FHIR Release 3 (STU) R4 Ballot #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.0.2: STU 3). (v3.5.0: R4 Ballot #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 . Page versions: R4B R4 R3 R2

2.37 10.2 Resource Media - Content

FHIR Infrastructure Orders and Observations Work Group Maturity Level : 1   Trial Use 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.

2.37.1 10.2.1 Scope and Usage

Trial-Use Note: The Orders and Observations workgroups wants to make the balloter aware than observations that require the attachment data types are represented by the Media resource instead of Observation. There have been several significant changes to the Media resource in order to align it with Observation and the workflow event pattern including:

  1. The addition of the partOf and issued elements.
  2. The required type was changed an optional category and the subtype element was renamed to modality .
  3. Additional reference targets added to the subject , operator , and basedOn elements
  4. The additions of several standard event extensions .

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 and videos of diagnostic or care provision procedures for recording purposes
  • Images contained in diagnostic reports

2.37.2 10.2.2 Boundaries and Relationships

This resource captures a specific type of Observation - an Observation whose value is audio, video or image data. This resource is the preferred representation of such forms of information as it exposes the metadata relevant for interpreting the information. However, in some legacy environments, media information may occasionally appear in Observation instead. Systems should be aware of this possibility.

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 AdverseEvent , ClinicalImpression , DeviceUseStatement , DiagnosticReport , ImagingStudy , MedicationKnowledge and Observation

2.37.3 10.2.3 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . Media I TU 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 Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Identifier(s) for the image
. . . basedOn Σ 0..* Reference ( ProcedureRequest ServiceRequest | CarePlan ) Procedure that caused this media to be created
. . . partOf Σ 0..* Reference ( Any ) Part of referenced event
.. . type status ?! Σ 1..1 code photo preparation | video in-progress | audio not-done | suspended | aborted | completed | entered-in-error | unknown
DigitalMediaType EventStatus ( Required )
. . . subtype type Σ 0..1 CodeableConcept Classification of media as image, video, or audio
Media Type ( Extensible )
... modality Σ 0..1 CodeableConcept The type of acquisition equipment/process
Media SubType Modality ( 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 | Location ) Who/What this Media is a record of
. . . context Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter / Episode associated with media
. . . occurrence[x] created[x] Σ 0..1 When Media was collected
. . . . occurrenceDateTime createdDateTime dateTime
. . . . occurrencePeriod createdPeriod Period
. . . issued Σ 0..1 instant Date/Time this version was made available
. . . operator Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson ) The person who generated the image
. . . reasonCode Σ 0..* CodeableConcept Why was event performed?
Procedure Reason Codes ( Example )
. . . bodySite Σ 0..1 CodeableConcept Body Observed body part in media
SNOMED CT Body Structures ( Example )
. . . deviceName Σ 0..1 string Name of the device/manufacturer
.. . device Σ 0..1 Reference ( Device | DeviceMetric | Device ) Observing Device
. . . 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 decimal Length in seconds (audio / video)
. . . content Σ 1..1 Attachment Actual Media - reference or data
. . . note 0..* Annotation Comments made about the media

