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Resource ExampleScenario/FHIR Server from package nhs.england.rad#current (79 ms)

Package nhs.england.rad
Type ExampleScenario
Id Id
FHIR Version R4
Source https://fhir.nhs.uk/England/RAD/https://build.fhir.org/ig/Interop-NWEngland/IHE-RAD/ExampleScenario-FindingImagingReportsStudiesAndImagesFederated.html
Url https://fhir.nhs.uk/England/RAD/ExampleScenario/FindingImagingReportsStudiesAndImagesFederated
Version 0.0.1-current
Status draft
Date 2025-04-09T05:34:28+00:00
Name FindingImagingReportsStudiesAndImagesFederated
Experimental False
Realm uk

Resources that use this resource

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Resources that this resource uses

No resources found



Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ExampleScenario FindingImagingReportsStudiesAndImagesFederated

url: FindingImagingReportsStudiesAndImagesFederated

version: 0.0.1-current

name: FindingImagingReportsStudiesAndImagesFederated

status: Draft

date: 2025-04-09 05:34:28+0000

publisher: NHS England

contact: https://www.ihe.net/ihe_domains/it_infrastructure/, iti@ihe.net, NHS England: iti@ihe.net

jurisdiction: United Kingdom of Great Britain and Northern Ireland

actor

actorId: user

type: System

name: Document Consumer

description:

The Document Consumer Actor queries for documents meeting certain criteria, and may retrieve selected documents.

actor

actorId: xds

type: System

name: Document Registry

description:

The Document Registry Actor maintains metadata about each registered document in a document entry. This includes a link to the Document in the Repository where it is stored. The Document Registry responds to queries from Document Consumer actors about documents meeting specific criteria.

actor

actorId: xca

type: System

name: Responding Gateway

description:

In NIR this is also known as Imaging Network. This is an infrastrcture service which enables federation.

actor

actorId: docs

type: System

name: Document Repository

description:

The Document Repository is responsible for both the persistent storage of these documents (e.g. Imaging Report)

actor

actorId: image

type: System

name: Imaging Repository

description:

The Imaging Repository is responsible for both the persistent storage of DICOM Images and Imaging Studies, these may also contain Imaging Reports. This is also known as a PACS.

instance

resourceId: IHESearchDocumentEntries

resourceType: Binary

name: Search for Document Entries - Imaging studies and reports

description:

See Finding and Retrieving Document Entries (IHE MHD) for API base contract. E.g.

GET https://example.nhs.uk/FHIR/R4/DocumentReference?patient:identifier=https://fhir.nhs.uk/Id/nhs-number|9912003888&category=http://snomed.info/sct|721981007,http://snomed.info/sct|4201000179104

The equivalent in an IHE XDS environment is Registry Stored Query [ITI-18]

Note: At present category and type which are common search parameters in IHE XDS, MHD and HL7 IPA, are not fully defined in UKCore-DocumentReference for widespread English NHS use, the codes used in the examples are broadly based on the elaboration of Document Entry

instance

resourceId: IHESearchResultsDocumentEntries

resourceType: Bundle

name: Return Document Entry search results

version

Extension Definition for ExampleScenario.instance.version.title for Version 5.0: Search Results

Extension Definition for ExampleScenario.instance.version.content for Version 5.0: Bundle: type = searchset; total = 1

versionId: 1

instance

resourceId: XCAQuery

resourceType: Binary

name: XCA Query

description:

instance

resourceId: XCAResponse

resourceType: Binary

name: XCA Query Response

description:

Example Response AdHocQueryReponse XML

instance

resourceId: IHEReadDiagnosticReport

resourceType: Binary

name: Read DiagnosticReport

description:

See Find and Retrieve Imaging Reports for API overview. E.g.

