Release 4 R5 Final QA

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0-draft-final: Final QA Preview for R5 - Mixed Normative and STU see ballot notes ) in it's permanent home (it will always be available at this URL). ). 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: R5 R4B R4 R3

Standards Status : Informative
Patient Care Imaging Integration icon Work Group Maturity Level : N/A 1   Trial Use Security Category : Patient Compartments : Patient

R3 : R4 Conversion maps Detailed Descriptions for FamilyMemberHistory. the elements in the ImagingSelection resource.

9.4.8.1 9.4.8.2 9.4.8.3 <p>No validation errors
ImagingSelection
Element Id ImagingSelection
Definition

Functional status A selection of DICOM SOP instances and/or frames within a single Study and Series. This might include additional specifics such as an image region, an Observation UID or a Segmentation Number, allowing linkage to an Observation Resource or transferring this information along with the ImagingStudy Resource.

Short Display A selection of DICOM SOP instances and/or frames
Cardinality 0..*
Type DomainResource
Summary false
ImagingSelection.identifier
Element Id ImagingSelection.identifier
Definition

A unique identifier assigned to this imaging selection.

Short Display Business Identifier for Imaging Selection
Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..*
Type Identifier
Requirements

Allows imaging selections to be distinguished and referenced.

Summary true
Comments

This is a business identifier, not a resource identifier -- see discussion under Business Identifiers .

ImagingSelection.status
Element Id ImagingSelection.status
Definition

The current state of the ImagingSelection resource. This is not the status of any ImagingStudy, ServiceRequest, or Task resources associated with the ImagingSelection.

Short Display available | entered-in-error | unknown
Cardinality 1..1
Terminology Binding Imaging Selection Status ( Required )
Type code
Is Modifier true (Reason: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summary true
Comments

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

ImagingSelection.subject
Element Id ImagingSelection.subject
Definition

The patient, or group of patients, location, device, organization, procedure or practitioner this map: 2 tests imaging selection is about and into whose or what record the imaging selection is placed.

Short Display Subject of the selected instances
Cardinality 0..1
Type Reference ( Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | Specimen )
Summary true
ImagingSelection.issued
Element Id ImagingSelection.issued
Definition

The date and time this imaging selection was created.

Short Display Date / Time when this imaging selection was created
Cardinality 0..1
Type instant
Summary true
ImagingSelection.performer
Element Id ImagingSelection.performer
Definition

Selector of the instances – human or machine.

Short Display Selector of the instances (human or machine)
Cardinality 0..*
Summary true
ImagingSelection.performer.function
Element Id ImagingSelection.performer.function
Definition

Distinguishes the type of involvement of the performer.

Short Display Type of performer
Cardinality 0..1
Terminology Binding ImagingStudy series performer function ( Extensible )
Type CodeableConcept
Requirements

Allows disambiguation of the types and involvement of different performers.

Summary true
ImagingSelection.performer.actor
Element Id ImagingSelection.performer.actor
Definition

Author – human or machine.

Short Display Author (human or machine)
Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Device | Organization | CareTeam | Patient | RelatedPerson | HealthcareService )
Summary true
ImagingSelection.basedOn
Element Id ImagingSelection.basedOn
Definition

A list of the diagnostic requests that all execute ok. resulted in this imaging selection being performed.

Short Display Associated request
Cardinality 0..*
Type Reference ( CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task )
Alternate Names AccessionNumber
Summary true
ImagingSelection.category
Element Id ImagingSelection.category
Definition

Classifies the imaging selection.

Short Display Classifies the imaging selection
Cardinality 0..*
Terminology Binding KeyObjectSelectionDocumentTitle icon ( Example )
Type CodeableConcept
Requirements

Used for filtering what imaging selections are retrieved and displayed.

Summary true
ImagingSelection.code
Element Id ImagingSelection.code
Definition

Reason for referencing the selected content.

Short Display Imaging Selection purpose text or code
Cardinality 1..1
Terminology Binding KeyObjectSelectionDocumentTitle icon ( Example )
Type CodeableConcept
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Alternate Names Description
Summary true
Comments

All tests pass round-trip testing code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

ImagingSelection.studyUid
Element Id ImagingSelection.studyUid
Definition

The Study Instance UID for the DICOM Study from which the images were selected.

Short Display DICOM Study Instance UID
Cardinality 0..1
Type id
Requirements

DICOM Study Instance UID. Required unless frameOfReferenceUid and 1 r3 resources imageRegion are invalid (0 errors). present and instance is not present.

Alternate Names StudyInstanceUID
Summary true
Comments

See DICOM PS3.3 C.7.2 icon.

ImagingSelection.derivedFrom
Element Id ImagingSelection.derivedFrom
Definition

The imaging study from which the imaging selection is made.