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..*] A procedure that is fulfilled in whole or in part by the creation of this media basedOn : Reference [0..*] ProcedureRequest « ServiceRequest | CarePlan » Whether the media A larger event of which this particular event is a photo (still image), an audio recording, component or a video recording step type partOf : Reference [0..*] « Any » The current state of the {{title}} (this element modifies the meaning of other elements) status : code [1..1] « Codes identifying the lifecycle stage of a event. (Strength=Required) EventStatus ! » Whether A code that classifies whether the media is a photo, video, an image, video or audio (Strength=Required) recording or some other media category DigitalMediaType ! type : CodeableConcept [0..1] « Codes for high level media categories. (Strength=Extensible) MediaType + » 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 modality : CodeableConcept [0..1] « Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it it. (Strength=Example) Media SubType MediaModality ?? » 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 image. (Strength=Example) Media Collection View/Project... MediaCollectionView/Projection ?? » Who/What this Media is a record of subject : Reference [0..1] « Patient | Practitioner | Group | Device | Specimen | Location » The encounter or episode of care that establishes the context for this media context : Reference [0..1] « Encounter | EpisodeOfCare » The date and time(s) at which the media was collected occurrence[x] created[x] : Type [0..1] « dateTime | Period » The date and time this version of the media was made available to providers, typically after having been reviewed issued : instant [0..1] The person who administered the collection of the image operator : Reference [0..1] « Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson » Describes why the event occurred in coded or textual form reasonCode : CodeableConcept [0..*] « The reason for the media media. (Strength=Example) Procedure Reason ProcedureReasonCodes ?? » Indicates the site on the subject's body where the media observation was collected made (i.e. the target site) bodySite : CodeableConcept [0..1] « Codes describing anatomical locations. May include laterality. (Strength=Example) SNOMED CT Body Structures SNOMEDCTBodyStructures ?? » The name of the device / manufacturer of the device that was used to make the recording deviceName : string [0..1] The device used to collect the media device : Reference [0..1] « Device | DeviceMetric | Device » 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 decimal [0..1] The actual content of the media - inline or by direct reference to the media source file content : Attachment [1..1] Comments made about the media by the performer, subject or other participants note : Annotation [0..*]

XML Template 

<

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

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) for the image --></identifier>
 <</basedOn>
 <
 <</subtype>

 <basedOn><!-- 0..* Reference(ServiceRequest|CarePlan) Procedure that caused this media to be created --></basedOn>
 <partOf><!-- 0..* Reference(Any) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown -->
 <type><!-- 0..1 CodeableConcept Classification of media as image, video, or audio --></type>
 <modality><!-- 0..1 CodeableConcept The type of acquisition equipment/process --></modality>

 <view><!-- 0..1 CodeableConcept Imaging view, e.g. Lateral or Antero-posterior --></view>
 <</subject>

 <subject><!-- 0..1 Reference(Patient|Practitioner|Group|Device|Specimen|Location) Who/What this Media is a record of --></subject>

 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with media --></context>
 <</occurrence[x]>
 <</operator>

 <created[x]><!-- 0..1 dateTime|Period When Media was collected --></created[x]>
 <issued value="[instant]"/><!-- 0..1 Date/Time this version was made available -->
 <operator><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization|
   CareTeam|Patient|Device|RelatedPerson) The person who generated the image --></operator>
 <reasonCode><!-- 0..* CodeableConcept Why was event performed? --></reasonCode>
 <</bodySite>
 <</device>
 <
 <
 <
 <

 <bodySite><!-- 0..1 CodeableConcept Observed body part --></bodySite>
 <deviceName value="[string]"/><!-- 0..1 Name of the device/manufacturer -->
 <device><!-- 0..1 Reference(Device|DeviceMetric|Device) Observing Device --></device>
 <height value="[positiveInt]"/><!-- 0..1 Height of the image in pixels (photo/video) -->
 <width value="[positiveInt]"/><!-- 0..1 Width of the image in pixels (photo/video) -->
 <frames value="[positiveInt]"/><!-- 0..1 Number of frames if > 1 (photo) -->
 <duration value="[decimal]"/><!-- 0..1 Length in seconds (audio / video) -->

 <content><!-- 1..1 Attachment Actual Media - reference or data --></content>
 <note><!-- 0..* Annotation Comments made about the media --></note>
</Media>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "Media",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  
  ">",
  " },
  "
  "
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  "

