Introduction

A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference.

Scope and Usage

In scope of the eHealth infrastructure Media resources are used with measurements, so that submitted measurement bundles can consist of e.g. Observations, QuestionnaireResponses, and Media. The actual media data can be contained as a payload of the Media resource (using the content.data element) or be referenced from the Media resource (using the content.url element).

Immutability

Media are immutable. Once they are created as a FHIR resource they cannot be updated or deleted, but they can be read based on id or searched based on certain elements.

Searching media

It is possible to search for Media based on:

• context
• subject
• code
• period
• deviceMeasuringQuality
• situationQuality
• operationQuality

At least one of "subject" and "context" must be provided. "period" searches on range of "occurence".

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

This structure is derived from Media

Name	Flags	Card.	Type	Description & Constraints
Media			Media
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
quality		0..*	(Complex)	Minimum requirements for qualities URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-quality
resolvedTiming		1..1	(Complex)	Resolved Timing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-resolved-timing
basedOn		1..1	Reference(ehealth-servicerequest) {r}	Procedure that caused this media to be created
subject		1..1	Reference(ehealth-patient | ehealth-practitioner | Group | ehealth-device | Specimen)	Who/What this Media is a record of
reference		1..1	string	Literal reference, Relative, internal or absolute URL
created[x]		1..1	dateTime, Period	When Media was collected
operator		0..1	Reference(ehealth-practitioner) {r}	The person who generated the image
device		0..1	Reference(ehealth-device | ehealth-devicemetric) {r}	Observing Device
note
Slices for author[x]		0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	Individual responsible for the annotation Slice: Unordered, Open by type:$this
author[x]:authorReference		0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString		0..1	string	Individual responsible for the annotation
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Media		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
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
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
quality		0..*	(Complex)	Minimum requirements for qualities URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-quality ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
resolvedTiming		1..1	(Complex)	Resolved Timing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-resolved-timing ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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
basedOn	Σ	1..1	Reference(ehealth-servicerequest) {r}	Procedure that caused this media to be created 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
subject	Σ	1..1	Reference(ehealth-patient | ehealth-practitioner | Group | ehealth-device | Specimen)	Who/What this Media is a record of ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
created[x]	Σ	1..1		When Media was collected ele-1: All FHIR elements must have a @value or children
createdDateTime			dateTime
createdPeriod			Period
operator	Σ	0..1	Reference(ehealth-practitioner) {r}	The person who generated the image ele-1: All FHIR elements must have a @value or children
device	Σ	0..1	Reference(ehealth-device | ehealth-devicemetric) {r}	Observing Device ele-1: All FHIR elements must have a @value or children
content	Σ	1..1	Attachment	Actual Media - reference or data ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Media.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
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
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
quality		0..*	(Complex)	Minimum requirements for qualities URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-quality
resolvedTiming		1..1	(Complex)	Resolved Timing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-resolved-timing
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) for the image
basedOn	Σ	1..1	Reference(ehealth-servicerequest) {r}	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.
type	Σ	0..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories.
modality	Σ	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	Σ	1..1	Reference(ehealth-patient | ehealth-practitioner | Group | ehealth-device | Specimen)	Who/What this Media is a record of
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with media
created[x]	Σ	1..1		When Media was collected
createdDateTime			dateTime
createdPeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
operator	Σ	0..1	Reference(ehealth-practitioner) {r}	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(ehealth-device | ehealth-devicemetric) {r}	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	Σ	1..1	Attachment	Actual Media - reference or data
note		0..*	Annotation	Comments made about the media
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for author[x]	Σ	0..1		Individual responsible for the annotation Slice: Unordered, Closed by type:$this
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
author[x]:authorReference	Σ	0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString	Σ	0..1	string	Individual responsible for the annotation
time	Σ	0..1	dateTime	When the annotation was made
text	Σ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Media.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Media.status	required	EventStatus 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.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types 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

Differential View

This structure is derived from Media

Name	Flags	Card.	Type	Description & Constraints
Media			Media
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
quality		0..*	(Complex)	Minimum requirements for qualities URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-quality
resolvedTiming		1..1	(Complex)	Resolved Timing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-resolved-timing
basedOn		1..1	Reference(ehealth-servicerequest) {r}	Procedure that caused this media to be created
subject		1..1	Reference(ehealth-patient | ehealth-practitioner | Group | ehealth-device | Specimen)	Who/What this Media is a record of
reference		1..1	string	Literal reference, Relative, internal or absolute URL
created[x]		1..1	dateTime, Period	When Media was collected
operator		0..1	Reference(ehealth-practitioner) {r}	The person who generated the image
device		0..1	Reference(ehealth-device | ehealth-devicemetric) {r}	Observing Device
note
Slices for author[x]		0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	Individual responsible for the annotation Slice: Unordered, Open by type:$this
author[x]:authorReference		0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString		0..1	string	Individual responsible for the annotation
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Media		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
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
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
quality		0..*	(Complex)	Minimum requirements for qualities URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-quality ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
resolvedTiming		1..1	(Complex)	Resolved Timing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-resolved-timing ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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
basedOn	Σ	1..1	Reference(ehealth-servicerequest) {r}	Procedure that caused this media to be created 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
subject	Σ	1..1	Reference(ehealth-patient | ehealth-practitioner | Group | ehealth-device | Specimen)	Who/What this Media is a record of ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
created[x]	Σ	1..1		When Media was collected ele-1: All FHIR elements must have a @value or children
createdDateTime			dateTime
createdPeriod			Period
operator	Σ	0..1	Reference(ehealth-practitioner) {r}	The person who generated the image ele-1: All FHIR elements must have a @value or children
device	Σ	0..1	Reference(ehealth-device | ehealth-devicemetric) {r}	Observing Device ele-1: All FHIR elements must have a @value or children
content	Σ	1..1	Attachment	Actual Media - reference or data ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Media.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
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
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
quality		0..*	(Complex)	Minimum requirements for qualities URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-quality
resolvedTiming		1..1	(Complex)	Resolved Timing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-resolved-timing
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) for the image
basedOn	Σ	1..1	Reference(ehealth-servicerequest) {r}	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.
type	Σ	0..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories.
modality	Σ	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	Σ	1..1	Reference(ehealth-patient | ehealth-practitioner | Group | ehealth-device | Specimen)	Who/What this Media is a record of
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with media
created[x]	Σ	1..1		When Media was collected
createdDateTime			dateTime
createdPeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
operator	Σ	0..1	Reference(ehealth-practitioner) {r}	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(ehealth-device | ehealth-devicemetric) {r}	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	Σ	1..1	Attachment	Actual Media - reference or data
note		0..*	Annotation	Comments made about the media
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for author[x]	Σ	0..1		Individual responsible for the annotation Slice: Unordered, Closed by type:$this
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
author[x]:authorReference	Σ	0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString	Σ	0..1	string	Individual responsible for the annotation
time	Σ	0..1	dateTime	When the annotation was made
text	Σ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Media.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Media.status	required	EventStatus 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.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types 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

This structure is derived from Media

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

• ehealth-servicerequest (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-servicerequest)
• ehealth-patient (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-patient)
• ehealth-practitioner (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-practitioner)
• ehealth-device (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-device)
• ehealth-devicemetric (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-devicemetric)
• ehealth-relatedperson (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-relatedperson)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-quality
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-resolved-timing

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Media.note.author[x]