GET https://example.nhs.uk/FHIR/R4//DiagnosticReport/ABCD

The equivalent in an IHE XDS environment is Retrieve Document Set [ITI-43]

instance

resourceId: IHEViewDiagnosticReport

resourceType: DiagnosticReport

name: Return DiagnosticReport

version

Extension Definition for ExampleScenario.instance.version.title for Version 5.0: Retrieve Diagnostic Report

Extension Definition for ExampleScenario.instance.version.content for Version 5.0: Diagnostic Report for 'MRA Upper limb Rt' for '->display: string (PrimitiveType/DiagnosticReport.subject.display): element = string -> display=string[Richard SMITH]'

versionId: 1

instance

resourceId: IHEReadImagingStudy

resourceType: Binary

name: Read ImagingStudy

description:

instance

resourceId: IHERetrieveImagingStudy

resourceType: Binary

name: Return ImagingStudy

description:

DICOM Key Object Selection (KOS) is a manifest, which includes references to images which are used to find and retrieve the DICOM Image Instance

instance

resourceId: IHEReadImageInstance

resourceType: Binary

name: Read Image Instance

description:

instance

resourceId: IHERetrieveImage

resourceType: Binary

name: Return Image Instance

description:

DICOM Image Instance

process

title: Query for patient image and/or report

description:

IHE XCA implements an Aggregator pattern. Each Responding Gateway is asked to same query that the Document Registry originally received, in our example this is HL7 FHIR RESTful query (this is also IHE MHD - Find Document References ITI-67) and this has been converted to IHE XML as an AdHocQueryRequest. Document Entry is a FHIR DocumentReference profile based on the NHS Data Dictionary definitions contained in IHE Europe - Metadata for exchange medical documents and images, this also contains mappings between IHE XDS Document Entry and IHE MHD/HL7 FHIR DocumentReference.

step

process

title: Search for Document Entries - Imaging studies and reports

step

operation

number: 1

type: search-type

name: Search for Document Entires

initiator: user

receiver: xds

Requests

-ResourceId
*IHESearchDocumentEntries

step

process

title: For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA)

step

operation

number: 1

type: search-type

name: Search for Document Entries in other networks

initiator: xds

receiver: xca

Requests

-ResourceId
*XCAQuery

Responses

-ResourceId
*XCAResponse

step

process

title: Aggregate and Return Search Results - Imaging studies and reports

step

operation

number: 1

type: search-type

name: Return Document Entry search results

initiator: xds

receiver: user

Responses

-ResourceId
*IHESearchResultsDocumentEntries

process

title: Option - Retrieve selected imaging report

description:

This is an optional step. The Document Consumer may choose to retrieve the Imaging Report. At present this is a Royal College of Radiologists HL7 ORU converted to a FHIR DiagnosticReport profile as Imaging Report, this also contains mappings between HL7 ORU and FHIR DiagnosticReport. Other options are being discussed by HL7 Europe such as a EU Medical imaging studies and reports which is likely to be a derivative of HL7 IPS, like the HL7 Europe Laboratory Report.

step

operation

number: 1

type: read

name: Retrieve Imaging Report

initiator: user

receiver: docs

Requests

-ResourceId
*IHEReadDiagnosticReport

Responses

-ResourceId
*IHEViewDiagnosticReport

process

title: Option - Retrieve selected imaging study

description:

This is an optional step. The Document Consumer may choose to retrieve the Imaging Study. At present this is a DICOM KOS which contains DICOM modalities to used for retrieval of the Image Instances. Other options include using FHIR ImagingStudy which is a FHIR version of the DICOM KOS.

