STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R4B R4 R3 R2

2.33 Resource Media - Content

FHIR Infrastructure

Work Group

Maturity Level: 1

Compartments: Device, Patient, Practitioner

A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference.

2.33.1 Scope and Usage

The Media resource contains photos, videos, and audio recordings. It is used with media acquired or used as part of the healthcare process. Here are some typical usages:

Photos of patients and staff for identification purposes
Photos and videos of diagnostic or care provision procedures for recording purposes
Storing scans and faxes of paper documents where not enough metadata exists to create a DocumentReference
Images on diagnostic reports

2.33.2 Boundaries and Relationships

The Media resource is able to contain medical images in a DICOM format. These images may also be made accessible through an ImagingStudy resource, which provides a direct reference to the image to a WADO-RS server.

For such images, the WADO-RS framework is a preferred method for representing the images - the WADO-RS service may include rendering the image with annotations and display parameters from an associated DICOM presentation state, for instance.

On the other hand, the media resource allows for a robust transfer of an image across boundaries where the WADO-RS service is not available. For this reason, medical images can also be represented in a Media resource, but the Media.content.url should provide a reference to a source WADO-RS service for the image.

This resource is referenced by diagnosticreport

Structure

Name	Flags	Card.	Type	Description & Constraints
Media	I		DomainResource	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference Height can only be used for a photo or video Width can only be used for a photo or video Frames can only be used for a photo Duration can only be used for an audio or a video
identifier	Σ	0..*	Identifier	Identifier(s) for the image
type	Σ	1..1	code	photo \| video \| audio DigitalMediaType (Required)
subtype	Σ	0..1	CodeableConcept	The type of acquisition equipment/process Media SubType (Example)
view	Σ	0..1	CodeableConcept	Imaging view, e.g. Lateral or Antero-posterior Media Collection View/Projection (Example)
subject	Σ	0..1	Reference(Patient \| Practitioner \| Group \| Device \| Specimen)	Who/What this Media is a record of
operator	Σ	0..1	Reference(Practitioner)	The person who generated the image
deviceName	Σ	0..1	string	Name of the device/manufacturer
height	ΣI	0..1	positiveInt	Height of the image in pixels (photo/video)
width	ΣI	0..1	positiveInt	Width of the image in pixels (photo/video)
frames	ΣI	0..1	positiveInt	Number of frames if > 1 (photo)
duration	ΣI	0..1	unsignedInt	Length in seconds (audio / video)
content		1..1	Attachment	Actual Media - reference or data
Documentation for this format

UML Diagram (Legend)

XML Template

<Media xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) for the image --></identifier>
 <type value="[code]"/><!-- 1..1 photo | video | audio -->
 <subtype><!-- 0..1 CodeableConcept The type of acquisition equipment/process --></subtype>
 <view><!-- 0..1 CodeableConcept Imaging view, e.g. Lateral or Antero-posterior --></view>
 <subject><!-- 0..1 Reference(Patient|Practitioner|Group|Device|Specimen) Who/What this Media is a record of --></subject>
 <operator><!-- 0..1 Reference(Practitioner) The person who generated the image --></operator>
 <deviceName value="[string]"/><!-- 0..1 Name of the device/manufacturer -->
 <height value="[positiveInt]"/><!--  0..1 Height of the image in pixels (photo/video) -->
 <width value="[positiveInt]"/><!--  0..1 Width of the image in pixels (photo/video) -->
 <frames value="[positiveInt]"/><!--  0..1 Number of frames if > 1 (photo) -->
 <duration value="[unsignedInt]"/><!--  0..1 Length in seconds (audio / video) -->
 <content><!-- 1..1 Attachment Actual Media - reference or data --></content>
</Media>

