Radiology (Sandbox)
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Requirement Specification

This is for collaboration and discussion purposes and is subject to change.

This is not an Implementation Guide

Radiology (Sandbox) - Local Development build (v0.0.1-current) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Finding Imaging Reports and Images - Federated (IHE) - TTL Representation

Draft as of 2024-10-24

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ExampleScenario ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "FindingImagingReportsStudiesAndImagesFederated"] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ExampleScenario FindingImagingReportsStudiesAndImagesFederated</b></p><a name=\"FindingImagingReportsStudiesAndImagesFederated\"> </a><a name=\"hcFindingImagingReportsStudiesAndImagesFederated\"> </a><a name=\"FindingImagingReportsStudiesAndImagesFederated-en-US\"> </a><p><b>url</b>: <a href=\"ExampleScenario-FindingImagingReportsStudiesAndImagesFederated.html\">FindingImagingReportsStudiesAndImagesFederated</a></p><p><b>version</b>: 0.0.1-current</p><p><b>name</b>: FindingImagingReportsStudiesAndImagesFederated</p><p><b>status</b>: Draft</p><p><b>date</b>: 2024-10-24 15:09:54+0000</p><p><b>publisher</b>: NHS England</p><p><b>contact</b>: <a href=\"https://www.ihe.net/ihe_domains/it_infrastructure/\">https://www.ihe.net/ihe_domains/it_infrastructure/</a>, <a href=\"mailto:iti@ihe.net\">iti@ihe.net</a>, NHS England: <a href=\"mailto:iti@ihe.net\">iti@ihe.net</a></p><p><b>jurisdiction</b>: <span title=\"Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}\">Global (Whole world)</span></p><blockquote><p><b>actor</b></p><p><b>actorId</b>: user</p><p><b>type</b>: System</p><p><b>name</b>: Document Consumer</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-DocumentConsumer.html\">Document Consumer</a> Actor queries for documents meeting certain criteria, and may retrieve selected documents.</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: xds</p><p><b>type</b>: System</p><p><b>name</b>: Document Registry</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-DocumentRegistry.html\">Document Registry</a> Actor maintains metadata about each registered document in a document entry. This includes a link to the Document in the Repository where it is stored. The Document Registry responds to queries from Document Consumer actors about documents meeting specific criteria.</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: xca</p><p><b>type</b>: System</p><p><b>name</b>: Responding Gateway</p><p><b>description</b>: </p><div><p>In NIR this is also known as <strong>Imaging Network</strong>. This is an infrastrcture service which enables federation.</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: docs</p><p><b>type</b>: System</p><p><b>name</b>: Document Repository</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-DocumentRepository.html\">Document Repository</a> is responsible for both the persistent storage of these documents (e.g. Imaging Report)</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: image</p><p><b>type</b>: System</p><p><b>name</b>: Imaging Repository</p><p><b>description</b>: </p><div><p>The <a href=\"ActorDefinition-ImagingRepository.html\">Imaging Repository</a> is responsible for both the persistent storage of DICOM Images and Imaging Studies, these may also contain Imaging Reports. This is also known as a PACS.</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHESearchDocumentEntries</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Search for Document Entries - Imaging studies and reports</p><p><b>description</b>: </p><div><p>See <a href=\"CapabilityStatement-FindDocumentsMHD.html\">Finding and Retrieving Document Entries (IHE MHD)</a> for API base contract. E.g.