step

operation

number: 1

type: read

name: Retrieve Imaging Study

initiator: user

receiver: image

Requests

-ResourceId
*IHEReadImagingStudy

Responses

-ResourceId
*IHERetrieveImagingStudy

step

process

title: Retrieve selected image - Optional

step

operation

number: 1

type: read

name: Retrieve Image

initiator: user

receiver: image

Requests

-ResourceId
*IHEReadImageInstance

Responses

-ResourceId
*IHERetrieveImage

Source

{
  "resourceType" : "ExampleScenario",
  "id" : "FindingImagingReportsStudiesAndImagesFederated",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ExampleScenario FindingImagingReportsStudiesAndImagesFederated</b></p><a name=\"FindingImagingReportsStudiesAndImagesFederated\"> </a><a name=\"hcFindingImagingReportsStudiesAndImagesFederated\"> </a><a name=\"FindingImagingReportsStudiesAndImagesFederated-en-GB\"> </a><p><b>url</b>: <a href=\"ExampleScenario-FindingImagingReportsStudiesAndImagesFederated.html\">FindingImagingReportsStudiesAndImagesFederated</a></p><p><b>version</b>: 0.0.1-current</p><p><b>name</b>: FindingImagingReportsStudiesAndImagesFederated</p><p><b>status</b>: Draft</p><p><b>date</b>: 2025-04-09 05:34:28+0000</p><p><b>publisher</b>: NHS England</p><p><b>contact</b>: <a href=\"https://www.ihe.net/ihe_domains/it_infrastructure/\">https://www.ihe.net/ihe_domains/it_infrastructure/</a>, <a href=\"mailto:iti@ihe.net\">iti@ihe.net</a>, NHS England: <a href=\"mailto:iti@ihe.net\">iti@ihe.net</a></p><p><b>jurisdiction</b>: <span title=\"Codes:{urn:iso:std:iso:3166 GB}\">United Kingdom of Great Britain and Northern Ireland</span></p><blockquote><p><b>actor</b></p><p><b>actorId</b>: user</p><p><b>type</b>: System</p><p><b>name</b>: Document Consumer</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-DocumentConsumer.html\">Document Consumer</a> Actor queries for documents meeting certain criteria, and may retrieve selected documents.</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: xds</p><p><b>type</b>: System</p><p><b>name</b>: Document Registry</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-DocumentRegistry.html\">Document Registry</a> Actor maintains metadata about each registered document in a document entry. This includes a link to the Document in the Repository where it is stored. The Document Registry responds to queries from Document Consumer actors about documents meeting specific criteria.</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: xca</p><p><b>type</b>: System</p><p><b>name</b>: Responding Gateway</p><p><b>description</b>: </p><div><p>In NIR this is also known as <strong>Imaging Network</strong>. This is an infrastrcture service which enables federation.</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: docs</p><p><b>type</b>: System</p><p><b>name</b>: Document Repository</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-DocumentRepository.html\">Document Repository</a> is responsible for both the persistent storage of these documents (e.g. Imaging Report)</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: image</p><p><b>type</b>: System</p><p><b>name</b>: Imaging Repository</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-ImagingRepository.html\">Imaging Repository</a> is responsible for both the persistent storage of DICOM Images and Imaging Studies, these may also contain Imaging Reports. This is also known as a PACS.</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHESearchDocumentEntries</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Search for Document Entries - Imaging studies and reports</p><p><b>description</b>: </p><div><p>See <a href=\"CapabilityStatement-FindDocumentsMHD.html\">Finding and Retrieving Document Entries (IHE MHD)</a> for API base contract. E.g.