STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R4B R4 R3 R2

2.33 Resource Media - Content

FHIR Infrastructure Work Group Maturity Level : 1 Compartments : Device , Patient , Practitioner

A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference.

2.33.1 Scope and Usage

The Media resource contains photos, videos, and audio recordings. It is used with media acquired or used as part of the healthcare process. Here are some typical usages:

  • Photos of patients and staff for identification purposes
  • Photos and videos of diagnostic or care provision procedures for recording purposes
  • Storing scans and faxes of paper documents where not enough metadata exists to create a DocumentReference
  • Images on diagnostic reports

2.33.2 Boundaries and Relationships

The Media resource is able to contain medical images in a DICOM format. These images may also be made accessible through an ImagingStudy resource, which provides a direct reference to the image to a WADO-RS server .

For such images, the WADO-RS framework is a preferred method for representing the images - the WADO-RS service may include rendering the image with annotations and display parameters from an associated DICOM presentation state, for instance.

On the other hand, the media resource allows for a robust transfer of an image across boundaries where the WADO-RS service is not available. For this reason, medical images can also be represented in a Media resource, but the Media.content.url should provide a reference to a source WADO-RS service for the image.

This resource is referenced by diagnosticreport

2.33.3 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . Media I DomainResource A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
Height can only be used for a photo or video
Width can only be used for a photo or video
Frames can only be used for a photo
Duration can only be used for an audio or a video
. . . identifier Σ 0..* Identifier Identifier(s) for the image
. . . type Σ 1..1 code photo | video | audio
DigitalMediaType ( Required )
. . . subtype Σ 0..1 CodeableConcept The type of acquisition equipment/process
Media SubType ( Example )
. . . view Σ 0..1 CodeableConcept Imaging view, e.g. Lateral or Antero-posterior
Media Collection View/Projection ( Example )
. . . subject Σ 0..1 Reference ( Patient | Practitioner | Group | Device | Specimen ) Who/What this Media is a record of
. . . operator Σ 0..1 Reference ( Practitioner ) The person who generated the image
. . . deviceName Σ 0..1 string Name of the device/manufacturer
. . . height Σ I 0..1 positiveInt Height of the image in pixels (photo/video)
. . . width Σ I 0..1 positiveInt Width of the image in pixels (photo/video)
. . . frames Σ I 0..1 positiveInt Number of frames if > 1 (photo)
. . . duration Σ I 0..1 unsignedInt Length in seconds (audio / video)
. . . content 1..1 Attachment Actual Media - reference or data

doco Documentation for this format

UML Diagram ( Legend )

Media ( DomainResource ) Identifiers associated with the image - these may include identifiers for the image itself, identifiers for the context of its collection (e.g. series ids) and context ids such as accession numbers or other workflow identifiers identifier : Identifier [0..*] Whether the media is a photo (still image), an audio recording, or a video recording type : code [1..1] « Whether the Media is a photo, video, or audio (Strength=Required) DigitalMediaType ! » Details of the type of the media - usually, how it was acquired (what type of device). If images sourced from a DICOM system, are wrapped in a Media resource, then this is the modality subtype : CodeableConcept [0..1] « Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it (Strength=Example) Media SubType ?? » The name of the imaging view e.g. Lateral or Antero-posterior (AP) view : CodeableConcept [0..1] « Imaging view (projection) used when collecting an image (Strength=Example) Media Collection View/Project... ?? » Who/What this Media is a record of subject : Reference [0..1] « Patient | Practitioner | Group | Device | Specimen » The person who administered the collection of the image operator : Reference [0..1] « Practitioner » The name of the device / manufacturer of the device that was used to make the recording deviceName : string [0..1] Height of the image in pixels (photo/video) height : positiveInt [0..1] Width of the image in pixels (photo/video) width : positiveInt [0..1] The number of frames in a photo. This is used with a multi-page fax, or an imaging acquisition context that takes multiple slices in a single image, or an animated gif. If there is more than one frame, this SHALL have a value in order to alert interface software that a multi-frame capable rendering widget is required frames : positiveInt [0..1] The duration of the recording in seconds - for audio and video duration : unsignedInt [0..1] The actual content of the media - inline or by direct reference to the media source file content : Attachment [1..1]

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Media;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Media.identifier [ Identifier ], ... ; # 0..* Identifier(s) for the image
  fhir:Media.type [ code ]; # 1..1 photo | video | audio
  fhir:Media.subtype [ CodeableConcept ]; # 0..1 The type of acquisition equipment/process
  fhir:Media.view [ CodeableConcept ]; # 0..1 Imaging view, e.g. Lateral or Antero-posterior
  fhir:Media.subject [ Reference(Patient|Practitioner|Group|Device|Specimen) ]; # 0..1 Who/What this Media is a record of
  fhir:Media.operator [ Reference(Practitioner) ]; # 0..1 The person who generated the image
  fhir:Media.deviceName [ string ]; # 0..1 Name of the device/manufacturer
  fhir:Media.height [ positiveInt ]; # 0..1 Height of the image in pixels (photo/video)
  fhir:Media.width [ positiveInt ]; # 0..1 Width of the image in pixels (photo/video)
  fhir:Media.frames [ positiveInt ]; # 0..1 Number of frames if > 1 (photo)
  fhir:Media.duration [ unsignedInt ]; # 0..1 Length in seconds (audio / video)
  fhir:Media.content [ Attachment ]; # 1..1 Actual Media - reference or data
]

