Enterprise Imaging (Proof of Concept)
0.1.0 - proof-of-concept
Enterprise Imaging (Proof of Concept)
0.1.0 - proof-of-concept
Enterprise Imaging (Proof of Concept) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Patients are often imaged at one organisation and treated or discussed at another - for example imaged at a local hospital and discussed at a specialist cancer MDT. Images and reports then need to be shared between organisations.
| Approach | How it works | Standards |
|---|---|---|
| Shared archive or PACS | Organisations in an imaging network share one PACS / VNA, or federate their archives | DICOM, DICOMweb |
| Point-to-point transfer | Images are pushed from one organisation's PACS to another's, for example for a referral. In England this has often been done through the Image Exchange Portal (IEP) | DICOM |
| Registry and repository (document sharing) | Each organisation keeps its own images; a registry indexes them and a manifest points to where they are | IHE XDS-I.b, XCA-I, MADO |
| National registry | NHS England National Imaging Registry indexes imaging held by organisations in England | FHIR, IHE XCA/XDS, DICOMweb |
Which approaches a region uses - and the membership of its imaging network - is To confirm for each region.
The NHS England National Imaging Registry lets authorised users find and retrieve a patient's diagnostic imaging and reports held by other organisations in England, for direct care. The data stays with the originating organisation. Its API offers FHIR, IHE XCA/XDS and DICOMweb interfaces. NHS England lists pathology as a possible future diagnostic area.
sequenceDiagram
participant MDT as Clinician / MDT<br/>Treating trust
participant NIR as National Imaging<br/>Registry
participant SRC as Originating trust<br/>PACS / VNA, RIS
MDT ->> NIR: Find patient's imaging (NHS number)
NIR -->> MDT: List of studies and reports, with locations
MDT ->> SRC: Retrieve report and images (via NIR)
SRC -->> MDT: Report, images
Images are retrieved with DICOMweb WADO-RS (IHE RAD WADO-RS Retrieve [RAD-107]). A DICOM Key Object Selection (KOS) document can act as a manifest listing the instances in a study. Which of these the National Imaging Registry uses in production is To confirm. The document sharing metadata (registry entries) for reports is covered by the NW GMSA DocumentReference profile.
At the MDT, the radiology-pathology correlation needs the imaging from wherever the patient was imaged - see Imaging in the Cancer Pathway.