</p>\n<pre><code>GET https://example.nhs.uk/FHIR/R4/DocumentReference?patient:identifier=https://fhir.nhs.uk/Id/nhs-number|9912003888&amp;category=http://snomed.info/sct|721981007,http://snomed.info/sct|4201000179104\n</code></pre>\n<p>The equivalent in an IHE XDS environment is <a href=\"https://profiles.ihe.net/ITI/TF/Volume2/ITI-18.html#3.18\">Registry Stored Query [ITI-18]</a></p>\n<p>Note: At present <code>category</code> and <code>type</code> which are common search parameters in IHE XDS, MHD and <a href=\"https://build.fhir.org/ig/HL7/fhir-ipa/index.html\">HL7 IPA</a>, are not fully defined in <a href=\"https://simplifier.net/hl7fhirukcorer4/ukcore-documentreference\">UKCore-DocumentReference</a> for widespread English NHS use, the codes used in the examples are broadly based on the elaboration of <a href=\"StructureDefinition-DocumentEntry.html\">Document Entry</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHESearchResultsDocumentEntries</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Return Document Entry search results</p><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Search Results</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"Bundle-MHDSearchResultsDocuments.html\">Bundle: type = searchset; total = 1</a></p><p><b>versionId</b>: 1</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: XCAQuery</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: XCA Query</p><p><b>description</b>: </p><div><p>Example Response <a href=\"AdHocQueryRequest.xml\">AdHocQueryRequest XML</a></p>\n<p>See <a href=\"https://profiles.ihe.net/ITI/TF/Volume1/ch-18.html\">IHE Cross-Community Access (XCA)</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: XCAResponse</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: XCA Query Response</p><p><b>description</b>: </p><div><p>Example Response <a href=\"AdHocQueryReponse.xml\">AdHocQueryReponse XML</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEReadDiagnosticReport</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Read DiagnosticReport</p><p><b>description</b>: </p><div><p>See <a href=\"CapabilityStatement-FindAndRetrieveImagingReports.html\">Find and Retrieve Imaging Reports</a> for API overview. E.g.</p>\n<pre><code>GET https://example.nhs.uk/FHIR/R4//DiagnosticReport/ABCD\n</code></pre>\n<p>The equivalent in an IHE XDS environment is <a href=\"https://profiles.ihe.net/ITI/TF/Volume2/ITI-43.html#3.43\">Retrieve Document Set [ITI-43]</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEViewDiagnosticReport</p><p><b>resourceType</b>: DiagnosticReport</p><p><b>name</b>: Return DiagnosticReport</p><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Retrieve Diagnostic Report</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"DiagnosticReport-DiagnosticReportImagingReportRCR.html\">Diagnostic Report for 'MRA Upper limb Rt' for '-&gt;display: string (PrimitiveType/DiagnosticReport.subject.display): element = string -&gt; display=string[Richard SMITH]'</a></p><p><b>versionId</b>: 1</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEReadImagingStudy</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Read ImagingStudy</p><p><b>description</b>: </p><div><p><a href=\"https://wiki.ihe.net/index.php/Web-based_Image_Access\">IHE WADO Retrieve (WADO-RS)</a>. See also <a href=\"CapabilityStatement-RetrieveImagingStudy.html\">Retrieve Imaging Study</a> for API overview</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHERetrieveImagingStudy</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Return ImagingStudy</p><p><b>description</b>: </p><div><p><a href=\"https://www.dicomstandard.org/News-dir/ftsup/docs/sups/sup59.pdf\">DICOM Key Object Selection (KOS)</a> is a manifest, which includes references to images which are used to find and retrieve the DICOM Image Instance</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEReadImageInstance</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Read Image Instance</p><p><b>description</b>: </p><div><p><a href=\"https://wiki.ihe.net/index.php/Web-based_Image_Access\">IHE WADO Retrieve (WADO-RS)</a>. See also <a href=\"CapabilityStatement-RetrieveImageInstances.html\">Retrieve Image Instances</a> for API overview</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHERetrieveImage</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Return Image Instance</p><p><b>description</b>: </p><div><p>DICOM Image Instance</p>\n</div></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Query for patient image and/or report</p><p><b>description</b>: </p><div><p>IHE XCA implements an <a href=\"https://www.enterpriseintegrationpatterns.com/patterns/conversation/Aggregator.html\">Aggregator</a> pattern. Each <strong>Responding Gateway</strong> is asked to same query that the <strong>Document Registry</strong> originally received, in our example this is HL7 FHIR RESTful query (this is also IHE MHD - <a href=\"https://profiles.ihe.net/ITI/MHD/ITI-67.html\">Find Document References ITI-67</a>) and this has been converted to IHE XML as an <code>AdHocQueryRequest</code>. <a href=\"StructureDefinition-DocumentEntry.html\">Document Entry</a> is a FHIR DocumentReference profile based on the NHS Data Dictionary definitions contained in <a href=\"https://www.ihe-europe.net/sites/default/files/2017-11/IHE_ITI_XDS_Metadata_Guidelines_v1.0.pdf\">IHE Europe - Metadata for exchange medical documents and images</a>, this also contains mappings between IHE XDS Document Entry and IHE MHD/HL7 FHIR DocumentReference.