  "identifier" : [{ Identifier }], // Identifier(s) for the image
  "basedOn" : [{ Reference(ServiceRequest|CarePlan) }], // Procedure that caused this media to be created
  "partOf" : [{ Reference(Any) }], // Part of referenced event
  "status" : "<code>", // R!  preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown
  "type" : { CodeableConcept }, // Classification of media as image, video, or audio
  "modality" : { CodeableConcept }, // The type of acquisition equipment/process
  "view" : { CodeableConcept }, // Imaging view, e.g. Lateral or Antero-posterior
  "subject" : { Reference(Patient|Practitioner|Group|Device|Specimen|Location) }, // Who/What this Media is a record of
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with media
  // created[x]: When Media was collected. One of these 2:

  "createdDateTime" : "<dateTime>",
  "createdPeriod" : { Period },
  "issued" : "<instant>", // Date/Time this version was made available
  "operator" : { Reference(Practitioner|PractitionerRole|Organization|
   CareTeam|Patient|Device|RelatedPerson) }, // The person who generated the image

  "reasonCode" : [{ CodeableConcept }], // Why was event performed?
  "bodySite" : { CodeableConcept }, // Observed body part
  "deviceName" : "<string>", // Name of the device/manufacturer
  "device" : { Reference(Device|DeviceMetric|Device) }, // Observing Device
  "height" : "<positiveInt>", // Height of the image in pixels (photo/video)
  "width" : "<positiveInt>", // Width of the image in pixels (photo/video)
  "frames" : "<positiveInt>", // Number of frames if > 1 (photo)
  "duration" : <decimal>, // Length in seconds (audio / video)
  "content" : { Attachment }, // R!  Actual Media - reference or data
  "note" : [{ Annotation }] // Comments made about the media

}

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:
  fhir:
  fhir:

  fhir:Media.basedOn [ Reference(ServiceRequest|CarePlan) ], ... ; # 0..* Procedure that caused this media to be created
  fhir:Media.partOf [ Reference(Any) ], ... ; # 0..* Part of referenced event
  fhir:Media.status [ code ]; # 1..1 preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown
  fhir:Media.type [ CodeableConcept ]; # 0..1 Classification of media as image, video, or audio
  fhir:Media.modality [ CodeableConcept ]; # 0..1 The type of acquisition equipment/process

  fhir:Media.view [ CodeableConcept ]; # 0..1 Imaging view, e.g. Lateral or Antero-posterior
  fhir:

  fhir:Media.subject [ Reference(Patient|Practitioner|Group|Device|Specimen|Location) ]; # 0..1 Who/What this Media is a record of

  fhir:Media.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with media
  # . One of these 2
    fhir: ]
    fhir: ]
  fhir:

  # Media.created[x] : 0..1 When Media was collected. One of these 2
    fhir:Media.createdDateTime [ dateTime ]
    fhir:Media.createdPeriod [ Period ]
  fhir:Media.issued [ instant ]; # 0..1 Date/Time this version was made available
  fhir:Media.operator [ Reference(Practitioner|PractitionerRole|Organization|CareTeam|Patient|Device|RelatedPerson) ]; # 0..1 The person who generated the image

  fhir:Media.reasonCode [ CodeableConcept ], ... ; # 0..* Why was event performed?
  fhir:
  fhir:

  fhir:Media.bodySite [ CodeableConcept ]; # 0..1 Observed body part
  fhir:Media.deviceName [ string ]; # 0..1 Name of the device/manufacturer
  fhir:Media.device [ Reference(Device|DeviceMetric|Device) ]; # 0..1 Observing Device

  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:

  fhir:Media.duration [ decimal ]; # 0..1 Length in seconds (audio / video)

  fhir:Media.content [ Attachment ]; # 1..1 Actual Media - reference or data
  fhir:Media.note [ Annotation ], ... ; # 0..* Comments made about the media
]