Changes since DSTU2

Media No Changes

See the Full Difference for further information

Structure

Name Flags Card. Type Description & Constraints doco
. . Media I DomainResource A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
Height can only be used for a photo or video
Width can only be used for a photo or video
Frames can only be used for a photo
Duration can only be used for an audio or a video
. . . identifier Σ 0..* Identifier Identifier(s) for the image
. . . type Σ 1..1 code photo | video | audio
DigitalMediaType ( Required )
. . . subtype Σ 0..1 CodeableConcept The type of acquisition equipment/process
Media SubType ( Example )
. . . view Σ 0..1 CodeableConcept Imaging view, e.g. Lateral or Antero-posterior
Media Collection View/Projection ( Example )
. . . subject Σ 0..1 Reference ( Patient | Practitioner | Group | Device | Specimen ) Who/What this Media is a record of
. . . operator Σ 0..1 Reference ( Practitioner ) The person who generated the image
. . . deviceName Σ 0..1 string Name of the device/manufacturer
. . . height Σ I 0..1 positiveInt Height of the image in pixels (photo/video)
. . . width Σ I 0..1 positiveInt Width of the image in pixels (photo/video)
. . . frames Σ I 0..1 positiveInt Number of frames if > 1 (photo)
. . . duration Σ I 0..1 unsignedInt Length in seconds (audio / video)
. . . content 1..1 Attachment Actual Media - reference or data

doco Documentation for this format

UML Diagram ( Legend )

Media ( DomainResource ) Identifiers associated with the image - these may include identifiers for the image itself, identifiers for the context of its collection (e.g. series ids) and context ids such as accession numbers or other workflow identifiers identifier : Identifier [0..*] Whether the media is a photo (still image), an audio recording, or a video recording type : code [1..1] « Whether the Media is a photo, video, or audio (Strength=Required) DigitalMediaType ! » Details of the type of the media - usually, how it was acquired (what type of device). If images sourced from a DICOM system, are wrapped in a Media resource, then this is the modality subtype : CodeableConcept [0..1] « Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it (Strength=Example) Media SubType ?? » The name of the imaging view e.g. Lateral or Antero-posterior (AP) view : CodeableConcept [0..1] « Imaging view (projection) used when collecting an image (Strength=Example) Media Collection View/Project... ?? » Who/What this Media is a record of subject : Reference [0..1] « Patient | Practitioner | Group | Device | Specimen » The person who administered the collection of the image operator : Reference [0..1] « Practitioner » The name of the device / manufacturer of the device that was used to make the recording deviceName : string [0..1] Height of the image in pixels (photo/video) height : positiveInt [0..1] Width of the image in pixels (photo/video) width : positiveInt [0..1] The number of frames in a photo. This is used with a multi-page fax, or an imaging acquisition context that takes multiple slices in a single image, or an animated gif. If there is more than one frame, this SHALL have a value in order to alert interface software that a multi-frame capable rendering widget is required frames : positiveInt [0..1] The duration of the recording in seconds - for audio and video duration : unsignedInt [0..1] The actual content of the media - inline or by direct reference to the media source file content : Attachment [1..1]

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Media;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Media.identifier [ Identifier ], ... ; # 0..* Identifier(s) for the image
  fhir:Media.type [ code ]; # 1..1 photo | video | audio
  fhir:Media.subtype [ CodeableConcept ]; # 0..1 The type of acquisition equipment/process
  fhir:Media.view [ CodeableConcept ]; # 0..1 Imaging view, e.g. Lateral or Antero-posterior
  fhir:Media.subject [ Reference(Patient|Practitioner|Group|Device|Specimen) ]; # 0..1 Who/What this Media is a record of
  fhir:Media.operator [ Reference(Practitioner) ]; # 0..1 The person who generated the image
  fhir:Media.deviceName [ string ]; # 0..1 Name of the device/manufacturer
  fhir:Media.height [ positiveInt ]; # 0..1 Height of the image in pixels (photo/video)
  fhir:Media.width [ positiveInt ]; # 0..1 Width of the image in pixels (photo/video)
  fhir:Media.frames [ positiveInt ]; # 0..1 Number of frames if > 1 (photo)
  fhir:Media.duration [ unsignedInt ]; # 0..1 Length in seconds (audio / video)
  fhir:Media.content [ Attachment ]; # 1..1 Actual Media - reference or data
]

Changes since DSTU2

Media No Changes

See the Full Difference for further information

 

Alternate definitions: Master Definition ( XML , JSON ), XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ), JSON-LD (for RDF as JSON-LD ),

2.33.3.1 Terminology Bindings

Path Definition Type Reference
Media.type Whether the Media is a photo, video, or audio Required DigitalMediaType
Media.subtype Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it Example Media SubType
Media.view Imaging view (projection) used when collecting an image Example Media Collection View/Projection

2.33.3.2 Constraints

  • mda-1 : Height can only be used for a photo or video ( expression : height.empty() or type != 'audio' )
  • mda-2 : Width can only be used for a photo or video ( expression : width.empty() or type != 'audio' )
  • mda-3 : Frames can only be used for a photo ( expression : frames.empty() or type = 'photo' )
  • mda-4 : Duration can only be used for an audio or a video ( expression : duration.empty() or type != 'photo' )

2.33.3.3 Implementation Notes

Note that the date of creation of the recording of the Media is found in Media.content.creation

2.33.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Paths In Common
created date Date attachment was first created Media.content.creation
identifier token Identifier(s) for the image Media.identifier
operator reference The person who generated the image Media.operator
( Practitioner )
patient reference Who/What this Media is a record of Media.subject
( Patient )
subject reference Who/What this Media is a record of Media.subject
( Practitioner , Group , Specimen , Device , Patient )
subtype token The type of acquisition equipment/process Media.subtype
type token photo | video | audio Media.type
view token Imaging view, e.g. Lateral or Antero-posterior Media.view