Wales FHIR Implementation Guide

DataStandardsWales-ImagingStudy

The ImagingStudy resource provides information on a DICOM imaging study, and the series and imaging objects in that study. It also provides information on how to retrieve that information (in a native DICOM format, or in a rendered format, such as JPEG). ImagingStudy is used to make available information about all parts of a single DICOM study.

The DataStandardsWales-ImagingStudy profile is derived from the HL7 R4 ImagingStudy Standard. It defines additional rules for use within health and care organisations in Wales.

A direct link to the Data Standards Wales asset can be accessed here - Data Standards Wales Imaging Study

Formal Views of Profile Content

Snapshot View
Differential View
Hybrid View
Examples

DataStandardsWalesImagingStudy (ImagingStudy)	I		ImagingStudy	There are no (further) constraints on this element Element id ImagingStudy Short description A set of images produced in single study (one or more series of references images) Definition Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities. Data type ImagingStudy Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event rim: Act[classCode=COMPOSITION, moodCode=EVN] dicom: Reference IHE radiology TF vol 2 table 4.14-1
id	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id ImagingStudy.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id ImagingStudy.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id ImagingStudy.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id ImagingStudy.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id ImagingStudy.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	S Σ	0..*	Identifier	There are no (further) constraints on this element Element id ImagingStudy.identifier Short description Identifiers for the whole study Alternate names StudyInstanceUID, AccessionNumber Definition Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. Requirements If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. Comments See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id and .inboundRelationship[typeCode=COMP].source[classCode=ACSN, moodCode=EVN].id dicom: StudyInstanceUID (0020,000D) \| Accession Number and Issuer (0080,0050)+(0080,0051) \| Study ID (0020,0010)
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id ImagingStudy.status Short description registered \| available \| cancelled \| entered-in-error \| unknown Definition The current state of the ImagingStudy. Comments Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. Data type code Binding The status of the ImagingStudy. ImagingStudyStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status v2: Varies by domain rim: .status
modality	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.modality Short description All series modality if actual acquisition modalities Alternate names ModalitiesInStudy Definition A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19). Data type Coding Binding Type of acquired data in the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class rim: .code dicom: (0008,0061)
subject	Σ	1..1	Reference(DataStandardsWalesPatient)	Element id ImagingStudy.subject Short description Who or what is the subject of the study Definition The subject, typically a patient, of the imaging study. Comments QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group. Data type Reference(DataStandardsWalesPatient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role dicom: (0010/) w5:* FiveWs.subject
encounter	Σ	0..1	Reference(DataStandardsWalesEncounter)	Element id ImagingStudy.encounter Short description Encounter with which this imaging study is associated Definition The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made. Comments This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test). Data type Reference(DataStandardsWalesEncounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
started	Σ	0..1	dateTime	There are no (further) constraints on this element Element id ImagingStudy.started Short description When the study was started Alternate names StudyDate, StudyTime Definition Date and time the study started. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2011-01-01T11:01:20+03:00 Mappings workflow: Event.occurrence[x] w5: FiveWs.init rim: .effectiveTime dicom: (0008,0020)+(0008,0030)
basedOn	Σ	0..*	Reference(CarePlan \| Appointment \| AppointmentResponse \| Task \| DataStandardsWalesServiceRequest)	Element id ImagingStudy.basedOn Short description Request fulfilled Definition A list of the diagnostic requests that resulted in this imaging study being performed. Requirements To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). Data type Reference(CarePlan \| Appointment \| AppointmentResponse \| Task \| DataStandardsWalesServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn w5: FiveWs.cause rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO] dicom: (0032,1064)
referrer	Σ	0..1	Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole)	Element id ImagingStudy.referrer Short description Referring physician Alternate names ReferringPhysiciansName Definition The requesting/referring physician. Data type Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.cause rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO].participation[typeCode=AUT].role dicom: (0008,0090)+(0008,0096)
interpreter	Σ	0..*	Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole)	Element id ImagingStudy.interpreter Short description Who interpreted images Alternate names Name of Physician(s) Reading Study Definition Who read the study and interpreted the images or other content. Data type Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.witness rim: .participation[typeCode=PRF].role dicom: (0008,1060)
endpoint	S Σ	0..*	Reference(DataStandardsWalesEndpoint)	Element id ImagingStudy.endpoint Short description Study access endpoint Definition The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. Requirements Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. Comments Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer. Data type Reference(DataStandardsWalesEndpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not supported
