DSTU2

This page is part of the FHIR Specification (v0.0.82: (v1.0.2: DSTU 1). 2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions

4.25 4.24 Resource ImagingObjectSelection - Content

This resource maintained by the
Imaging Integration Work Group Maturity Level : 1 Compartments : Device , Patient , Practitioner , RelatedPerson

A set of DICOM SOP Instances of a patient, selected for some application purpose, e.g., quality assurance, teaching, conference, consulting, etc. Objects selected can be from different studies, but must be of the same patient. Manifest manifest of a set of DICOM objects Service-Object Pair Instances (SOP Instances). The referenced SOP Instances (images or other data types) content) are for a single patient, and may be from one or more studies, with an intended purpose. studies. The referenced objects SOP Instances have been selected for a purpose, such as quality assurance, conference, or consult. Reflecting that range of purposes, typical ImagingObjectSelection resources may include every image all SOP Instances in a study to be shared (perhaps for sharing through a health information exchange, a list of Health Information Exchange); key images for from multiple studies (for reference by a referring or treating physician, physician); a multi-frame ultrasound instance ("cine" video clip) and a set of images to be included measurements taken from that instance (for inclusion in a teaching file, or similar purposes. file); and so on.

4.25.1 4.24.1 Scope and Usage

This resource summarizes a set of images or other instances gathered for some specified purpose, and provides references to where the images are available using WADO-RS. This resource is used to make available information concerning images etc. that are intended to be exchanged into other clinical contexts such as diagnostic reports, Care Plans, etc.

This resource is referenced by diagnosticreport

4.25.2 4.24.2 Resource Content

Structure

Uid of the selected
Name Flags Card. Type Description & Constraints doco
. . ImagingObjectSelection Σ DomainResource Key Object Selection
. . . uid Σ 1..1 oid Instance UID
. . . patient Σ 1..1 Reference ( Patient ) Patient of the selected objects
. . . title Σ 1..1 CodeableConcept Reason for selection
KOStitle ( Example Required )
. . . description Σ 0..1 string Description text
. . . author Σ 0..1 Reference ( Practitioner | Device | Organization | Patient | RelatedPerson ) Author (human or machine)
. . . authoringTime Σ 0..1 dateTime Authoring time of the selection
. . . study Σ 1..* Element BackboneElement Study identity of the selected instances
. . . . uid Σ 1..1 oid Study instance uid UID
. . . . url Σ 0..1 uri Retrieve study URL
. . . . imagingStudy Σ 0..1 Reference ( ImagingStudy ) Reference to ImagingStudy
.... series Σ 1..* Element BackboneElement Series identity of the selected instances
. . . . . uid Σ 0..1 oid Series instance uid UID
. . . . . url Σ 0..1 uri Retrieve series URL
. . . . . instance Σ 1..* Element BackboneElement The selected instance
. . . . . . sopClass Σ 1..1 oid SOP class uid UID of instance
. . . . . . uid Σ 1..1 oid Selected instance UID
. . . . . . url Σ 1..1 uri Retrieve instance URL
. . . . . . frames Σ 0..* Element BackboneElement The frame set
. . . . . . . frameNumbers Σ 1..* integer unsignedInt Frame numbers
. . . . . . . url Σ 1..1 uri Retrieve frame URL

