Tuesday, January 21, 2020

Mobile Health Document Sharing (MHDS) - First Public Comment

MHDS is published for public comment. This is the first of two Public Comment periods, with the next one this spring. We are doing two public comment phases in order to get broad set of review.

The Mobile Health Document Sharing (MHDS) Profile is a 100% FHIR Document Sharing infrastructure leveraging many IHE FHIR profiles including MHD. Where MHD has historically been an API to an XDS or XCA environment; MHDS introduces a new Central Registry actor and discusses how to build a complete Document Sharing infrastructure using other IHE Profiles.

This Document Sharing includes support for sharing FHIR-Documents, but is content format agnostic, thus equally capable of sharing CDA documents, PDF documents, or imaging. The big difference with MHDS is that one does not need to have an XDS or XCA backbone, as the backbone of MHD is purely a FHIR server.

Please review and comment. Good and bad. We need to reach a new #FHIR audience, new markets, new solutions. Here is the announcement and details on how to review and comment https://mailchi.mp/ihe/ihe-iti-tf-supplement-published-for-pc-2020-01-21 Note that the deadline for comments is February 14th, a bit shorter than normal, but we need to get comments in by the next IHE face-to-face meeting scheduled for the following week.

Here is the public comment forum and link to the MHD supplement

Included is support for

a system that is publishing documents

a system that is consuming documents

a relationship to mXDE enabled consumption of FHIR resources

Thursday, January 2, 2020

2019 wrap

I am not impressed by 2019. Not personally, not for the healthcare industry, not for my country, and not for our world. This is depressing, but also gives me many things to work on. It is working on fixing problems that gives a Systems Designer something to look forward to in the morning.


On my blog, I only posted 28 articles, which is average more than two a month. But realistically I had a few months where nothing was posted, and other months where a set of four posts happened.

  • Segmentation and Security Labeling: 1, 23, and 4
  • Blockchain: 1
  • Provenance: 1, 2, and 3
  • HIE on FHIR: 1, 2, 3, 4, 5, 6, 7, and 8
  • IHE: 1, 2, 3, 4, and 5
  • Patient Empowerment: 1, 2, and 3
  • Speaking Engagements: 1, and 2


My engagements with standards have been the most productive part of my work life. It is hard to come up with describable milestones, but I know that I have succeeded at many milestones.
  • The IHE profiles from ITI are all now aligned on FHIR R4, and all have FHIR conformance resources published. This is not all me, in many cases I was just the one pushing the authors 
  • I am now part of a team funded by the cooperative agreement between ONC and IHE-USA to position IHE as a major organization for standardization of FHIR based Profiles (aka Implementation Guides)
    • Catalog IHE Profiles that utilize the FHIR standard to enable cross community health information exchange
    • Identify and prioritize new profiling opportunities to leverage the FHIR standard.
    • Accelerate the development of robust, real world testing processes and adoption of the updated FHIR-focused IHE profile and HL7 implementation guides 
    • Actively engage with HL7 and IHE International on lessons learned through profiling improvements and real-world testing
  • IHE use of the HL7 Implementation Guide publication system is coming along. It is taking longer than anyone wants, but we keep coming up with instances where the tooling is (a) hard to use, (b) unstable, and (c) missing important features. In all cases we are working with HL7 leadership together to make this tooling better for everyone.  


The big win for the year was a 60 pound weight loss (4.25 stone) on a Keto diet. The bad news is the last three months have been flat. I wish that was my plan, but I really want to loose another 50-60 pounds. Injury to legs and feet have kept me from exercising.  I feel a bit better, and do enjoy doing things that last year would have exhausted me. But not good enough, yet...