</p>\n<pre><code>GET https://example.nhs.uk/FHIR/R4/DocumentReference?patient:identifier=https://fhir.nhs.uk/Id/nhs-number|9912003888&amp;category=http://snomed.info/sct|721981007,http://snomed.info/sct|4201000179104\n</code></pre>\n<p>The equivalent in an IHE XDS environment is <a href=\"https://profiles.ihe.net/ITI/TF/Volume2/ITI-18.html#3.18\">Registry Stored Query [ITI-18]</a></p>\n<p>Note: At present <code>category</code> and <code>type</code> which are common search parameters in IHE XDS, MHD and <a href=\"https://build.fhir.org/ig/HL7/fhir-ipa/index.html\">HL7 IPA</a>, are not fully defined in <a href=\"https://simplifier.net/hl7fhirukcorer4/ukcore-documentreference\">UKCore-DocumentReference</a> for widespread English NHS use, the codes used in the examples are broadly based on the elaboration of <a href=\"StructureDefinition-DocumentEntry.html\">Document Entry</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHESearchResultsDocumentEntries</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Return Document Entry search results</p><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Search Results</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"Bundle-MHDSearchResultsDocuments.html\">Bundle: type = searchset; total = 1</a></p><p><b>versionId</b>: 1</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: XCAQuery</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: XCA Query</p><p><b>description</b>: </p><div><p>Example Response <a href=\"AdHocQueryRequest.xml\">AdHocQueryRequest XML</a></p>\n<p>See <a href=\"https://profiles.ihe.net/ITI/TF/Volume1/ch-18.html\">IHE Cross-Community Access (XCA)</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: XCAResponse</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: XCA Query Response</p><p><b>description</b>: </p><div><p>Example Response <a href=\"AdHocQueryReponse.xml\">AdHocQueryReponse XML</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEReadDiagnosticReport</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Read DiagnosticReport</p><p><b>description</b>: </p><div><p>See <a href=\"CapabilityStatement-FindAndRetrieveImagingReports.html\">Find and Retrieve Imaging Reports</a> for API overview. E.g.</p>\n<pre><code>GET https://example.nhs.uk/FHIR/R4//DiagnosticReport/ABCD\n</code></pre>\n<p>The equivalent in an IHE XDS environment is <a href=\"https://profiles.ihe.net/ITI/TF/Volume2/ITI-43.html#3.43\">Retrieve Document Set [ITI-43]</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEViewDiagnosticReport</p><p><b>resourceType</b>: DiagnosticReport</p><p><b>name</b>: Return DiagnosticReport</p><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Retrieve Diagnostic Report</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"DiagnosticReport-DiagnosticReportImagingReportRCR.html\">Diagnostic Report for 'MRA Upper limb Rt' for '-&gt;display: string (PrimitiveType/DiagnosticReport.subject.display): element = string -&gt; display=string[Richard SMITH]'</a></p><p><b>versionId</b>: 1</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEReadImagingStudy</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Read ImagingStudy</p><p><b>description</b>: </p><div><p><a href=\"https://wiki.ihe.net/index.php/Web-based_Image_Access\">IHE WADO Retrieve (WADO-RS)</a>. See also <a href=\"CapabilityStatement-RetrieveImagingStudy.html\">Retrieve Imaging Study</a> for API overview</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHERetrieveImagingStudy</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Return ImagingStudy</p><p><b>description</b>: </p><div><p><a href=\"https://www.dicomstandard.org/News-dir/ftsup/docs/sups/sup59.pdf\">DICOM Key Object Selection (KOS)</a> is a manifest, which includes references to images which are used to find and retrieve the DICOM Image Instance</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHEReadImageInstance</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Read Image Instance</p><p><b>description</b>: </p><div><p><a href=\"https://wiki.ihe.net/index.php/Web-based_Image_Access\">IHE WADO Retrieve (WADO-RS)</a>. See also <a href=\"CapabilityStatement-RetrieveImageInstances.html\">Retrieve Image Instances</a> for API overview</p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: IHERetrieveImage</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Return Image Instance</p><p><b>description</b>: </p><div><p>DICOM Image Instance</p>\n</div></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Query for patient image and/or report</p><p><b>description</b>: </p><div><p>IHE XCA implements an <a