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IHE MHD Query Minimal DocumentReference

To obtain potentially relevant attachment documents for the referral letter from the source XIS, ZorgDomein follows the implementation of MedMij for exchanging unstructured documents containing health information. MedMij adopts as much as possible from the Mobile access to Health Documents (MHD) profile from Integrating the Healthcare Enterprise (IHE). Hence the request for relevant attachment documents is a query for DocumentReference resources that conform to IHE MHD Profile on DocumentReference from a Query with Minimal Metadata

Resources conforming to this profile are requested by ZorgDomein when populating the list with selectable attachments from the source information system. Queries on the https://[FHIRServerUrl]/DocumentReference endpoint may include the following query parameters:

  • patient=[PatientID]: [PatientID] refers to the patient ID that was provided to ZorgDomein at SSO.
  • indexed=ge[date]: the resources in the search result must only contain DocumentReference resources that have a DocumentReference.indexed value that is greater than or equal to [date]. 
  • related-id=[TaskId]TaskId refers to the id of the Task resource that was provided to ZorgDomein at SSO. This way ZorgDomein queries for attachments that are directly related to the task or transaction in the information system of the sender. These attachments will be added automatically to the document in ZorgDomein.

NB: After the XIS has returned the DocumentReference resources to ZorgDomein and the user has selected one or more documents to attach to the referral letter, ZorgDomein will send individual GET requests for the url in DocumentReference.content.attachment.url to obtain the actual binary data of each document. This url may point to a Binary resource (eg https://[FHIRServerUrl]/Binary/1234) but can also directly point to the document itself (eg https://domain.com/path/to/document.pdf). 

Resource example

Below you find an example of a DocumentReference resource that conforms to the IHE MHD Query Minimal DocumentReference profile.

{
  "resourceType": "DocumentReference",
  "id": "1868",
  "meta": {
    "profile": [
      "http://nictiz.nl/fhir/StructureDefinition/IHE.MHD.Provide.Minimal.DocumentReference"
    ]
  },
  "masterIdentifier": {
      "value": "43cfc5a6-885b-4448-b96e-4749a1a4c796"
  },
  "status": "current",
  "type": {
    "text": "attachment"
  },
  "subject": {
    "reference": "Patient/1"
  },
  "indexed": "2020-03-30T00:00:00.000+02:00",
  "description": "MRI knie (rechts)",
  "content": [
    {
      "attachment": {
        "contentType": "image/jpeg",
        "url": "https://tio.zorgdomein.nl/fhir-test-server/baseDstu3/Binary/266/_history/1",
        "size": 16538,
        "title": "mri_knie_rechts.jpg"
      }
    }
  ],
  "context": {
    "related": [
      {
        "identifier": {
          "value": "1865"
        }
      }
    ]
  }
}
<DocumentReference xmlns="http://hl7.org/fhir">
  <id value="1868"/>
  <meta>
    <profile value="http://nictiz.nl/fhir/StructureDefinition/IHE.MHD.Provide.Minimal.DocumentReference"/>
  </meta>
  <masterIdentifier>
    <value value="43cfc5a6-885b-4448-b96e-4749a1a4c796"/>
  </masterIdentifier>
  <status value="current"/>
  <type>
    <text value="attachment"/>
  </type>
  <subject>
    <reference value="Patient/1"/>
  </subject>
  <indexed value="2020-03-30T00:00:00.000+02:00"/>
  <description value="MRI knie (rechts)"/>
  <content>
    <attachment>
      <contentType value="image/jpeg"/>
      <url value="https://tio.zorgdomein.nl/fhir-test-server/baseDstu3/Binary/266/_history/1"/>
      <size value="16538"/>
      <title value="mri_knie_rechts.jpg"/>
    </attachment>
  </content>
  <context>
    <related>
      <identifier>
        <value value="1865"/>
      </identifier>
    </related>
  </context>
</DocumentReference>