
    <masterIdentifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7"/>
    </masterIdentifier>
    <!-- DocumentEntry.patientId -->
    <subject>
        <reference value="#patient"/>
    </subject>
    <!-- DocumentEntry.typeCode -->
    <type>
        <coding>
            <system value="urn:oid:2.16.840.1.113883.6.1"/>
            <code value="28651-8"/>
            <display value="Nurse Transfer note"/>
        </coding>
    </type>
    <!-- DocumentEntry.classCode -->
    <class>
        <coding>
            <system value="urn:oid:1.3.6.1.4.1.21367.100.1"/>
            <code value="DEMO-Pt Mgmt"/>
            <display value="Patient Management"/>
        </coding>
    </class>
    <!-- DocumentEntry.author 
         this is required by FHIR and optional in XDS -->
    <author>
        <reference value="#docdave"/>
    </author>
    <!-- DocumentEntry.creationTime -->
    <created value="2005-12-24T09:35:00"/>
    <!-- required by FHIR - when was DocumentReference created -->
    <indexed value="2005-12-24T09:35:00"/>
    <!-- DocumentEntry.availabilityStatus (Approved) 
         FHIR requires this on submission -->
    <status value="current"/>
    <!-- DocumentEntry.confidentialityCode -->
    <confidentiality>
        <coding>
            <system value="urn:oid:2.16.840.1.113883.5.25"/>
            <code value="N"/>
            <display value="Normal"/>
        </coding>
    </confidentiality>
    <!-- DocumentEntry.languageCode -->
    <primaryLanguage value="en-US"/>
    <!-- DocumentEntry.mimeType -->
    <mimeType value="text/plain"/>
    <!-- DocumentEntry.formatCode - 
         not a coded value like in XDS -->
    <format value="urn:wustl:mir:ppoc:1999"/>
    <context>
        <!-- DocumentEntry.healthcareFacilityTypeCode -->
        <facilityType>
            <coding>
                <system value="urn:oid:2.16.840.1.113883.5.11"/>
                <code value="PEDHO"/>
                <display value="Pediatric oncology clinic"/>
            </coding>
        </facilityType>
    </context>
</DocumentReference>

Minimal DocumentManifest

<?xml version="1.0" encoding="UTF-8"?>

<!-- DocumentManifest
    This is the absolute minimalistic coding of an MHD DocumentManifest with
    requirements coming from both FHIR and XDS.
-->

<DocumentManifest xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
    xsi:schemaLocation="http://hl7.org/fhir file:/Users/bmajur/Documents/HL7/FHIR/Schema/fhir-all-xsd/fhir-all.xsd"
    xmlns="http://hl7.org/fhir">
    <!-- SubmissionSet.contentTypeCode. See Open Issue MHD022 for discussion on why this may be wrong! -->
    <extension url="http://ihe.net/fhir/Profile/XDS/extensions#contentTypeCode">
        <valueCodeableConcept>
            <coding>
                <system value="2.16.840.1.113883.6.1"/>
                <code value="28570-0"/>
                <display value="Procedure Note"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"/>
    </text>
    <contained>
        <!-- only detail is Patient ID 
             referenced by <subject/> SubmissionSet.patientId 
             this is the Affinity Domain patientID -->
        <Patient id="patient">
            <identifier>
                <system value="urn:oid:1.3.6.1.4.1.21367.2005.3.7"/>
                <value value="1234"/>
            </identifier>
        </Patient>
    </contained>
    <!-- SubmissionSet.uniqueId -->
    <masterIdentifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.8"/>
    </masterIdentifier>
    <!-- DocumentEntry.patientId -->
    <subject>
        <reference value="#patient"/>
    </subject>
    <!-- SubmissionSet.availabilityStatus 
         FHIR requires this on submission -->
    <status value="current"/>
    <!-- This takes the place of the HasMember association placing
         a DocumentEntry/DocumentReference in the SubmissionSet. The
         referenced value is not present in the example since this is an example
         of just the DocumentManifest object. -->
    <content>
        <reference value="#DocumentEntry1"/>
    </content>
</DocumentManifest>