</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: Search for Document Entries - Imaging studies and reports</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: search-type</p><p><b>name</b>: Search for Document Entires</p><p><b>initiator</b>: user</p><p><b>receiver</b>: xds</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHESearchDocumentEntries</td></tr></table></blockquote></blockquote></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA)</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: search-type</p><p><b>name</b>: Search for Document Entries in other networks</p><p><b>initiator</b>: xds</p><p><b>receiver</b>: xca</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>XCAQuery</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>XCAResponse</td></tr></table></blockquote></blockquote></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: Aggregate and Return Search Results - Imaging studies and reports</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: search-type</p><p><b>name</b>: Return Document Entry search results</p><p><b>initiator</b>: xds</p><p><b>receiver</b>: user</p><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHESearchResultsDocumentEntries</td></tr></table></blockquote></blockquote></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Option - Retrieve selected imaging report</p><p><b>description</b>: </p><div><p>This is an optional step. The <strong>Document Consumer</strong> may choose to retrieve the <strong>Imaging Report</strong>. At present this is a <a href=\"https://www.rcr.ac.uk/media/wwtp2mif/rcr-publications_radiology-reporting-networks-understanding-the-technical-options_march-2022.pdf\">Royal College of Radiologists HL7 ORU</a> converted to a FHIR DiagnosticReport profile as <a href=\"StructureDefinition-ImagingReport.html\">Imaging Report</a>, this also contains mappings between HL7 ORU and FHIR DiagnosticReport. Other options are being discussed by HL7 Europe such as a <a href=\"https://health.ec.europa.eu/document/download/0079ad26-8f8f-435b-9472-3cd8625f4220_en?filename=ehn_mi_guidelines_en.pdf\">EU Medical imaging studies and reports</a> which is likely to be a derivative of <a href=\"https://build.fhir.org/ig/HL7/fhir-ips/index.html\">HL7 IPS</a>, like the <a href=\"https://build.fhir.org/ig/hl7-eu/laboratory/\">HL7 Europe Laboratory Report</a>.</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: read</p><p><b>name</b>: Retrieve Imaging Report</p><p><b>initiator</b>: user</p><p><b>receiver</b>: docs</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEReadDiagnosticReport</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEViewDiagnosticReport</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Option - Retrieve selected imaging study</p><p><b>description</b>: </p><div><p>This is an optional step. The <strong>Document Consumer</strong> may choose to retrieve the Imaging Study. At present this is a <a href=\"https://dicom.nema.org/dicom/supps/sup59_lb.pdf\">DICOM KOS</a> which contains DICOM modalities to used for retrieval of the Image Instances. Other options include using FHIR ImagingStudy which is a FHIR version of the DICOM KOS.</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: read</p><p><b>name</b>: Retrieve Imaging Study</p><p><b>initiator</b>: user</p><p><b>receiver</b>: image</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEReadImagingStudy</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHERetrieveImagingStudy</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: Retrieve selected image - Optional</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: read</p><p><b>name</b>: Retrieve Image</p><p><b>initiator</b>: user</p><p><b>receiver</b>: image</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEReadImageInstance</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHERetrieveImage</td></tr></table></blockquote></blockquote></blockquote></blockquote></blockquote></div>"
