The following standards and related specifications were identified as the recommended approach to support the in-scope requirements. The table lists the summary with the rationale.
Standardization Requirement | Options | Choice | Rationale |
Document and Image Sharing | IHE Cross-Enterprise Document Sharing - Imaging (XDS/XDS-I) | X | The IHE XDS-I.b profile specifies the use of existing standards including HL7 v2/CDA and DICOM to enable registration and sharing of images and reports. A Canadian XDS Affinity domain guide is available to support implementation of the profile. |
DICOM / HL7 v2 and Clinical Document Architecture (CDA) |
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Imaging Report Format | Clinical Document Architecture (CDA) R2 | X | It is the goal of the Canadian XDS Affinity domain that reports will be stored in HL7 CDA format (using the pan-Canadian header format) as these reports (a) support required metadata, and (b) can be transformed to all other formats.
* Raw text based HL7 v2 ORU and DICOM SR are widely used and present in DI-R systems. |
Portable Document Format (PDF) |
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DICOM SR / SC* |
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Raw Text* |
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Anatomic Region Code | Coarse Body Parts (SNOMED CT subset) | X | The DICOM CID 4 value set is very detailed and generally inconsistent with the general approach of “casting a wide net” employed when fetching content within the FEM use cases. |
Anatomic Region (DICOM Context Identifier/CID 4) |
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