Release 4 4B

This page is part of the FHIR Specification (v4.0.1: R4 (v4.3.0: R4B - Mixed Normative and STU ) 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: R4B R4 R4B R4 R3 R2

Orders and Observations Work Group Maturity Level : 1   Trial Use Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner

Detailed Descriptions for the elements in the Media resource.

Media
Element Id Media
Definition

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

Cardinality 0..*
Type DomainResource
Summary false
Media.identifier
Element Id Media.identifier
Definition

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.

Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..*
Type Identifier
Summary true
Comments

The identifier label and use can be used to determine what kind of identifier it is.

Media.basedOn
Element Id Media.basedOn
Definition

A procedure that is fulfilled in whole or in part by the creation of this media.

Cardinality 0..*
Type Reference ( ServiceRequest | CarePlan )
Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Alternate Names fulfills
Summary true
Media.partOf
Element Id Media.partOf
Definition

A larger event of which this particular event is a component or step.

Cardinality 0..*
Type Reference ( Any )
Requirements

E.g. Drug administration as part of a procedure, procedure as part of observation, etc.

Alternate Names container
Summary true
Comments

Not to be used to link an event to an Encounter - use Media.encounter for that.

[The allowed reference resources may be adjusted as appropriate for the event resource].

Media.status
Element Id Media.status
Definition

The current state of the {{title}}.

Cardinality 1..1
Terminology Binding EventStatus ( Required )
Type code
Is Modifier true (Reason: This element is labelled 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

A nominal state-transition diagram can be found in the [[event.html#statemachine | Event pattern]] documentation

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.

Media.type
Element Id Media.type
Definition

A code that classifies whether the media is an image, video or audio recording or some other media category.

Cardinality 0..1
Terminology Binding Media Type ( Extensible )
Type CodeableConcept
Requirements

Used for filtering what observations are retrieved and displayed.

Summary true
Media.modality
Element Id Media.modality
Definition

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.

Cardinality 0..1
Terminology Binding Media Modality ( Example )
Type CodeableConcept
Summary true
Media.view
Element Id Media.view
Definition

The name of the imaging view e.g. Lateral or Antero-posterior (AP).

Cardinality 0..1
Terminology Binding Media Collection View/Projection ( Example )
Type CodeableConcept
Summary true
Media.subject
Element Id Media.subject
Definition

Who/What this Media is a record of.

Cardinality 0..1
Type Reference ( Patient | Practitioner | PractitionerRole | Group | Device | Specimen | Location )
Summary true
Media.encounter
Element Id Media.encounter
Definition

The encounter that establishes the context for this media.

Cardinality 0..1
Type Reference ( Encounter )
Requirements

Links the Media to the Encounter context.

Alternate Names context
Summary true
Comments

This will typically be the encounter the media occurred within.

Media.created[x]
Element Id Media.created[x]
Definition

The date and time(s) at which the media was collected.

Cardinality 0..1
Type dateTime | Period
[x] Note See Choice of Data Types for further information about how to use [x]
Alternate Names timing
Summary true
Media.issued
Element Id Media.issued
Definition

The date and time this version of the media was made available to providers, typically after having been reviewed.

Cardinality 0..1
Type instant
Summary true
Comments

It may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that does not require the new version to be reviewed and verified again.

Media.operator
Element Id Media.operator
Definition

The person who administered the collection of the image.

Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson )
Summary true
Media.reasonCode
Element Id Media.reasonCode
Definition

Describes why the event occurred in coded or textual form.

Cardinality 0..*
Terminology Binding Procedure Reason Codes ( Example )
Type CodeableConcept
Summary true
Comments

Textual reasons can be captured using reasonCode.text.

Media.bodySite
Element Id Media.bodySite
Definition

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Cardinality 0..1
Terminology Binding SNOMED CT Body Structures ( Example )
Type CodeableConcept
Summary true
Comments

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite .

Media.deviceName
Element Id Media.deviceName
Definition

The name of the device / manufacturer of the device that was used to make the recording.

Cardinality 0..1
Type string
Summary true
Media.device
Element Id Media.device
Definition

The device used to collect the media.

Cardinality 0..1
Type Reference ( Device | DeviceMetric | Device )
Summary true
Comments

An extension should be used if further typing of the device is needed. Secondary devices used to support collecting a media can be represented using either extension or through the Observation.related element.

Media.height
Element Id Media.height
Definition

Height of the image in pixels (photo/video).

Cardinality 0..1
Type positiveInt
Summary true
Media.width
Element Id Media.width
Definition

Width of the image in pixels (photo/video).

Cardinality 0..1
Type positiveInt
Summary true
Media.frames
Element Id Media.frames
Definition

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.

Cardinality 0..1
Type positiveInt
Summary true
Comments

if the number of frames is not supplied, the value may be unknown. Applications should not assume that there is only one frame unless it is explicitly stated.

Media.duration
Element Id Media.duration
Definition

The duration of the recording in seconds - for audio and video.

Cardinality 0..1
Type decimal
Summary true
Comments

The duration might differ from occurrencePeriod if recording was paused.

Media.content
Element Id Media.content
Definition

The actual content of the media - inline or by direct reference to the media source file.

Cardinality 1..1
Type Attachment
Summary true
Comments

Recommended content types: image/jpeg, image/png, image/tiff, video/mpeg, audio/mp4, application/dicom. Application/dicom can contain the transfer syntax as a parameter. For media that covers a period of time (video/sound), the content.creationTime is the end time. Creation time is used for tracking, organizing versions and searching.

Media.note
Element Id Media.note
Definition

Comments made about the media by the performer, subject or other participants.

Cardinality 0..*
Type Annotation
Summary false
Comments

Not to be used for observations, conclusions, etc. Instead use an Observation based on the Media/ImagingStudy resource.