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Standard | Fit for Pupose | Stewardship | Quality | |||||
Fits | Implementation | Vendor Support | Canadian | SDO | Complexity | Standard | Training, Support and Tooling | |
IHE Cross-Enterprise Document Sharing - Imaging (XDS/XDS-I) | Yes | Production | Medium | Yes | Yes | High | High | Yes |
DICOM / HL7 | Yes | Production | High | No | Yes | Medium | High | Unknown |
Architectural Constraints and Considerations | Secondary Benefits | |||||||
None of these standards impose significant architectural constraints |
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Recommendation | Supporting Rationale | |||||||
IHE Cross-Enterprise Document Sharing - Imaging (XDS/XDS-I) | The IHE XDS-I.b profile specifies the use of existing standards including HL7 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. | |||||||
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Standard | Fit for Purpose | Stewardship | Quality | |||||
Fits | Implementation | Vendor | Canadian | SDO | Complexity | Standard | Training, Support | |
Clinical Document Architecture (CDA) R2 | Yes | Limited in | Limited | No | Yes | High | Normative | Some |
Portable Document Format (PDF) | Partial | Production | High | No | N/A | Low | N/A | Good |
DICOM SR / SC | Partial | Production | High | No | Yes | Medium | Normative | Unknown |
Raw Text | Partial | Production | Unknown | No | No | Low | N/A | None |
Architectural Constraints and Considerations | Secondary Benefits | |||||||
Use of CDA document allows content to be rendered in all other formats. Raw text based HL7 ORU and DICOM SR are widely used and present in DI-R systems and require support. | PDF may preclude secondary use, while the structured data of a CDA document supports machine readability and may enable secondary use of clinical data, clinical decision support or application of administrative/demographic data to analytics/business intelligence. | |||||||
Recommendation | Supporting Rationale | |||||||
Clinical Document Architecture (CDA) R2 | 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. | |||||||
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Standard | Fit for Purpose | Stewardship | Quality | |||||
Fits | Implementation | Vendor | Canadian | SDO | Complexity | Standard Maturity | Training, Support | |
Coarse Body Parts (SNOMED CT subset) | Yes | Production | High | Yes | Localized | Medium | Normative | Good |
Anatomic Region (DICOM CID 4) | Limited | International | High | No | Yes | Medium | Normative | Unknown |
Architectural Constraints and Considerations | Secondary Benefits | |||||||
Both terminology subsets referenced are published as flat lists with descriptions and codes. | Using pan-Canadian terminology subsets supports inter-jurisdictional interoperability. SNOMED CT’s terminology model can be leveraged to support aggregation and analysis of the information captured within vaccination records. | |||||||
Recommendation | Supporting Rationale | |||||||
Coarse Body Parts (SNOMED CT subset) | 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. | |||||||
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