  },
  "url" : "https://fhir.nhs.uk/England/RAD/ExampleScenario/FindingImagingReportsStudiesAndImagesFederated",
  "version" : "0.0.1-current",
  "name" : "FindingImagingReportsStudiesAndImagesFederated",
  "status" : "draft",
  "date" : "2025-04-09T05:34:28+00:00",
  "publisher" : "NHS England",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.ihe.net/ihe_domains/it_infrastructure/"
        }
      ]
    },
    {
      "telecom" : [
        {
          "system" : "email",
          "value" : "iti@ihe.net"
        }
      ]
    },
    {
      "name" : "NHS England",
      "telecom" : [
        {
          "system" : "email",
          "value" : "iti@ihe.net"
        }
      ]
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "GB",
          "display" : "United Kingdom of Great Britain and Northern Ireland"
        }
      ]
    }
  ],
  "actor" : [
    {
      "actorId" : "user",
      "type" : "entity",
      "name" : "Document Consumer",
      "description" : "The [Document Consumer](ActorDefinition-DocumentConsumer.html) Actor queries for documents meeting certain criteria, and may retrieve selected documents."
    },
    {
      "actorId" : "xds",
      "type" : "entity",
      "name" : "Document Registry",
      "description" : "The [Document Registry](ActorDefinition-DocumentRegistry.html) Actor maintains metadata about each registered document in a document entry. This includes a link to the Document in the Repository where it is stored. The Document Registry responds to queries from Document Consumer actors about documents meeting specific criteria."
    },
    {
      "actorId" : "xca",
      "type" : "entity",
      "name" : "Responding Gateway",
      "description" : "In NIR this is also known as **Imaging Network**. This is an infrastrcture service which enables federation."
    },
    {
      "actorId" : "docs",
      "type" : "entity",
      "name" : "Document Repository",
      "description" : "The [Document Repository](ActorDefinition-DocumentRepository.html) is responsible for both the persistent storage of these documents (e.g. Imaging Report)"
    },
    {
      "actorId" : "image",
      "type" : "entity",
      "name" : "Imaging Repository",
      "description" : "The [Imaging Repository](ActorDefinition-ImagingRepository.html) is responsible for both the persistent storage of DICOM Images and Imaging Studies, these may also contain Imaging Reports. This is also known as a PACS."
    }
  ],
  "instance" : [
    {
      "resourceId" : "IHESearchDocumentEntries",
      "resourceType" : "Binary",
      "name" : "Search for Document Entries - Imaging studies and reports",
      "description" : " See [Finding and Retrieving Document Entries (IHE MHD)](CapabilityStatement-FindDocumentsMHD.html) for API base contract. E.g. \n```\nGET https://example.nhs.uk/FHIR/R4/DocumentReference?patient:identifier=https://fhir.nhs.uk/Id/nhs-number|9912003888&category=http://snomed.info/sct|721981007,http://snomed.info/sct|4201000179104\n```\n\nThe equivalent in an IHE XDS environment is [Registry Stored Query [ITI-18]](https://profiles.ihe.net/ITI/TF/Volume2/ITI-18.html#3.18)\n\nNote: At present `category` and `type` which are common search parameters in IHE XDS, MHD and [HL7 IPA](https://build.fhir.org/ig/HL7/fhir-ipa/index.html), are not fully defined in [UKCore-DocumentReference](https://simplifier.net/hl7fhirukcorer4/ukcore-documentreference) for widespread English NHS use, the codes used in the examples are broadly based on the elaboration of [Document Entry](StructureDefinition-DocumentEntry.html) "
    },
    {
      "resourceId" : "IHESearchResultsDocumentEntries",
      "resourceType" : "Bundle",
      "name" : "Return Document Entry search results",
      "version" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
              "valueString" : "Search Results"
            },
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
              "valueReference" : {
                "reference" : "Bundle/MHDSearchResultsDocuments"
              }
            }
          ],
          "versionId" : "1"
        }
      ]
    },
    {
      "resourceId" : "XCAQuery",
      "resourceType" : "Binary",
      "name" : "XCA Query",
