1300 North 17th Street, Suite 900
Arlington, VA 22209, USA
+1-703- 475-9217
http://dicom.nema.org
E-mail: dicom@medicalimaging.org
MINUTES
Joint Meeting of
DICOM WORKING GROUP TWENTY
(Integration of Imaging and Information Systems)
Hosting
DICOM WORKING GROUP TWENTY-SEVEN
(Web Services for DICOM)
Date:
Sept. 18, 2014
Place:
HL7 Meetings
Chicago Hilton Hotel
Chicago, IL, USA
Members Present
Represented by
ACR/Johns Hopkins
AGFA Healthcare
GE Healthcare
Siemens Healthcare
Toshiba/Vital Images
James Philbin (P)
Brad Genereaux
Solomon, Harry
Koenig, Helmut
Jonathan Whitby (P)
Members Absent
Voting Representative
*Merge Healthcare
*PixelMed
Philips Healthcare
Cowan, Ron
Clunie, D.
Chris Melo
_________________________________________________________________________
Minutes - DICOM Joint WG-20&WG-27, Sept. 18, 2014
Page 1
Others Present
Affiliated with
Yongjian Bao
Fred Behlen
Chris Carr
Chris Lindop
Kevin O’Donnell
Stephen Vastagh
*=Not counted for quorum
P= Phone
GE Healthcare
ACR/Laitek
RSNA
GE Healthcare
Toshiba (P)
MITA
Presiding Officers
Helmut Koenig, Siemens, Co-Chair
Harry Solomon, GE Healthcare, Co-Chair
1. Opening
The meeting was called to order at 11.00 Central Time. The antitrust rules were reviewed.
The agenda was approved.
2. Imaging Resource in FHIR
Y. Bao introduced the topic:
 The FHIR ImagingStudy Resource currently represents a single study, but due to the way it is
structured, it cannot be used to represent a KOS Manifest. A KOS Manifest contains only a
subset of information that an ImagingStudy resource may contain. A KOS Manifest may contain
multiple Study Instances (whereas ImagingStudy is only one). This must be reconciled.
 He proposed to create a second object type in FHIR that mimics the structure of a KOS Manifest
(references to SOP Instance UIDs) while maintaining the hierarchy of Study, Series and
Instance, with a new root class (so multiple studies can be contained).
 The objective is to be able to represent KOS objects in a variety of use cases, including for IHE
XDS-I, Key Objects for referring physicians, etc.
A detailed technical discussion followed which included the following points:
 The concept of the ‘manifest’ of the imaging study is a “point in time” representation of a set of
related SOP Instances that may span multiple studies if the situation demands it.
 The concept of the ‘imaging study’ represents all of the known information about a set of SOP
Instances that belong to a single Study.
 ImagingStudy cannot be used to represent a manifest (multiple study issues), nor can a Manifest
be used to represent an ImagingStudy
_________________________________________________________________________
Minutes - DICOM Joint WG-20&WG-27, Sept. 18, 2014
Page 2



The use case for using FHIR in imaging workflows is so that an EMR can speak to a FHIRenabled PACS and still converse in a more “native language” of HL7, whereas the PACS can
still converse to its constituents (like modalities) in a DICOM-centric way
Instead of developing an object just to represent an XDS-I Manifest, it was recommended that
ImagingManifest actually defines a representation of a general Key Object Selection document.
The name “ImagingManifest” was selected, rather than “KeyObjectSelection”, as the
terminology should mean something to FHIR-based implementations.
Y. Bao will provide the structure for the FHIR committee to consider.
Other business relating to harmonization between FHIR and DICOM was discussed. In particular, the
question of what other technologies need to be aligned was raised. The joint committee discussed the
feasibility of UPS-RS being used in FHIR-based workflows. There currently isn’t a clear way that this
can be mapped onto FHIR objects.
Conclusion
o Propose an ImagingManifest resource that represents a general Key Object Selection document
o Amend the ImagingStudy to clarify intended use, and correct minor discrepancies (i.e.,
“modality” at the Study level should instead be “modalityList”; and, the relation between Series
and Instance should be 0..n and not 1..n)
3. HL7 Change Proposals
The Group has finalized and submitted to HL7 several change proposals for minor corrections.
4. Next Meetings
Next meeting with HL7:
The next joint meetings between DICOM and HL7, and the WG-20 meetings will be held, during
January 18-23, 2015 in San Antonio, TX.
Preliminary Schedule:
Tuesday, Jan. 20, 2015
Jt. Meetings hosted by HL7 WGs
Wednesday, Jan. 21, 2015
09.00-10.30 (Q1) II-WG-20 Meeting
11.00-12.30 (Q2) Joint Mtg with HL7 O&O
13.45-17.00 (Q3-Q4) II-WG-20 Meeting
_________________________________________________________________________
Minutes - DICOM Joint WG-20&WG-27, Sept. 18, 2014
Page 3
Thursday, Jan. 22, 2015
09.00-10.30 (Q1) Joint Mtg with HL7 SD
11.00-15.00 (Q2-Q3) Joint Mtg with WG-27
15:30-17.00 (Q4) Joint Mtg with WG-27 & HL7 FHIR
Friday, Jan 23, 2015 (Subject to confirmation)
09.00-12.30 (Q1-Q2) WG-10
13.45-17.00 (Q2-Q3) Joint meeting of WG-10 and ISO TC215 WG2
Future Meetings of HL7:
2015

Jan. 18-22, 2015 – Hyatt Regency, San Antonio, TX

May 10-14, 2015 – Paris France
Preliminary Schedule:
o Sunday, May 10, 2015 – DICOM Standards Committee
o Monday-Thursday, May 11-14 Working Group Meetings
And Joint Meetings

Oct. 4-9, 2015 – Atlanta, GA
2016

Jan. 2016 – TBA

May 2016 –TBA

Sep 18-23, 2016 - Baltimore
5. Adjournment
The meeting was adjourned at 15.00.
Reported by Stephen Vastagh, Secretary
Reviewed by legal counsel: Clark Silcox
_________________________________________________________________________
Minutes - DICOM Joint WG-20&WG-27, Sept. 18, 2014
Page 4