numberOfSeries	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.numberOfSeries Short description Number of Study Related Series Alternate names NumberOfStudyRelatedSeries Definition Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=OBSSER, moodCode=EVN].repeatNumber dicom: (0020,1206)
numberOfInstances	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.numberOfInstances Short description Number of Study Related Instances Alternate names NumberOfStudyRelatedInstances Definition Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber dicom: (0020,1208)
procedureReference	Σ	0..1	Reference(UKCoreProcedure)	Element id ImagingStudy.procedureReference Short description The performed Procedure reference Definition The procedure which this ImagingStudy was part of. Data type Reference(UKCoreProcedure) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN] dicom: (0008,1032)
procedureCode	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id ImagingStudy.procedureCode Short description The performed procedure code Alternate names ProcedureCodeSequence Definition The code for the performed procedure type. Data type CodeableConcept Binding The performed procedure type. http://www.rsna.org/RadLex_Playbook.aspx (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN] dicom: (0008,1032)
location	Σ	0..1	Reference(DataStandardsWalesLocation)	Element id ImagingStudy.location Short description Where ImagingStudy occurred Definition The principal physical location where the ImagingStudy was performed. Requirements Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting). Data type Reference(DataStandardsWalesLocation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.location w5: FiveWs.where[x] v2: EVN.7 rim: .participation[typeCode=LOC].role dicom: (0008,1040) \| (0040,0243)
reasonCode	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id ImagingStudy.reasonCode Short description Why the study was requested Definition Description of clinical condition indicating why the ImagingStudy was requested. Data type CodeableConcept Binding The reason for the study. ProcedureReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonCode w5: FiveWs.why[x] rim: .reasonCode dicom: (0040,1002)
reasonReference	Σ	0..*	Reference(Media \| DocumentReference \| DataStandardsWalesObservation \| DataStandardsWalesDiagnosticReport \| UKCoreCondition)	Element id ImagingStudy.reasonReference Short description Why was study performed Definition Indicates another resource whose existence justifies this Study. Data type Reference(Media \| DocumentReference \| DataStandardsWalesObservation \| DataStandardsWalesDiagnosticReport \| UKCoreCondition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference w5: FiveWs.why[x] v2: EVN.4 or by domain rim: .outboundRelationship[typeCode=RSON].target
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id ImagingStudy.note Short description User-defined comments Definition Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note rim: unknown
description	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.description Short description Institution-generated description Alternate names StudyDescription Definition The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .text dicom: (0008,1030)
series	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series Short description Each study has one or more series of instances Definition Each study has one or more series of images or other content. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBSSER, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
uid	Σ	1..1	id	There are no (further) constraints on this element Element id ImagingStudy.series.uid Short description DICOM Series Instance UID for the series Alternate names SeriesInstanceUID Definition The DICOM Series Instance UID for the series. Requirements DICOM Series Instance UID. Comments See DICOM PS3.3 C.7.3. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2.16.124.113543.6003.2588828330.45298.17418.2723805630 Mappings rim: .id dicom: (0020,000E)
number	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.number Short description Numeric identifier of this series Alternate names SeriesNumber Definition The numeric identifier of this series in the study. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 3 Mappings rim: .inboundRelationship[type=COMP, source[classCode=COMPOSITION, moodCode=EVN]].sequenceNumber dicom: (0020,0011)
modality	Σ	1..1	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.series.modality Short description The modality of the instances in the series Alternate names Modality Definition The modality of this series sequence. Data type Coding Binding Type of acquired data in the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .code dicom: (0008,0060)
description	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.description Short description A short human readable summary of the series Alternate names SeriesDescription Definition A description of the series. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General CT Surview 180 Mappings rim: .text dicom: (0008,103E)
numberOfInstances	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.numberOfInstances Short description Number of Series Related Instances Alternate names NumberOfSeriesRelatedInstances Definition Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber dicom: (0020,1209)
endpoint	Σ	0..*	Reference(DataStandardsWalesEndpoint)	Element id ImagingStudy.series.endpoint Short description Series access endpoint Definition The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. Requirements Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. Comments Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances. Data type Reference(DataStandardsWalesEndpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not supported
bodySite	Σ	0..1	Coding	There are no (further) constraints on this element Element id ImagingStudy.series.bodySite Short description Body part examined Alternate names BodyPartExamined Definition The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality. Data type Coding Binding Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .targetSiteCode dicom: (0018,0015)
laterality	Σ	0..1	Coding	There are no (further) constraints on this element Element id ImagingStudy.series.laterality Short description Body part laterality Definition The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite. Data type Coding Binding Codes describing body site laterality (left, right, etc.). Laterality (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .targetSiteCode dicom: (0020,0060)
