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Combining the best of IHE XDS with HL7 FHIR

Publication date: Jun 27, 2019

What would happen if one were to combine the best features of XDS with FHIR? This post is not just about IHE MHD, but speculates as to what one could achieve by combining some of the fuatures of FHIR with IHE XDS.


IHE XDS is an architectural approach which separates the management of documents (well, any kind of data blob, really) from the management of metadata (data which describes the data blob). FHIR offers things like FHIR Documents, current medication/allergy/concern lists, and the profiling of data-sets comprised of FHIR resources.

Although not always a popular topic at a FHIR DevDays (most attendees are solely focused on FHIR) real live implementations of FHIR will surely bump into existing data sharing infrastructures such as XDS. As such I volunteered to speak about this combination during the recent FHIR DevDays in Redmond WA (USA).

XDS, adding two table spoons of FHIR (DevDays 2019 presentation)

Should you already know about IHE MHD, then please skip the video to 18:57. Should you also know about FHIR Documents, then please skip to 21:45. That's the point in the presentation were I start to discuss the nature of documents (what is a "document" anyway?). Effectively (kudos to John Moehrke for pointing it out) a document in XDS is effectively a blob with a mime type, which has been authored by some source. As such any bundle of FHIR Resources would qualify as a document. Such bundles could be $current-lists, or comply with the structure of a GraphDefinition resource if its contents comply with a particular graph based resource structure.

The XDS on-demand feature is a nice extension point in XDS, effectively allowing for the invocation of a FHIR like operation to create on the fly documents. However, if the content of the to-be-assembled document is fully defined by a client, there is no real authorship of its content (the content is automatically assembled, but not authored).

One could limit ones implementation to IHE MHD, but if one extrapolates what the future options could be when combining XDS and FHIR, there are many more options. However, all the world is not a doccument, and as such there are plenty of use cases where FHIR will be used next to the XDS document/metadata architectural approach.


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