Short Display The imaging study from which the imaging selection is derived
Cardinality 0..*
Type Reference ( see documentation) ImagingStudy | DocumentReference )
Summary true
ImagingSelection.endpoint
Element Id ImagingSelection.endpoint
Definition

The network service providing retrieval access to the selected images, frames, etc. See implementation notes for information about using DICOM endpoints.

Short Display The network service providing retrieval for the images referenced in the imaging selection
Cardinality R3 0..*
Type Reference ( Endpoint )
Requirements

Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the selected images, frames, etc.

Summary true
Comments

Typical endpoint types include DICOM WADO-RS, which is used to R4 retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach.

ImagingSelection.seriesUid
Element Id ImagingSelection.seriesUid
Definition

The Series Instance UID for the DICOM Series from which the images were selected.

Short Display DICOM Series Instance UID
Cardinality map "http://hl7.org/fhir/StructureMap/FamilyMemberHistory3to4" = "R3 to R4 Conversions for FamilyMemberHistory" uses "http://hl7.org/fhir/3.0/StructureDefinition/FamilyMemberHistory" alias FamilyMemberHistoryR3 as source uses "http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" alias FamilyMemberHistory as target imports "http://hl7.org/fhir/StructureMap/*3to4" group FamilyMemberHistory(source src : FamilyMemberHistoryR3, target tgt : FamilyMemberHistory) extends DomainResource <<type+>> { src.identifier -> tgt.identifier; src.definition -> tgt.instantiatesCanonical; src.status -> tgt.status; src.notDone as v -> tgt.extension as vt, vt.url = 'http://hl7.org/fhir/3.0/StructureDefinition/extension-FamilyMemberHistory.notDone', vt.value = v; src.notDoneReason -> tgt.dataAbsentReason; src.patient -> tgt.patient; src.date -> tgt.date; src.name -> tgt.name; src.relationship -> tgt.relationship; src.gender as v -> tgt.sex as cc, cc.coding as c, c.system = 'http://hl7.org/fhir/administrative-gender', c.code = v; src.born : Period as vs -> tgt.born = create('Period') as vt then Period(vs, vt); src.born : Date as vs -> tgt.born = create('date') as vt then Date(vs, vt); src.born : string as vs -> tgt.born = create('string') as vt then string(vs, vt); src.age : Age as vs -> tgt.age = create('Age') as vt then Age(vs, vt); src.age : Range as vs -> tgt.age = create('Range') as vt then Range(vs, vt); src.age : string as vs -> tgt.age = create('string') as vt then string(vs, vt); src.estimatedAge -> tgt.estimatedAge; src.deceased : boolean as vs -> tgt.deceased = create('boolean') as vt then boolean(vs, vt); src.deceased : Age as vs -> tgt.deceased = create('Age') as vt then Age(vs, vt); src.deceased : Range as vs -> tgt.deceased = create('Range') as vt then Range(vs, vt); src.deceased : Date as vs -> tgt.deceased = create('date') as vt then Date(vs, vt); src.deceased : string as vs -> tgt.deceased = create('string') as vt then string(vs, vt); src.reasonCode -> tgt.reasonCode; src.reasonReference -> tgt.reasonReference; src.note -> tgt.note; src.condition as s -> tgt.condition as t then condition(s, t); } group condition(source src, target tgt) extends BackboneElement { src.code -> tgt.code; src.outcome -> tgt.outcome; src.onset : string as vs -> tgt.onset = create('string') as vt then string(vs, vt); src.onset : Age as vs -> tgt.onset = create('Age') as vt then Age(vs, vt); src.onset : Range as vs -> tgt.onset = create('Range') as vt then Range(vs, vt); src.onset : Period as vs -> tgt.onset = create('Period') as vt then Period(vs, vt); src.note -> tgt.note; } 0..1
Type R4 id
Requirements

DICOM Series Instance UID. Required unless frameOfReferenceUid and imageRegion are present and instance is not present.

Alternate Names SeriesInstanceUID
Summary true
Comments

See DICOM PS3.3 C.7.3 icon.

ImagingSelection.seriesNumber
Element Id ImagingSelection.seriesNumber
Definition

The Series Number for the DICOM Series from which the images were selected.

Short Display DICOM Series Number
Cardinality 0..1
Type unsignedInt
Requirements

DICOM Series Number.

Alternate Names SeriesNumber
Summary true
Comments

See DICOM PS3.3 C.7.3 icon.

ImagingSelection.frameOfReferenceUid
Element Id ImagingSelection.frameOfReferenceUid
Definition

The Frame of Reference UID identifying the coordinate system that conveys spatial and/or temporal information for the selected images or frames.

Short Display The Frame of Reference UID for the selected images
Cardinality 0..1
Type id
Requirements

DICOM Frame of Reference UID. Required if studyInstanceUid and seriesInstanceUid are not present.

