Ontario Medical Imaging HL7® FHIR® Implementation Guide v1.0.0-Ballot
For a full list of available versions, see the Directory of published versions
This model is linked to Ontario’s Electronic Health Record (EHR) Conceptual Information Model 2.0 (CIM 2.0). See: https://ehealthontario.on.ca/files/public/support/Architecture/Ontario_EHR_CIM_2.0.pdf
To support the use of structured data through the adoption of data content and health terminology standards in the solution, this page includes high-level entity relationships and FHIR resources used in this specification. The model does not repeat the structure of the messages laid out in FHIR. Links to FHIR specs are included for entity definitions and field code values. In any difference of meaning between cited FHIR elements and this model, FHIR is the authoritative voice. This model relies on the following specifications:
The FHIR resources used in each category of MI data entity and their relationship is described in the Entity Relationship Diagram (ERD) below. The main resource is highlighted in green and it is linked to the other resources through references. In each scenario, a DocumentReference resource is created internally to support index and retrieval of the main resource.
| Entity Name | Description | FHIR Resource Name |
|---|---|---|
| Imaging Order (i.e. MI Order) | A request for a diagnostic imaging procedure for a patient | ServiceRequest |
| Imaging Manifest | A summary of the data stored in a DICOM imaging study as is stored in a PACS | ImagingStudy |
| Imaging Report (i.e. MI Report) | A clinical document with medical image interpretation after practitioner reviews images from a diagnostic scan, such as an X-ray, MRI, CT scan, or ultrasound | DiagnosticReport |
| Patient | An individual receiving MI services. | Patient |
| Practitioner | A healthcare professional involved in ordering or interpreting imaging studies and reports | Practitioner, PractitionerRole |
| Organization | An HIC that is the legal authority of the imaging data for the patient | Organization |
| Document Reference | Metadata used to index and retrieve imaging-related documents. DocumentReferences are not part of the submission. They are generated by miCDR solution for submission of orders and reports. miCDR supports the search on DocumentReferences to enable query across all three MI data entities based on common metadata such as accession number. | DocumentReference |
| Location | The physical place where the MI services are provided | Location |
| Observation | Imaging-related findings or measurements. | Observation |
| Encounter | The context of care during which the order was made | Encounter |