Australian Digital Health Agency FHIR Implementation Guide

This profile identifies the additional constraints, extensions, and value sets that build on and extend Media that are supported.

This profile is designed to set a core Media standard for:

• Query for a generic media observation for a patient
• Record or update a generic media observation belonging to a patient

This profile may be referred to by APIs, which will be listed here when available.

Profile specific guidance

• When generated during a diagnostic examination a Media resource may contain the same identifier in Media.identifier as in the order or report connecting the resources that are related to a single request fulfilment workflow.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Media

Name	Flags	Card.	Type	Description & Constraints
Media	C	0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference inv-dh-media-02: If present, an operator shall at least have a reference, an identifier or a display
identifier	S	0..*	Identifier	Identifier(s) for the image
status		1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Required Pattern: completed
type	S	1..1	CodeableConcept	Classification of media as image, video, or audio
modality	S	0..1	CodeableConcept	The type of acquisition equipment/process
subject	SC	1..1	Reference(ADHA Core Patient)	Who/What this Media is a record of inv-dh-media-01: At least reference or a valid identifier shall be present
created[x]	SC	1..1	dateTime, Period	When Media was collected inv-dh-media-03: Date shall be at least to day
issued	S	0..1	instant	Date/Time this version was made available
operator	SC	0..1	Reference(ADHA Core PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA System Device | ADHA Core RelatedPerson)	The person who generated the image
content	S	1..1	Attachment	Actual Media - reference or data
note	S	0..*	Annotation	Comments made about the media
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-media-01	error	Media.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-media-02	error	Media	If present, an operator shall at least have a reference, an identifier or a display : operator.exists() implies operator.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())
inv-dh-media-03	error	Media.created[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Name	Flags	Card.	Type	Description & Constraints
Media	C	0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management inv-dh-media-02: If present, an operator shall at least have a reference, an identifier or a display
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	0..*	Identifier	Identifier(s) for the image ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event. ele-1: All FHIR elements must have a @value or children Required Pattern: completed
type	SΣ	1..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories. ele-1: All FHIR elements must have a @value or children
modality	SΣ	0..1	CodeableConcept	The type of acquisition equipment/process Binding: MediaModality (example): Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it. ele-1: All FHIR elements must have a @value or children
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who/What this Media is a record of ele-1: All FHIR elements must have a @value or children inv-dh-media-01: At least reference or a valid identifier shall be present
created[x]	SΣC	1..1		When Media was collected ele-1: All FHIR elements must have a @value or children inv-dh-media-03: Date shall be at least to day
createdDateTime			dateTime
createdPeriod			Period
issued	SΣ	0..1	instant	Date/Time this version was made available ele-1: All FHIR elements must have a @value or children
operator	SΣC	0..1	Reference(ADHA Core PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA System Device | ADHA Core RelatedPerson)	The person who generated the image ele-1: All FHIR elements must have a @value or children
content	SΣ	1..1	Attachment	Actual Media - reference or data ele-1: All FHIR elements must have a @value or children
note	S	0..*	Annotation	Comments made about the media ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Media.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Media.type	extensible	MediaType http://hl7.org/fhir/ValueSet/media-type from the FHIR Standard
Media.modality	example	MediaModality http://hl7.org/fhir/ValueSet/media-modality from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-media-01	error	Media.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-media-02	error	Media	If present, an operator shall at least have a reference, an identifier or a display : operator.exists() implies operator.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())
inv-dh-media-03	error	Media.created[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Name	Flags	Card.	Type	Description & Constraints
Media	C	0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference inv-dh-media-02: If present, an operator shall at least have a reference, an identifier or a display
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) for the image
basedOn	Σ	0..*	Reference(ServiceRequest | CarePlan)	Procedure that caused this media to be created
partOf	Σ	0..*	Reference(Resource)	Part of referenced event
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event. Required Pattern: completed
type	SΣ	1..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories.
modality	SΣ	0..1	CodeableConcept	The type of acquisition equipment/process Binding: MediaModality (example): Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it.
view	Σ	0..1	CodeableConcept	Imaging view, e.g. Lateral or Antero-posterior Binding: MediaCollectionView/Projection (example): Imaging view (projection) used when collecting an image.
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who/What this Media is a record of inv-dh-media-01: At least reference or a valid identifier shall be present
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with media
created[x]	SΣC	1..1		When Media was collected inv-dh-media-03: Date shall be at least to day
createdDateTime			dateTime
createdPeriod			Period
issued	SΣ	0..1	instant	Date/Time this version was made available
operator	SΣC	0..1	Reference(ADHA Core PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA System Device | ADHA Core RelatedPerson)	The person who generated the image
reasonCode	Σ	0..*	CodeableConcept	Why was event performed? Binding: ProcedureReasonCodes (example): The reason for the media.
bodySite	Σ	0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
deviceName	Σ	0..1	string	Name of the device/manufacturer
device	Σ	0..1	Reference(Device | DeviceMetric | Device)	Observing Device
height	Σ	0..1	positiveInt	Height of the image in pixels (photo/video)
width	Σ	0..1	positiveInt	Width of the image in pixels (photo/video)
frames	Σ	0..1	positiveInt	Number of frames if > 1 (photo)
duration	Σ	0..1	decimal	Length in seconds (audio / video)
content	SΣ	1..1	Attachment	Actual Media - reference or data
note	S	0..*	Annotation	Comments made about the media
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Media.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Media.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Media.type	extensible	MediaType http://hl7.org/fhir/ValueSet/media-type from the FHIR Standard
Media.modality	example	MediaModality http://hl7.org/fhir/ValueSet/media-modality from the FHIR Standard
Media.view	example	MediaCollectionView/Projection http://hl7.org/fhir/ValueSet/media-view from the FHIR Standard
Media.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Media.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-media-01	error	Media.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-media-02	error	Media	If present, an operator shall at least have a reference, an identifier or a display : operator.exists() implies operator.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())
inv-dh-media-03	error	Media.created[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Differential View