Alternate Names FrameOfReferenceUID
Summary true
Comments

See DICOM PS3.3 C.7.4.1 icon.

ImagingSelection.bodySite
Element Id ImagingSelection.bodySite
Definition

The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to R3 SNOMED-CT mappings.

Short Display Body part examined
Cardinality map "http://hl7.org/fhir/StructureMap/FamilyMemberHistory4to3" = "R4 to R3 Conversion for FamilyMemberHistory" uses "http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" alias FamilyMemberHistory as source uses "http://hl7.org/fhir/3.0/StructureDefinition/FamilyMemberHistory" alias FamilyMemberHistoryR3 as target imports "http://hl7.org/fhir/StructureMap/*4to3" group FamilyMemberHistory(source src : FamilyMemberHistory, target tgt : FamilyMemberHistoryR3) extends DomainResource <<type+>> { src.identifier -> tgt.identifier; src.instantiatesCanonical -> tgt.definition; src.status -> tgt.status; src.extension as e where url = 'http://hl7.org/fhir/3.0/StructureDefinition/extension-FamilyMemberHistory.notDone' then { e.value -> tgt.notDone; }; src.dataAbsentReason -> tgt.notDoneReason; src.dataAbsentReason where src.extension.where(url = 'http://hl7.org/fhir/3.0/StructureDefinition/extension-FamilyMemberHistory.notDone').empty() -> tgt.notDone = true; src.patient -> tgt.patient; src.date -> tgt.date; src.name -> tgt.name; src.relationship -> tgt.relationship; src.sex as cc then { cc.coding as c where system = 'http://hl7.org/fhir/administrative-gender' then { c.code -> tgt.gender; }; }; src.born : Period as vs -> tgt.born = create('Period') as vt then Period(vs, vt); src.born : Date as vs -> tgt.born = create('date') as vt then Date(vs, vt); src.born : string as vs -> tgt.born = create('string') as vt then string(vs, vt); src.age : Age as vs -> tgt.age = create('Age') as vt then Age(vs, vt); src.age : Range as vs -> tgt.age = create('Range') as vt then Range(vs, vt); src.age : string as vs -> tgt.age = create('string') as vt then string(vs, vt); src.estimatedAge -> tgt.estimatedAge; src.deceased : boolean as vs -> tgt.deceased = create('boolean') as vt then boolean(vs, vt); src.deceased : Age as vs -> tgt.deceased = create('Age') as vt then Age(vs, vt); src.deceased : Range as vs -> tgt.deceased = create('Range') as vt then Range(vs, vt); src.deceased : Date as vs -> tgt.deceased = create('date') as vt then Date(vs, vt); src.deceased : string as vs -> tgt.deceased = create('string') as vt then string(vs, vt); src.reasonCode -> tgt.reasonCode; src.reasonReference -> tgt.reasonReference; src.note -> tgt.note; src.condition as s -> tgt.condition as t then condition(s, t); } group condition(source src, target tgt) extends BackboneElement { src.code -> tgt.code; src.outcome -> tgt.outcome; src.onset : string as vs -> tgt.onset = create('string') as vt then string(vs, vt); src.onset : Age as vs -> tgt.onset = create('Age') as vt then Age(vs, vt); src.onset : Range as vs -> tgt.onset = create('Range') as vt then Range(vs, vt); src.onset : Period as vs -> tgt.onset = create('Period') as vt then Period(vs, vt); src.note -> tgt.note; } 0..1
Terminology Binding R4 Validation Errors SNOMED CT Body Structures ( Example )
Type CodeableReference ( BodyStructure )
Alternate Names BodyPartExamined
Summary true
ImagingSelection.focus
Element Id ImagingSelection.focus
Definition

The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Short Display Related resource that is the focus for the imaging selection
Cardinality 0..*
Type Reference ( ImagingSelection )
Summary true
Comments

An imaging selection may reference a DICOM resource that itself references other DICOM resources. e.g. a presentation state references a set of source images or frames.

ImagingSelection.instance
Element Id ImagingSelection.instance
Definition

Each imaging selection includes one or more selected DICOM SOP instances.

Short Display The selected instances
Cardinality 0..*
Requirements

Required if the the selection does not include all instances in the specified series.

Summary true
ImagingSelection.instance.uid
Element Id ImagingSelection.instance.uid
Definition

The SOP Instance UID for the selected DICOM instance.

Short Display DICOM SOP Instance UID
Cardinality 1..1
Type id
Requirements

DICOM SOP Instance UID.

Alternate Names SOPInstanceUID
Summary true
Comments

See DICOM PS3.3 C.12.1 icon.

ImagingSelection.instance.number
Element Id ImagingSelection.instance.number
Definition

The Instance Number for the selected DICOM instance.