href=\"https://www.enterpriseintegrationpatterns.com/patterns/conversation/Aggregator.html\">Aggregator</a> pattern. Each <strong>Responding Gateway</strong> is asked to same query that the <strong>Document Registry</strong> originally received, in our example this is HL7 FHIR RESTful query (this is also IHE MHD - <a href=\"https://profiles.ihe.net/ITI/MHD/ITI-67.html\">Find Document References ITI-67</a>) and this has been converted to IHE XML as an <code>AdHocQueryRequest</code>. <a href=\"StructureDefinition-DocumentEntry.html\">Document Entry</a> is a FHIR DocumentReference profile based on the NHS Data Dictionary definitions contained in <a href=\"https://www.ihe-europe.net/sites/default/files/2017-11/IHE_ITI_XDS_Metadata_Guidelines_v1.0.pdf\">IHE Europe - Metadata for exchange medical documents and images</a>, this also contains mappings between IHE XDS Document Entry and IHE MHD/HL7 FHIR DocumentReference.</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: Search for Document Entries - Imaging studies and reports</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: search-type</p><p><b>name</b>: Search for Document Entires</p><p><b>initiator</b>: user</p><p><b>receiver</b>: xds</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHESearchDocumentEntries</td></tr></table></blockquote></blockquote></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA)</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: search-type</p><p><b>name</b>: Search for Document Entries in other networks</p><p><b>initiator</b>: xds</p><p><b>receiver</b>: xca</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>XCAQuery</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>XCAResponse</td></tr></table></blockquote></blockquote></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: Aggregate and Return Search Results - Imaging studies and reports</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: search-type</p><p><b>name</b>: Return Document Entry search results</p><p><b>initiator</b>: xds</p><p><b>receiver</b>: user</p><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHESearchResultsDocumentEntries</td></tr></table></blockquote></blockquote></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Option - Retrieve selected imaging report</p><p><b>description</b>: </p><div><p>This is an optional step. The <strong>Document Consumer</strong> may choose to retrieve the <strong>Imaging Report</strong>. At present this is a <a href=\"https://www.rcr.ac.uk/media/wwtp2mif/rcr-publications_radiology-reporting-networks-understanding-the-technical-options_march-2022.pdf\">Royal College of Radiologists HL7 ORU</a> converted to a FHIR DiagnosticReport profile as <a href=\"StructureDefinition-ImagingReport.html\">Imaging Report</a>, this also contains mappings between HL7 ORU and FHIR DiagnosticReport. Other options are being discussed by HL7 Europe such as a <a href=\"https://health.ec.europa.eu/document/download/0079ad26-8f8f-435b-9472-3cd8625f4220_en?filename=ehn_mi_guidelines_en.pdf\">EU Medical imaging studies and reports</a> which is likely to be a derivative of <a href=\"https://build.fhir.org/ig/HL7/fhir-ips/index.html\">HL7 IPS</a>, like the <a href=\"https://build.fhir.org/ig/hl7-eu/laboratory/\">HL7 Europe Laboratory Report</a>.</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: read</p><p><b>name</b>: Retrieve Imaging Report</p><p><b>initiator</b>: user</p><p><b>receiver</b>: docs</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEReadDiagnosticReport</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEViewDiagnosticReport</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Option - Retrieve selected imaging study</p><p><b>description</b>: </p><div><p>This is an optional step. The <strong>Document Consumer</strong> may choose to retrieve the Imaging Study. At present this is a <a href=\"https://dicom.nema.org/dicom/supps/sup59_lb.pdf\">DICOM KOS</a> which contains DICOM modalities to used for retrieval of the Image Instances. Other options include using FHIR ImagingStudy which is a FHIR version of the DICOM KOS.</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: read</p><p><b>name</b>: Retrieve Imaging Study</p><p><b>initiator</b>: user</p><p><b>receiver</b>: image</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEReadImagingStudy</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHERetrieveImagingStudy</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>process</b></p><p><b>title</b>: Retrieve selected image - Optional</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: read</p><p><b>name</b>: Retrieve Image</p><p><b>initiator</b>: user</p><p><b>receiver</b>: image</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHEReadImageInstance</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>IHERetrieveImage</td></tr></table></blockquote></blockquote></blockquote></blockquote></blockquote></div>"