specimen	Σ	0..*	Reference(UKCoreSpecimen)	Element id ImagingStudy.series.specimen Short description Specimen imaged Definition The specimen imaged, e.g., for whole slide imaging of a biopsy. Data type Reference(UKCoreSpecimen) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Role[classCode=SPEC] dicom: (0040,0551) + (0040,0562)
started	Σ	0..1	dateTime	There are no (further) constraints on this element Element id ImagingStudy.series.started Short description When the series started Definition The date and time the series was started. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime dicom: (0008,0021) + (0008,0031)
performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series.performer Short description Who performed the series Alternate names PerformingPhysicianName, OperatorName Definition Indicates who or what performed the series and how they were involved. Requirements The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers. Comments If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer rim: .participation[typeCode=PRF].role dicom: (0008, 1050) \| (0008, 1052) \| (0008, 1070) \| (0008, 1072)
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id ImagingStudy.series.performer.function Short description Type of performance Definition Distinguishes the type of involvement of the performer in the series. Requirements Allows disambiguation of the types of involvement of different performers. Data type CodeableConcept Binding The type of involvement of the performer. ImagingStudySeriesPerformerFunction (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=PRF].role
actor	Σ	1..1	Reference(CareTeam \| DataStandardsWalesPractitioner \| DataStandardsWalesOrganization \| DataStandardsWalesPractitionerRole \| DataStandardsWalesPatient \| DataStandardsWalesDevice \| DataStandardsWalesRelatedPerson)	Element id ImagingStudy.series.performer.actor Short description Who performed the series Definition Indicates who or what performed the series. Data type Reference(CareTeam \| DataStandardsWalesPractitioner \| DataStandardsWalesOrganization \| DataStandardsWalesPractitionerRole \| DataStandardsWalesPatient \| DataStandardsWalesDevice \| DataStandardsWalesRelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.actor v2: EVN.5 or by domain rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
instance		0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series.instance Short description A single SOP instance from the series Definition A single SOP instance within the series, e.g. an image, or presentation state. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=DGIMG, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.instance.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.instance.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.instance.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
uid		1..1	id	There are no (further) constraints on this element Element id ImagingStudy.series.instance.uid Short description DICOM SOP Instance UID Alternate names SOPInstanceUID Definition The DICOM SOP Instance UID for this image or other DICOM content. Requirements DICOM SOP Instance UID. Comments See DICOM PS3.3 C.12.1. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2.16.124.113543.6003.189642796.63084.16748.2599092903 Mappings rim: .id dicom: (0008,0018)
sopClass		1..1	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.series.instance.sopClass Short description DICOM class type Alternate names SOPClassUID Definition DICOM instance type. Data type Coding Binding The sopClass for the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=COMP]. source[classCode=OBS, moodCode=EVN, code="sop class"].value dicom: (0008,0016)
number		0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.instance.number Short description The number of this instance in the series Alternate names InstanceNumber Definition The number of instance in the series. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 1 Mappings rim: .inboundRelationship[typeCode=COMP, source[classCode=OBSSER, moodCode=EVN]].sequenceNumber dicom: (0020,0013)
title		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.instance.title Short description Description of instance Definition The description of the instance. Comments Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .title dicom: (0008,0008) \| (0007,0080) \| (0040,A043) + (0008,0104) \| (0042,0010)

DataStandardsWalesImagingStudy (ImagingStudy)	I		ImagingStudy	There are no (further) constraints on this element Element id ImagingStudy Short description A set of images produced in single study (one or more series of references images) Definition Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities. Data type ImagingStudy Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event rim: Act[classCode=COMPOSITION, moodCode=EVN] dicom: Reference IHE radiology TF vol 2 table 4.14-1
id	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id ImagingStudy.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id ImagingStudy.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id ImagingStudy.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id ImagingStudy.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id ImagingStudy.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	S Σ	0..*	Identifier	There are no (further) constraints on this element Element id ImagingStudy.identifier Short description Identifiers for the whole study Alternate names StudyInstanceUID, AccessionNumber Definition Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. Requirements If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. Comments See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id and .inboundRelationship[typeCode=COMP].source[classCode=ACSN, moodCode=EVN].id dicom: StudyInstanceUID (0020,000D) \| Accession Number and Issuer (0080,0050)+(0080,0051) \| Study ID (0020,0010)
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id ImagingStudy.status Short description registered \| available \| cancelled \| entered-in-error \| unknown Definition The current state of the ImagingStudy. Comments Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. Data type code Binding The status of the ImagingStudy. ImagingStudyStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status v2: Varies by domain rim: .status
