FindingImagingReportsStudiesAndImagesFederated
type: ExampleScenario
node role: treeRoot
id:
  v: FindingImagingReportsStudiesAndImagesFederated
text:
  status:
    v: extensions
  div: Generated Narrative: ExampleScenario FindingImagingReportsStudiesAndImagesFederated url: FindingImagingReportsStudiesAndImagesFederated version: 0.0.1-current name: FindingImagingReportsStudiesAndImagesFederated status: Draft date: 2025-06-10 07:39:07+0000 publisher: NHS England contact: https://www.ihe.net/ihe_domains/it_infrastructure/, iti@ihe.net, NHS England: iti@ihe.net jurisdiction: United Kingdom of Great Britain and Northern Ireland actor actorId: user type: System name: Document Consumer description: The Document Consumer Actor queries for documents meeting certain criteria, and may retrieve selected documents. actor actorId: xds type: System name: Document Registry description: The Document Registry 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. actor actorId: xca type: System name: Responding Gateway description: In NIR this is also known as Imaging Network. This is an infrastrcture service which enables federation. actor actorId: docs type: System name: Document Repository description: The Document Repository is responsible for both the persistent storage of these documents (e.g. Imaging Report) actor actorId: image type: System name: Imaging Repository description: The Imaging Repository 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. instance resourceId: IHESearchDocumentEntries resourceType: Binary name: Search for Document Entries - Imaging studies and reports description: See Finding and Retrieving Document Entries (IHE MHD) for API base contract. E.g. 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/s…
url:
  v: https://fhir.nhs.uk/England/RAD/ExampleScenario/FindingImagingReportsStudiesAndImagesFederated
version:
  v: 0.0.1-current
name:
  v: FindingImagingReportsStudiesAndImagesFederated
status:
  v: draft
date:
  v: 2025-06-10T07:39:07+00:00
publisher:
  v: NHS England
contact:
  telecom:
    system:
      v: url
    value:
      v: https://www.ihe.net/ihe_domains/it_infrastructure/
contact:
  telecom:
    system:
      v: email
contact:
  name:
    v: NHS England
  telecom:
    system:
      v: email
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: GB
    display:
      v: United Kingdom of Great Britain and Northern Ireland
actor:
  actor id:
    v: user
  type:
    v: entity
  name:
    v: Document Consumer
  description:
    v: The [Document Consumer](ActorDefinition-DocumentConsumer.html) Actor queries for documents meeting certain criteria, and may retrieve selected documents.
actor:
  actor id:
    v: xds
  type:
    v: entity
  name:
    v: Document Registry
  description:
    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.
actor:
  actor id:
    v: xca
  type:
    v: entity
  name:
    v: Responding Gateway
  description:
    v: In NIR this is also known as **Imaging Network**. This is an infrastrcture service which enables federation.
actor:
  actor id:
    v: docs
  type:
    v: entity
  name:
    v: Document Repository
  description:
    v: The [Document Repository](ActorDefinition-DocumentRepository.html) is responsible for both the persistent storage of these documents (e.g. Imaging Report)
actor:
  actor id:
    v: image
  type:
    v: entity
  name:
    v: Imaging Repository
  description:
    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.
instance:
  resource id:
    v: IHESearchDocumentEntries
  resource type:
    v: Binary
  name:
    v: Search for Document Entries - Imaging studies and reports
  description:
    v: See [Finding and Retrieving Document Entries (IHE MHD)](CapabilityStatement-FindDocumentsMHD.html) for API base contract. E.g. ``` 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 ``` The equivalent in an IHE XDS environment is [Registry Stored Query [ITI-18]](https://profiles.ihe.net/ITI/TF/Volume2/ITI-18.html#3.18) Note: 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)
instance:
  resource id:
    v: IHESearchResultsDocumentEntries
  resource type:
    v: Bundle
  name:
    v: Return Document Entry search results
  version:
    extension:
      url:
        v: http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title
      value: string
        v: Search Results
    extension:
      url:
        v: http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content
      value: Reference
        link: https://fhir.nhs.uk/England/RAD/Bundle/MHDSearchResultsDocuments
    version id:
      v: 1
instance:
  resource id:
    v: XCAQuery
  resource type:
    v: Binary
  name:
    v: XCA Query
  description:
    v: Example Response [AdHocQueryRequest XML](AdHocQueryRequest.xml) See [IHE Cross-Community Access (XCA)](https://profiles.ihe.net/ITI/TF/Volume1/ch-18.html)
instance:
  resource id:
    v: XCAResponse
  resource type:
    v: Binary
  name:
    v: XCA Query Response
  description:
    v: Example Response [AdHocQueryReponse XML](AdHocQueryReponse.xml)
instance:
  resource id:
    v: IHEReadDiagnosticReport
  resource type:
    v: Binary
  name:
    v: Read DiagnosticReport
  description:
    v: See [Find and Retrieve Imaging Reports](CapabilityStatement-FindAndRetrieveImagingReports.html) for API overview. E.g. ``` GET https://example.nhs.uk/FHIR/R4//DiagnosticReport/ABCD ``` The equivalent in an IHE XDS environment is [Retrieve Document Set [ITI-43]](https://profiles.ihe.net/ITI/TF/Volume2/ITI-43.html#3.43)
instance:
  resource id:
    v: IHEViewDiagnosticReport
  resource type:
    v: DiagnosticReport
  name:
    v: Return DiagnosticReport
  version:
    extension:
      url:
        v: http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title
      value: string
        v: Retrieve Diagnostic Report
    extension:
      url:
        v: http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content
      value: Reference
        link: https://fhir.nhs.uk/England/RAD/DiagnosticReport/DiagnosticReportImagingReportRCR
    version id:
      v: 1
instance:
  resource id:
    v: IHEReadImagingStudy
  resource type:
    v: Binary
  name:
    v: Read ImagingStudy
  description:
    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
instance:
  resource id:
    v: IHERetrieveImagingStudy
  resource type:
    v: Binary
  name:
    v: Return ImagingStudy
  description:
    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
instance:
  resource id:
    v: IHEReadImageInstance
  resource type:
    v: Binary
  name:
    v: Read Image Instance
  description:
    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
instance:
  resource id:
    v: IHERetrieveImage
  resource type:
    v: Binary
  name:
    v: Return Image Instance
  description:
    v: DICOM Image Instance

v: Bundle/MHDSearchResultsDocuments

v: DiagnosticReport/DiagnosticReportImagingReportRCR

title:
  v: Query for patient image and/or report
description:
  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.
step:
  process:
    title:
      v: Search for Document Entries - Imaging studies and reports
step:
  process:
    title:
      v: For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA)
step:
  process:
    title:
      v: Aggregate and Return Search Results - Imaging studies and reports

v: 1

v: search-type

v: Search for Document Entires

v: user

v: xds

resource id:
  v: IHESearchDocumentEntries

v: 1

v: search-type

v: Search for Document Entries in other networks

v: xds

v: xca

resource id:
  v: XCAQuery

resource id:
  v: XCAResponse

v: 1

v: search-type

v: Return Document Entry search results

v: xds

v: user

resource id:
  v: IHESearchResultsDocumentEntries

title:
  v: Option - Retrieve selected imaging report
description:
  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/).
step:
  operation:
    number:
      v: 1
    type:
      v: read
    name:
      v: Retrieve Imaging Report
    initiator:
      v: user
    receiver:
      v: docs
    request:
      resource id:
        v: IHEReadDiagnosticReport
    response:
      resource id:
        v: IHEViewDiagnosticReport

title:
  v: Option - Retrieve selected imaging study
description:
  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.
step:
  operation:
    number:
      v: 1
    type:
      v: read
    name:
      v: Retrieve Imaging Study
    initiator:
      v: user
    receiver:
      v: image
    request:
      resource id:
        v: IHEReadImagingStudy
    response:
      resource id:
        v: IHERetrieveImagingStudy
step:
  process:
    title:
      v: Retrieve selected image - Optional

v: 1

v: read

v: Retrieve Image

v: user

v: image

resource id:
  v: IHEReadImageInstance

resource id:
  v: IHERetrieveImage