  ] ; # 
  fhir:url [ fhir:v "https://fhir.nhs.uk/England/RAD/ExampleScenario/FindingImagingReportsStudiesAndImagesFederated"^^xsd:anyURI] ; # 
  fhir:version [ fhir:v "0.0.1-current"] ; # 
  fhir:name [ fhir:v "FindingImagingReportsStudiesAndImagesFederated"] ; # 
  fhir:status [ fhir:v "draft"] ; # 
  fhir:date [ fhir:v "2024-10-24T15:09:54+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "NHS England"] ; # 
  fhir:contact ( [
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "https://www.ihe.net/ihe_domains/it_infrastructure/" ]     ] )
  ] [
    ( fhir:telecom [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "iti@ihe.net" ]     ] )
  ] [
fhir:name [ fhir:v "NHS England" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "iti@ihe.net" ]     ] )
  ] ) ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
fhir:code [ fhir:v "001" ]     ] )
  ] ) ; # 
  fhir:actor ( [
fhir:actorId [ fhir:v "user" ] ;
fhir:type [ fhir:v "entity" ] ;
fhir:name [ fhir:v "Document Consumer" ] ;
fhir:description [ fhir:v "The [Document Consumer](ActorDefinition-DocumentConsumer.html) Actor queries for documents meeting certain criteria, and may retrieve selected documents." ]
  ] [
fhir:actorId [ fhir:v "xds" ] ;
fhir:type [ fhir:v "entity" ] ;
fhir:name [ fhir:v "Document Registry" ] ;
fhir:description [ fhir:v "The [Document Registry](ActorDefinition-DocumentRegistry.html) Actor maintains metadata about each registered document in a document entry. This includes a link to the Document in the Repository where it is stored. The Document Registry responds to queries from Document Consumer actors about documents meeting specific criteria." ]
  ] [
fhir:actorId [ fhir:v "xca" ] ;
fhir:type [ fhir:v "entity" ] ;
fhir:name [ fhir:v "Responding Gateway" ] ;
fhir:description [ fhir:v "In NIR this is also known as **Imaging Network**. This is an infrastrcture service which enables federation." ]
  ] [
fhir:actorId [ fhir:v "docs" ] ;
fhir:type [ fhir:v "entity" ] ;
fhir:name [ fhir:v "Document Repository" ] ;
fhir:description [ fhir:v "The [Document Repository](ActorDefinition-DocumentRepository.html) is responsible for both the persistent storage of these documents (e.g. Imaging Report)" ]
  ] [
fhir:actorId [ fhir:v "image" ] ;
fhir:type [ fhir:v "entity" ] ;
fhir:name [ fhir:v "Imaging Repository" ] ;
fhir:description [ fhir:v "The [Imaging Repository](ActorDefinition-ImagingRepository.html) is responsible for both the persistent storage of DICOM Images and Imaging Studies, these may also contain Imaging Reports. This is also known as a PACS." ]
  ] ) ; # 
  fhir:instance ( [
fhir:resourceId [ fhir:v "IHESearchDocumentEntries" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "Search for Document Entries - Imaging studies and reports" ] ;
fhir:description [ fhir:v " See [Finding and Retrieving Document Entries (IHE MHD)](CapabilityStatement-FindDocumentsMHD.html) for API base contract. E.g. \n```\nGET https://example.nhs.uk/FHIR/R4/DocumentReference?patient:identifier=https://fhir.nhs.uk/Id/nhs-number|9912003888&category=http://snomed.info/sct|721981007,http://snomed.info/sct|4201000179104\n```\n\nThe equivalent in an IHE XDS environment is [Registry Stored Query [ITI-18]](https://profiles.ihe.net/ITI/TF/Volume2/ITI-18.html#3.18)\n\nNote: At present `category` and `type` which are common search parameters in IHE XDS, MHD and [HL7 IPA](https://build.fhir.org/ig/HL7/fhir-ipa/index.html), are not fully defined in [UKCore-DocumentReference](https://simplifier.net/hl7fhirukcorer4/ukcore-documentreference) for widespread English NHS use, the codes used in the examples are broadly based on the elaboration of [Document Entry](StructureDefinition-DocumentEntry.html) " ]