doco Documentation for this format

UML Diagram

ImagingObjectSelection ( DomainResource ) Instance UID of the DICOM KOS SOP Instances represenetd represented in this resource uid : oid 1..1 [1..1] A patient resource reference which is the patient subject of all DICOM SOP Instances in this key object selection ImagingObjectSelection patient : Reference ( [1..1] « Patient ) 1..1 » The reason for, or significance of, the selection of objects referenced in the resource title : CodeableConcept 1..1 [1..1] « ( The document title code of key object selection (Strength=Required) KOStitle ) ! » Text description of the DICOM SOP instances selected in the key object selection. ImagingObjectSelection. This should be aligned with the content of the title element, and can provide further explanation of the SOP instances in the selection description : string 0..1 [0..1] Author of key object selection. ImagingObjectSelection. It can be a human authtor author or a device which made the decision of the SOP instances selected. For example, a radiologist selected a set of imaging SOP instances to attached attach in a diagnostic report, and a CAD application may author a selection to describe SOP instances it used to generate a detection conclusion author : Reference ( [0..1] « Practitioner | Device | Organization | Patient | RelatedPerson ) 0..1 » Date and time when the key object selection was authored. Note that this is the date and time of the DICOM SOP referenced instances in the selection were selected (selection decision making). made. It is (typically) different from the creation date of the selection resource, and from dates associated with the referenced instances (e.g. capture time of the selection resource referenced image) authoringTime : dateTime 0..1 [0..1] Study Study instance uid UID of the SOP instances in the selection uid : oid 1..1 [1..1] WADO-RS URL to retrieve the study. Note that this URL retrieves all SOP instances of the study, not only those in the selection url : uri 0..1 [0..1] Reference to the Imaging Study in FHIR form imagingStudy : Reference [0..1] « ImagingStudy » Series Series instance uid UID of the SOP instances in the selection uid : oid 0..1 [0..1] WADO-RS URL to retrieve the series series. Note that this URL retrieves all SOP instances of the series not only those in the selection url : uri 0..1 [0..1] Instance SOP class uid UID of the selected instance sopClass : oid 1..1 [1..1] SOP Instance uid UID of the selected instance uid : oid 1..1 [1..1] WADO-RS URL to retrieve the DICOM SOP Instance url : uri 1..1 [1..1] Frames The frame numbers in the frame set frameNumbers : integer unsignedInt 1..* [1..*] WADO-RS URL to retrieve the DICOM frames url : uri 1..1 [1..1] Identity and location information of the frames in the selected instance frames 0..* [0..*] Identity and locating information of the selected DICOM SOP instances instance 1..* [1..*] Series indetity identity and locating information of the DICOM SOP instances in the selection series 1..* [1..*] Study identity and locating information of the DICOM SOP instances in the selection study 1..* [1..*]

XML Template 

<

<ImagingObjectSelection xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <
 <</patient>
 <</title>
 <
 <|
   </author>
 <

 <uid value="[oid]"/><!-- 1..1 Instance UID -->
 <patient><!-- 1..1 Reference(Patient) Patient of the selected objects --></patient>
 <title><!-- 1..1 CodeableConcept Reason for selection --></title>
 <description value="[string]"/><!-- 0..1 Description text -->
 <author><!-- 0..1 Reference(Practitioner|Device|Organization|Patient|
   RelatedPerson) Author (human or machine) --></author>

 <authoringTime value="[dateTime]"/><!-- 0..1 Authoring time of the selection -->

 <study>  <!-- 1..* Study identity of the selected instances -->
  <
  <
  <
   <
   <

  <uid value="[oid]"/><!-- 1..1 Study instance UID -->
  <url value="[uri]"/><!-- 0..1 Retrieve study URL -->
  <imagingStudy><!-- 0..1 Reference(ImagingStudy) Reference to ImagingStudy --></imagingStudy>
  <series>  <!-- 1..* Series identity of the selected instances -->
   <uid value="[oid]"/><!-- 0..1 Series instance UID -->
   <url value="[uri]"/><!-- 0..1 Retrieve series URL -->

   <instance>  <!-- 1..* The selected instance -->
    <
    <
    <

    <sopClass value="[oid]"/><!-- 1..1 SOP class UID of instance -->
    <uid value="[oid]"/><!-- 1..1 Selected instance UID -->
    <url value="[uri]"/><!-- 1..1 Retrieve instance URL -->

    <frames>  <!-- 0..* The frame set -->
     <
     <

     <frameNumbers value="[unsignedInt]"/><!-- 1..* Frame numbers -->
     <url value="[uri]"/><!-- 1..1 Retrieve frame URL -->

    </frames>
   </instance>
  </series>
 </study>
</ImagingObjectSelection>

Structure

Uid of the selected
Name Flags Card. Type Description & Constraints doco
. . ImagingObjectSelection Σ DomainResource Key Object Selection
. . . uid Σ 1..1 oid Instance UID
. . . patient Σ 1..1 Reference ( Patient ) Patient of the selected objects
. . . title Σ 1..1 CodeableConcept Reason for selection
KOStitle ( Example Required )
. . . description Σ 0..1 string Description text
. . . author Σ 0..1 Reference ( Practitioner | Device | Organization | Patient | RelatedPerson ) Author (human or machine)
. . . authoringTime Σ 0..1 dateTime Authoring time of the selection
. . . study Σ 1..* Element BackboneElement Study identity of the selected instances
. . . . uid Σ 1..1 oid Study instance uid UID
. . . . url Σ 0..1 uri Retrieve study URL
. . . . imagingStudy Σ 0..1 Reference ( ImagingStudy ) Reference to ImagingStudy
.... series Σ 1..* Element BackboneElement Series identity of the selected instances
. . . . . uid Σ 0..1 oid Series instance uid UID
. . . . . url Σ 0..1 uri Retrieve series URL
. . . . . instance Σ 1..* Element BackboneElement The selected instance
. . . . . . sopClass Σ 1..1 oid SOP class uid UID of instance
. . . . . . uid Σ 1..1 oid Selected instance UID
. . . . . . url Σ 1..1 uri Retrieve instance URL
. . . . . . frames Σ 0..* Element BackboneElement The frame set
. . . . . . . frameNumbers Σ 1..* integer unsignedInt Frame numbers
. . . . . . . url Σ 1..1 uri Retrieve frame URL

