HL7 Europe Imaging Report R5
1.0.0-beta - ci-build 150

HL7 Europe Imaging Report R5, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-beta built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/imaging-r5/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Requirements: Actor Definitions

The following artifacts define the types of individuals and/or systems that will interact as part of the use cases covered by this implementation guide.

ActorDefinition: Imaging Report Consumer

The actor responsible for consuming the Imaging Report resources.

ActorDefinition: Imaging Report Producer

The actor responsible for producing the Imaging Report resources.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

EEHRxF Imaging Report Document Access Provider CapabilityStatement

CapabilityStatement for the EEHRxF Imaging Report Document Access Provider actor. This composite actor provides access to EEHRxF FHIR Documents by serving them to Document Consumers via query APIs.

EEHRxF Imaging Report Document Consumer CapabilityStatement

CapabilityStatement for the EEHRxF Imaging Report Document Consumer actor. This composite actor consumes EEHRxF FHIR Imaging Report Documents by querying a Imaging Report Document Access Provider.

EEHRxF Imaging Report Resource Access Provider CapabilityStatement

CapabilityStatement for the EEHRxF Imaging Report Resource Access Provider actor. This actor serves clinical data resources following the International Patient Access (IPA) patterns and IHE QEDm Clinical Data Source capabilities.

EEHRxF Imaging Report Resource Consumer CapabilityStatement

CapabilityStatement for the EEHRxF Imaging Report Resource Consumer actor. This actor queries for clinical data resources following the International Patient Access (IPA) patterns and IHE QEDm Clinical Data Consumer capabilities.

Behavior: Operation Definitions

These are custom operations that can be supported by and/or invoked by systems conforming to this implementation guide.

OperationDefinition: $document on DiagnosticReport

OperationDefinition for creating a document Bundle based on a DiagnosticReport.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

AdverseEvent: Imaging Adverse Event

Adverse Event that occurred during an imaging procedure.

Bundle: Imaging Report

Document Bundle for Imaging Report

Bundle: Imaging Report Minimal Metadata

Collection Bundle with minimal metadata for imaging report exchange

Composition: Imaging Report

Clinical document used to represent a Imaging Report for the scope of the HL7 Europe project.

Device: Imaging Device

The device the made the image.

DiagnosticReport: Imaging Report

DiagnosticReport profile for Imaging Reports. This document represents the report of an imaging study. It is the anchor resource that refers to all structured data as well as the Composition resource that contains the narrative text of the report.
The structure of the modelled has been aligned with the DiagnosticResource as defined by IHE-RAD-HL7IDR. As this specification has not been published yet, the relevant extensions have been included in this specification.

DiagnosticReport: Imaging Report Minimal Metadata

DiagnosticReport profile for minimal metadata imaging report exchange. This profile shares all common imaging report modeling with DiagnosticReportEuImaging but does not require a matching Composition resource.

DocumentReference: Key Image

A document containing key images for a patient. It can refer to a DICOM or non-DICOM image. When referring to a DICOM image, the DocumentReference.content.attachment.url should be a WADO-URI. When referring to a non-DICOM image, the DocumentReference.content.attachment.url should be a direct URL to the image.

When the resource represents a DICOM instance it SHALL contain a the SOP Instance UID in the identifier element. When the resource represents a DICOM series it SHALL contain the Series Instance UID in the identifier element.

EEHRxF MHD DocumentReference Profile for Imaging Reports

Profile for DocumentReference resources used in the EEHRxF context, based on the IHE MHD Minimal DocumentReference profile. This profile is used for the DocumentReference resources that represent imaging reports in the EEHRxF context. It includes additional constraints and extensions specific to imaging reports, such as the type of report, the clinical specialty, the anatomical region of interest and the profile of the imaging report.

ImagingSelection: DICOM SR Instance

Imaging Selection referring to a DICOM SR instance

ImagingSelection: General

Imaging Selection

ImagingSelection: Key Image

Key images represented as an ImagingSelection

ImagingStudy: General

This profile represents an imaging study instance.

Observation: Gestational Age

Gestational Age Observation

Observation: Imaging Finding

Finding during imaging procedure.

Observation: Radiation Dose

A record for the radiation dose the subject has been exposed to during an imaging procedure. E.g. based on information from https://dicom.nema.org/medical/dicom/current/output/html/part16.html and https://build.fhir.org/ig/HL7/fhir-radiation-dose-summary-ig/index.html

Procedure: Imaging Acquisition

This profile on Procedure represents the imaging procedure. In this DICOM this is referred as the 'Performed Procedure Step' (PPS). This profile is used to capture metadata about the imaging procedure itself.

