CDA Reference in DICOM

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CDA Reference in DICOM

• WG20 Discussion
• 19-21 January 2004

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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.

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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)

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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)

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What do we need beyond a bare UID?

• 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

SOP Class
implicit C-MOVE
AE Title
Study/Series hierarchy
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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

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Options

• Bare UID
• SOP Class / Instance UIDs
• UID with access attributes