Changes since DSTU2 R3

Media
Media.basedOn
  • Added Element Type changed from Reference(ProcedureRequest) to Reference(ServiceRequest|CarePlan)
Media.context Media.partOf
  • Added Element
Media.occurrence[x] Media.status
  • Added Element
Media.type
  • Min Cardinality changed from 1 to 0
  • Type changed from code to CodeableConcept
  • Change binding strength from required to extensible
  • Change value set from http://hl7.org/fhir/ValueSet/digital-media-type to http://hl7.org/fhir/ValueSet/media-type
Media.reasonCode Media.modality
  • Added Element
Media.subject
  • Type changed from Reference(Patient|Practitioner|Group|Device|Specimen) to Reference(Patient|Practitioner|Group|Device|Specimen|Location)
Media.bodySite Media.created[x]
  • Added Element
Media.device Media.issued
  • Added Element
Media.operator
  • Type changed from Reference(Practitioner) to Reference(Practitioner|PractitionerRole|Organization|CareTeam|Patient|Device|RelatedPerson)
Media.note Media.deviceName
  • Added Element
Media.device
  • Type changed from Reference(Device|DeviceMetric) to Reference(Device|DeviceMetric|Device)
Media.frames
  • Default Value "1" removed
Media.duration
  • Type changed from unsignedInt to decimal
Media.deviceName Media.subtype
  • deleted
Media.occurrence[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 3 4 tests that all of which 4 fail to execute ok. All tests pass round-trip testing and all r3 resources are valid.). .)

Structure

Name Flags Card. Type Description & Constraints doco
. . Media I TU 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 Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Identifier(s) for the image
. . . basedOn Σ 0..* Reference ( ProcedureRequest ServiceRequest | CarePlan ) Procedure that caused this media to be created
. . . partOf Σ 0..* Reference ( Any ) Part of referenced event
.. . type status ?! Σ 1..1 code photo preparation | video in-progress | audio not-done | suspended | aborted | completed | entered-in-error | unknown
DigitalMediaType EventStatus ( Required )
. . . subtype type Σ 0..1 CodeableConcept Classification of media as image, video, or audio
Media Type ( Extensible )
... modality Σ 0..1 CodeableConcept The type of acquisition equipment/process
Media SubType Modality ( 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 | Location ) Who/What this Media is a record of
. . . context Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter / Episode associated with media
. . . occurrence[x] created[x] Σ 0..1 When Media was collected
. . . . occurrenceDateTime createdDateTime dateTime
. . . . occurrencePeriod createdPeriod Period
. . . issued Σ 0..1 instant Date/Time this version was made available
. . . operator Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson ) The person who generated the image
. . . reasonCode Σ 0..* CodeableConcept Why was event performed?
Procedure Reason Codes ( Example )
. . . bodySite Σ 0..1 CodeableConcept Body Observed body part in media
SNOMED CT Body Structures ( Example )
. . . deviceName Σ 0..1 string Name of the device/manufacturer
.. . device Σ 0..1 Reference ( Device | DeviceMetric | Device ) Observing Device
. . . 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 decimal Length in seconds (audio / video)
. . . content Σ 1..1 Attachment Actual Media - reference or data
. . . note 0..* Annotation Comments made about the media