modality	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.modality Short description All series modality if actual acquisition modalities Alternate names ModalitiesInStudy Definition A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19). Data type Coding Binding Type of acquired data in the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class rim: .code dicom: (0008,0061)
subject	Σ	1..1	Reference(DataStandardsWalesPatient)	Element id ImagingStudy.subject Short description Who or what is the subject of the study Definition The subject, typically a patient, of the imaging study. Comments QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group. Data type Reference(DataStandardsWalesPatient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role dicom: (0010/) w5:* FiveWs.subject
encounter	Σ	0..1	Reference(DataStandardsWalesEncounter)	Element id ImagingStudy.encounter Short description Encounter with which this imaging study is associated Definition The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made. Comments This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test). Data type Reference(DataStandardsWalesEncounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
started	Σ	0..1	dateTime	There are no (further) constraints on this element Element id ImagingStudy.started Short description When the study was started Alternate names StudyDate, StudyTime Definition Date and time the study started. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2011-01-01T11:01:20+03:00 Mappings workflow: Event.occurrence[x] w5: FiveWs.init rim: .effectiveTime dicom: (0008,0020)+(0008,0030)
basedOn	Σ	0..*	Reference(CarePlan \| Appointment \| AppointmentResponse \| Task \| DataStandardsWalesServiceRequest)	Element id ImagingStudy.basedOn Short description Request fulfilled Definition A list of the diagnostic requests that resulted in this imaging study being performed. Requirements To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). Data type Reference(CarePlan \| Appointment \| AppointmentResponse \| Task \| DataStandardsWalesServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn w5: FiveWs.cause rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO] dicom: (0032,1064)
referrer	Σ	0..1	Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole)	Element id ImagingStudy.referrer Short description Referring physician Alternate names ReferringPhysiciansName Definition The requesting/referring physician. Data type Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.cause rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO].participation[typeCode=AUT].role dicom: (0008,0090)+(0008,0096)
interpreter	Σ	0..*	Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole)	Element id ImagingStudy.interpreter Short description Who interpreted images Alternate names Name of Physician(s) Reading Study Definition Who read the study and interpreted the images or other content. Data type Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.witness rim: .participation[typeCode=PRF].role dicom: (0008,1060)
endpoint	S Σ	0..*	Reference(DataStandardsWalesEndpoint)	Element id ImagingStudy.endpoint Short description Study access endpoint Definition The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. Requirements Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. Comments Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer. Data type Reference(DataStandardsWalesEndpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not supported
numberOfSeries	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.numberOfSeries Short description Number of Study Related Series Alternate names NumberOfStudyRelatedSeries Definition Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=OBSSER, moodCode=EVN].repeatNumber dicom: (0020,1206)
numberOfInstances	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.numberOfInstances Short description Number of Study Related Instances Alternate names NumberOfStudyRelatedInstances Definition Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber dicom: (0020,1208)
procedureReference	Σ	0..1	Reference(UKCoreProcedure)	Element id ImagingStudy.procedureReference Short description The performed Procedure reference Definition The procedure which this ImagingStudy was part of. Data type Reference(UKCoreProcedure) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN] dicom: (0008,1032)
procedureCode	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id ImagingStudy.procedureCode Short description The performed procedure code Alternate names ProcedureCodeSequence Definition The code for the performed procedure type. Data type CodeableConcept Binding The performed procedure type. http://www.rsna.org/RadLex_Playbook.aspx (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN] dicom: (0008,1032)
location	Σ	0..1	Reference(DataStandardsWalesLocation)	Element id ImagingStudy.location Short description Where ImagingStudy occurred Definition The principal physical location where the ImagingStudy was performed. Requirements Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting). Data type Reference(DataStandardsWalesLocation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.location w5: FiveWs.where[x] v2: EVN.7 rim: .participation[typeCode=LOC].role dicom: (0008,1040) \| (0040,0243)
reasonCode	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id ImagingStudy.reasonCode Short description Why the study was requested Definition Description of clinical condition indicating why the ImagingStudy was requested. Data type CodeableConcept Binding The reason for the study. ProcedureReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonCode w5: FiveWs.why[x] rim: .reasonCode dicom: (0040,1002)
reasonReference	Σ	0..*	Reference(Media \| DocumentReference \| DataStandardsWalesObservation \| DataStandardsWalesDiagnosticReport \| UKCoreCondition)	Element id ImagingStudy.reasonReference Short description Why was study performed Definition Indicates another resource whose existence justifies this Study. Data type Reference(Media \| DocumentReference \| DataStandardsWalesObservation \| DataStandardsWalesDiagnosticReport \| UKCoreCondition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference w5: FiveWs.why[x] v2: EVN.4 or by domain rim: .outboundRelationship[typeCode=RSON].target
