Use Cases 1)A Clinical outpatient facility providing images to a shared image repository. 2) Sending images and other clinical documents to a referring clinician without the use of CD media. 3) Connecting a Hospital or Clinical practice PACS to a Regional Repository that is an XDS-I.b Image Document Source. 4) Submitting images for a clinical trial 5) Submitting Dose reports to a National registry.

A Clinical outpatient facility providing images to a shared image repository. 1)What would the number of Manifests to be included per transaction? (0-N?) 0 2) Special Metadata Considerations? Mandate metadata, if populated, needs to match images Patient ID must have the assigning authority, if affinity domain is known, must include Recipient may need to be an importer actor Accession number needs Issuer ID Image Source Image Recipient Provide and Register Document Set-b [RAD-68]  shared Image repository (Image Manager Instances Stored [RAD-70])

Sending images and other clinical documents to a referring clinician (stand-alone) 1) What would the number of Manifests to be included per transaction? (0-N?) 0 2)Special Metadata Considerations? None, manual lookup by patient name & demographics Does it make sense for multiple patient push? Probably not, use multiple submission sets/transactions) Note. Recipient is a drop box. Display is out of scope Image Source Image Recipient Provide and Register Document Set-b [RAD-68] 

Connecting a Hospital or Clinical practice PACS to a Regional Repository that is an XDS-I.b Image Document Source. 1)What would the number of Manifests to be included per transaction? (0-N?) 0 A new manifest would have to constructed at the receiving end pointing to the receiving image document source for future retrieval transactions. No. 2)Special Metadata Considerations? Mandate metadata, if populated by sender, needs to match images Patient ID must have the assigning authority, if affinity domain is known, must include Recipient may need to be an importer actor Accession number needs Issuer ID Associations linkages are out-of-scope Image Source Image Recipient Provide and Register Document Set-b [RAD-68]  XDS-I.b Image Document Source Image Manager/ Archive (Image Manager Instances Stored [RAD-70]) Hospital Regional Repository

Submitting images for a clinical trial. 1) What would the number of Manifests to be included per transaction? (0-N?) 2)Special Metadata Considerations? Mandate metadata, if populated by sender, needs to match images Assigning authority may be specific to the clinical trial pseudononmynous namespace Patient ID must have the assigning authority, if affinity domain is known, must include Recipient may need to be an importer actor Accession number not important Image Source Image Recipient Provide and Register Document Set-b [RAD-68]  Receiver Export Manager (Export Instances [RAD-53] )

Submitting Dose reports to a National registry. 1) What would the number of Manifests to be included per transaction? (0-N?) - none 2)Special Metadata Considerations? Assigning authority may be specific to the National Registry pseudononmynous namespace Patient ID must have the assigning authority, if affinity domain is known, must include Recipient may need to be an importer actor Accession number not important Image Source Image Recipient Provide and Register Document Set-b [RAD-68]  Dose Registry Dose Information Reporter ([RAD-63] Submit Dose Information)

General considerations Importer actor needs to be considered as a minimum grouping for standalone Need to consider groupings in general Do we need any special considerations for large image sets? Review error states Concern regarding size. Should we zip as a package or other alternatives? Review in context to a generic XDR recipient How do we know Send as multiple parts How do we handle association negotiation? We don’t. Is the source equivalent to an exporter/ media creator ? Is there any special considerations for a PHR? Metadata would not necessarily be equivalent with data transfer outbound. Could be a big issue. ONLY DICOM images with XDR-I, reports in a separate transaction Bundling rules what has to, may and may not be permitted go together. – Has to (nothing) Should we include non-imaging objects? Associations Using IOCM in XDR-I should be acceptable Report reference case Grouping considerations need to be included