The IT Infrastructure Technical Committee has published the following updated supplement (as HTML) for trial implementation as of December 7, 2022:
- Mobile Access to Health Documents (MHD) - Rev. 4.2.0

Significant changes since MHD Version 4.1.0
- Changed to AuditEvent profiling leveraging Basic Audit Log Patterns (BALP) Release 1.1.0.
- changes to RESTful type and query subtype
- Improved clarity on types of Identifier.
- Added a method to support DocumentReference replace that is used by the Document Source to mark the old/replaced DocumentReference instance as superseded.
- Added new features
- Added a Generate Metadata Option that adds the ITI-106 operation that allows for one structured/coded document to be published.
- Added a Simplified Publish Option that allows for one DocumentReference with the document in the .data element to be published, expecting the Document Recipient to create the SubmissionSet derived off of the DocumentReference and Community mapping policy.
- Added an ITI-65 FHIR Documents Publish Option with support in ITI-65 to include a FHIR Document Bundle as an alternative to Binary. This reduces the burden on the Document Source to serialize the content into an appropriate Binary format, as that requirement is moved to the Document Recipient. There are use-cases where the Document Recipient will use the FHIR Document Bundle directly, and there are requirements on the Document Recipient to serialize the FHIR Document Bundle when grouped with non-FHIR Actors like XDS/XDR/XDM.
- This is added as an option at this time to keep base compatibility with existing MHD. This may eventually become normal functionality of ITI-65.
Note: Based on interest, the new Options may remain or be removed. Please voice your interest by testing these options at an upcoming IHE Connectathon.
The profile contained within the above document may be available for testing at subsequent IHE Connectathons. The document is available at
https://profiles.ihe.net/ITI/. Comments on this IT Infrastructure document are welcome at any time and can be submitted via traditional methods at
ITI Public Comments or by submitting a
GitHub Issue.