  ] [
fhir:resourceId [ fhir:v "IHESearchResultsDocumentEntries" ] ;
fhir:resourceType [ fhir:v "Bundle" ] ;
fhir:name [ fhir:v "Return Document Entry search results" ] ;
    ( fhir:version [
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Search Results" ]       ] [
fhir:url [ fhir:v "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "Bundle/MHDSearchResultsDocuments" ]         ]       ] ) ;
fhir:versionId [ fhir:v "1" ]     ] )
  ] [
fhir:resourceId [ fhir:v "XCAQuery" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "XCA Query" ] ;
fhir:description [ fhir:v " Example Response [AdHocQueryRequest XML](AdHocQueryRequest.xml) \n\n See [IHE Cross-Community Access (XCA)](https://profiles.ihe.net/ITI/TF/Volume1/ch-18.html) " ]
  ] [
fhir:resourceId [ fhir:v "XCAResponse" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "XCA Query Response" ] ;
fhir:description [ fhir:v " Example Response [AdHocQueryReponse XML](AdHocQueryReponse.xml)  " ]
  ] [
fhir:resourceId [ fhir:v "IHEReadDiagnosticReport" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "Read DiagnosticReport" ] ;
fhir:description [ fhir:v " See [Find and Retrieve Imaging Reports](CapabilityStatement-FindAndRetrieveImagingReports.html) for API overview. E.g. \n```\nGET https://example.nhs.uk/FHIR/R4//DiagnosticReport/ABCD\n```\n \n\nThe equivalent in an IHE XDS environment is [Retrieve Document Set [ITI-43]](https://profiles.ihe.net/ITI/TF/Volume2/ITI-43.html#3.43) " ]
  ] [
fhir:resourceId [ fhir:v "IHEViewDiagnosticReport" ] ;
fhir:resourceType [ fhir:v "DiagnosticReport" ] ;
fhir:name [ fhir:v "Return DiagnosticReport" ] ;
    ( fhir:version [
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Retrieve Diagnostic Report" ]       ] [
fhir:url [ fhir:v "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "DiagnosticReport/DiagnosticReportImagingReportRCR" ]         ]       ] ) ;
fhir:versionId [ fhir:v "1" ]     ] )
  ] [
fhir:resourceId [ fhir:v "IHEReadImagingStudy" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "Read ImagingStudy" ] ;
fhir:description [ fhir:v "[IHE WADO Retrieve (WADO-RS)](https://wiki.ihe.net/index.php/Web-based_Image_Access). See also [Retrieve Imaging Study](CapabilityStatement-RetrieveImagingStudy.html) for API overview " ]
  ] [
fhir:resourceId [ fhir:v "IHERetrieveImagingStudy" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "Return ImagingStudy" ] ;
fhir:description [ fhir:v "[DICOM Key Object Selection (KOS)](https://www.dicomstandard.org/News-dir/ftsup/docs/sups/sup59.pdf) is a manifest, which includes references to images which are used to find and retrieve the DICOM Image Instance " ]
  ] [
fhir:resourceId [ fhir:v "IHEReadImageInstance" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "Read Image Instance" ] ;
fhir:description [ fhir:v "[IHE WADO Retrieve (WADO-RS)](https://wiki.ihe.net/index.php/Web-based_Image_Access). See also [Retrieve Image Instances](CapabilityStatement-RetrieveImageInstances.html) for API overview " ]
  ] [
fhir:resourceId [ fhir:v "IHERetrieveImage" ] ;
fhir:resourceType [ fhir:v "Binary" ] ;
fhir:name [ fhir:v "Return Image Instance" ] ;
fhir:description [ fhir:v "DICOM Image Instance" ]
  ] ) ; # 
  fhir:process ( [
fhir:title [ fhir:v "Query for patient image and/or report" ] ;
fhir:description [ fhir:v "IHE XCA implements an [Aggregator](https://www.enterpriseintegrationpatterns.com/patterns/conversation/Aggregator.html) pattern. Each **Responding Gateway** is asked to same query that the **Document Registry** originally received, in our example this is HL7 FHIR RESTful query (this is also IHE MHD - [Find Document References ITI-67](https://profiles.ihe.net/ITI/MHD/ITI-67.html)) and this has been converted to IHE XML as an `AdHocQueryRequest`. [Document Entry](StructureDefinition-DocumentEntry.html) is a FHIR DocumentReference profile based on the NHS Data Dictionary definitions contained in [IHE Europe - Metadata for exchange medical documents and images](https://www.ihe-europe.net/sites/default/files/2017-11/IHE_ITI_XDS_Metadata_Guidelines_v1.0.pdf), this also contains mappings between IHE XDS Document Entry and IHE MHD/HL7 FHIR DocumentReference." ] ;