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id ImagingStudy.note Short description User-defined comments Definition Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note rim: unknown
description	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.description Short description Institution-generated description Alternate names StudyDescription Definition The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .text dicom: (0008,1030)
series	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series Short description Each study has one or more series of instances Definition Each study has one or more series of images or other content. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBSSER, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
uid	Σ	1..1	id	There are no (further) constraints on this element Element id ImagingStudy.series.uid Short description DICOM Series Instance UID for the series Alternate names SeriesInstanceUID Definition The DICOM Series Instance UID for the series. Requirements DICOM Series Instance UID. Comments See DICOM PS3.3 C.7.3. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2.16.124.113543.6003.2588828330.45298.17418.2723805630 Mappings rim: .id dicom: (0020,000E)
number	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.number Short description Numeric identifier of this series Alternate names SeriesNumber Definition The numeric identifier of this series in the study. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 3 Mappings rim: .inboundRelationship[type=COMP, source[classCode=COMPOSITION, moodCode=EVN]].sequenceNumber dicom: (0020,0011)
modality	Σ	1..1	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.series.modality Short description The modality of the instances in the series Alternate names Modality Definition The modality of this series sequence. Data type Coding Binding Type of acquired data in the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .code dicom: (0008,0060)
description	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.description Short description A short human readable summary of the series Alternate names SeriesDescription Definition A description of the series. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General CT Surview 180 Mappings rim: .text dicom: (0008,103E)
numberOfInstances	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.numberOfInstances Short description Number of Series Related Instances Alternate names NumberOfSeriesRelatedInstances Definition Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber dicom: (0020,1209)
endpoint	Σ	0..*	Reference(DataStandardsWalesEndpoint)	Element id ImagingStudy.series.endpoint Short description Series access endpoint Definition The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. Requirements Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. Comments Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances. Data type Reference(DataStandardsWalesEndpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not supported
bodySite	Σ	0..1	Coding	There are no (further) constraints on this element Element id ImagingStudy.series.bodySite Short description Body part examined Alternate names BodyPartExamined Definition The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality. Data type Coding Binding Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .targetSiteCode dicom: (0018,0015)
laterality	Σ	0..1	Coding	There are no (further) constraints on this element Element id ImagingStudy.series.laterality Short description Body part laterality Definition The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite. Data type Coding Binding Codes describing body site laterality (left, right, etc.). Laterality (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .targetSiteCode dicom: (0020,0060)
specimen	Σ	0..*	Reference(UKCoreSpecimen)	Element id ImagingStudy.series.specimen Short description Specimen imaged Definition The specimen imaged, e.g., for whole slide imaging of a biopsy. Data type Reference(UKCoreSpecimen) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Role[classCode=SPEC] dicom: (0040,0551) + (0040,0562)
started	Σ	0..1	dateTime	There are no (further) constraints on this element Element id ImagingStudy.series.started Short description When the series started Definition The date and time the series was started. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime dicom: (0008,0021) + (0008,0031)
performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series.performer Short description Who performed the series Alternate names PerformingPhysicianName, OperatorName Definition Indicates who or what performed the series and how they were involved. Requirements The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers. Comments If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer rim: .participation[typeCode=PRF].role dicom: (0008, 1050) \| (0008, 1052) \| (0008, 1070) \| (0008, 1072)
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id ImagingStudy.series.performer.function Short description Type of performance Definition Distinguishes the type of involvement of the performer in the series. Requirements Allows disambiguation of the types of involvement of different performers. Data type CodeableConcept Binding The type of involvement of the performer. ImagingStudySeriesPerformerFunction (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=PRF].role
actor	Σ	1..1	Reference(CareTeam \| DataStandardsWalesPractitioner \| DataStandardsWalesOrganization \| DataStandardsWalesPractitionerRole \| DataStandardsWalesPatient \| DataStandardsWalesDevice \| DataStandardsWalesRelatedPerson)	Element id ImagingStudy.series.performer.actor Short description Who performed the series Definition Indicates who or what performed the series. Data type Reference(CareTeam \| DataStandardsWalesPractitioner \| DataStandardsWalesOrganization \| DataStandardsWalesPractitionerRole \| DataStandardsWalesPatient \| DataStandardsWalesDevice \| DataStandardsWalesRelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.actor v2: EVN.5 or by domain rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
