1. DICOMweb and FHIR Interoperability
Harry Solomon
Interoperability Architect, GE Healthcare
Co-Chair, DICOM Standards Committee
Credit: René Spronk (Ringholm), “FHIR Overview for executives”

2. DICOMweb is not the only thing happening in healthcare web services General healthcare interoperability being addressed in other standards organizations, particularly HL7

3. FHIR Fast Healthcare Interoperable Resources New standard from HL7
Currently Draft Standard for Trial Use (DSTU)
HL7’s response to same strategic needs that drive DICOMweb™

4. FHIR Resources
Small, discrete concepts that can be maintained independently
Akin to HL7v2 segments, DICOM IEs
Resources are smallest units of transaction
Built-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’

5. FHIR Resources

6. Example – Patient Resource
References to other
Resources

7. Extensions

8. Extension with reference to its definition
Human Readable Summary
Standard Data Content:
MRN
Name
Gender
Date of Birth
Provider
System for gender is wrong . . .

9. StructureDefinition Resource (profile)
“After”
“Before”
GET

10. OperationDefinition Resource (Profile)
Read
Search
Standard
FHIR REST
Update
Custom
Operations
Check Drug Interaction
Merge
Patient
Search on Maiden name

11. Computable Profiles Publication Compliance
GET
Publication
Compliance

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

13. 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 server FHIR ImagingStudy – retrieves fixed set of typically used Study, Series, and Instance attributes