HL7 Europe Imaging Report R5
0.2.1-ballot - 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 0.2.1-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/ehdsimaging-r5/ and changes regularly. See the Directory of published versions

Xt-EHR mapping

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

Core models of the Imaging Report IG

EHDSImagingReport

Ongoing alignment: The Xt-EHR logical models are under active revision and continuous refinement. Updates from Xt-EHR will be progressively incorporated into this Implementation Guide to maintain alignment with the evolving EHDS specifications.

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

Mapping Context
EHDSImagingReport → FHIR Profiles (R5)
EHDSImagingReport (Logical Model) Relationship Target FHIR Resource
Element Description Relation Resource Element Notes
header Basic metadata for this information N/A
header.subject Patient/subject information equivalent CompositionEuImaging subject
header.subject Patient/subject information equivalent DiagnosticReportEuImaging subject
header.identifier Business identifier for the object, unique within its system. Supporting disambiguation between different contexts (systems/countries). equivalent CompositionEuImaging identifier
header.identifier Business identifier for the object, unique within its system. Supporting disambiguation between different contexts (systems/countries). equivalent DiagnosticReportEuImaging identifier
header.author[x] The author of the report. equivalent CompositionEuImaging author[author]
header.author[x] The author of the report. equivalent DiagnosticReportEuImaging resultsInterpreter[author]
header.author[x] The author of the report. equivalent DiagnosticReportEuImaging performer[organization]
header.author[x] The author of the report. equivalent DiagnosticReportEuImaging resultsInterpreter[author]
header.date Date and optionally time of authoring/issuing equivalent CompositionEuImaging date
header.date Date and optionally time of authoring/issuing equivalent DiagnosticReportEuImaging issued
header.status Status of the report equivalent CompositionEuImaging status
header.status Status of the report equivalent DiagnosticReportEuImaging status
header.source Source of information (e.g. patient, patient's proxy). Used in case the patient has authored the information or the author has submitted patient-stated information. N/A
header.language Language in which the resource is written. Language is expressed by the IETF language tag. equivalent CompositionEuImaging language
header.language Language in which the resource is written. Language is expressed by the IETF language tag. equivalent DiagnosticReportEuImaging language
header.documentType Type of document (e.g. 18748-4 Diagnostic imaging study) equivalent CompositionEuImaging category
header.documentTitle Human readable document title that can be displayed in search results, etc. This can be documentType's display name, or it can be assembled from multiple elements. Examples: 'Laboratory Result Report', 'Patient Summary of Jane Green 10.12.2024' equivalent CompositionEuImaging title
header.period Time of service that is being documented equivalent CompositionEuImaging event.period
header.period Time of service that is being documented equivalent DiagnosticReportEuImaging effectivePeriod
header.version Business version of the document. The exact algorithm for versioning is decided by the producer/custodian equivalent CompositionEuImaging version
header.version Business version of the document. The exact algorithm for versioning is decided by the producer/custodian equivalent DiagnosticReportEuImaging extension[artifactVersion]
header.attestation Document attestation details CompositionEuImaging attester[resultValidator]
header.attestation.attester[x] Attester who validated the document equivalent CompositionEuImaging attester[resultValidator].party
header.attestation.attester[x] Attester who validated the document equivalent CompositionEuImaging attester[resultValidator].party.extension[deviceAttester]
header.attestation.datetime Date and time of the approval of the document by Attester equivalent CompositionEuImaging attester[resultValidator].time
header.legalAuthentication Document legal authentication details CompositionEuImaging attester[legalAuthenticator]
header.legalAuthentication.legalAuthenticator[x] The person or organisation taking responsibility for the medical content of the document (typically the person who signs it) equivalent attester[legalAuthenticator].party
header.legalAuthentication.legalAuthenticator[x] The person or organisation taking responsibility for the medical content of the document (typically the person who signs it) equivalent attester[legalAuthenticator].party
header.legalAuthentication.datetime Date and time when the document was authorised equivalent CompositionEuImaging attester[legalAuthenticator].time
header.eventType Categorisation of the event covered by the document (e.g. imaging study types, body regions, modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. source-is-broader-than-target CompositionEuImaging category[diagnostic-service]
header.eventType Categorisation of the event covered by the document (e.g. imaging study types, body regions, modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. source-is-broader-than-target ProcedureEuImaging code
header.eventType Categorisation of the event covered by the document (e.g. imaging study types, body regions, modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. source-is-broader-than-target ImagingStudyEuImaging series.modality
