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CDA Reference in DICOM

This work item aims to define a common method of referencing CDA documents in DICOM instances, enabling access to pre-imaging procedure lab test results, patient advance medical directives, outpatient history and physical reports, and more. It explores the use of various DICOM objects and attributes to support CDA documents in DICOM-based workflows.

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CDA Reference in DICOM

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  1. CDA Reference in DICOM WG20 Discussion 19-21 January 2004

  2. TheWork Item • CDA OID reference in DICOM • Use case: Provide access to relevant CDA documents to a DICOM-based application, such as pre-imaging-procedure lab test results, or patient advance medical directives, or an outpatient history and physical report. • Work Item: Define common method of referencing CDA documents in DICOM instances, including such new attributes in various objects as required to support CDA documents in the DICOM-based workflows.

  3. Use Locations • Modality Worklist • General Purpose Worklist • Relevant Information Sequence • C.17-3 Macro • Structured Report • Pertinent Other Evidence Sequence • C.17-3 Macro • Composite Object Reference Macro • SOP Class / Instance • DICOMDIR • SOP Class / Instance, File ID (name)

  4. C.17-3 Macro • Study / Series / SOP Class / Instance • Retrieve AE Tile (per Series) • Not appropriate for non-hierachical objects, or not collected in DICOM acquisition context • Hanging Protocol objects • Registration (Atlas) Frame of Reference • Advance medical directives (CDA) • Nursing notes (CDA)

  5. What do we need beyond a bare UID? SOP Class • Identification of object type • MIME type / sub-type • Identification of access service • URI Scheme: FTP, HTTP, … • Identification of access point • URI Authority • Identification of access string • URI Path or Query • May replicate OID if that is part of the access string? • Cf. HL7v2 RP, HL7v3 ED data types implicit C-MOVE AE Title Study/Series hierarchy

  6. Question: Do we want a CDA SOP Class? • Pro: Allows us to treat CDA documents in a DICOM context like other DICOM objects • E.g., in SR COMPOSITE Content Item • Con: Implies definition of a Service that will be used to operate on CDA documents • Rejoinder: The service does not necessarily need to be a DICOM Service • Comparable question wrt/ Registration FoR

  7. Options • Bare UID • SOP Class / Instance UIDs • UID with access attributes

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