Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). 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

Orders and Observations Work GroupMaturity Level: 1 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner

Detailed Descriptions for the elements in the Media resource.

Media
Element IdMedia
Definition

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

Cardinality0..*
TypeDomainResource
Media.identifier
Element IdMedia.identifier
Definition

Identifiers associated with the image - these may include identifiers for the image itself, identifiers for the context of its collection (e.g. series ids) and context ids such as accession numbers or other workflow identifiers.

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Summarytrue
Comments

The identifier label and use can be used to determine what kind of identifier it is.

Media.basedOn
Element IdMedia.basedOn
Definition

A procedure that is fulfilled in whole or in part by the creation of this media.

Cardinality0..*
TypeReference(ServiceRequest | CarePlan)
Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Alternate Namesfulfills
Summarytrue
Media.partOf
Element IdMedia.partOf
Definition

A larger event of which this particular event is a component or step.

Cardinality0..*
TypeReference(Any)
Requirements

E.g. Drug administration as part of a procedure, procedure as part of observation, etc.

Alternate Namescontainer
Summarytrue
Comments

Not to be used to link an event to an Encounter - use Media.encounter for that.

[The allowed reference resources may be adjusted as appropriate for the event resource].

Media.status
Element IdMedia.status
Definition

The current state of the {{title}}.

Cardinality1..1
Terminology BindingEventStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

A nominal state-transition diagram can be found in the [[event.html#statemachine | Event pattern]] documentation

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

Media.type
Element IdMedia.type
Definition

A code that classifies whether the media is an image, video or audio recording or some other media category.

Cardinality0..1
Terminology BindingMedia Type (Extensible)
TypeCodeableConcept
Requirements

Used for filtering what observations are retrieved and displayed.

Summarytrue
Media.modality
Element IdMedia.modality
Definition

Details of the type of the media - usually, how it was acquired (what type of device). If images sourced from a DICOM system, are wrapped in a Media resource, then this is the modality.

Cardinality0..1
Terminology BindingMedia Modality (Example)
TypeCodeableConcept
Summarytrue
Media.view
Element IdMedia.view
Definition

The name of the imaging view e.g. Lateral or Antero-posterior (AP).

Cardinality0..1
Terminology BindingMedia Collection View/Projection (Example)
TypeCodeableConcept
Summarytrue
Media.subject
Element IdMedia.subject
Definition

Who/What this Media is a record of.

Cardinality0..1
TypeReference(Patient | Practitioner | PractitionerRole | Group | Device | Specimen | Location)
Summarytrue
Media.encounter
Element IdMedia.encounter
Definition

The encounter that establishes the context for this media.

Cardinality0..1
TypeReference(Encounter)
Requirements

Links the Media to the Encounter context.

Alternate Namescontext
Summarytrue
Comments

This will typically be the encounter the media occurred within.

Media.created[x]
Element IdMedia.created[x]
Definition

The date and time(s) at which the media was collected.

Cardinality0..1
TypedateTime|Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Alternate Namestiming
Summarytrue
Media.issued
Element IdMedia.issued
Definition

The date and time this version of the media was made available to providers, typically after having been reviewed.

Cardinality0..1
Typeinstant
Summarytrue
Comments

It may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that does not require the new version to be reviewed and verified again.

Media.operator
Element IdMedia.operator
Definition

The person who administered the collection of the image.

Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)
Summarytrue
Media.reasonCode
Element IdMedia.reasonCode
Definition

Describes why the event occurred in coded or textual form.

Cardinality0..*
Terminology BindingProcedure Reason Codes (Example)
TypeCodeableConcept
Summarytrue
Comments

Textual reasons can be captured using reasonCode.text.

Media.bodySite
Element IdMedia.bodySite
Definition

Indicates the site on the subject's body where the observation was made (i.e. the target site).

Cardinality0..1
Terminology BindingSNOMED CT Body Structures (Example)
TypeCodeableConcept
Summarytrue
Comments

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

Media.deviceName
Element IdMedia.deviceName
Definition

The name of the device / manufacturer of the device that was used to make the recording.

Cardinality0..1
Typestring
Summarytrue
Media.device
Element IdMedia.device
Definition

The device used to collect the media.

Cardinality0..1
TypeReference(Device | DeviceMetric | Device)
Summarytrue
Comments

An extension should be used if further typing of the device is needed. Secondary devices used to support collecting a media can be represented using either extension or through the Observation.related element.

Media.height
Element IdMedia.height
Definition

Height of the image in pixels (photo/video).

Cardinality0..1
TypepositiveInt
Summarytrue
Media.width
Element IdMedia.width
Definition

Width of the image in pixels (photo/video).

Cardinality0..1
TypepositiveInt
Summarytrue
Media.frames
Element IdMedia.frames
Definition

The number of frames in a photo. This is used with a multi-page fax, or an imaging acquisition context that takes multiple slices in a single image, or an animated gif. If there is more than one frame, this SHALL have a value in order to alert interface software that a multi-frame capable rendering widget is required.

Cardinality0..1
TypepositiveInt
Summarytrue
Comments

if the number of frames is not supplied, the value may be unknown. Applications should not assume that there is only one frame unless it is explicitly stated.

Media.duration
Element IdMedia.duration
Definition

The duration of the recording in seconds - for audio and video.

Cardinality0..1
Typedecimal
Summarytrue
Comments

The duration might differ from occurrencePeriod if recording was paused.

Media.content
Element IdMedia.content
Definition

The actual content of the media - inline or by direct reference to the media source file.

Cardinality1..1
TypeAttachment
Summarytrue
Comments

Recommended content types: image/jpeg, image/png, image/tiff, video/mpeg, audio/mp4, application/dicom. Application/dicom can contain the transfer syntax as a parameter. For media that covers a period of time (video/sound), the content.creationTime is the end time. Creation time is used for tracking, organizing versions and searching.

Media.note
Element IdMedia.note
Definition

Comments made about the media by the performer, subject or other participants.

Cardinality0..*
TypeAnnotation
Comments

Not to be used for observations, conclusions, etc. Instead use an Observation based on the Media/ImagingStudy resource.