DICOMweb and FHIR Interoperability

The DICOMweb 2015 Conferenceand Hands-On WorkshopSeptember 10-11 Philadelphia PA

DICOMweb and FHIR Interoperability

Harry SolomonInteroperability Architect, GE Healthcare Co-Chair, DICOM Standards Committee

Credit: René Spronk (Ringholm), “FHIR Overview for executives”


DICOMweb is not the only thing happening in healthcare web servicesGeneral healthcare interoperability being addressed in other standards organizations, particularly HL7

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FHIR

Fast Healthcare Interoperable ResourcesNew standard from HL7 • Currently Draft Standard for Trial Use (DSTU)• HL7’s response to same strategic needs that

drive DICOMweb™

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FHIR Resources

Small, discrete concepts that can be maintained independently• Akin to HL7v2 segments, DICOM IEsResources are smallest units of transactionBuilt-in extension mechanism• Elements used by 80% of implementers are part of

the base resource.• All other elements are handled as extensions

Resources have a ‘textual description’


FHIR Resources

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Example – Patient Resource

References to otherResources


Extensions

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Human Readable Summary

Standard Data Content: MRN Name Gender Date of Birth Provider

Extension with reference to its definition


StructureDefinition Resource (profile)

“Before”

“After”

GET http://myfhirserver.com/StructureDefinition?resource=Patient


OperationDefinition Resource (Profile)

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StandardFHIR REST

CustomOperations

Read

Update

Search

Check Drug Interaction

MergePatient

Search on Maiden name


Computable Profiles

GET http://myfhirserver.com/Conformance

Compliance

Publication


DICOM Related FHIR Resources

Resources aligned with DICOM• Allow navigation and reference of DICOM resources

from FHIR• WADO-RS specified as method to access DICOM

objectsImagingStudy – Basic metadata and content (by reference)ImagingObjectSelector – Equivalent to Key Object Selection instance• IHE Key Image Note, XDS-I Manifest

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DICOMweb & FHIR Study Query Comparison

QIDO – Retrieves requested attributes as managed by server database (C-FIND equivalent)WADO-RS metadata – retrieves all attributes from DICOM header as stored in instances in serverFHIR ImagingStudy – retrieves fixed set of typically used Study, Series, and Instance attributes

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DICOMweb and FHIR Interoperability

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