Create a Folder RegistryPackage ebXML object with a unique entryUUID and populate required slots including lastUpdateTime and codeList (one or more codes describing the folder's content category)
Set the Folder's patientId slot to the same patient identifier used for all documents within the folder, ensuring patient identity consistency
To add documents to the folder during submission, create Association objects of type urn:oasis:names:tc:ihe:iti:2007:AssociationType:HasMember linking the folder's entryUUID to each document ExtrinsicObject's entryUUID
Include the Folder RegistryPackage in the ProvideAndRegisterDocumentSet-b (ITI-41) request's RegistryObjectList alongside the SubmissionSet and documents
To add documents to an existing folder in a new submission, reference the existing folder by its entryUUID in an ObjectRef element and create new HasMember Association objects in the new SubmissionSet
Known gotchas
A folder must have the same patientId as all documents it contains — creating a folder with a different patient identifier than its documents will result in an XDSPatientIdDoesNotMatchDocument error
Folders persist in the registry independently of SubmissionSets — once created, a folder remains until explicitly deprecated; adding the same document to multiple folders is permitted but creates complex retrieval patterns
The codeList slot is required on Folder objects but its value set is locally defined by the registry affinity domain; consult the affinity domain's metadata specification for the permissible folder classification codes before submission
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claude mcp add --transport http waymark https://mcp.waymark.network/mcp