JSON Template

{
  "resourceType" : "Media",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier(s) for the image
  "type" : "<code>", // R!  photo | video | audio
  "subtype" : { CodeableConcept }, // The type of acquisition equipment/process
  "view" : { CodeableConcept }, // Imaging view, e.g. Lateral or Antero-posterior
  "subject" : { Reference(Patient|Practitioner|Group|Device|Specimen) }, // Who/What this Media is a record of
  "operator" : { Reference(Practitioner) }, // The person who generated the image
  "deviceName" : "<string>", // Name of the device/manufacturer
  "height" : "<positiveInt>", // C? Height of the image in pixels (photo/video)
  "width" : "<positiveInt>", // C? Width of the image in pixels (photo/video)
  "frames" : "<positiveInt>", // C? Number of frames if > 1 (photo)
  "duration" : "<unsignedInt>", // C? Length in seconds (audio / video)
  "content" : { Attachment } // R!  Actual Media - reference or data
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Media;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Media.identifier [ Identifier ], ... ; # 0..* Identifier(s) for the image
  fhir:Media.type [ code ]; # 1..1 photo | video | audio
  fhir:Media.subtype [ CodeableConcept ]; # 0..1 The type of acquisition equipment/process
  fhir:Media.view [ CodeableConcept ]; # 0..1 Imaging view, e.g. Lateral or Antero-posterior
  fhir:Media.subject [ Reference(Patient|Practitioner|Group|Device|Specimen) ]; # 0..1 Who/What this Media is a record of
  fhir:Media.operator [ Reference(Practitioner) ]; # 0..1 The person who generated the image
  fhir:Media.deviceName [ string ]; # 0..1 Name of the device/manufacturer
  fhir:Media.height [ positiveInt ]; # 0..1 Height of the image in pixels (photo/video)
  fhir:Media.width [ positiveInt ]; # 0..1 Width of the image in pixels (photo/video)
  fhir:Media.frames [ positiveInt ]; # 0..1 Number of frames if > 1 (photo)
  fhir:Media.duration [ unsignedInt ]; # 0..1 Length in seconds (audio / video)
  fhir:Media.content [ Attachment ]; # 1..1 Actual Media - reference or data
]

Changes since DSTU2

Media

No Changes

See the Full Difference for further information

Structure

Name	Flags	Card.	Type	Description & Constraints
Media	I		DomainResource	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference Height can only be used for a photo or video Width can only be used for a photo or video Frames can only be used for a photo Duration can only be used for an audio or a video
identifier	Σ	0..*	Identifier	Identifier(s) for the image
type	Σ	1..1	code	photo \| video \| audio DigitalMediaType (Required)
subtype	Σ	0..1	CodeableConcept	The type of acquisition equipment/process Media SubType (Example)
view	Σ	0..1	CodeableConcept	Imaging view, e.g. Lateral or Antero-posterior Media Collection View/Projection (Example)
subject	Σ	0..1	Reference(Patient \| Practitioner \| Group \| Device \| Specimen)	Who/What this Media is a record of
operator	Σ	0..1	Reference(Practitioner)	The person who generated the image
deviceName	Σ	0..1	string	Name of the device/manufacturer
height	ΣI	0..1	positiveInt	Height of the image in pixels (photo/video)
width	ΣI	0..1	positiveInt	Width of the image in pixels (photo/video)
frames	ΣI	0..1	positiveInt	Number of frames if > 1 (photo)
duration	ΣI	0..1	unsignedInt	Length in seconds (audio / video)
content		1..1	Attachment	Actual Media - reference or data
Documentation for this format

UML Diagram (Legend)

XML Template

<Media xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) for the image --></identifier>
 <type value="[code]"/><!-- 1..1 photo | video | audio -->
 <subtype><!-- 0..1 CodeableConcept The type of acquisition equipment/process --></subtype>
 <view><!-- 0..1 CodeableConcept Imaging view, e.g. Lateral or Antero-posterior --></view>
 <subject><!-- 0..1 Reference(Patient|Practitioner|Group|Device|Specimen) Who/What this Media is a record of --></subject>
 <operator><!-- 0..1 Reference(Practitioner) The person who generated the image --></operator>
 <deviceName value="[string]"/><!-- 0..1 Name of the device/manufacturer -->
 <height value="[positiveInt]"/><!--  0..1 Height of the image in pixels (photo/video) -->
 <width value="[positiveInt]"/><!--  0..1 Width of the image in pixels (photo/video) -->
 <frames value="[positiveInt]"/><!--  0..1 Number of frames if > 1 (photo) -->
 <duration value="[unsignedInt]"/><!--  0..1 Length in seconds (audio / video) -->
 <content><!-- 1..1 Attachment Actual Media - reference or data --></content>
</Media>