Short Display DICOM Instance Number
Cardinality 0..1
Type unsignedInt
Requirements

DICOM Instance Number.

Alternate Names InstanceNumber
Summary true
Comments

See DICOM PS3.3 C.7.6.1 icon. Note: A multiframe instance has a single instance number with each frame identified by a frame number.

ImagingSelection.instance.sopClass
Element Id ImagingSelection.instance.sopClass
Definition

The SOP Class UID for the selected DICOM instance.

Short Display DICOM SOP Class UID
Cardinality 0..1
Terminology Binding sopClass icon:
Type Coding
Requirements

DICOM SOP Class UID.

Alternate Names SOPClassUID
Summary false
Comments

See DICOM PS3.3 C.12.1 icon.

ImagingSelection.instance.subset
Element Id ImagingSelection.instance.subset
Definition

Selected subset of the SOP Instance. The content and format of the subset item is determined by the SOP Class of the selected instance. May be one of: - A list of frame numbers selected from a multiframe SOP Instance. - A list of Content Item Observation UID values selected from a DICOM SR or other structured document SOP Instance. - A list of segment numbers selected from a segmentation SOP Instance. - A list of Region of Interest (ROI) numbers selected from a radiotherapy structure set SOP Instance.

Short Display The selected subset of the SOP Instance
Cardinality 0..*
Type string
Summary false
ImagingSelection.instance.imageRegion2D
Element Id ImagingSelection.instance.imageRegion2D
Definition

Each imaging selection instance or frame list might includes an image region, specified by a region type and a set of 2D coordinates. If the parent imagingSelection.instance contains a subset element of type frame, the image region applies to all conversions frames in the subset list.

Short Display A specific 2D region in a DICOM image / frame
Cardinality 0..*
Requirements

Shall not be present if the parent imagingSelection.instance is not an image.

Summary false
ImagingSelection.instance.imageRegion2D.regionType
Element Id ImagingSelection.instance.imageRegion2D.regionType
Definition

Specifies the type of image region.

Short Display point | polyline | interpolated | circle | ellipse
Cardinality 1..1
Terminology Binding Imaging Selection2 D Graphic Type ( Required )
Type code
Alternate Names GraphicType
Summary false
Comments

See DICOM PS3.3 C.10.5.1.2 icon.

ImagingSelection.instance.imageRegion2D.coordinate
Element Id ImagingSelection.instance.imageRegion2D.coordinate
Definition

The coordinates describing the image region. Encoded as a set of (column, row) pairs that denote positions in the selected image / frames specified with sub-pixel resolution. The origin at the TLHC of the TLHC pixel is 0.0\0.0, the BRHC of the TLHC pixel is 1.0\1.0, and the BRHC of the BRHC pixel is the number of columns\rows in the image / frames. The values must be within the range 0\0 to the number of columns\rows in the image / frames.

Short Display Specifies the coordinates that define the image region
Cardinality 1..*
Type decimal
Element Order Meaning The values are clean</p> an ordered set of (x, y) coordinates.
Requirements

The number of values must be a multiple of two.

Alternate Names GraphicData
Summary false
Comments

For a description of how 2D coordinates are encoded, see DICOM PS3.3 C.18.6 icon.

ImagingSelection.instance.imageRegion3D
Element Id ImagingSelection.instance.imageRegion3D
Definition

Each imaging selection might includes a 3D image region, specified by a region type and a set of 3D coordinates.

Short Display A specific 3D region in a DICOM frame of reference
Cardinality 0..*
Requirements

Requires that the ImagingSelection.frameOfReferenceUid element is present.

Summary false
ImagingSelection.instance.imageRegion3D.regionType
Element Id ImagingSelection.instance.imageRegion3D.regionType
Definition

Specifies the type of image region.

Short Display point | multipoint | polyline | polygon | ellipse | ellipsoid
Cardinality 1..1
Terminology Binding Imaging Selection3 D Graphic Type ( Required )
Type code
Alternate Names GraphicType
Summary false
Comments

See DICOM PS3.3 C.18.9.1.2 icon.

ImagingSelection.instance.imageRegion3D.coordinate
Element Id ImagingSelection.instance.imageRegion3D.coordinate
Definition

The coordinates describing the image region. Encoded as an ordered set of (x,y,z) triplets (in mm and may be negative) that define a region of interest in the patient-relative Reference Coordinate System defined by ImagingSelection.frameOfReferenceUid element.

Short Display Specifies the coordinates that define the image region
Cardinality 1..*
Type decimal
Element Order Meaning The values are an ordered set of (x, y, z) coordinates.
Requirements

The number of values must be a multiple of three.

Alternate Names GraphicData
Summary false
Comments

For a description of how 3D coordinates are encoded, see DICOM PS3.3 C.18.9 icon.