The Clinical Data Repository is responsible for the persistent storage of clinical data items (observations, conditions, immunisations, etc). E.g. PHR, EHR and EPR

Provides lookup or query services for master Organisation, Facility, Location, Practitioner, Healthcare Service, OrganisationAffiliation, and Endpoint records which meet specific criteria.

The Document Consumer Actor queries for documents meeting certain criteria, and may retrieve selected documents.

The Document Registry Actor maintains maintains a index of records held in Document Repositories and Form Repositories, the index metadata is called a Document Entry (or DocumentReference in FHIR) 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. E.g. XDS System, NRL and is also often found Clinical Data Repositories.

The Document Repository is responsible for both the persistent storage of these documents (and compositions). E.g. XDS System, EPR and EDMS

The Event Consumer Actor receives events.

The Event Source Actor produces events based event triggers which occur during clinical activity (e.g. patient discharged).

The Imaging Repository is responsible for both the persistent storage of DICOM Images and Imaging Studies, these may also contain Imaging Reports. E.g. PACS.

This is a capture of requirements coming from this project.

Although this is classed here as a Document Repository, it may often be implemented as a Clinical Data Repository and so the actual API may be more expressive e.g. IHE Query for Existing Data for Mobile (QEDm).

Finding and Retrieving Document Entries

This is IHE Mobile access to Health Documents (MHD) - Find Document References ITI-67 linked to UK/NHS England specific Document Metadata

This is a local version of

• National Record Locator - FHIR API v3 - Retrieve document pointers (GET)
• National Record Locator - FHIR API v3 - Get a single document pointer

for documentation purposes.

This is a capture of requirements coming from this project.

The actual API is:

• DICOM Retrieve (WADO-RS)
• IHE WADO Retrieve (WADO-RS)
• IHE Radiology (RAD) Technical Framework

This is a capture of requirements coming from this project.

The actual API is:

• DICOM Retrieve (WADO-RS)
• IHE Retrieve (WADO-RS)
• IHE Radiology (RAD) Technical Framework

Is a logical representation of a variety of structured data entities which are normally made available by a repository. For unstructured data items this is classed as a Binary and will be in traditional document formats such as pdf or jpeg. Within NHS England this is also known as a Health Record and this is what a pointer points to.

Structured Data Items (documents) in this project include:

• Imaging Report (FHIR DiagnosticReport)
• Imaging Study
• Image

Based on

• IHE Europe Metadata for exchange medical documents and images
• IHE Mobile access to Health Documents (MHD)

At present this is not based on UK Core DocumentReference as this is analysis of enterprise entity models but will be at a later date.

See IHE MHD Minimal DocumentReference

Documentation only at present - is not currently required in the project.

Notes on (DICOM) Image.

DiagnosticReport based on

• Royal College of Radiologists - Understanding the Technical Options HL7 v2 ORU
• UK Core DiagnosticReport

Users should also review this analysis in conjunction with IHE Interactive Multimedia Report (IMR) - IMR DiagnosticReport

Ignore, just a collection of notes.

This is based on National Record Locator - FHIR API v3 - Producer - Create new, or Supersede existing, document pointers and is for documentation purposes only.

Ignore, just a collection of notes.

From eRS ASID Description

Accredited System Identifier is an identifier used in Spine Directory Service (SDS) to reference an IT system which has been accredited for use in a specific health or care organisation.

The application created within API Management will be bound to an ASID. This is a one-to-one mapping and the ASID is representative of the end-user organisation. If you’re working with many end-user organisations you will need multiple ASIDs.

GENERAL MEDICAL COUNCIL REFERENCE NUMBER which is a CONSULTANT CODE

Format CNNNNNNN

• HL7 v3/OID: 2.16.840.1.113883.2.1.3.2.4.16.63
• HL7 v2: GMC
• HL7 FHIR https://fhir.hl7.org.uk/Id/gmc-number

GENERAL MEDICAL PRACTITIONER PPD CODE. Formerly called GP General National Code (GNC).

Format G[1234589]NNNNNN

• HL7 v3/OID: 2.16.840.1.113883.2.1.3.2.4.16.62
• HL7 v2: GMP
• HL7 FHIR: https://fhir.hl7.org.uk/Id/gmp-number

Only use in References if the NHS Number is not known or unverified.

Only traced NHS Number SHOULD be used, un-traced NHS Numbers MUST be clearly indicated.

Format: NNNNNNNNNN (400 000 000 to 499 999 999, and 600 000 000 to 799 999)

NHS Data Dictionary ORGANISATION_CODE

NHS Data Dictionary ORGANISATION SITE IDENTIFIER

Use ODS Site code relevant for organisation. E.g. Use Mid Yorkshire Hospitals NHS Trust (RXF) version of Pinderfields Hospital (RXF05) when referring to Mid Yorks, not others in the director

A Reference data type where the referenced resource is expected to be resolvable RESTfully.

A Reference data type where the referenced resource could be resolvable RESTfully or pointed to logically.

• Digital Health and Care Scotland - (EH4001) CLINICAL DOCUMENT INDEXING STANDARDS
• Switzerland DocumentEntry.classCode

• Switzerland DocumentEntry.typeCode
• Digital Health and Care Scotland - (EH4001) CLINICAL DOCUMENT INDEXING STANDARDS
• UKCore DocumentType, NHS England Terminology Browser Refset 1127551000000109
• NHS England Data Dictionary IMAGING CODE (SNOMED CT)
  • NHS England Terminology Browser Refset 999001111000000105
• NHS England National Interim Clinical Imaging Procedure code set which mentions a ConceptMap to SNOMED CT (according Data Dictionary for Care (DD4C) NICIP, and the SNOMED refset are all referring to the same procedures)
  • NHS England Data Dictionary IMAGING CODE (SNOMED CT)
  • NHS England Terminology Browser Refset 999001111000000105

Experimental

ACTIVITY LOCATION TYPE CODE

IMAGING CODE (NICIP)

Concept Map between NHS England UK SNOMED CT and NICIP Mapping spreadsheet

Modality

• TREATMENT FUNCTION CODE
• UKCoreCareSettingType

E.g. NICIP?

Not specified in eRS and BARS

• MAIN SPECIALTY CODE
• UKCorePracticeSettingCode

New method of populating NRL from IHE XDS or like systems

New method of populating NRL from IHE XDS or like systems

New method of populating NRL from IHE XDS or like systems

Example search results for Imaging Report with an id of ABCD

GET https://example.nhs.uk/FHIR/R4/DiagnosticReport?_id=ABCD

Example search results for patient with a NHS Number: 9912003888 who has Diagnostic studies reports and Imaging report

GET 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

Example search results for patient with a NHS Number: 9912003888

GET https://example.nhs.uk/FHIR/R4/DocumentReference?patient:identifier=https://fhir.nhs.uk/Id/nhs-number|9912003888

Example of IHE MHD Provide Document Bundle [ITI-65] minimal metadata. This is a FHIR Transaction Bundle containing a DocumentReference for an Imaging Stufy (which is referenced via a url/pointer) to the study) and a Document SubmissionSet (FHIR List) POST https://example.nhs.uk/FHIR/R4/

Example sending of a FHIR Transaction Bundle containing a DocumentReference for an Imaging Report

POST https://example.nhs.uk/FHIR/R4/

This is the same DocumentReference IHE for a Imaging Study with an embedded document to meet ITI-65 requirements.

DocumentReference IHE for a Imaging Report

DocumentReference IHE for a Imaging Study - can be also be in IHE XDS Document Entry format

Document Reference NRL

DocumentReference NRL for a Imaging Study