      "description" : " Example Response [AdHocQueryRequest XML](AdHocQueryRequest.xml) \n\n See [IHE Cross-Community Access (XCA)](https://profiles.ihe.net/ITI/TF/Volume1/ch-18.html) "
    },
    {
      "resourceId" : "XCAResponse",
      "resourceType" : "Binary",
      "name" : "XCA Query Response",
      "description" : " Example Response [AdHocQueryReponse XML](AdHocQueryReponse.xml) "
    },
    {
      "resourceId" : "IHEReadDiagnosticReport",
      "resourceType" : "Binary",
      "name" : "Read DiagnosticReport",
      "description" : " See [Find and Retrieve Imaging Reports](CapabilityStatement-FindAndRetrieveImagingReports.html) for API overview. E.g. \n```\nGET https://example.nhs.uk/FHIR/R4//DiagnosticReport/ABCD\n```\n \n\nThe equivalent in an IHE XDS environment is [Retrieve Document Set [ITI-43]](https://profiles.ihe.net/ITI/TF/Volume2/ITI-43.html#3.43) "
    },
    {
      "resourceId" : "IHEViewDiagnosticReport",
      "resourceType" : "DiagnosticReport",
      "name" : "Return DiagnosticReport",
      "version" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
              "valueString" : "Retrieve Diagnostic Report"
            },
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
              "valueReference" : {
                "reference" : "DiagnosticReport/DiagnosticReportImagingReportRCR"
              }
            }
          ],
          "versionId" : "1"
        }
      ]
    },
    {
      "resourceId" : "IHEReadImagingStudy",
      "resourceType" : "Binary",
      "name" : "Read ImagingStudy",
      "description" : "[IHE WADO Retrieve (WADO-RS)](https://wiki.ihe.net/index.php/Web-based_Image_Access). See also [Retrieve Imaging Study](CapabilityStatement-RetrieveImagingStudy.html) for API overview "
    },
    {
      "resourceId" : "IHERetrieveImagingStudy",
      "resourceType" : "Binary",
      "name" : "Return ImagingStudy",
      "description" : "[DICOM Key Object Selection (KOS)](https://www.dicomstandard.org/News-dir/ftsup/docs/sups/sup59.pdf) is a manifest, which includes references to images which are used to find and retrieve the DICOM Image Instance "
    },
    {
      "resourceId" : "IHEReadImageInstance",
      "resourceType" : "Binary",
      "name" : "Read Image Instance",
      "description" : "[IHE WADO Retrieve (WADO-RS)](https://wiki.ihe.net/index.php/Web-based_Image_Access). See also [Retrieve Image Instances](CapabilityStatement-RetrieveImageInstances.html) for API overview "
    },
    {
      "resourceId" : "IHERetrieveImage",
      "resourceType" : "Binary",
      "name" : "Return Image Instance",
      "description" : "DICOM Image Instance"
    }
  ],
  "process" : [
    {
      "title" : "Query for patient image and/or report",
      "description" : "IHE XCA implements an [Aggregator](https://www.enterpriseintegrationpatterns.com/patterns/conversation/Aggregator.html) pattern. Each **Responding Gateway** is asked to same query that the **Document Registry** originally received, in our example this is HL7 FHIR RESTful query (this is also IHE MHD - [Find Document References ITI-67](https://profiles.ihe.net/ITI/MHD/ITI-67.html)) and this has been converted to IHE XML as an `AdHocQueryRequest`. [Document Entry](StructureDefinition-DocumentEntry.html) is a FHIR DocumentReference profile based on the NHS Data Dictionary definitions contained in [IHE Europe - Metadata for exchange medical documents and images](https://www.ihe-europe.net/sites/default/files/2017-11/IHE_ITI_XDS_Metadata_Guidelines_v1.0.pdf), this also contains mappings between IHE XDS Document Entry and IHE MHD/HL7 FHIR DocumentReference.",
      "step" : [
        {
          "process" : [
            {
              "title" : "Search for Document Entries - Imaging studies and reports",
              "step" : [
                {
                  "operation" : {
                    "number" : "1",
                    "type" : "search-type",
                    "name" : "Search for Document Entires",
                    "initiator" : "user",
                    "receiver" : "xds",
                    "request" : {
                      "resourceId" : "IHESearchDocumentEntries"
                    }
                  }
                }
              ]
            }
          ]
        },
        {
          "process" : [
            {