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..*] A procedure that is fulfilled in whole or in part by the creation of this media basedOn : Reference [0..*] ProcedureRequest « ServiceRequest | CarePlan » Whether the media A larger event of which this particular event is a photo (still image), an audio recording, component or a video recording step type partOf : Reference [0..*] « Any » The current state of the {{title}} (this element modifies the meaning of other elements) status : code [1..1] « Codes identifying the lifecycle stage of a event. (Strength=Required) EventStatus ! » Whether A code that classifies whether the media is a photo, video, an image, video or audio (Strength=Required) recording or some other media category DigitalMediaType ! type : CodeableConcept [0..1] « Codes for high level media categories. (Strength=Extensible) MediaType + » 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 modality : CodeableConcept [0..1] « Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it it. (Strength=Example) Media SubType MediaModality ?? » 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 image. (Strength=Example) Media Collection View/Project... MediaCollectionView/Projection ?? » Who/What this Media is a record of subject : Reference [0..1] « Patient | Practitioner | Group | Device | Specimen | Location » The encounter or episode of care that establishes the context for this media context : Reference [0..1] « Encounter | EpisodeOfCare » The date and time(s) at which the media was collected occurrence[x] created[x] : Type [0..1] « dateTime | Period » The date and time this version of the media was made available to providers, typically after having been reviewed issued : instant [0..1] The person who administered the collection of the image operator : Reference [0..1] « Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson » Describes why the event occurred in coded or textual form reasonCode : CodeableConcept [0..*] « The reason for the media media. (Strength=Example) Procedure Reason ProcedureReasonCodes ?? » Indicates the site on the subject's body where the media observation was collected made (i.e. the target site) bodySite : CodeableConcept [0..1] « Codes describing anatomical locations. May include laterality. (Strength=Example) SNOMED CT Body Structures SNOMEDCTBodyStructures ?? » The name of the device / manufacturer of the device that was used to make the recording deviceName : string [0..1] The device used to collect the media device : Reference [0..1] « Device | DeviceMetric | Device » 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 decimal [0..1] The actual content of the media - inline or by direct reference to the media source file content : Attachment [1..1] Comments made about the media by the performer, subject or other participants note : Annotation [0..*]

XML Template 

<

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

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) for the image --></identifier>
 <</basedOn>
 <
 <</subtype>

 <basedOn><!-- 0..* Reference(ServiceRequest|CarePlan) Procedure that caused this media to be created --></basedOn>
 <partOf><!-- 0..* Reference(Any) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown -->
 <type><!-- 0..1 CodeableConcept Classification of media as image, video, or audio --></type>
 <modality><!-- 0..1 CodeableConcept The type of acquisition equipment/process --></modality>

 <view><!-- 0..1 CodeableConcept Imaging view, e.g. Lateral or Antero-posterior --></view>
 <</subject>

 <subject><!-- 0..1 Reference(Patient|Practitioner|Group|Device|Specimen|Location) Who/What this Media is a record of --></subject>

 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with media --></context>
 <</occurrence[x]>
 <</operator>

 <created[x]><!-- 0..1 dateTime|Period When Media was collected --></created[x]>
 <issued value="[instant]"/><!-- 0..1 Date/Time this version was made available -->
 <operator><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization|
   CareTeam|Patient|Device|RelatedPerson) The person who generated the image --></operator>
 <reasonCode><!-- 0..* CodeableConcept Why was event performed? --></reasonCode>
 <</bodySite>
 <</device>
 <
 <
 <
 <

 <bodySite><!-- 0..1 CodeableConcept Observed body part --></bodySite>
 <deviceName value="[string]"/><!-- 0..1 Name of the device/manufacturer -->
 <device><!-- 0..1 Reference(Device|DeviceMetric|Device) Observing Device --></device>
 <height value="[positiveInt]"/><!-- 0..1 Height of the image in pixels (photo/video) -->
 <width value="[positiveInt]"/><!-- 0..1 Width of the image in pixels (photo/video) -->
 <frames value="[positiveInt]"/><!-- 0..1 Number of frames if > 1 (photo) -->
 <duration value="[decimal]"/><!-- 0..1 Length in seconds (audio / video) -->

 <content><!-- 1..1 Attachment Actual Media - reference or data --></content>
 <note><!-- 0..* Annotation Comments made about the media --></note>
</Media>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "Media",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  
  ">",
  " },
  "
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  "

  "identifier" : [{ Identifier }], // Identifier(s) for the image
  "basedOn" : [{ Reference(ServiceRequest|CarePlan) }], // Procedure that caused this media to be created
  "partOf" : [{ Reference(Any) }], // Part of referenced event
  "status" : "<code>", // R!  preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown
  "type" : { CodeableConcept }, // Classification of media as image, video, or audio
  "modality" : { CodeableConcept }, // The type of acquisition equipment/process
  "view" : { CodeableConcept }, // Imaging view, e.g. Lateral or Antero-posterior
  "subject" : { Reference(Patient|Practitioner|Group|Device|Specimen|Location) }, // Who/What this Media is a record of
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with media
  // created[x]: When Media was collected. One of these 2:

  "createdDateTime" : "<dateTime>",
  "createdPeriod" : { Period },
  "issued" : "<instant>", // Date/Time this version was made available
  "operator" : { Reference(Practitioner|PractitionerRole|Organization|
   CareTeam|Patient|Device|RelatedPerson) }, // The person who generated the image

  "reasonCode" : [{ CodeableConcept }], // Why was event performed?
  "bodySite" : { CodeableConcept }, // Observed body part
  "deviceName" : "<string>", // Name of the device/manufacturer
  "device" : { Reference(Device|DeviceMetric|Device) }, // Observing Device
  "height" : "<positiveInt>", // Height of the image in pixels (photo/video)
  "width" : "<positiveInt>", // Width of the image in pixels (photo/video)
  "frames" : "<positiveInt>", // Number of frames if > 1 (photo)
  "duration" : <decimal>, // Length in seconds (audio / video)
  "content" : { Attachment }, // R!  Actual Media - reference or data
  "note" : [{ Annotation }] // Comments made about the media

}

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:
  fhir:
  fhir:

  fhir:Media.basedOn [ Reference(ServiceRequest|CarePlan) ], ... ; # 0..* Procedure that caused this media to be created
  fhir:Media.partOf [ Reference(Any) ], ... ; # 0..* Part of referenced event
  fhir:Media.status [ code ]; # 1..1 preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown
  fhir:Media.type [ CodeableConcept ]; # 0..1 Classification of media as image, video, or audio
  fhir:Media.modality [ CodeableConcept ]; # 0..1 The type of acquisition equipment/process

  fhir:Media.view [ CodeableConcept ]; # 0..1 Imaging view, e.g. Lateral or Antero-posterior
  fhir:

  fhir:Media.subject [ Reference(Patient|Practitioner|Group|Device|Specimen|Location) ]; # 0..1 Who/What this Media is a record of

  fhir:Media.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with media
  # . One of these 2
    fhir: ]
    fhir: ]
  fhir:

  # Media.created[x] : 0..1 When Media was collected. One of these 2
    fhir:Media.createdDateTime [ dateTime ]
    fhir:Media.createdPeriod [ Period ]
  fhir:Media.issued [ instant ]; # 0..1 Date/Time this version was made available
  fhir:Media.operator [ Reference(Practitioner|PractitionerRole|Organization|CareTeam|Patient|Device|RelatedPerson) ]; # 0..1 The person who generated the image

  fhir:Media.reasonCode [ CodeableConcept ], ... ; # 0..* Why was event performed?
  fhir:
  fhir:

  fhir:Media.bodySite [ CodeableConcept ]; # 0..1 Observed body part
  fhir:Media.deviceName [ string ]; # 0..1 Name of the device/manufacturer
  fhir:Media.device [ Reference(Device|DeviceMetric|Device) ]; # 0..1 Observing Device

  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:

  fhir:Media.duration [ decimal ]; # 0..1 Length in seconds (audio / video)

  fhir:Media.content [ Attachment ]; # 1..1 Actual Media - reference or data
  fhir:Media.note [ Annotation ], ... ; # 0..* Comments made about the media
]