header.eventType Categorisation of the event covered by the document (e.g. imaging study types, body regions, modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. source-is-broader-than-target ImagingStudyEuImaging modality
header.serviceSpecialty Additional details about where the content was created (e.g. clinical specialty) equivalent DiagnosticReportEuImaging category[diagnostic-service]
header.serviceSpecialty Additional details about where the content was created (e.g. clinical specialty) equivalent CompositionEuImaging category[diagnostic-service]
header.custodian Organisation that is in charge of maintaining the document/report. equivalent CompositionEuImaging custodian
presentedForm A narrative easy-to-read representation of the full data set, e.g. PDF-version of a document equivalent DiagnosticReportEuImaging presentedForm
presentedForm A narrative easy-to-read representation of the full data set, e.g. PDF-version of a document 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 Accession number - an identifier, managed by the RIS at the local level, which usually uniquely identifies an imaging procedure request, and links it to imaging study(ies) and related imaging report(s). equivalent ServiceRequestOrderEuImaging identifier[accessionNumber]
header.intendedRecipient[x] Information recipient (intended recipient or recipients of the report, additional recipients might be identified by the ordering party, e.g. GP, other specialist), if applicable equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[x] Information recipient (intended recipient or recipients of the report, additional recipients might be identified by the ordering party, e.g. GP, other specialist), if applicable equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[x] Information recipient (intended recipient or recipients of the report, additional recipients might be identified by the ordering party, e.g. GP, other specialist), if applicable equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[x] Information recipient (intended recipient or recipients of the report, additional recipients might be identified by the ordering party, e.g. GP, other specialist), if applicable equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[x] Information recipient (intended recipient or recipients of the report, additional recipients might be identified by the ordering party, e.g. GP, other specialist), if applicable equivalent CompositionEuImaging extension[informationRecipient]
header.intendedRecipient[x] Information recipient (intended recipient or recipients of the report, additional recipients might be identified by the ordering party, e.g. GP, other specialist), if applicable equivalent DiagnosticReportEuImaging extension[informationRecipient]
body Imaging report structured body N/A
body.orderInformation Order Information (Imaging Result Report could respond to multiple orders). equivalent CompositionEuImaging section[order]
body.orderInformation.orderId Identifier(s) of the imaging service order. equivalent CompositionEuImaging extension[basedOn]
body.orderInformation.orderId Identifier(s) of the imaging service order. equivalent DiagnosticReportEuImaging basedOn[ServiceRequestOrderEuImagingaccession]
body.orderInformation.orderDateAndTime Date and time of the order placement. equivalent ServiceRequestOrderEuImaging authoredOn
body.orderInformation.orderPlacer[x] The person/organisation authorised to place the order. Order placer could be either a health professional, health professional organisation or the patient himself. equivalent ServiceRequestOrderEuImaging requester
body.orderInformation.orderReason[x] An explanation or justification for why this service is being requested. equivalent ServiceRequestOrderEuImaging reason.concept
body.orderInformation.orderReason[x] An explanation or justification for why this service is being requested.
body.orderInformation.orderReason[x] An explanation or justification for why this service is being requested.
body.orderInformation.orderReason[x] An explanation or justification for why this service is being requested.
body.orderInformation.clinicalQuestion Specification of clinical question (goal of the investigation) to be answered by the imaging investigation. source-is-narrower-than-target ServiceRequestOrderEuImaging reason.concept Order reason and clinical question map to the same element by design choice
body.supportingInformation This information includes diagnosis, clinical findings and other observations. This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the metal implants present in patient's body. N/A
body.supportingInformation.observation Clinical findings and other observations (e.g., height and weights of the patient). source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.condition Conditions that may influence the service or result interpretation. source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.priorMedicationAdministration Medication administered before ordering the service specifically for this procedure. source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.device List of implants or devices that affect the course of the examination or its interpretation (e.g. metal implants). source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.pregnancyStatus Pregnancy status when the imaging examination was performed (e.g., pregnant, not pregnant, unknown). source-is-narrower-than-target CompositionEuImaging section[history].entry
