FHIRcast, published by HL7 International / Infrastructure And Messaging. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhircast-docs/ and changes regularly. See the Directory of published versions
eventMaturity | 2 - Tested |
The DiagnosticReport-update
event is used by Subscribers to support content sharing in communication with a Hub which also supports content sharing. A DiagnosticReport-update
request will be posted to the Hub when a Subscriber desires to add, change, or remove exchanged information in the anchor context. For a DiagnosticReport-update
, the anchor context
is the DiagnosticReport
context established by the corresponding DiagnosticReport-open
. One or more update requests MAY occur while the anchor context is open.
The updates include:
Key | Cardinality | Description |
---|---|---|
report |
1..1 | FHIR DiagnosticReport resource specifying the anchor context in which the update is being made. Note the mandatory elements defined in the DiagnosticReport update profile. Other attributes may be present in the DiagnosticReport resource if their values have changed or were newly populated. |
patient |
0..1 | Present if one or more attributes in the Patient resource associated with the report have changed. |
study |
0..1 | Present if one or more attributes in the ImagingStudy resource associated with the report have changed |
updates |
1..1 | Contains a single Bundle resource holding changes to be made to the current content of the anchor context |
The following profiles provide guidance as to which resource attributes should be present and considerations as to how each attribute should be valued in a DiagnosticReport-update request:
Each entry
in the updates
Bundle resource SHALL contain one of the below method
values in an entry's request
attribute. No resource SHALL appear multiple times in the updates
Bundle. One and only one transaction Bundle
SHALL be present in a DiagnosticReport-update
request.
Request Method | Operation |
---|---|
PUT |
Add a new resource or update a resource already existing in the content |
DELETE |
Remove an existing resource |
The following example shows adding an imaging study to the existing diagnostic report context and a new observation. The context.versionId
matches the context.versionId
provided by the Hub in the most recent DiagnosticReport-open
or DiagnosticReport-update
event. The report
key in the context
array holds the id
of the diagnostic report and is required in all DiagnosticReport-update
events. The Bundle
in the updates
key holds the addition (PUT) of an imaging study and adds (PUT) an observation derived from this study.
{
"timestamp": "2019-09-10T14:58:45.988Z",
"id": "cc4d016a-f516-4ce7-8f1a-e0baf0beb94d",
"event": {
"hub.topic": "fdb2f928-5546-4f52-87a0-0648e9ded065",
"hub.event": "DiagnosticReport-update",
"context.versionId": "b9574cb0-e9e5-4be1-8957-5fcb51ef33c1",
"context": [
{
"key": "report",
"resource": {
"resourceType": "DiagnosticReport",
"id": "2402d3bd-e988-414b-b7f2-4322e86c9327",
"status": "unknown",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "19005-8",
"display": "Radiology Imaging study [Impression] (narrative)"
}
]
}
}
},
{
"key": "updates",
"resource": {
"resourceType": "Bundle",
"type": "transaction",
"entry": [
{
"request": {
"method": "PUT"
},
"resource": {
"resourceType": "ImagingStudy",
"description": "CHEST XRAY",
"started": "2010-02-14T01:10:00.000Z",
"id": "7e9deb91-0017-4690-aebd-951cef34aba4",
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "ACSN"
}
]
},
"value": "3478116342"
},
{
"system": "urn:dicom:uid",
"value": "urn:oid:2.16.124.113543.6003.1154777499.30276.83661.3632298176"
}
]
}
},
{
"request": {
"method": "PUT"
},
"resource": {
"resourceType": "Observation",
"id": "40afe766-3628-4ded-b5bd-925727c013b3",
"partOf": {
"reference": "ImagingStudy/7e9deb91-0017-4690-aebd-951cef34aba4"
},
"status": "preliminary",
"category": {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "imaging",
"display": "Imaging"
},
"code": {
"coding": [
{
"system": "http://www.radlex.org",
"code": "RID49690",
"display": "simple cyst"
}
]
},
"issued": "2020-09-07T15:02:03.651Z"
}
}
]
}
}
]
}
}
The Hub SHALL distribute a corresponding event to all Subscribers. The Hub SHALL replace the context.versionId
in the request with a new context.versionId
generated and retained by the Hub. The prior version, context.priorVersionId
of the context is also provided to ensure that a Subscriber is currently in sync with the latest context prior to applying the new updates. If the value of context.priorVersionId
is not in agreement with the context.versionId
last received by a Subscriber, it is recommended that the Subscriber issue a GET request to the Hub in order to retrieve the latest version of the context (note that the GET request returns the context, all existing content, and the current context.versionId
).
{
"timestamp": "2019-09-10T14:58:45.988Z",
"id": "cc4d016a-f516-4ce7-8f1a-e0baf0beb94d",
"event": {
"hub.topic": "fdb2f928-5546-4f52-87a0-0648e9ded065",
"hub.event": "DiagnosticReport-update",
"context.versionId": "efcac43a-ed38-49e4-8d79-73f78290292a",
"context.priorVersionId": "b9574cb0-e9e5-4be1-8957-5fcb51ef33c1",
"context": [
{
"key": "report",
"resource": {
"resourceType": "DiagnosticReport",
"id": "2402d3bd-e988-414b-b7f2-4322e86c9327",
"status": "unknown",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "19005-8",
"display": "Radiology Imaging study [Impression] (narrative)"
}
]
}
}
},
{
"key": "updates",
"resource": {
"resourceType": "Bundle",
"type": "transaction",
"entry": [
{
"request": {
"method": "PUT"
},
"resource": {
"resourceType": "ImagingStudy",
"description": "CHEST XRAY",
"started": "2010-02-14T01:10:00.000Z",
"id": "7e9deb91-0017-4690-aebd-951cef34aba4",
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "ACSN"
}
]
},
"value": "3478116342"
},
{
"system": "urn:dicom:uid",
"value": "urn:oid:2.16.124.113543.6003.1154777499.30276.83661.3632298176"
}
]
}
},
{
"request": {
"method": "PUT"
},
"resource": {
"resourceType": "Observation",
"id": "40afe766-3628-4ded-b5bd-925727c013b3",
"partOf": {
"reference": "ImagingStudy/7e9deb91-0017-4690-aebd-951cef34aba4"
},
"status": "preliminary",
"category": {
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "imaging",
"display": "Imaging"
},
"code": {
"coding": [
{
"system": "http://www.radlex.org",
"code": "RID49690",
"display": "simple cyst"
}
]
},
"issued": "2020-09-07T15:02:03.651Z"
}
}
]
}
}
]
}
}
The following example shows a request to delete an observation from a content sharing session.
{
"timestamp": "2019-09-10T15:02:33.343Z",
"id": "d30734f1-3c7d-4fe4-a343-fbf4d80faddb",
"event": {
"hub.topic": "fdb2f928-5546-4f52-87a0-0648e9ded065",
"hub.event": "DiagnosticReport-update",
"context.versionId": "efcac43a-ed38-49e4-8d79-73f78290292a",
"context": [
{
"key": "report",
"resource": {
"resourceType": "DiagnosticReport",
"id": "2402d3bd-e988-414b-b7f2-4322e86c9327",
"status": "unknown",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "19005-8",
"display": "Radiology Imaging study [Impression] (narrative)"
}
]
}
}
},
{
"key": "updates",
"resource": {
"resourceType": "Bundle",
"type": "transaction",
"entry": [
{
"fullUrl": "Observation/40afe766-3628-4ded-b5bd-925727c013b3"
"request": {
"method": "DELETE"
}
}
]
}
}
]
}
}
Version | Description |
---|---|
0.1 | Initial draft |
1.0 | Updated for STU3 |