instance		0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series.instance Short description A single SOP instance from the series Definition A single SOP instance within the series, e.g. an image, or presentation state. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=DGIMG, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.instance.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.instance.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.instance.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
uid		1..1	id	There are no (further) constraints on this element Element id ImagingStudy.series.instance.uid Short description DICOM SOP Instance UID Alternate names SOPInstanceUID Definition The DICOM SOP Instance UID for this image or other DICOM content. Requirements DICOM SOP Instance UID. Comments See DICOM PS3.3 C.12.1. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2.16.124.113543.6003.189642796.63084.16748.2599092903 Mappings rim: .id dicom: (0008,0018)
sopClass		1..1	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.series.instance.sopClass Short description DICOM class type Alternate names SOPClassUID Definition DICOM instance type. Data type Coding Binding The sopClass for the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=COMP]. source[classCode=OBS, moodCode=EVN, code="sop class"].value dicom: (0008,0016)
number		0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.instance.number Short description The number of this instance in the series Alternate names InstanceNumber Definition The number of instance in the series. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 1 Mappings rim: .inboundRelationship[typeCode=COMP, source[classCode=OBSSER, moodCode=EVN]].sequenceNumber dicom: (0020,0013)
title		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.instance.title Short description Description of instance Definition The description of the instance. Comments Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .title dicom: (0008,0008) \| (0007,0080) \| (0040,A043) + (0008,0104) \| (0042,0010)

DataStandardsWalesImagingStudy (ImagingStudy)	I		ImagingStudy	There are no (further) constraints on this element Element id ImagingStudy Short description A set of images produced in single study (one or more series of references images) Definition Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities. Data type ImagingStudy Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event rim: Act[classCode=COMPOSITION, moodCode=EVN] dicom: Reference IHE radiology TF vol 2 table 4.14-1
id	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id ImagingStudy.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id ImagingStudy.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id ImagingStudy.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id ImagingStudy.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id ImagingStudy.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	S Σ	0..*	Identifier	There are no (further) constraints on this element Element id ImagingStudy.identifier Short description Identifiers for the whole study Alternate names StudyInstanceUID, AccessionNumber Definition Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number. Requirements If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2. Comments See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id and .inboundRelationship[typeCode=COMP].source[classCode=ACSN, moodCode=EVN].id dicom: StudyInstanceUID (0020,000D) \| Accession Number and Issuer (0080,0050)+(0080,0051) \| Study ID (0020,0010)
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id ImagingStudy.status Short description registered \| available \| cancelled \| entered-in-error \| unknown Definition The current state of the ImagingStudy. Comments Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. Data type code Binding The status of the ImagingStudy. ImagingStudyStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status v2: Varies by domain rim: .status
modality	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.modality Short description All series modality if actual acquisition modalities Alternate names ModalitiesInStudy Definition A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19). Data type Coding Binding Type of acquired data in the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class rim: .code dicom: (0008,0061)
subject	Σ	1..1	Reference(DataStandardsWalesPatient)	Element id ImagingStudy.subject Short description Who or what is the subject of the study Definition The subject, typically a patient, of the imaging study. Comments QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group. Data type Reference(DataStandardsWalesPatient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=SBJ].role dicom: (0010/) w5:* FiveWs.subject
encounter	Σ	0..1	Reference(DataStandardsWalesEncounter)	Element id ImagingStudy.encounter Short description Encounter with which this imaging study is associated Definition The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made. Comments This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test). Data type Reference(DataStandardsWalesEncounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
started	Σ	0..1	dateTime	There are no (further) constraints on this element Element id ImagingStudy.started Short description When the study was started Alternate names StudyDate, StudyTime Definition Date and time the study started. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2011-01-01T11:01:20+03:00 Mappings workflow: Event.occurrence[x] w5: FiveWs.init rim: .effectiveTime dicom: (0008,0020)+(0008,0030)
basedOn	Σ	0..*	Reference(CarePlan \| Appointment \| AppointmentResponse \| Task \| DataStandardsWalesServiceRequest)	Element id ImagingStudy.basedOn Short description Request fulfilled Definition A list of the diagnostic requests that resulted in this imaging study being performed. Requirements To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT). Data type Reference(CarePlan \| Appointment \| AppointmentResponse \| Task \| DataStandardsWalesServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn w5: FiveWs.cause rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO] dicom: (0032,1064)