body.supportingInformation.sexForClinicalUse Sex parameter for clinical use - provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc. This property is intended for use in clinical decision making, and indicates that treatment or diagnostic tests should consider best practices associated with the relevant reference population. equivalent EuPatient extension[sex-for-clinical-use]
body.specimen Specimen information. Note: A specimen (not attached to a body) can be used for diagnostic, forensic and medical research purposes. equivalent ImagingStudyEuImaging series.specimen
body.exposureInformation Information on total exposure to ionising radiation. This information is required by regulations in several EU countries. equivalent DiagnosticReportEuImaging extension[radiationDose] Comments in this issue https://github.com/Xt-EHR/xt-ehr-common/issues/365
body.exposureInformation Information on total exposure to ionising radiation. This information is required by regulations in several EU countries. equivalent CompositionEuImaging section[procedure].extension[radiationDose] Comments in this issue https://github.com/Xt-EHR/xt-ehr-common/issues/365
body.exposureInformation Information on total exposure to ionising radiation. This information is required by regulations in several EU countries. equivalent ObservationRadiationDoseEuImaging value[x] Comments in this issue https://github.com/Xt-EHR/xt-ehr-common/issues/365
body.examinationReport Examination report content. N/A
body.examinationReport.modality Imaging modality (or modalities) used during imaging investigation (DICOM CID029). equivalent ImagingStudyEuImaging series.modality
body.examinationReport.bodySite All body parts investigated equivalent ImagingStudyEuImaging series.bodySite
body.examinationReport.imagingProcedures Imaging procedure performed during imaging study. equivalent CompositionEuImaging section[procedure].entry[procedure]
body.examinationReport.imagingProcedures Imaging procedure performed during imaging study. equivalent DiagnosticReportEuImaging extension[procedure]
body.examinationReport.medicationAdministration Information about medications administered (contrast, sedation, stress agents, etc) during the procedure. equivalent EuMedicationAdministration
body.examinationReport.adverseReaction Adverse reactions manifested during imaging investigation. equivalent AdverseEventEuImaging
body.examinationReport.adverseReaction Adverse reactions manifested during imaging investigation. equivalent CompositionEuImaging section[procedure].entry[adverse-event]
body.examinationReport.results[x] Imaging report result data (report could consist of multiple observations) TN ObservationFindingEuImaging
body.examinationReport.results[x] Imaging report result data (report could consist of multiple observations) equivalent CompositionEuImaging section[findings].extension[note]
body.examinationReport.results[x] Imaging report result data (report could consist of multiple observations) equivalent DiagnosticReportEuImaging note
body.examinationReport.conclusion A concise and clinically contextualised summary including interpretation/impression of the diagnostic report. N/A
body.examinationReport.conclusion.impression Narrative description of the clinical conclusion (impression). equivalent CompositionEuImaging section[impression].extension[note]
body.examinationReport.conclusion.impression Narrative description of the clinical conclusion (impression). equivalent DiagnosticReportEuImaging note
body.examinationReport.conclusion.conditionOrFinding[x] Condition or finding from imaging investigation. equivalent CompositionEuImaging section[impression].entry[impression]
body.examinationReport.conclusion.conditionOrFinding[x] Condition or finding from imaging investigation. equivalent DiagnosticReportEuImaging extension[impression]
body.examinationReport.conclusion.conditionOrFinding[x] Condition or finding from imaging investigation. equivalent CompositionEuImaging section[impression].entry[finding]
body.examinationReport.conclusion.conditionOrFinding[x] Condition or finding from imaging investigation. equivalent DiagnosticReportEuImaging extension[impression]
body.recommendation Recommendation section for additional imaging tests or other actions equivalent CompositionEuImaging section[recommendation]
body.recommendation Recommendation section for additional imaging tests or other actions equivalent DiagnosticReportEuImaging extension[recommendation]
body.recommendation.description Narrative description of the recommended activities including additional test, medication etc. equivalent EuCarePlan description
body.recommendation.carePlan A complex and structured information about recommended goals, activities and objectives in the form of one or more formal care plan. equivalent CompositionEuImaging section[recommendation].entry[suggestion]
body.comparisonStudy Documentation (reference) of a prior Imaging Report to which the current images were compared. equivalent CompositionEuImaging section[comparison].entry[comparedstudy]
body.comparisonStudy Documentation (reference) of a prior Imaging Report to which the current images were compared. equivalent DiagnosticReportEuImaging extension[comparison]
dicomStudyMetadata Metadata of the DICOM study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities. equivalent ImagingStudyEuImaging
attachments Report attachments equivalent DiagnosticReportEuImaging media
attachments Report attachments equivalent ObservationFindingEuImaging derivedFrom