JSON Template

{
  "resourceType" : "Media",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier(s) for the image
  "type" : "<code>", // R!  photo | video | audio
  "subtype" : { CodeableConcept }, // The type of acquisition equipment/process
  "view" : { CodeableConcept }, // Imaging view, e.g. Lateral or Antero-posterior
  "subject" : { Reference(Patient|Practitioner|Group|Device|Specimen) }, // Who/What this Media is a record of
  "operator" : { Reference(Practitioner) }, // The person who generated the image
  "deviceName" : "<string>", // Name of the device/manufacturer
  "height" : "<positiveInt>", // C? Height of the image in pixels (photo/video)
  "width" : "<positiveInt>", // C? Width of the image in pixels (photo/video)
  "frames" : "<positiveInt>", // C? Number of frames if > 1 (photo)
  "duration" : "<unsignedInt>", // C? Length in seconds (audio / video)
  "content" : { Attachment } // R!  Actual Media - reference or data
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Media;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Media.identifier [ Identifier ], ... ; # 0..* Identifier(s) for the image
  fhir:Media.type [ code ]; # 1..1 photo | video | audio
  fhir:Media.subtype [ CodeableConcept ]; # 0..1 The type of acquisition equipment/process
  fhir:Media.view [ CodeableConcept ]; # 0..1 Imaging view, e.g. Lateral or Antero-posterior
  fhir:Media.subject [ Reference(Patient|Practitioner|Group|Device|Specimen) ]; # 0..1 Who/What this Media is a record of
  fhir:Media.operator [ Reference(Practitioner) ]; # 0..1 The person who generated the image
  fhir:Media.deviceName [ string ]; # 0..1 Name of the device/manufacturer
  fhir:Media.height [ positiveInt ]; # 0..1 Height of the image in pixels (photo/video)
  fhir:Media.width [ positiveInt ]; # 0..1 Width of the image in pixels (photo/video)
  fhir:Media.frames [ positiveInt ]; # 0..1 Number of frames if > 1 (photo)
  fhir:Media.duration [ unsignedInt ]; # 0..1 Length in seconds (audio / video)
  fhir:Media.content [ Attachment ]; # 1..1 Actual Media - reference or data
]

Changes since DSTU2

Media

No Changes

See the Full Difference for further information

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle), JSON-LD (for RDF as JSON-LD),

2.33.3.1 Terminology Bindings

Path	Definition	Type	Reference
Media.type	Whether the Media is a photo, video, or audio	Required	DigitalMediaType
Media.subtype	Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it	Example	Media SubType
Media.view	Imaging view (projection) used when collecting an image	Example	Media Collection View/Projection

Path

Definition

Type

Reference

Media.type

Whether the Media is a photo, video, or audio

Required

DigitalMediaType

Media.subtype

Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it

Example

Media SubType

Media.view

Imaging view (projection) used when collecting an image

Example

Media Collection View/Projection

2.33.3.2 Constraints

mda-1: Height can only be used for a photo or video (expression : height.empty() or type != 'audio')
mda-2: Width can only be used for a photo or video (expression : width.empty() or type != 'audio')
mda-3: Frames can only be used for a photo (expression : frames.empty() or type = 'photo')
mda-4: Duration can only be used for an audio or a video (expression : duration.empty() or type != 'photo')

2.33.3.3 Implementation Notes

Note that the date of creation of the recording of the Media is found in Media.content.creation

2.33.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Paths	In Common
created	date	Date attachment was first created	Media.content.creation
identifier	token	Identifier(s) for the image	Media.identifier
operator	reference	The person who generated the image	Media.operator (Practitioner)
patient	reference	Who/What this Media is a record of	Media.subject (Patient)
subject	reference	Who/What this Media is a record of	Media.subject (Practitioner, Group, Specimen, Device, Patient)
subtype	token	The type of acquisition equipment/process	Media.subtype
type	token	photo \| video \| audio	Media.type
view	token	Imaging view, e.g. Lateral or Antero-posterior	Media.view