How are images (like x-rays) stored and retrieved for FHIR servers


#1

Hello,

I am very new to FHIR schema, and I am working on a server that hosts FHIR data and an application that represent the data.

I was wondering how to represent images associated with FHIR data. For example, if I have x-ray images from an Observation, can I upload the images to the FHIR server and have them retrieved, or should they be uploaded to a different storage and only their urls are given to the FHIR data?

I would also like to know which resourceType to use with the images. I’ve found Media, ImagingStudy, and ImagingManifest on stu3, but it’s difficult for me understand them fully. Am I correct that images themselves need to be Media and ImagingStudy ties them to the Patient?

Thank you,


#2

ImagingManifest is being removed in R4. Your real choice is between Media and ImagingStudy. Media is a simple wrapper around something jpg/png; it provides some simple metadata and links directly to patient. ImagingStudy is an alternative that, instead of containing the pixels in some format, refers to the images as available on a DICOM-WS server. The second option brings to bear to the awesome power of the DICOM stack, but also brings the price and complexity of that.

Which is a better choice is not one the FHIR standard can make for you; it just defines these 2 different paths so that you can choose. In terms of your question, I think it depends where and how you get the images.