HL7 Europe Imaging Report R4
1.0.0-ballot - ci-build 150

HL7 Europe Imaging Report R4, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/imaging-r4/ and changes regularly. See the Directory of published versions

Mapping to EHDS Logical Model profiles

STU note: These mapping tables are based on version 1.0.0 of the Xt-EHR logical model. They will be reviewed and updated, where needed, when the revised EHDS implementing-act requirements (including relevant Art. 15 details) are published and finalized.

The following tables describe the way the Xt-EHR logical model has been mapped onto the FHIR profiles defined in this specification.

For orientation, the upstream Xt-EHR logical models for medical imaging are described in the Xt-EHR common IG model overview.

XtEHR Release Reference: This mapping is based on the Xt-EHR logical models release 1.0.0. These models are expected to continue evolving and, as part of the EU comitology process, it is likely that changes will be made; such changes are to be published in the implementing acts related to article 15 of the EHDS Regulation. When updated models are published, the changes will be progressively incorporated into this Implementation Guide to maintain alignment with the EHDS Implementing Acts.

Key element cardinalities

The table below summarises the cardinalities of the main top-level elements of the EHDSImagingReport logical model, to help readers orient without navigating to the formal profile pages.

Element Cardinality Description
header 1..1 Imaging report header
header.legalAuthentication 0..* Document legal authentication details
header.attestation 0..* Document attestation details
body 0..1 Imaging report structured body
body.orderInformation 0..* Order information
body.comparisonStudy 0..* Prior imaging report reference
body.examinationReport 1..1 Examination report content
dicomStudyMetadata 0..* DICOM study metadata
presentedForm 0..* Narrative / rendered form
attachments 0..* Report attachments

Core models of the Imaging Report IG

EHDSImagingReport

The following table shows the mapping from EHDSImagingReport logical model elements to FHIR profiles.