referrer	Σ	0..1	Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole)	Element id ImagingStudy.referrer Short description Referring physician Alternate names ReferringPhysiciansName Definition The requesting/referring physician. Data type Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.cause rim: .outboundRelationship[typeCode=FLFS].target[classCode=DGIMG, moodCode=RQO].participation[typeCode=AUT].role dicom: (0008,0090)+(0008,0096)
interpreter	Σ	0..*	Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole)	Element id ImagingStudy.interpreter Short description Who interpreted images Alternate names Name of Physician(s) Reading Study Definition Who read the study and interpreted the images or other content. Data type Reference(DataStandardsWalesPractitioner \| DataStandardsWalesPractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.witness rim: .participation[typeCode=PRF].role dicom: (0008,1060)
endpoint	S Σ	0..*	Reference(DataStandardsWalesEndpoint)	Element id ImagingStudy.endpoint Short description Study access endpoint Definition The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType. Requirements Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type. Comments Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer. Data type Reference(DataStandardsWalesEndpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not supported
numberOfSeries	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.numberOfSeries Short description Number of Study Related Series Alternate names NumberOfStudyRelatedSeries Definition Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=OBSSER, moodCode=EVN].repeatNumber dicom: (0020,1206)
numberOfInstances	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.numberOfInstances Short description Number of Study Related Instances Alternate names NumberOfStudyRelatedInstances Definition Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber dicom: (0020,1208)
procedureReference	Σ	0..1	Reference(UKCoreProcedure)	Element id ImagingStudy.procedureReference Short description The performed Procedure reference Definition The procedure which this ImagingStudy was part of. Data type Reference(UKCoreProcedure) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN] dicom: (0008,1032)
procedureCode	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id ImagingStudy.procedureCode Short description The performed procedure code Alternate names ProcedureCodeSequence Definition The code for the performed procedure type. Data type CodeableConcept Binding The performed procedure type. http://www.rsna.org/RadLex_Playbook.aspx (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code rim: .outboundRelationship[typeCode=COMP].target[classCode=PROC, moodCode=EVN] dicom: (0008,1032)
location	Σ	0..1	Reference(DataStandardsWalesLocation)	Element id ImagingStudy.location Short description Where ImagingStudy occurred Definition The principal physical location where the ImagingStudy was performed. Requirements Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting). Data type Reference(DataStandardsWalesLocation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.location w5: FiveWs.where[x] v2: EVN.7 rim: .participation[typeCode=LOC].role dicom: (0008,1040) \| (0040,0243)
reasonCode	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id ImagingStudy.reasonCode Short description Why the study was requested Definition Description of clinical condition indicating why the ImagingStudy was requested. Data type CodeableConcept Binding The reason for the study. ProcedureReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonCode w5: FiveWs.why[x] rim: .reasonCode dicom: (0040,1002)
reasonReference	Σ	0..*	Reference(Media \| DocumentReference \| DataStandardsWalesObservation \| DataStandardsWalesDiagnosticReport \| UKCoreCondition)	Element id ImagingStudy.reasonReference Short description Why was study performed Definition Indicates another resource whose existence justifies this Study. Data type Reference(Media \| DocumentReference \| DataStandardsWalesObservation \| DataStandardsWalesDiagnosticReport \| UKCoreCondition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference w5: FiveWs.why[x] v2: EVN.4 or by domain rim: .outboundRelationship[typeCode=RSON].target
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id ImagingStudy.note Short description User-defined comments Definition Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note rim: unknown
description	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.description Short description Institution-generated description Alternate names StudyDescription Definition The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .text dicom: (0008,1030)
series	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series Short description Each study has one or more series of instances Definition Each study has one or more series of images or other content. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=OBSSER, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
uid	Σ	1..1	id	There are no (further) constraints on this element Element id ImagingStudy.series.uid Short description DICOM Series Instance UID for the series Alternate names SeriesInstanceUID Definition The DICOM Series Instance UID for the series. Requirements DICOM Series Instance UID. Comments See DICOM PS3.3 C.7.3. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2.16.124.113543.6003.2588828330.45298.17418.2723805630 Mappings rim: .id dicom: (0020,000E)
number	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.number Short description Numeric identifier of this series Alternate names SeriesNumber Definition The numeric identifier of this series in the study. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 3 Mappings rim: .inboundRelationship[type=COMP, source[classCode=COMPOSITION, moodCode=EVN]].sequenceNumber dicom: (0020,0011)
modality	Σ	1..1	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.series.modality Short description The modality of the instances in the series Alternate names Modality Definition The modality of this series sequence. Data type Coding Binding Type of acquired data in the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .code dicom: (0008,0060)
description	Σ	0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.description Short description A short human readable summary of the series Alternate names SeriesDescription Definition A description of the series. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General CT Surview 180 Mappings rim: .text dicom: (0008,103E)