              "title" : "For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA)",
              "step" : [
                {
                  "operation" : {
                    "number" : "1",
                    "type" : "search-type",
                    "name" : "Search for Document Entries in other networks",
                    "initiator" : "xds",
                    "receiver" : "xca",
                    "request" : {
                      "resourceId" : "XCAQuery"
                    },
                    "response" : {
                      "resourceId" : "XCAResponse"
                    }
                  }
                }
              ]
            }
          ]
        },
        {
          "process" : [
            {
              "title" : "Aggregate and Return Search Results - Imaging studies and reports",
              "step" : [
                {
                  "operation" : {
                    "number" : "1",
                    "type" : "search-type",
                    "name" : "Return Document Entry search results",
                    "initiator" : "xds",
                    "receiver" : "user",
                    "response" : {
                      "resourceId" : "IHESearchResultsDocumentEntries"
                    }
                  }
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "title" : "Option - Retrieve selected imaging report",
      "description" : "This is an optional step. The **Document Consumer** may choose to retrieve the **Imaging Report**. At present this is a [Royal College of Radiologists HL7 ORU](https://www.rcr.ac.uk/media/wwtp2mif/rcr-publications_radiology-reporting-networks-understanding-the-technical-options_march-2022.pdf) converted to a FHIR DiagnosticReport profile as [Imaging Report](StructureDefinition-ImagingReport.html), this also contains mappings between HL7 ORU and FHIR DiagnosticReport. Other options are being discussed by HL7 Europe such as a [EU Medical imaging studies and reports](https://health.ec.europa.eu/document/download/0079ad26-8f8f-435b-9472-3cd8625f4220_en?filename=ehn_mi_guidelines_en.pdf) which is likely to be a derivative of [HL7 IPS](https://build.fhir.org/ig/HL7/fhir-ips/index.html), like the [HL7 Europe Laboratory Report](https://build.fhir.org/ig/hl7-eu/laboratory/).",
      "step" : [
        {
          "operation" : {
            "number" : "1",
            "type" : "read",
            "name" : "Retrieve Imaging Report",
            "initiator" : "user",
            "receiver" : "docs",
            "request" : {
              "resourceId" : "IHEReadDiagnosticReport"
            },
            "response" : {
              "resourceId" : "IHEViewDiagnosticReport"
            }
          }
        }
      ]
    },
    {
      "title" : "Option - Retrieve selected imaging study",
      "description" : "This is an optional step. The **Document Consumer** may choose to retrieve the Imaging Study. At present this is a [DICOM KOS](https://dicom.nema.org/dicom/supps/sup59_lb.pdf) which contains DICOM modalities to used for retrieval of the Image Instances. Other options include using FHIR ImagingStudy which is a FHIR version of the DICOM KOS.",
      "step" : [
        {
          "operation" : {
            "number" : "1",
            "type" : "read",
            "name" : "Retrieve Imaging Study",
            "initiator" : "user",
            "receiver" : "image",
            "request" : {
              "resourceId" : "IHEReadImagingStudy"
            },
            "response" : {
              "resourceId" : "IHERetrieveImagingStudy"
            }
          }
        },
        {
          "process" : [
            {
              "title" : "Retrieve selected image - Optional",
              "step" : [
                {
                  "operation" : {
                    "number" : "1",
                    "type" : "read",
                    "name" : "Retrieve Image",
                    "initiator" : "user",
                    "receiver" : "image",
                    "request" : {
                      "resourceId" : "IHEReadImageInstance"
                    },
                    "response" : {
                      "resourceId" : "IHERetrieveImage"
                    }
                  }
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}

XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.