How to embed #DICOM medical imaging studies in your #EHR with #FHIR and #IHE IID

Have you ever wanted to embed medical images into your healthcare application but don’t know where to start? Today’s snippet shows you how to do just that in two easy steps. With the interoperable healthcare technology available today, you can perform some very powerful integrations, essentially out-of-the-box. I will describe how you can harness the discovery prowess of FHIR‘s ImagingStudy, and couple it with the IHE Radiology profile, called Invoke Image Display (IID), to do some awesome.

Step 1 : FHIR the ImagingStudy query to discover studies for your patient

Construct a FHIR query, as follows :

GET http://<FHIR server>/fhir/ImagingStudy?_format=application/json&subject=<Patient ID>

Replace the FHIR server with an actual FHIR server, and the patient ID as the subject. This query will return back a response containing the list of all imaging studies available for the patient ID passed in. In the example above, I’ve asked for JSON, but XML is also available.

In the response, in the “entry” section, you will note an array of all imaging studies, with each object containing metadata and references to each study. This contains many useful attributes, such as the following:

 "resourceType": "ImagingStudy",
 "dateTime": "2011-01-01T11:01:20",
 "uid": "urn:oid:",
 "accessionNo": "1234",
 "modality": "CR",
 "description": "CHEST 2 VIEWS",
 "numberOfSeries": 1,
 "numberOfInstances": 2

While some of this information will be helpful to determine which study someone would like to display, the key to integrating this with your image viewer is the “uid” attribute. Lop off the “urn:oid:” and you’ll have a bona fide Study Instance UID, to use in the next step.

Step 2 : Invoke the Image Display to display a study for your patient

Construct an IID URL, as follows :

http://<IID server>/IHEInvokeImageDisplay?requestType=STUDY&studyUID=<Study Instance UID>&viewerType=IHE_BIR

Replace the IID server and the Study Instance UID placeholders with appropriate values (study instance UID is obtained from the previous step. This will launch a viewer showing the study requested – simple as that. You can take this URL, and launch this inside an Iframe, as an example.

Two easy steps is all it took, to image enable your EMR. Just like that.

Side Note:

  • You will have to consider how you will secure this integration. Both FHIR and IID use industry standard security mechanisms described in their respective specifications.