doco Documentation for this format

UML Diagram

ImagingObjectSelection ( DomainResource ) Instance UID of the DICOM KOS SOP Instances represenetd represented in this resource uid : oid 1..1 [1..1] A patient resource reference which is the patient subject of all DICOM SOP Instances in this key object selection ImagingObjectSelection patient : Reference ( [1..1] « Patient ) 1..1 » The reason for, or significance of, the selection of objects referenced in the resource title : CodeableConcept 1..1 [1..1] « ( The document title code of key object selection (Strength=Required) KOStitle ) ! » Text description of the DICOM SOP instances selected in the key object selection. ImagingObjectSelection. This should be aligned with the content of the title element, and can provide further explanation of the SOP instances in the selection description : string 0..1 [0..1] Author of key object selection. ImagingObjectSelection. It can be a human authtor author or a device which made the decision of the SOP instances selected. For example, a radiologist selected a set of imaging SOP instances to attached attach in a diagnostic report, and a CAD application may author a selection to describe SOP instances it used to generate a detection conclusion author : Reference ( [0..1] « Practitioner | Device | Organization | Patient | RelatedPerson ) 0..1 » Date and time when the key object selection was authored. Note that this is the date and time of the DICOM SOP referenced instances in the selection were selected (selection decision making). made. It is (typically) different from the creation date of the selection resource, and from dates associated with the referenced instances (e.g. capture time of the selection resource referenced image) authoringTime : dateTime 0..1 [0..1] Study Study instance uid UID of the SOP instances in the selection uid : oid 1..1 [1..1] WADO-RS URL to retrieve the study. Note that this URL retrieves all SOP instances of the study, not only those in the selection url : uri 0..1 [0..1] Reference to the Imaging Study in FHIR form imagingStudy : Reference [0..1] « ImagingStudy » Series Series instance uid UID of the SOP instances in the selection uid : oid 0..1 [0..1] WADO-RS URL to retrieve the series series. Note that this URL retrieves all SOP instances of the series not only those in the selection url : uri 0..1 [0..1] Instance SOP class uid UID of the selected instance sopClass : oid 1..1 [1..1] SOP Instance uid UID of the selected instance uid : oid 1..1 [1..1] WADO-RS URL to retrieve the DICOM SOP Instance url : uri 1..1 [1..1] Frames The frame numbers in the frame set frameNumbers : integer unsignedInt 1..* [1..*] WADO-RS URL to retrieve the DICOM frames url : uri 1..1 [1..1] Identity and location information of the frames in the selected instance frames 0..* [0..*] Identity and locating information of the selected DICOM SOP instances instance 1..* [1..*] Series indetity identity and locating information of the DICOM SOP instances in the selection series 1..* [1..*] Study identity and locating information of the DICOM SOP instances in the selection study 1..* [1..*]

XML Template 

<

<ImagingObjectSelection xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <
 <</patient>
 <</title>
 <
 <|
   </author>
 <

 <uid value="[oid]"/><!-- 1..1 Instance UID -->
 <patient><!-- 1..1 Reference(Patient) Patient of the selected objects --></patient>
 <title><!-- 1..1 CodeableConcept Reason for selection --></title>
 <description value="[string]"/><!-- 0..1 Description text -->
 <author><!-- 0..1 Reference(Practitioner|Device|Organization|Patient|
   RelatedPerson) Author (human or machine) --></author>

 <authoringTime value="[dateTime]"/><!-- 0..1 Authoring time of the selection -->

 <study>  <!-- 1..* Study identity of the selected instances -->
  <
  <
  <
   <
   <

  <uid value="[oid]"/><!-- 1..1 Study instance UID -->
  <url value="[uri]"/><!-- 0..1 Retrieve study URL -->
  <imagingStudy><!-- 0..1 Reference(ImagingStudy) Reference to ImagingStudy --></imagingStudy>
  <series>  <!-- 1..* Series identity of the selected instances -->
   <uid value="[oid]"/><!-- 0..1 Series instance UID -->
   <url value="[uri]"/><!-- 0..1 Retrieve series URL -->