Mapping Context
EHDSImagingReport → FHIR Profiles (R4)
EHDSImagingReport (Logical Model) Relationship Target FHIR Resource
Element Relation Resource Element Notes
header N/A
header.subject equivalent CompositionEuImaging subject
header.subject equivalent DiagnosticReportEuImaging subject
header.identifier equivalent CompositionEuImaging identifier
header.identifier equivalent DiagnosticReportEuImaging identifier
header.author[EHDSHealthProfessional] equivalent CompositionEuImaging author[author]
header.author[EHDSHealthProfessional] equivalent CompositionEuImaging author[organization]
header.author[EHDSOrganisation] equivalent DiagnosticReportEuImaging performer[organization]
header.author[EHDSDevice] equivalent DiagnosticReportEuImaging resultsInterpreter[author]
header.date equivalent CompositionEuImaging date
header.date equivalent DiagnosticReportEuImaging issued
header.status equivalent CompositionEuImaging status
header.status equivalent DiagnosticReportEuImaging status
header.source N/A
header.language equivalent CompositionEuImaging language
header.language equivalent DiagnosticReportEuImaging language
header.documentType equivalent CompositionEuImaging category[diagnostic-service]
header.documentTitle equivalent CompositionEuImaging title
header.period equivalent CompositionEuImaging event.period
header.period equivalent DiagnosticReportEuImaging effectivePeriod
header.version equivalent CompositionEuImaging extension[version]
header.version equivalent DiagnosticReportEuImaging extension[artifactVersion]
header.attestation CompositionEuImaging attester[resultValidator]
header.attestation.attester[EHDSHealthProfessional] equivalent CompositionEuImaging attester[resultValidator].party
header.attestation.attester[EHDSDevice] equivalent CompositionEuImaging attester[resultValidator].party
header.attestation.datetime equivalent CompositionEuImaging attester[resultValidator].time
header.legalAuthentication CompositionEuImaging attester[legalAuthenticator]
header.legalAuthentication.legalAuthenticator[EHDSHealthProfessional] equivalent CompositionEuImaging attester[legalAuthenticator].party
header.legalAuthentication.legalAuthenticator[EHDSOrganisation] equivalent CompositionEuImaging attester[legalAuthenticator].party
header.legalAuthentication.datetime equivalent CompositionEuImaging attester[legalAuthenticator].time
header.eventType source-is-broader-than-target CompositionEuImaging category[diagnostic-service]
header.eventType source-is-broader-than-target ProcedureEuImaging code
header.eventType source-is-broader-than-target ImagingStudyEuImaging series.modality
header.eventType source-is-broader-than-target ImagingStudyEuImaging modality
header.serviceSpecialty equivalent DiagnosticReportEuImaging category[diagnostic-service]
header.serviceSpecialty equivalent DiagnosticReportEuImaging category[diagnostic-service]
header.custodian equivalent CompositionEuImaging custodian
presentedForm equivalent DiagnosticReportEuImaging presentedForm
presentedForm equivalent CompositionEuImaging text For all the resources that don't have a .presentedForm element, the .text is the default element to map this requirement.
header.accessionNumber equivalent ServiceRequestOrderEuImaging identifier[accessionNumber]
header.intendedRecipient[EHDSPatient] equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[EHDSRelatedPerson] equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[EHDSHealthProfessional] equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[EHDSOrganisation] equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[EHDSDevice] equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[EHDSPatient] equivalent CompositionEuImaging extension[informationRecipient]
body N/A
body.orderInformation equivalent CompositionEuImaging section[order]
body.orderInformation.orderId equivalent CompositionEuImaging extension[basedOn]
body.orderInformation.orderId equivalent DiagnosticReportEuImaging basedOn[ServiceRequestOrderEuImagingaccession]
body.orderInformation.orderDateAndTime equivalent ServiceRequestOrderEuImaging authoredOn
body.orderInformation.orderPlacer[EHDSHealthProfessional] equivalent ServiceRequestOrderEuImaging requester
body.orderInformation.orderReason[CodeableConcept] equivalent ServiceRequestOrderEuImaging extension[reason].extension[concept].valueCodeableConcept
body.orderInformation.orderReason[EHDSCondition]
body.orderInformation.orderReason[EHDSObservation]
body.orderInformation.orderReason[string]
body.orderInformation.clinicalQuestion source-is-narrower-than-target ServiceRequestOrderEuImaging extension[reason].extension[concept].valueCodeableConcept Order reason and clinical question map to the same element by design choice
body.supportingInformation N/A
body.supportingInformation.observation source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.observation DiagnosticReportEuImaging extension[patientHistory]
body.supportingInformation.condition source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.condition DiagnosticReportEuImaging extension[patientHistory]
body.supportingInformation.priorMedicationAdministration source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.priorMedicationAdministration DiagnosticReportEuImaging extension[patientHistory]
body.supportingInformation.device source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.device DiagnosticReportEuImaging extension[patientHistory]
body.supportingInformation.pregnancyStatus source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.pregnancyStatus DiagnosticReportEuImaging extension[patientHistory]
body.supportingInformation.sexForClinicalUse equivalent
body.specimen equivalent ImagingStudyEuImaging series.specimen
body.exposureInformation equivalent DiagnosticReportEuImaging extension[procedure] Comments in this issue https://github.com/Xt-EHR/xt-ehr-common/issues/365
body.exposureInformation equivalent CompositionEuImaging section[procedure].entry[radiation-dose] Comments in this issue https://github.com/Xt-EHR/xt-ehr-common/issues/365
body.exposureInformation equivalent ObservationRadiationDoseEuImaging value[x] Comments in this issue https://github.com/Xt-EHR/xt-ehr-common/issues/365
body.examinationReport N/A
body.examinationReport.modality equivalent ImagingStudyEuImaging series.modality
body.examinationReport.bodySite equivalent ImagingStudyEuImaging series.bodySite
body.examinationReport.imagingProcedures equivalent CompositionEuImaging section[procedure].entry[procedure]
body.examinationReport.imagingProcedures equivalent DiagnosticReportEuImaging extension[procedure]
body.examinationReport.medicationAdministration equivalent MedicationAdministration partOf
body.examinationReport.adverseReaction equivalent AdverseEventEuImaging
body.examinationReport.adverseReaction equivalent CompositionEuImaging section[procedure].entry[adverse-event]
body.examinationReport.results[EHDSObservation] equivalent CompositionEuImaging section[findings].entry[finding]
body.examinationReport.results[string] equivalent ObservationNarrativeReport value[x]
body.examinationReport.results[string] equivalent CompositionEuImaging section[report].entry[narrative-report]
body.examinationReport.results[string] equivalent CompositionEuImaging section[findings].entry[finding]
body.examinationReport.results[string] equivalent DiagnosticReportEuImaging result
body.examinationReport.conclusion N/A
body.examinationReport.conclusion.impression equivalent CompositionEuImaging section[impression].text
body.examinationReport.conclusion.impression equivalent DiagnosticReportEuImaging result
body.examinationReport.conclusion.conditionOrFinding[EHDSCondition] equivalent CompositionEuImaging section[impression].entry[impression]
body.examinationReport.conclusion.conditionOrFinding[EHDSCondition] equivalent DiagnosticReportEuImaging extension[impression]
body.examinationReport.conclusion.conditionOrFinding[EHDSObservation] equivalent CompositionEuImaging section[impression].entry[finding]
body.examinationReport.conclusion.conditionOrFinding[EHDSObservation] equivalent DiagnosticReportEuImaging .extension[impression]
body.recommendation equivalent CompositionEuImaging section[recommendation]
body.recommendation equivalent DiagnosticReportEuImaging extension[recommendation]
body.recommendation.description equivalent CarePlan description
body.recommendation.carePlan equivalent CompositionEuImaging section[recommendation].entry[suggestion]
body.comparisonStudy equivalent CompositionEuImaging section[comparison].entry[comparedstudy]
body.comparisonStudy equivalent DiagnosticReportEuImaging extension[comparison]
dicomStudyMetadata equivalent ImagingStudyEuImaging
attachments equivalent DiagnosticReportEuImaging media

