FHIR for Radiology Reports: Connecting the Order, Image, and Report
FHIR for Radiology Reports | SanteNet
Summary
FHIR provides a clinical information layer across the entire radiology workflow—from ordering to image acquisition and reporting. This integration connects orders, images, and reports seamlessly, enabling comprehensive patient care.
Details
This article outlines the technical approach to solving complex interoperability challenges in radiology. The typical workflow starts with an imaging request from the EHR, coordinated by the RIS, followed by image generation (CT/MRI) and storage in PACS/VNA. FHIR serves as the clinical information layer across this entire process. Specifically, FHIR's ServiceRequest defines the 'order,' while Appointment and Task track scheduling and workflow states. DICOM remains the primary standard for image data; FHIR ImagingStudy exposes study metadata without replacing the underlying DICOM environment. The report itself is structured using DiagnosticReport (for status/findings) and Observation (for measurements). For web access, DICOMweb provides RESTful services (like QIDO-RS and WADO-RS). Furthermore, SMART on FHIR enables authorized applications to launch securely within the EHR context. IHE profiles provide necessary implementation guidance across vendors, ensuring clinicians receive a single, coherent clinical story: why the exam was ordered, what images were acquired, and what the radiologist concluded.
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