ServiceRequest: Imaging Order

This profile on ServiceRequest represents the order for the Imaging Study and report. In DICOM this is referred to as the Requested Procedure. The code element represents the requested imaging procedure type which includes the requested modality.

Structures: Data Type Profiles

These define constraints on FHIR data types for systems conforming to this implementation guide.

Identifier: Accession Number

This profile on Identifier represents the Accession Number for the Imaging Order.

Within a Hospital Information System environment, accession numbers will usually uniquely identify a manifest or report but are not required to always map 1:1 with a report or manifest due to certain imaging workflows. The imaging report may not be uniquely identified by accession number in an overread scenario (two radiologists reading a single imaging study). The manifest may not be uniquely identified by accession number in the case that the RIS imaging request (accession number assigner) requires two imaging modalities to perform the exam, and thus produces two image manifests.

In order to ensure uniqueness across Hospital Information Systems, accession numbers are required to have a system value that identifies the namespace for the issuing authority (ensuring their global uniqueness).

Identifier: SOP Instance UID

This profile on Identifier represents the SOP Instance UID (0008,0018) for the Imaging Order.

Identifier: Study Instance UID

This profile on Identifier represents the Study Instance UID (0020,000D) for the Imaging Order.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Extension: Anatomical Region

The anatomical region in an ImagingStudy instance. This is additional information next to ImagingStudy.series.bodySite.

Extension: HL7IDR Communication

Communications captures what communications have been made with other care providers

Extension: HL7IDR DiagnosticReport Comparison Study

Studies used for comparison in part of diagnostic reporting

Extension: HL7IDR Imaging Procedure

Imaging procedure used for the imaging acquisition and procedure specific information.

Extension: HL7IDR Impression

Impression in the imaging report

Extension: HL7IDR KeyImage Finding

KeyImage in the imaging report

Extension: HL7IDR Patient History

Patient history that are relevant for the report

Extension: HL7IDR Recommendation

Recommendations for any follow up actions

Extension: Instance Description

A description of the instance in an ImagingStudy.

Extension: Number of Frames

The number of frames in an ImagingStudy instance as required by Xt-EHR logical ImagingStudy logical model.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

ValueSet: Anatomical Region

A shortlist of anatomical regions that can be used for searching reports and manifests. When the MADO manifest is implemented, this ValueSet can be replaced with a reference to that ValueSet.

ValueSet: DiagnosticReport supportInfo codes

Codes to be used in DiagnosticReport.supportInfo for imaging reports.

ValueSet: Imaging Device Type

Imaging Device Type.

ValueSet: Imaging Procedure Type

This value set includes all imaging procedure types defined in SNOMED CT. The codes represent combinations of the modality to be used and the procedure to be performed.

ValueSet: Imaging Study Performer Type Value Set

Imaging Study series performer type codes, it extends on the base set defined in the FHIR specification.

ValueSet: Radiology Report Types

The set of radiology types as defined by LOINC.

ValueSet: Reasons a section in an imaging report is empty.

Reasons a section in an imaging report is empty.

ValueSet: Section codes used to label annotations.

These codes define what an annotation annotates.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

ValueSet: Diagnostic Report Support Info Code System

Code system for codes to be used in DiagnosticReport.supportInfo for imaging reports.

ValueSet: Missing DICOM Terminology

Code system for codes that are defined in DICOM but for which no matching code system is available in FHIR.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Bundle: Imaging Report minimal metadata (unstructured example)

Minimal metadata bundle carrying the report anchor and context resources.

Bundle: Imaging Report semi-structured

Document bundle grouping resources in the semi-structured example.

Bundle: Imaging Report structured

Document bundle grouping resources in the structured example.

Composition: semi-structured

Example of a CompositionEuImaging showing the report for the left/right foot study

Composition: structured report

Example of a CompositionEuImaging showing the report with structured data.

DiagnosticReport: semi-structured report

Example of a DiagnosticReportEuImaging showing the report for the left/right foot study

DiagnosticReport: structured report

Example of a DiagnosticReportEuImaging showing the report for a stress echo

DiagnosticReport: unstructured minimal metadata

Minimal metadata DiagnosticReport compliant with DiagnosticReportEuImaging profile.