    ( fhir:step [
      ( fhir:process [
fhir:title [ fhir:v "Search for Document Entries - Imaging studies and reports" ] ;
        ( fhir:step [
fhir:operation [
fhir:number [ fhir:v "1" ] ;
fhir:type [ fhir:v "search-type" ] ;
fhir:name [ fhir:v "Search for Document Entires" ] ;
fhir:initiator [ fhir:v "user" ] ;
fhir:receiver [ fhir:v "xds" ] ;
fhir:request [
fhir:resourceId [ fhir:v "IHESearchDocumentEntries" ]             ]           ]         ] )       ] )     ] [
      ( fhir:process [
fhir:title [ fhir:v "For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA)" ] ;
        ( fhir:step [
fhir:operation [
fhir:number [ fhir:v "1" ] ;
fhir:type [ fhir:v "search-type" ] ;
fhir:name [ fhir:v "Search for Document Entries in other networks" ] ;
fhir:initiator [ fhir:v "xds" ] ;
fhir:receiver [ fhir:v "xca" ] ;
fhir:request [
fhir:resourceId [ fhir:v "XCAQuery" ]             ] ;
fhir:response [
fhir:resourceId [ fhir:v "XCAResponse" ]             ]           ]         ] )       ] )     ] [
      ( fhir:process [
fhir:title [ fhir:v "Aggregate and Return Search Results - Imaging studies and reports" ] ;
        ( fhir:step [
fhir:operation [
fhir:number [ fhir:v "1" ] ;
fhir:type [ fhir:v "search-type" ] ;
fhir:name [ fhir:v "Return Document Entry search results" ] ;
fhir:initiator [ fhir:v "xds" ] ;
fhir:receiver [ fhir:v "user" ] ;
fhir:response [
fhir:resourceId [ fhir:v "IHESearchResultsDocumentEntries" ]             ]           ]         ] )       ] )     ] )
  ] [
fhir:title [ fhir:v "Option - Retrieve selected imaging report" ] ;
fhir:description [ fhir:v "This is an optional step. The **Document Consumer** may choose to retrieve the **Imaging Report**. At present this is a [Royal College of Radiologists HL7 ORU](https://www.rcr.ac.uk/media/wwtp2mif/rcr-publications_radiology-reporting-networks-understanding-the-technical-options_march-2022.pdf) converted to a FHIR DiagnosticReport profile as [Imaging Report](StructureDefinition-ImagingReport.html), this also contains mappings between HL7 ORU and FHIR DiagnosticReport. Other options are being discussed by HL7 Europe such as a [EU Medical imaging studies and reports](https://health.ec.europa.eu/document/download/0079ad26-8f8f-435b-9472-3cd8625f4220_en?filename=ehn_mi_guidelines_en.pdf) which is likely to be a derivative of [HL7 IPS](https://build.fhir.org/ig/HL7/fhir-ips/index.html), like the [HL7 Europe Laboratory Report](https://build.fhir.org/ig/hl7-eu/laboratory/)." ] ;
    ( fhir:step [
fhir:operation [
fhir:number [ fhir:v "1" ] ;
fhir:type [ fhir:v "read" ] ;
fhir:name [ fhir:v "Retrieve Imaging Report" ] ;
fhir:initiator [ fhir:v "user" ] ;
fhir:receiver [ fhir:v "docs" ] ;
fhir:request [
fhir:resourceId [ fhir:v "IHEReadDiagnosticReport" ]         ] ;
fhir:response [
fhir:resourceId [ fhir:v "IHEViewDiagnosticReport" ]         ]       ]     ] )
  ] [
fhir:title [ fhir:v "Option - Retrieve selected imaging study" ] ;
fhir:description [ fhir:v "This is an optional step. The **Document Consumer** may choose to retrieve the Imaging Study. At present this is a [DICOM KOS](https://dicom.nema.org/dicom/supps/sup59_lb.pdf) which contains DICOM modalities to used for retrieval of the Image Instances. Other options include using FHIR ImagingStudy which is a FHIR version of the DICOM KOS." ] ;
    ( fhir:step [
fhir:operation [
fhir:number [ fhir:v "1" ] ;
fhir:type [ fhir:v "read" ] ;
fhir:name [ fhir:v "Retrieve Imaging Study" ] ;
fhir:initiator [ fhir:v "user" ] ;
fhir:receiver [ fhir:v "image" ] ;
fhir:request [
fhir:resourceId [ fhir:v "IHEReadImagingStudy" ]         ] ;
fhir:response [
fhir:resourceId [ fhir:v "IHERetrieveImagingStudy" ]         ]       ]     ] [
      ( fhir:process [
fhir:title [ fhir:v "Retrieve selected image - Optional" ] ;
        ( fhir:step [
fhir:operation [
fhir:number [ fhir:v "1" ] ;
fhir:type [ fhir:v "read" ] ;
fhir:name [ fhir:v "Retrieve Image" ] ;
fhir:initiator [ fhir:v "user" ] ;
fhir:receiver [ fhir:v "image" ] ;
fhir:request [
fhir:resourceId [ fhir:v "IHEReadImageInstance" ]             ] ;
fhir:response [
fhir:resourceId [ fhir:v "IHERetrieveImage" ]             ]           ]         ] )       ] )     ] )
  ] ) . #