numberOfInstances	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.numberOfInstances Short description Number of Series Related Instances Alternate names NumberOfSeriesRelatedInstances Definition Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target[classCode=DGIMG, moodCode=EVN].repeatNumber dicom: (0020,1209)
endpoint	Σ	0..*	Reference(DataStandardsWalesEndpoint)	Element id ImagingStudy.series.endpoint Short description Series access endpoint Definition The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType. Requirements Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level. Comments Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances. Data type Reference(DataStandardsWalesEndpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Not supported
bodySite	Σ	0..1	Coding	There are no (further) constraints on this element Element id ImagingStudy.series.bodySite Short description Body part examined Alternate names BodyPartExamined Definition The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality. Data type Coding Binding Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .targetSiteCode dicom: (0018,0015)
laterality	Σ	0..1	Coding	There are no (further) constraints on this element Element id ImagingStudy.series.laterality Short description Body part laterality Definition The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite. Data type Coding Binding Codes describing body site laterality (left, right, etc.). Laterality (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .targetSiteCode dicom: (0020,0060)
specimen	Σ	0..*	Reference(UKCoreSpecimen)	Element id ImagingStudy.series.specimen Short description Specimen imaged Definition The specimen imaged, e.g., for whole slide imaging of a biopsy. Data type Reference(UKCoreSpecimen) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Role[classCode=SPEC] dicom: (0040,0551) + (0040,0562)
started	Σ	0..1	dateTime	There are no (further) constraints on this element Element id ImagingStudy.series.started Short description When the series started Definition The date and time the series was started. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime dicom: (0008,0021) + (0008,0031)
performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series.performer Short description Who performed the series Alternate names PerformingPhysicianName, OperatorName Definition Indicates who or what performed the series and how they were involved. Requirements The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers. Comments If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer rim: .participation[typeCode=PRF].role dicom: (0008, 1050) \| (0008, 1052) \| (0008, 1070) \| (0008, 1072)
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id ImagingStudy.series.performer.function Short description Type of performance Definition Distinguishes the type of involvement of the performer in the series. Requirements Allows disambiguation of the types of involvement of different performers. Data type CodeableConcept Binding The type of involvement of the performer. ImagingStudySeriesPerformerFunction (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .participation[typeCode=PRF].role
actor	Σ	1..1	Reference(CareTeam \| DataStandardsWalesPractitioner \| DataStandardsWalesOrganization \| DataStandardsWalesPractitionerRole \| DataStandardsWalesPatient \| DataStandardsWalesDevice \| DataStandardsWalesRelatedPerson)	Element id ImagingStudy.series.performer.actor Short description Who performed the series Definition Indicates who or what performed the series. Data type Reference(CareTeam \| DataStandardsWalesPractitioner \| DataStandardsWalesOrganization \| DataStandardsWalesPractitionerRole \| DataStandardsWalesPatient \| DataStandardsWalesDevice \| DataStandardsWalesRelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.actor v2: EVN.5 or by domain rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
instance		0..*	BackboneElement	There are no (further) constraints on this element Element id ImagingStudy.series.instance Short description A single SOP instance from the series Definition A single SOP instance within the series, e.g. an image, or presentation state. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=DGIMG, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.instance.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.instance.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id ImagingStudy.series.instance.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
uid		1..1	id	There are no (further) constraints on this element Element id ImagingStudy.series.instance.uid Short description DICOM SOP Instance UID Alternate names SOPInstanceUID Definition The DICOM SOP Instance UID for this image or other DICOM content. Requirements DICOM SOP Instance UID. Comments See DICOM PS3.3 C.12.1. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 2.16.124.113543.6003.189642796.63084.16748.2599092903 Mappings rim: .id dicom: (0008,0018)
sopClass		1..1	CodingBinding	There are no (further) constraints on this element Element id ImagingStudy.series.instance.sopClass Short description DICOM class type Alternate names SOPClassUID Definition DICOM instance type. Data type Coding Binding The sopClass for the instance. http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=COMP]. source[classCode=OBS, moodCode=EVN, code="sop class"].value dicom: (0008,0016)
number		0..1	unsignedInt	There are no (further) constraints on this element Element id ImagingStudy.series.instance.number Short description The number of this instance in the series Alternate names InstanceNumber Definition The number of instance in the series. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 1 Mappings rim: .inboundRelationship[typeCode=COMP, source[classCode=OBSSER, moodCode=EVN]].sequenceNumber dicom: (0020,0013)
title		0..1	string	There are no (further) constraints on this element Element id ImagingStudy.series.instance.title Short description Description of instance Definition The description of the instance. Comments Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .title dicom: (0008,0008) \| (0007,0080) \| (0040,A043) + (0008,0104) \| (0042,0010)

Example ImagingStudy - CT Abdomen