DocumentReference: Renderable format semi-structured

MHD DocumentReference for semi-structured report.

DocumentReference: Renderable format structured

MHD DocumentReference for structured report.

DocumentReference: Renderable format with basic metadata

MHD DocumentReference for unstructured report.

DocumentReference: key image rest

Key image showing the ultrasound at rest.

DocumentReference: key image stress

Key image showing the ultrasound during stress.

DocumentReference: structured report WMSI image

Shows the WMSI graphs.

ImagingStudy: semi-structured report 1

Example ImagingStudy showing an MRI for the left foot

ImagingStudy: semi-structured report 2

Example ImagingStudy showing an MRI for the right foot

ImagingStudy: structured-report study

Transthoracic echocardiogram for 3D TEE 2D

Observation: WMSI apex at rest - normal

WMSI measurement.

Observation: WMSI apex under stress - normal

WMSI measurement.

Observation: WMSI apical anterior at rest - normal

WMSI measurement.

Observation: WMSI apical anterior under stress - normal

WMSI measurement.

Observation: WMSI apical inferior at rest - normal

WMSI measurement.

Observation: WMSI apical inferior under stress - normal

WMSI measurement.

Observation: WMSI apical lateral at rest - normal

WMSI measurement.

Observation: WMSI apical lateral under stress - normal

WMSI measurement.

Observation: WMSI apical septum at rest - normal

WMSI measurement.

Observation: WMSI apical septum under stress - normal

WMSI measurement.

Observation: WMSI basal anterior at rest - hypokinetic

WMSI measurement.

Observation: WMSI basal anterior lateral at rest - normal

WMSI measurement.

Observation: WMSI basal anterior lateral under stress - normal

WMSI measurement.

Observation: WMSI basal anterior septum at rest - normal

WMSI measurement.

Observation: WMSI basal anterior septum under stress - normal

WMSI measurement.

Observation: WMSI basal anterior under stress - hypokinetic

WMSI measurement.

Observation: WMSI basal inferior at rest - normal

WMSI measurement.

Observation: WMSI basal inferior lateral at rest - hypokinetic

WMSI measurement.

Observation: WMSI basal inferior lateral under stress - mildly hypokinetic

WMSI measurement.

Observation: WMSI basal inferior septum at rest - normal

WMSI measurement.

Observation: WMSI basal inferior septum under stress - normal

WMSI measurement.

Observation: WMSI basal inferior under stress - normal

WMSI measurement.

Observation: WMSI mid anterior at rest - normal

WMSI measurement.

Observation: WMSI mid anterior lateral at rest - normal

WMSI measurement.

Observation: WMSI mid anterior lateral under stress - normal

WMSI measurement.

Observation: WMSI mid anterior septum at rest - normal

WMSI measurement.

Observation: WMSI mid anterior septum under stress - normal

WMSI measurement.

Observation: WMSI mid anterior under stress - normal

WMSI measurement.

Observation: WMSI mid inferior at rest - normal

WMSI measurement.

Observation: WMSI mid inferior lateral at rest - normal

WMSI measurement.

Observation: WMSI mid inferior lateral under stress - normal

WMSI measurement.

Observation: WMSI mid inferior septum at rest - normal

WMSI measurement.

Observation: WMSI mid inferior septum under stress - normal

WMSI measurement.

Observation: WMSI mid inferior under stress - normal

WMSI measurement.

Observation: patient blood pressure

Patient blood pressure in echo report history section

Observation: patient heart rate

Patient height in echo report history section

Observation: patient height

Patient height in echo report history section

Observation: patient weight

Patient weight in echo report history section

Organization: semi-structured

The organization employing the report author.

Organization: structured report

Organization of the report author.

Organization: unstructured report

Organization used in the unstructured report

Patient: semi-structured report

The patient in the semi-structured report

Patient: structured report

Patient used in the structured report example

Patient: unstructured report

Patient used in the unstructured report

Practitioner: semi-structured report.

The author details

Practitioner: structured report

The report author.

PractitionerRole: semi-structured

The role the author has in the organization.

PractitionerRole: structured report

Role of the report author.

ServiceRequest: structured report recommendation

Order to come back next year

Other

These are resources that are used within this implementation guide that do not fit into one of the other categories.

BinarySemistructuredReport
BinaryStructuredReport
BinaryUnstructuredReport