Manifest-based Access to DICOM Objects (MADO)
0.1.0 - trial-use

Manifest-based Access to DICOM Objects (MADO), published by IHE Radiology Technical Committee. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/RAD.MADO/ and changes regularly. See the Directory of published versions

## Download

You can download:

- this entire guide,
- the definition resources in json, xml, ttl, or csv format, or
- the example resources in json, xml or ttl format.

The source code for this Implementation Guide can be found on IHE RAD.MADO Github Repo.

#### Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (ihe.rad.mado.r4) and R4B (ihe.rad.mado.r4b) are available.

#### Dependency Table

IG | Package | FHIR | Comment
--- | --- | --- | ---
Manifest-based Access to DICOM Objects (MADO) | ihe.rad.mado#0.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.1.0 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 |
Mobile access to Health Documents (MHD) | ihe.iti.mhd#4.2.3 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.5.0 | R4 |
Basic Audit Log Patterns (BALP) | ihe.iti.balp#1.1.4 | R4 |
FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 | hl7.fhir.uv.xver-r5.r4#0.0.1-snapshot-2 | R4 |
fhir.dicom | fhir.dicom#2025.3.20250714 | R4 |
IHE FormatCode Vocabulary | ihe.formatcode.fhir#1.5.0 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#1.1.2 | R4 | for example references

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package ihe.iti.balp#1.1.4 The Basic Audit Log Patterns (BALP) Implementation Guide is a Content Profile that defines some basic and reusable AuditEvent patterns. This includes basic audit log profiles for FHIR RESTful operations to be used when there is not a more specific audit event defined. A focus is enabling Privacy centric AuditEvent logs that hold well formed indication of the Patient when they are the subject of the activity being recorded in the log. Where a more specific audit event can be defined it should be derived off of these basic patterns. (built Fri, Oct 31, 2025 12:53-0500-05:00)

Package ihe.iti.mhd#4.2.3 ImplementationGuide for IHE IT Infrastructure Technical Framework Supplement Mobile access to Health Documents (MHD) (built Fri, Oct 31, 2025 14:32-0500-05:00)

Package hl7.fhir.uv.xver-r5.r4#0.0.1-snapshot-2 The cross-version extensions available in FHIR R4 from FHIR R5 (built Sat, Sep 13, 2025 16:55-0400-04:00)

Package ihe.formatcode.fhir#1.5.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Sat, Mar 14, 2026 21:01-0500-05:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

#### Globals Table

There are no Global profiles defined

#### IP Statements

This publication includes IP covered under the following statements.

- Some content from IHE® Copyright © 2015 IHE International, Inc .
  Show Usage
  - IHE Format Code set for use with Document Sharing: DocumentReference/DocumentReferenceFHIR, DocumentReference/DocumentReferenceFHIRwithTransform, DocumentReference/mado-documentreference-fhir--2047166865, DocumentReference/mado-documentreference-fhir--2047166866 and MadoFhirDocumentReference
- These codes are excerpted from Digital Imaging and Communications in Medicine (DICOM) Standard, Part 16: Content Mapping Resource, Copyright Â© 2011 by the National Electrical Manufacturers Association.
  Show Usage
  - DICOM Controlled Terminology Definitions: Bundle/mado-bundle--2047166865, Bundle/mado-bundle--2047166866... Show 13 more, Bundle/mado-bundle-589331894518000, DocumentReference/DocumentReferenceFHIR, DocumentReference/DocumentReferenceFHIRwithTransform, DocumentReference/DocumentReferenceKOS, DocumentReference/DocumentReferenceKOSNoRelated, DocumentReference/DocumentReferenceKOSwithTransform, DocumentReference/mado-documentreference-fhir--2047166865, DocumentReference/mado-documentreference-fhir--2047166866, DocumentReference/mado-documentreference-kos--2047166865, DocumentReference/mado-documentreference-kos--2047166866, MadoAccessionNumberIdentifier, MadoKeyObjectDocumentTitle and MadoStudyInstanceUidIdentifier
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  - LOINC: DocumentReference/DocumentReferenceFHIR, DocumentReference/DocumentReferenceFHIRwithTransform... Show 7 more, DocumentReference/DocumentReferenceKOS, DocumentReference/DocumentReferenceKOSNoRelated, DocumentReference/DocumentReferenceKOSwithTransform, DocumentReference/mado-documentreference-fhir--2047166865, DocumentReference/mado-documentreference-fhir--2047166866, DocumentReference/mado-documentreference-kos--2047166865 and DocumentReference/mado-documentreference-kos--2047166866
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
  Show Usage
  - SNOMED Clinical Terms&reg; (SNOMED CT&reg;): Bundle/mado-bundle--2047166865, Bundle/mado-bundle--2047166866... Show 14 more, Bundle/mado-bundle-589331894518000, DocumentReference/DocumentReferenceFHIR, DocumentReference/DocumentReferenceFHIRwithTransform, DocumentReference/DocumentReferenceKOS, DocumentReference/DocumentReferenceKOSNoRelated, DocumentReference/DocumentReferenceKOSwithTransform, DocumentReference/mado-documentreference-fhir--2047166865, DocumentReference/mado-documentreference-fhir--2047166866, MadoAnatomicalRegionExtension, MadoDicomKosDocumentReference, MadoFhirDocumentReference, MadoRequestedProcedure, ProcedureEuImagingType and ValueSetAnatomicalRegion
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  Show Usage
  - Endpoint Connection Type: Bundle/mado-bundle--2047166865, Bundle/mado-bundle--2047166866... Show 4 more, Bundle/mado-bundle-589331894518000, Endpoint/EndpointWadoExampleNoAddress, MadoWadoEndpoint and WADO endpoint
  - Endpoint Payload Type: MadoWebViewerEndpoint
  - Provenance participant type: Bundle/mado-bundle--2047166865, Bundle/mado-bundle--2047166866, Bundle/mado-bundle-589331894518000 and MadoProvenance
  - identifierType: Bundle/mado-bundle--2047166865, Bundle/mado-bundle--2047166866... Show 14 more, Bundle/mado-bundle-589331894518000, DocumentReference/DocumentReferenceFHIR, DocumentReference/DocumentReferenceFHIRwithTransform, DocumentReference/DocumentReferenceKOS, DocumentReference/DocumentReferenceKOSNoRelated, DocumentReference/DocumentReferenceKOSwithTransform, DocumentReference/mado-documentreference-fhir--2047166865, DocumentReference/mado-documentreference-fhir--2047166866, DocumentReference/mado-documentreference-kos--2047166865, DocumentReference/mado-documentreference-kos--2047166866, MadoAccessionNumberIdentifier, MadoRequestedProcedure, Patient/pat-mrn--1097192655 and Patient/pat-mrn-1538098370
  - HL7 Document Format Codes: MadoFhirDocumentReference