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FHIR und die Anwendung in IHE & DICOM
René Spronk
Trainer/Tutor
Ringholm bv (Niederlande)
eMail: [email protected]
Web: http://www.Ringholm.com
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FHIR
Anwendung in DICOM
1. DICOMWeb (RESTful DICOM)
2. Abstimmung der Inhalte der FHIR
Resourcen
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RESTful DICOM Transport
PACS
Viewer Get Metadata
Return metadata
Se
ve
ral se
con
ds
ove
r G
ig/E
Once metadata is received, the viewer can figure out what images it needs
Get Image #1-2000
Return Images #1 - 2000
Patient Study
Series Series Series
SOP Instances SOP Instances SOP Instances
x
Metadata
Voice Clip
Image
Private
Attributes
PACS
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DICOMWeb (RESTful DICOM)
Web, mobile, and integration friendly
Metadata separated from image data
Fetch
Simple URL-based search (UID based); Parse
XML or JSON response
1. Download metadata, subset of images
2. Download rest of study in background
Upload
New evidence / artifacts, entire studies
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DICOMweb Components
Query
(QIDO)
Retrieve
(WADO)
Store
(STOW)
Slide: Don Dennison
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QIDO-RS then WADO-RS
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GET https://dicomweb.myhospital.com/studies/?00100010=THOMPSON
Accept: application/json
Retrieve URL (0008,1190) contained in response:
"00081190": { "vr": "UT",
"Value": [ "https://dicomweb.myhospital.com/studies/
1.2.392.200036.9116.2.2.2.1762893313.1029997326.9473" ] }
GET https://dicomweb.myhospital.com/studies/
1.2.392.200036.9116.2.2.2.1762893313.1029997326.9473
Accept: multipart/related; type=image/jpeg
QIDO
WADO
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STORE-WS, Details POST myserver/studies/1.2.3.4
multipart/related; type=application/dicom
multipart/related; type=application/dicom+xml
multipart/related; type=application/dicom+json
7 (additional details on the reasons that the SOP instances weren’t accepted )
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Web based Image Capture (IHE WIC)
Key use case:
Uniform way of uploading of non-dicom
images/videos
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Image Manager
Image Manager Image Capturer
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Patient
Device
Media
ImagingStudy
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ImagingStudy Resource
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Classic XDS-I: KOS Object
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FHIR
Anwendung in IHE
1. IHE PDQm Profil
2. IHE MHD Profil
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Use Cases for ‘mobile’ profiles
Mobile devices used by physicians (for
example: a mobile app for electronic patient
charts)
Web based EHR/EMR applications
A health portal securely exposing data to
browser based plugins,
Medical devices
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PDQ Profile Patient Demographics Query
Patient Demographics
Supplier
Patient Demographics
Consumer
Patient demographics
Query [ITI-47] (HL7 v3)
Patient demographics
Query [ITI-21] (HL7 v2)
Mobile Patient Demographics
Query [ITI-78] (FHIR)
Patient Demographics
Supplier
Patient Demographics
Consumer
Patient demographics
Query [ITI-21] (HL7 v2)
Patient Demographics
Supplier
Patient Demographics
Consumer
Mobile Patient Demographics
Query [ITI-78] (FHIR)
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PDQm Query Parameters
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Profiled PDQm Response Model
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<extension url="http://pdqm-sample:8080/ITI-78/Profile/pdqm#mothersMaidenName"> <valueHumanName> <family value="Smith"/> <given value="Mary"/> </valueHumanName> </extension>
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IHE XDS/MHD Profiles Mobile access to Health Docs.
Document
Creator
Document
Repository
Document
Registry
Query
Documents
Retrieve
Document
Set
Register Document Set
Provide & Register
Document Set
XDS
Document
Consumer
Document
Recepient
Document
Source
Document
Responder
MHD
Document
Consumer
Put Document Dossier
Find Document Dossier
Get Document Dossier
Get Document
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DocumentReference Resource
Classic XDS: ebRM based XDS DocumentEntry metadata
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DMS/Repository
XDS Registry
PACS/VNA
EHR
ImagingStudy ImagingStudy
ImagingStudy ImagingStudy
condition
FHIR+MHD+RESTful DICOM
Media
Patient condition
Media
Composition
provider
observation
medication patient
LIST
ImagingStudy
encounter provider
Document
Reference
document
Reference
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Status of these standards
IHE
MHD: ‘trial implementation’ status
WIC: Draft for Comment 2015
www.ihe.net/Technical_Frameworks
HL7 FHIR: ‘draft standard for trial use’
www.hl7.org/fhir
RESTful DICOM (sup 161,163, 166): final
medical.nema.org
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Fragen?