This structure is derived from Media

Name	Flags	Card.	Type	Description & Constraints
Media	C	0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference inv-dh-media-02: If present, an operator shall at least have a reference, an identifier or a display
identifier	S	0..*	Identifier	Identifier(s) for the image
status		1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Required Pattern: completed
type	S	1..1	CodeableConcept	Classification of media as image, video, or audio
modality	S	0..1	CodeableConcept	The type of acquisition equipment/process
subject	SC	1..1	Reference(ADHA Core Patient)	Who/What this Media is a record of inv-dh-media-01: At least reference or a valid identifier shall be present
created[x]	SC	1..1	dateTime, Period	When Media was collected inv-dh-media-03: Date shall be at least to day
issued	S	0..1	instant	Date/Time this version was made available
operator	SC	0..1	Reference(ADHA Core PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA System Device | ADHA Core RelatedPerson)	The person who generated the image
content	S	1..1	Attachment	Actual Media - reference or data
note	S	0..*	Annotation	Comments made about the media
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-media-01	error	Media.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-media-02	error	Media	If present, an operator shall at least have a reference, an identifier or a display : operator.exists() implies operator.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())
inv-dh-media-03	error	Media.created[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Media	C	0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management inv-dh-media-02: If present, an operator shall at least have a reference, an identifier or a display
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	0..*	Identifier	Identifier(s) for the image ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event. ele-1: All FHIR elements must have a @value or children Required Pattern: completed
type	SΣ	1..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories. ele-1: All FHIR elements must have a @value or children
modality	SΣ	0..1	CodeableConcept	The type of acquisition equipment/process Binding: MediaModality (example): Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it. ele-1: All FHIR elements must have a @value or children
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who/What this Media is a record of ele-1: All FHIR elements must have a @value or children inv-dh-media-01: At least reference or a valid identifier shall be present
created[x]	SΣC	1..1		When Media was collected ele-1: All FHIR elements must have a @value or children inv-dh-media-03: Date shall be at least to day
createdDateTime			dateTime
createdPeriod			Period
issued	SΣ	0..1	instant	Date/Time this version was made available ele-1: All FHIR elements must have a @value or children
operator	SΣC	0..1	Reference(ADHA Core PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA System Device | ADHA Core RelatedPerson)	The person who generated the image ele-1: All FHIR elements must have a @value or children
content	SΣ	1..1	Attachment	Actual Media - reference or data ele-1: All FHIR elements must have a @value or children
note	S	0..*	Annotation	Comments made about the media ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Media.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Media.type	extensible	MediaType http://hl7.org/fhir/ValueSet/media-type from the FHIR Standard
Media.modality	example	MediaModality http://hl7.org/fhir/ValueSet/media-modality from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-media-01	error	Media.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-media-02	error	Media	If present, an operator shall at least have a reference, an identifier or a display : operator.exists() implies operator.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())
