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1. Proposed Workitem: SWF on FHIR

  • Proposal Editor: Chris Lindop, Jonathan Whitby
  • Editor: <Name of candidate Lead Editor for the Profile, if known>
  • Domain: Radiology

2. The Problem

FHIR is the emerging clinical information standard that industry has adopted world-wide. Scheduled Workflow is the most widely adopted IHE profile throughout the world. However, it provides no guidance on implementing FHIR. HL7 provides minimal guidance with regards to implementing FHIR for Imaging.

This leaves vendors and users to develop their own implementations for deploying FHIR-based imaging workflows. The result is apparent. Each deployed site will be unique. Vendors will need to adopt and implement a unique configuration for every clinical site's deployed environment.

3. Key Use Case

The key use cases are documented in the IHE Radiology Technical Framework Volume 1 Section 3.3 Scheduled Workflow Process flow. No changes are proposed.

4. Standards and Systems

Relevant Systems

Relevant systems are the same as those systems implementing Scheduled workflow. No change is proposed to the existing relevant systems.

Relevant Standards

  • IHE Scheduled Workflow
  • HL7 FHIR

5. Discussion

Currently, the joint HL7/DICOM Imaging Integration Working group is planning to address gaps with the HL7 v2/FHIR mapping relevant to imaging. This will be key input.

The RSNA IAIP demonstration is currently defining FHIR resources relative to SWF that will be accessed during the demonstration.

IHE is the owner of SWF. IHE is the appropriate venue for incorporating FHIR with the profile. IHE has the most expertise on this subject.

Realizing that this is an extensive and most significant update requested of SWF, the level of effort should be constrained in the first cycle to resource mapping with no changes to the existing Transactions. This will ensure backward compatibility and support of mixed environments.

No new Transactions or Actors are proposed. The profile will add the applicable FHIR resources and the mapping of the existing HL7 v2.5 messaging fields.

Proposed FHIR Resources: ImagingStudy, ServiceRequest, Procedure, Patient, Visit