Interactive Multimedia Report (IMR)
1.0.0 - Trial-Implementation International flag

This page is part of the IHE Interactive Multimedia Report (IMR) (v1.0.0: Trial Implementation) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

Rendered Report Reader

IHE Radiology Interactive Multimedia Report (IMR) - Rendered Report Reader

Report Creator

IHE Radiology Interactive Multimedia Report (IMR) - Report Creator

Report Reader

IHE Radiology Interactive Multimedia Report (IMR) - Report Reader

Report Repository

IHE Radiology Interactive Multimedia Report (IMR) - Report Repository

Behavior: Search Parameters

These define the properties by which a RESTful server can be searched. They can also be used for sorting and including related resources.

Search on the imagingStudy attribute in IMR DiagnosticReport

This SearchParameter enables finding DiagnosticReports by ImagingStudy.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide

IMR DiagnosticReport

IHE Interactive Multimedia Report (IMR) profile on DiagnosticReport

IMR Find Multimedia Report Response message

A profile on the Find Multimedia Report Response message

IMR ImagingStudy

IHE Interactive Multimedia Report (IMR) profile on ImagingStudy

(Experimental) Imaging Observation

Experimental profile on Observation for Imaging

IMR ServiceRequest

IHE Interactive Multimedia Report (IMR) profile on ServiceRequest

An IMR ServiceRequest captures the service request (a.k.a. order) for an imaging procedure. An IMR ServiceRequest is usually created before an imaging study is acquired (e.g. in radiology) while some other departments (e.g. cardiology) may not create an order at all.

IMR Store Multimedia Report Bundle

IHE Interactive Multimedia Report (IMR) profile on Bundle

IMR Store Multimedia Report Bundle Response

A profile on the Bundle transaction-response for [RAD-141] Store Multimedia Report Response.

  • shall be a transaction response
  • shall have at least 1 entry for each entry in the request, in the same order as received in the request
    • entry response location must be indicated
Imaging Study Endpoint

IHE Radiology profile on Endpoint for Study

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide

IMR DiagnosticReport Associated Study

Associated studies used in part of diagnostic reporting

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide

IMR ServiceRequest intent Value Set

Codes representing the applicable intent for a ServiceRequestd.

Imaging Study Endpoint ConnectionType Value Set

Codes representing the applicable endpoint connectionType to retrieve a study.

Imaging Study Endpoint PayloadType Value Set

Codes representing the applicable endpoint payloadType to retrieve a study.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like

IMR DiagnosticReport example

This example uses IMR DiagnosticReport to capture the following real world radiology diagnostic report.

— SAMPLE REPORT —

Patient Name: John Smith

MRN: 1234567

Accession Number: 12345

Study Date: December 31, 2020

Study Type: CT CHEST W/O CONTRAST


FULL REPORT

EXAMINATION: CT CHEST W/O CONTRAST

INDICATION: History: 24M with stent placement in the left main bronchus presents with right sided chest pain since 9am

TECHNIQUE: Volumetric, multidetector CT of the chest was performed without intravenous or oral contrast administration. Images are presented for display in the axial plane at 5 mm and 1.25 mm collimation. A series of multiplanar reformation images are also submitted for review.

DLP: 373 mGy-cm.

COMPARISON: CT of the chest dated January 1, 2020.

FINDINGS:

The imaged portion of a thyroid gland is unremarkable. Prominent or mildly enlarged mediastinal and bilateral hilar lymph nodes measure up to 1.2 x 0.8 cm in the right paratracheal station (2:12) , 2.3 x 1.4 cm in the subcarinal station (2:18), and 1.4 x 0.9 cm in the right hilar stations (2:16). No significant axillary lymphadenopathy is detected. The esophagus is unremarkable. The thoracic aorta is normal in caliber with a typical 3 vessel takeoff from the arch. The pulmonary arterial trunk is normal in caliber. The heart is normal in size without pericardial effusion.

There is focal narrowing of the proximal portion of the bronchial stent in the left mainstem bronchus (601b:56), which is nearly collapsed and appears new from the prior chest radiograph. Trace fluid or debris is seen in the distal lumen of the stent (4:71). A tracheostomy tube is unchanged in position without evidence of complications. There is circumferential thickening of the tracheal and bronchial walls, which is unchanged, in keeping with the patient’s known diagnosis of polychondritis. The remainder of the tracheobronchial tree is patent to the subsegmental levels. The airways are normal in caliber.

Within the pulmonary parenchyma, there is diffuse peribronchovascular nodular and ground-glass opacities becoming confluent in the right middle (601:52) and left upper (601:65) and lower lobes (601:72) consistent with multifocal pneumonia. There is a small left and trace right pleural effusion. No pneumothorax is present. There are no suspicious masses or pleural abnormalities.

The patient is status post median sternotomy with intact sternal wires. No blastic or lytic lesion suspicious for malignancy is present.

Although this study is not tailored for the evaluation of subdiaphragmatic contents, the imaged upper abdomen demonstrates diffuse hypoattenuation of the liver consistent with hepatic steatosis.

IMPRESSION:

  1. Multifocal pneumonia involving the right middle, left upper and left lower lobes with small left and trace right pleural effusions.

  2. Central medianstinal lymphadenopathy is likely reactive.

  3. Focal stenosis of the proximal portion of the left main stem bronchial stent, which appears new from the prior chest radiograph. There is trace fluid or debris within the distal lumen of the stent.

  4. Unchanged circumferential thickening of the tracheal and bronchial walls, in keeping with the patient’s known diagnosis of polychondritis.

  5. Hepatic steatosis.

(Experimental) IMR DiagnosticReport example with experimental IMR Observation

This example uses IMR DiagnosticReport to capture the same real world radiology diagnostic report, with the addition of using the experimental IMR Observation to capture findings and impressions.

(Experimental) IMR Observation of all findings and technique

Experimental example of encoding a complex clinical findings that include multiple components

(Experimental) IMR Observation of Impression 1

Experimental example of encoding an impression as text

(Experimental) IMR Observation of Impression 2

Experimental example of encoding an impression as text

(Experimental) IMR Observation of Impression 3

Experimental example of encoding an impression as text

(Experimental) IMR Observation of Impression 4

Experimental example of encoding an impression as text

(Experimental) IMR Observation of Impression 5

Experimental example of encoding an impression as text

IMR ImagingStudy example

Simple IMR ImagingStudy to be used in DiagnosticReport

IMR ImagingStudy example

Simple IMR ImagingStudy to be used as a comparison study in DiagnosticReport

Imaging Endpoint for Series example

Simple Imaging Series Endpoint

Imagin Endpoint for Study example

Simple Imagin Study Endpoint

Imaging Endpoint for Study example

Simple Imaging Study Endpoint fpr the comparison study

Organization example

Simple Organization to be used in DiagnosticReport

Patient example

Simple Patient used in IMR example

Practitioner example

Simple Practitioner to be used in DiagnosticReport

IMR ServiceRequest example

Simple IMR ServiceRequest example with a condition

Store Multimedia Report Bundle example

Sample Store Multimedia Report Bundle used to store an IMR

Store Multimedia Report Bundle Response example

Sample Store Multimedia Report Bundle Response in IMR

Example of an IMR Find Multimedia Report Response

Example of an IMR Find Multimedia Report Bundle Search Set