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 |
No resources found
No resources found
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
andtype
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:
Example Response AdHocQueryRequest XML
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:
IHE WADO Retrieve (WADO-RS). See also Retrieve Imaging Study for API overview
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:
IHE WADO Retrieve (WADO-RS). See also Retrieve Image Instances for API overview
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
{
"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&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 '->display: string (PrimitiveType/DiagnosticReport.subject.display): element = string -> 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.