MHD support on FHIR R5

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John Moehrke

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Oct 16, 2025, 9:16:49 AM (10 days ago) Oct 16
to IHE ITI Technical Committee
Hi ITI Tech

I am working on the MHD support for FHIR R5, as was agreed at the October 9th meeting. We have our first call scheduled for October 30 at 10AM US Central. At which I will request approval for Public-Comment.

As discussed last week, I have the IG already converted. The plan is to publish a new version of MHD, version 5.0.0, that is based on FHIR R5; while continuing to publish MHD version 4.* based on FHIR R4, and the default for MHD will be the FHIR R4 version. Thus one must explicitly look for the MHD Version 5.

There was a concern brought forward that to do this the MHD 5 would need to have a different package id, canonical, and thus a different publication folder. I have spent extensive time with Grahame understanding that the package/canonical methodology is when one IG is producing more than one package, as this is needed for internal distinction. Given that we are using distinction on the major version of the IG, this package naming is not necessary. When the IG tooling does support this, well into the future (likely after publication of FHIR R6), then we would use that method in the MHD version 6.

Our use of a version, and thus github branch, will make this publication more difficult to manage. This is understood and accepted in order to hit urgency.

There is urgency, due to EU EHDS efforts, to get this MHD 5 published as soon as possible. Given that I have already prepared the publication, I would like us to focus on a decision to publish for Public Comment, with that decision being made at the October 30 meeting. Clearly if it is not ready, then this will not happen. However I want to bring attention to this unique request so as to get the most critical review prior to the meeting.

The MHD version 5 must have no new features, so this is not a time to "improve" MHD; but rather to make sure that the version 5 is equivalent to the version 4.

REVIEW

To assist your review
- Github issue for tracking -- https://github.com/IHE/ITI.MHD/issues/251
- The Github Diff of this branch with master -- https://github.com/IHE/ITI.MHD/compare/master...MHD5
- A Github PR to update the 4 branch for visible clarity -- https://github.com/IHE/ITI.MHD/pull/253


If you do submit github issues, please include the MHD5 branch so that we can track these.

John Moehrke 🔥 Architect: Healthcare Informatics Standards - Interoperability, Privacy, and Security
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