EHDSImagingStudy

Ongoing alignment: The Xt-EHR logical models are under active revision and continuous refinement. Updates from Xt-EHR will be progressively incorporated into this Implementation Guide to maintain alignment with the evolving EHDS specifications.

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

Mapping Context
EHDSImagingStudy → FHIR Profiles (R5)
EHDSImagingStudy (Logical Model) Relationship Target FHIR Resource
Element Description Relation Resource Element Notes
header Basic metadata for this information N/A
header.subject Patient/subject information equivalent ImagingStudyEuImaging subject
header.identifier Business identifier for the object, unique within its system. Supporting disambiguation between different contexts (systems/countries). equivalent ImagingStudyEuImaging identifier[studyInstanceUid]
header.author[x] Author(s) responsible for the provided information. The exact role of the responsible author varies across use cases and is specific to individual models. equivalent ImagingStudyEuImaging series.performer[performer]
header.author[x] Author(s) responsible for the provided information. The exact role of the responsible author varies across use cases and is specific to individual models. ImagingStudyEuImaging series.performer[organization]
header.author[x] Author(s) responsible for the provided information. The exact role of the responsible author varies across use cases and is specific to individual models. equivalent ImagingStudyEuImaging series.performer[device]
header.date Date and optionally time of authoring/issuing 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 Status of the resource or document equivalent ImagingStudyEuImaging status
header.source Source of information (e.g. patient, patient's proxy). Used in case the patient has authored the information or the author has submitted patient-stated information.
header.language Language in which the resource is written. Language is expressed by the IETF language tag. equivalent ImagingStudyEuImaging language
modality All of the distinct values for series' modalities equivalent ImagingStudyEuImaging series.modality
bodySite All of the distinct values for series' examined body parts. equivalent ImagingStudyEuImaging series.bodySite
encounter Reference to the encounter with which this imaging study is associated equivalent ImagingStudyEuImaging encounter
started Date and time the study started. equivalent ImagingStudyEuImaging started
basedOn References to the diagnostic requests that resulted in this imaging study being performed. equivalent ImagingStudyEuImaging basedOn
numberOfSeries Number of series in the study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present. equivalent ImagingStudyEuImaging numberOfSeries
numberOfInstances Number of service-object pair (SOP) instances in the study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. equivalent ImagingStudyEuImaging numberOfInstances
description The imaging manager description of the study. Institution-generated description or classification of the study (component) performed. equivalent ImagingStudyEuImaging description
studyCustodian Organisation name, address, contact information. equivalent ImagingStudyEuImaging series.performer[custodian]
studyEndpoint Study endpoint describing the technical details of a location that can be connected to for the delivery/retrieval of information. Sufficient information is required to ensure that a connection can be made securely, and appropriate data transmitted as defined by the endpoint owner. These may be locally hosted services, regional services, or national service. equivalent ImagingStudyEuImaging endpoint
series Series. Each study has one or more series of instances, but they may be absent when no series information needs to be conveyed equivalent ImagingStudyEuImaging series
series.seriesUid DICOM Series Instance UID for the series equivalent ImagingStudyEuImaging series.uid
series.number Numeric identifier of this series equivalent ImagingStudyEuImaging series.number
series.seriesModality Acquisition modality - the modality used for this series equivalent ImagingStudyEuImaging series.modality
series.description A short human readable summary of the series equivalent ImagingStudyEuImaging series.description
series.numberOfInstances Number of series related instances equivalent ImagingStudyEuImaging series.numberOfInstances
series.seriesEndpoint Series endpoint describing the technical details of a location that can be connected to for the delivery/retrieval of information. Sufficient information is required to ensure that a connection can be made securely, and appropriate data transmitted as defined by the endpoint owner. These may be locally hosted services, regional services, or national service. equivalent ImagingStudyEuImaging series.endpoint
series.bodySite Body part (with laterality) examined equivalent ImagingStudyEuImaging series.bodySite
series.specimen Specimen imaged equivalent ImagingStudyEuImaging series.specimen
series.started When the series started equivalent ImagingStudyEuImaging series.started
series.instancesInTheSeries Each series has one or more instances, but they may be absent when no instance information needs to be conveyed equivalent ImagingStudyEuImaging series.instance
series.instancesInTheSeries.instanceTitle Instance title that is the description of the instance. equivalent ImagingStudyEuImaging series.instance.extension[instance-description]
series.instancesInTheSeries.instanceUid DICOM SOP Instance UID equivalent ImagingStudyEuImaging series.instance.uid
series.instancesInTheSeries.sopClass SOP class - DICOM class type equivalent ImagingStudyEuImaging series.instance.sopClass
series.instancesInTheSeries.instanceNumber The number of this instance in the series equivalent ImagingStudyEuImaging series.instance.number
series.instancesInTheSeries.numberOfFrames The number of frames in a multiframe instance equivalent ImagingStudyEuImaging series.instance.extension[number-of-frames]
series.instancesInTheSeries.keyImage List of key image flags with a reason why this image is selected as a key image, and reference to the Key Image Note that flags the image as significant within the Imaging Study Manifest
series.instancesInTheSeries.keyImage.flag Reason for flagging the image as significant
series.instancesInTheSeries.keyImage.reason Textual reason for flagging the image as significant
series.instancesInTheSeries.keyImage.seriesUID Series instance UID for the series that contains the instances flagged as significant
series.instancesInTheSeries.keyImage.instanceUID SOP Instance UID for the instances flagged as significant by the Key Image Note object (DICOM KOS) that flags this image

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:

Models not included in this IG

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