Changes since DSTU2 Release 3

Media
Media.basedOn
  • Added Element Type changed from Reference(ProcedureRequest) to Reference(ServiceRequest|CarePlan)
Media.context Media.partOf
  • Added Element
Media.occurrence[x] Media.status
  • Added Element
Media.type
  • Min Cardinality changed from 1 to 0
  • Type changed from code to CodeableConcept
  • Change binding strength from required to extensible
  • Change value set from http://hl7.org/fhir/ValueSet/digital-media-type to http://hl7.org/fhir/ValueSet/media-type
Media.reasonCode Media.modality
  • Added Element
Media.subject
  • Type changed from Reference(Patient|Practitioner|Group|Device|Specimen) to Reference(Patient|Practitioner|Group|Device|Specimen|Location)
Media.bodySite Media.created[x]
  • Added Element
Media.device Media.issued
  • Added Element
Media.operator
  • Type changed from Reference(Practitioner) to Reference(Practitioner|PractitionerRole|Organization|CareTeam|Patient|Device|RelatedPerson)
Media.note Media.deviceName
  • Added Element
Media.device
  • Type changed from Reference(Device|DeviceMetric) to Reference(Device|DeviceMetric|Device)
Media.frames
  • Default Value "1" removed
Media.duration
  • Type changed from unsignedInt to decimal
Media.deviceName Media.subtype
  • deleted
Media.occurrence[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 3 4 tests that all of which 4 fail to execute ok. All tests pass round-trip testing and all r3 resources are valid.). .)

 

Alternate See the Profiles & Extensions and the alternate definitions: Master Definition ( XML , + JSON ), , XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis

2.37.3.1 10.2.3.1 Terminology Bindings

Media.type Media.subtype
Path Definition Type Reference
Media.status Whether Codes identifying the media is lifecycle stage of a photo, video, or audio event. Required DigitalMediaType EventStatus
Media.type Codes for high level media categories. Extensible MediaType
Media.modality Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it it. Example Media SubType MediaModality
Media.view Imaging view (projection) used when collecting an image image. Example Media Collection View/Projection MediaCollectionView/Projection
Media.reasonCode The reason for the media media. Example Procedure Reason Codes ProcedureReasonCodes
Media.bodySite Codes describing anatomical locations. May include laterality. Example SNOMED CT Body Structures SNOMEDCTBodyStructures

2.37.3.2 Constraints 10.2.3.2 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' ) Implementation Notes 2.37.3.3 Implementation Notes

The media resource contains several date/times:

  • Media.occurrence[x] Media.created[x] - The date(/time) of collection, or the period over which collection occured occurred
  • Media.duration - The duration of the media. The duration might differ from occurrencePeriod createdPeriod if recording was paused
  • Media.content.creation - This should be consistent with the Media.occurrence[x] Media.created[x] but might be different due to partial / edited recordings

This resource can embed the image information directly through the attachment.data element. However, good practice is generally to use the attachment.url element to point to a Binary resource. Servers will frequently be able to persist Binary resources in purpose-dedicated repositories more suitable to potentially large artifacts.

2.37.4 10.2.4 Search Parameters

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

date Date attachment was first created Media.content.creation subtype token
Name Type Description Expression In Common
based-on reference Procedure that caused this media to be created Media.basedOn
( ProcedureRequest CarePlan , ServiceRequest )
context reference Encounter / Episode associated with media Media.context
( EpisodeOfCare , Encounter ) 		created
date created date When Media was collected Media.occurrence Media.created
device reference Observing Device Media.device
( Device , DeviceMetric )
identifier token Identifier(s) for the image Media.identifier
modality token The type of acquisition equipment/process Media.modality
operator reference The person who generated the image Media.operator
( Practitioner , Organization , CareTeam , Device , Patient , PractitionerRole , RelatedPerson )
patient reference Who/What this Media is a record of Media.subject Media.subject.where(resolve() is Patient)
( Patient )
site token Body Observed body part in media Media.bodySite
status token preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown Media.status
subject reference Who/What this Media is a record of Media.subject
( Practitioner , Group , Specimen , Device , Patient , Location ) 		The type of acquisition equipment/process Media.subtype
type token photo | video | Classification of media as image, video, or audio Media.type
view token Imaging view, e.g. Lateral or Antero-posterior Media.view