   <instance>  <!-- 1..* The selected instance -->
    <
    <
    <

    <sopClass value="[oid]"/><!-- 1..1 SOP class UID of instance -->
    <uid value="[oid]"/><!-- 1..1 Selected instance UID -->
    <url value="[uri]"/><!-- 1..1 Retrieve instance URL -->

    <frames>  <!-- 0..* The frame set -->
     <
     <

     <frameNumbers value="[unsignedInt]"/><!-- 1..* Frame numbers -->
     <url value="[uri]"/><!-- 1..1 Retrieve frame URL -->

    </frames>
   </instance>
  </series>
 </study>
</ImagingObjectSelection>

 

Alternate definitions: Schema / Schematron , Resource Profile ( XML , JSON ), Questionnaire

4.25.2.1 4.24.2.1 Terminology Bindings

Path Definition Type Reference
ImagingObjectSelection.title The document title code of key object selection Example Required http://hl7.org/fhir/kos-title KOStitle

4.24.2.2 Use Case

Joe Angina complains of shortness of breath and occasional chest pain to his primary care physician, Dr. Pat Down at Local MultiClinic, who orders a stress echocardiogram; the order is created as a FHIR Order resource to manage the workflow, with a link to a DiagnosticOrder resource with the details of the request. The order is scheduled and assigned to cardiologist Dr. Art Skann, also at Local MultiClinic.

On the scheduled day of the exam, Joe arrives at the echo lab to meet with Dr. Skann and have the study done. Dr. Skann’s workstation shows the daily list of Orders, and he follows the link to retrieve the DiagnosticOrder. (He may follow the links through the referenced Patient resource to access Joe’s electronic medical record, but that is not the concern of this storyboard.)

The Order/DiagnosticOrder has been transcoded to a DICOM Modality Worklist Scheduled Procedure Step, and in the echo lab the equipment has downloaded the Modality Worklist. The study is performed, and the acquired images and sonographer’s preliminary measurements are stored in the Local MultiClinic Picture Archiving and Communication System (PACS). The PACS creates an ImagingStudy resource for each study it manages.

Dr. Skann interprets the study on a PACS workstation, and he selects two key image frames to be included in the diagnostic report; this selection is stored back to the PACS as a DICOM Key Object Selection with the title "For Report Attachment", and the PACS makes it available (transcodes it) as a FHIR ImagingObjectSelection resource. Dr. Skann dictates the report using a structured data entry report writing program, including a recommendation for a cardiac catheterization procedure, and signs it. The report writing program formats the report as a CDA document, retrieves the ImagingObjectSelection resource, and inserts the referenced key images into the report.

Dr. Down meets again with Joe, and they review the results of the stress test. Joe has a question about the findings that the key images in the report do not show, so Dr. Down uses the Local MultiClinic EMR to query the PACS for the full ImagingStudy resource, and uses the references there to open an image display for the full study. Joe agrees to proceed to catheterization, and Dr. Down sends a referral to the Ginormous University Hospital cath department, and triggers the PACS to share the echo study through the Metropolitan Health Information Exchange.

The PACS creates a manifest of the study as an ImagingObjectSelection resource, which includes all the images but excludes the sonographer’s preliminary measurements (which as a matter of policy are not shared outside the Local MultiClinic). The manifest is published to the Metro HIE. (In accordance with IHE XDS-I, the images themselves are not directly published to the HIE, but available for on-demand retrieval from the PACS.)

At Ginormous Hospital, Dr. Cora Plummer receives the cath referral, and looks up the study in the Metro HIE registry. She retrieves the study manifest ImagingObjectSelection, and uses it to access the shared images, which she uses to prepare for the cath procedure.

4.25.3 4.24.3 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
author reference Author of key DICOM object selection ImagingObjectSelection.author
( Device , Patient , Organization , Practitioner , RelatedPerson )
authoring-time date Time of key DICOM object selection authoring ImagingObjectSelection.authoringTime
identifier token uri UID of key DICOM object selection ImagingObjectSelection.uid
patient reference Subject of key DICOM object selection ImagingObjectSelection.patient
( Patient )
selected-study token uri Study selected in key DICOM object selection ImagingObjectSelection.study.uid
title token Title of key DICOM object selection ImagingObjectSelection.title