EHDSImagingStudy

The following table shows the mapping from EHDSImagingStudy logical model elements to FHIR profiles.

Mapping Context
EHDSImagingStudy → FHIR Profiles (R4)
EHDSImagingStudy (Logical Model) Relationship Target FHIR Resource
Element Relation Resource Element Notes
header N/A
header.subject equivalent ImagingStudyEuImaging subject
header.identifier equivalent ImagingStudyEuImaging identifier[studyInstanceUid]
header.author[EHDSHealthProfessional] equivalent ImagingStudyEuImaging series.performer[performer]
header.author[EHDSOrganisation] ImagingStudyEuImaging series.performer[organization]
header.author[EHDSDevice] equivalent ImagingStudyEuImaging series.performer[device]
header.date equivalent ImagingStudyEuImaging started No core element to map the issuing of the Study. An extension might be needed to be defined as part of the Imaging-manifest IG
header.status equivalent ImagingStudyEuImaging status
header.source
header.language equivalent ImagingStudyEuImaging language
modality equivalent ImagingStudyEuImaging series.modality
bodySite equivalent ImagingStudyEuImaging series.bodySite
encounter equivalent ImagingStudyEuImaging encounter
started equivalent ImagingStudyEuImaging started
basedOn equivalent ImagingStudyEuImaging basedOn
numberOfSeries equivalent ImagingStudyEuImaging numberOfSeries
numberOfInstances equivalent ImagingStudyEuImaging numberOfInstances
description equivalent ImagingStudyEuImaging description
studyCustodian equivalent ImagingStudyEuImaging series.performer[custodian]
studyEndpoint equivalent ImagingStudyEuImaging endpoint
series equivalent ImagingStudyEuImaging series
series.seriesUid equivalent ImagingStudyEuImaging series.uid
series.number equivalent ImagingStudyEuImaging series.number
series.seriesModality equivalent ImagingStudyEuImaging series.modality
series.description equivalent ImagingStudyEuImaging series.description
series.numberOfInstances equivalent ImagingStudyEuImaging series.numberOfInstances
series.seriesEndpoint equivalent ImagingStudyEuImaging series.endpoint
series.bodySite equivalent ImagingStudyEuImaging series.bodySite
series.specimen equivalent ImagingStudyEuImaging series.specimen
series.started equivalent ImagingStudyEuImaging series.started
series.instancesInTheSeries equivalent ImagingStudyEuImaging series.instance
series.instancesInTheSeries.instanceTitle equivalent ImagingStudyEuImaging series.instance.extension[instance-description]
series.instancesInTheSeries.instanceUid equivalent ImagingStudyEuImaging series.instance.uid
series.instancesInTheSeries.sopClass equivalent ImagingStudyEuImaging series.instance.sopClass
series.instancesInTheSeries.instanceNumber equivalent ImagingStudyEuImaging series.instance.number
series.instancesInTheSeries.numberOfFrames equivalent ImagingStudyEuImaging series.instance.extension[number-of-frames]
series.instancesInTheSeries.keyImage
series.instancesInTheSeries.keyImage.flag
series.instancesInTheSeries.keyImage.reason
series.instancesInTheSeries.keyImage.seriesUID
series.instancesInTheSeries.keyImage.instanceUID

Other logical models that are used by this IG

The following logical models describe data that is used in the context of this IG, but the mapping will be defined by another higher level IG, because they are common to many domains:

The mapping of these common models to FHIR is defined in the HL7 Europe Base / core guide, following the same approach used by other EHDS specifications (e.g. the Patient Summary and Hospital Discharge Report guides).

Models not included in this IG

The following logical models describe data that is not used in the context of this Imaging Report IG: