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/sct|4201000179104 The equivalent in an IHE XDS environment is Registry Stored Query [ITI-18] Note: At present category and type which are common search parameters in IHE XDS, MHD and HL7 IPA, are not fully defined in UKCore-DocumentReference for widespread English NHS use, the codes used in the examples are broadly based on the elaboration of Document Entry instance resourceId: IHESearchResultsDocumentEntries resourceType: Bundle name: Return Document Entry search results version Extension Definition for ExampleScenario.instance.version.title for Version 5.0: Search Results Extension Definition for ExampleScenario.instance.version.content for Version 5.0: Bundle: type = searchset; total = 1 versionId: 1 instance resourceId: XCAQuery resourceType: Binary name: XCA Query description: Example Response AdHocQueryRequest XML See IHE Cross-Community Access (XCA) instance resourceId: XCAResponse resourceType: Binary name: XCA Query Response description: Example Response AdHocQueryReponse XML instance resourceId: IHEReadDiagnosticReport resourceType: Binary name: Read DiagnosticReport description: See Find and Retrieve Imaging Reports 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] instance resourceId: IHEViewDiagnosticReport resourceType: DiagnosticReport name: Return DiagnosticReport version Extension Definition for ExampleScenario.instance.version.title for Version 5.0: Retrieve Diagnostic Report Extension Definition for ExampleScenario.instance.version.content for Version 5.0: Diagnostic Report for 'MRA Upper limb Rt' for '->display: string (PrimitiveType/DiagnosticReport.subject.display): element = string -> display=string[Richard SMITH]' versionId: 1 instance resourceId: IHEReadImagingStudy resourceType: Binary name: Read ImagingStudy description: IHE WADO Retrieve (WADO-RS). See also Retrieve Imaging Study for API overview instance resourceId: IHERetrieveImagingStudy resourceType: Binary name: Return ImagingStudy description: DICOM Key Object Selection (KOS) is a manifest, which includes references to images which are used to find and retrieve the DICOM Image Instance instance resourceId: IHEReadImageInstance resourceType: Binary name: Read Image Instance description: IHE WADO Retrieve (WADO-RS). See also Retrieve Image Instances for API overview instance resourceId: IHERetrieveImage resourceType: Binary name: Return Image Instance description: DICOM Image Instance process title: Query for patient image and/or report description: IHE XCA implements an Aggregator 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) and this has been converted to IHE XML as an AdHocQueryRequest. Document Entry is a FHIR DocumentReference profile based on the NHS Data Dictionary definitions contained in IHE Europe - Metadata for exchange medical documents and images, this also contains mappings between IHE XDS Document Entry and IHE MHD/HL7 FHIR DocumentReference. step process title: Search for Document Entries - Imaging studies and reports step operation number: 1 type: search-type name: Search for Document Entires initiator: user receiver: xds Requests - ResourceId * IHESearchDocumentEntries step process title: For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA) step operation number: 1 type: search-type name: Search for Document Entries in other networks initiator: xds receiver: xca Requests - ResourceId * XCAQuery Responses - ResourceId * XCAResponse step process title: Aggregate and Return Search Results - Imaging studies and reports step operation number: 1 type: search-type name: Return Document Entry search results initiator: xds receiver: user Responses - ResourceId * IHESearchResultsDocumentEntries process title: Option - Retrieve selected imaging report description: 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 converted to a FHIR DiagnosticReport profile as Imaging Report, 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 which is likely to be a derivative of HL7 IPS, like the HL7 Europe Laboratory Report. step operation number: 1 type: read name: Retrieve Imaging Report initiator: user receiver: docs Requests - ResourceId * IHEReadDiagnosticReport Responses - ResourceId * IHEViewDiagnosticReport process title: Option - Retrieve selected imaging study description: This is an optional step. The Document Consumer may choose to retrieve the Imaging Study. At present this is a DICOM KOS 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: 1 type: read name: Retrieve Imaging Study initiator: user receiver: image Requests - ResourceId * IHEReadImagingStudy Responses - ResourceId * IHERetrieveImagingStudy step process title: Retrieve selected image - Optional step operation number: 1 type: read name: Retrieve Image initiator: user receiver: image Requests - ResourceId * IHEReadImageInstance Responses - ResourceId * IHERetrieveImage
United Kingdom of Great Britain and Northern Ireland
The [Document Consumer](ActorDefinition-DocumentConsumer.html) Actor queries for documents meeting certain criteria, and may retrieve selected documents.
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.
In NIR this is also known as **Imaging Network**. This is an infrastrcture service which enables federation.
The [Document Repository](ActorDefinition-DocumentRepository.html) is responsible for both the persistent storage of these documents (e.g. Imaging Report)
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.
Search for Document Entries - Imaging studies and reports
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)
Example Response [AdHocQueryRequest XML](AdHocQueryRequest.xml) See [IHE Cross-Community Access (XCA)](https://profiles.ihe.net/ITI/TF/Volume1/ch-18.html)
Example Response [AdHocQueryReponse XML](AdHocQueryReponse.xml)
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)
[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
[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
[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
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.
For each Network/Gateway - Search for Document Entries via IHE XCA Cross-Community Access (XCA)
Search for Document Entries in other networks
Aggregate and Return Search Results - Imaging studies and reports
Option - Retrieve selected imaging report
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/).
Option - Retrieve selected imaging study
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.