IHE Mobile access to Health Documents (MHD)

The foundational IHE profile for document sharing that MHD extends into the mobile space. XDS.b defines a Document Registry and Document Repository actor pair, using ebXML and SOAP-based transactions. MHD maps these same actors to a FHIR-based RESTful interface, allowing lightweight mobile clients to interact with the same backend infrastructure. Key mappings include:

• Provide and Register Document Set-b [ITI-41] → MHD's Provide Document Bundle [ITI-65]
• Registry Stored Query [ITI-18] → MHD's Find Document References [ITI-66]
• Retrieve Document Set-b [ITI-43] → MHD's Retrieve Document [ITI-68]

An IHE profile that adds OAuth 2.0 authorization to HTTP-based transactions, including those defined by MHD. IUA specifies how a resource server (the MHD Document Responder) validates access tokens issued by an Authorization Server. This is critical for mobile deployments where a native app must prove its identity and the user's consent before submitting or retrieving clinical documents. IUA leverages the SMART on FHIR framework for scopes and token introspection.

The IHE security profile that mandates secure node authentication using X.509 certificates and TLS mutual authentication for all network connections. MHD actors must comply with ATNA to establish a trusted channel before any document exchange occurs. ATNA also defines the syslog-based audit record format (RFC 5424) required to log all MHD transactions, including queries, document retrievals, and submissions, ensuring a complete, non-repudiable record of clinical data access.

A companion IHE profile that provides a FHIR-based interface for patient identity lookup. Before an MHD client can submit a document, it must identify the correct patient. PDQm defines a Patient Demographics Consumer querying a Patient Demographics Supplier using GET [base]/Patient?name=X&birthdate=Y. The returned FHIR Patient resource provides the logical reference (Patient/123) used in MHD's DocumentReference.subject to link the document to the correct record.

An IHE profile that extends document sharing across organizational boundaries by federating multiple XDS communities. MHD can serve as the mobile-facing gateway into an XCA network. An MHD Find Document References [ITI-66] request can be proxied by an Initiating Gateway to query remote communities, aggregating results into a single FHIR Bundle. This enables a single mobile app to retrieve documents from a regional health information exchange (HIE) without understanding the underlying cross-community topology.

An IHE profile that defines a FHIR-based directory for discovering healthcare organizations, locations, and practitioners. In an MHD workflow, mCSD resolves the organizational context for document submission. An MHD client can query mCSD to find the correct Document Recipient endpoint for a specific facility or department, using the returned FHIR Organization and Endpoint resources to route the Provide Document Bundle [ITI-65] transaction to the appropriate repository.