inv-dh-media-03	error	Media.created[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Media	C	0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference inv-dh-media-02: If present, an operator shall at least have a reference, an identifier or a display
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) for the image
basedOn	Σ	0..*	Reference(ServiceRequest | CarePlan)	Procedure that caused this media to be created
partOf	Σ	0..*	Reference(Resource)	Part of referenced event
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event. Required Pattern: completed
type	SΣ	1..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories.
modality	SΣ	0..1	CodeableConcept	The type of acquisition equipment/process Binding: MediaModality (example): Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it.
view	Σ	0..1	CodeableConcept	Imaging view, e.g. Lateral or Antero-posterior Binding: MediaCollectionView/Projection (example): Imaging view (projection) used when collecting an image.
subject	SΣC	1..1	Reference(ADHA Core Patient)	Who/What this Media is a record of inv-dh-media-01: At least reference or a valid identifier shall be present
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with media
created[x]	SΣC	1..1		When Media was collected inv-dh-media-03: Date shall be at least to day
createdDateTime			dateTime
createdPeriod			Period
issued	SΣ	0..1	instant	Date/Time this version was made available
operator	SΣC	0..1	Reference(ADHA Core PractitionerRole | ADHA Core Organization | ADHA Core Patient | ADHA System Device | ADHA Core RelatedPerson)	The person who generated the image
reasonCode	Σ	0..*	CodeableConcept	Why was event performed? Binding: ProcedureReasonCodes (example): The reason for the media.
bodySite	Σ	0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
deviceName	Σ	0..1	string	Name of the device/manufacturer
device	Σ	0..1	Reference(Device | DeviceMetric | Device)	Observing Device
height	Σ	0..1	positiveInt	Height of the image in pixels (photo/video)
width	Σ	0..1	positiveInt	Width of the image in pixels (photo/video)
frames	Σ	0..1	positiveInt	Number of frames if > 1 (photo)
duration	Σ	0..1	decimal	Length in seconds (audio / video)
content	SΣ	1..1	Attachment	Actual Media - reference or data
note	S	0..*	Annotation	Comments made about the media
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Media.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Media.status	required	Pattern: completed http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Media.type	extensible	MediaType http://hl7.org/fhir/ValueSet/media-type from the FHIR Standard
Media.modality	example	MediaModality http://hl7.org/fhir/ValueSet/media-modality from the FHIR Standard
Media.view	example	MediaCollectionView/Projection http://hl7.org/fhir/ValueSet/media-view from the FHIR Standard
Media.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Media.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-media-01	error	Media.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-media-02	error	Media	If present, an operator shall at least have a reference, an identifier or a display : operator.exists() implies operator.all($this.reference.exists() or $this.identifier.exists() or $this.display.exists())
inv-dh-media-03	error	Media.created[x]	Date shall be at least to day : $this is DateTime implies $this.toString().length() >= 10

This structure is derived from Media

Summary

Mandatory: 3 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• ADHA Core Patient (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-patient-core-1)
• ADHA Core PractitionerRole (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-practitionerrole-core-1)
• ADHA Core Organization (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-organization-core-1)
• ADHA System Device (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-device-system-1)
• ADHA Core RelatedPerson (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-relatedperson-core-1)

Below is an overview of the mandatory and optional search parameters. FHIR search operations and the syntax used to describe the interactions is described here.