Resource type: media

Description

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

Elements

PathShortDefinitionComments
A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct referenceA photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference.
identifierIdentifier(s) for the imageIdentifiers 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.The identifier label and use can be used to determine what kind of identifier it is.
basedOnProcedure that caused this media to be createdA procedure that is fulfilled in whole or in part by the creation of this media.
partOfPart of referenced eventA larger event of which this particular event is a component or step.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].
statuspreparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknownThe current state of the {{title}}.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.
typeClassification of media as image, video, or audioA code that classifies whether the media is an image, video or audio recording or some other media category.
modalityThe type of acquisition equipment/processDetails 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.
viewImaging view, e.g. Lateral or Antero-posteriorThe name of the imaging view e.g. Lateral or Antero-posterior (AP).
subjectWho/What this Media is a record ofWho/What this Media is a record of.
encounterEncounter associated with mediaThe encounter that establishes the context for this media.This will typically be the encounter the media occurred within.
created[x]When Media was collectedThe date and time(s) at which the media was collected.
issuedDate/Time this version was made availableThe date and time this version of the media was made available to providers, typically after having been reviewed.It may be the same as the [`lastUpdated` ](resource-definitions.html#Meta.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.
operatorThe person who generated the imageThe person who administered the collection of the image.
reasonCodeWhy was event performed?Describes why the event occurred in coded or textual form.Textual reasons can be captured using reasonCode.text.
bodySiteObserved body partIndicates the site on the subject's body where the observation was made (i.e. the target site).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](extension-bodysite.html).
deviceNameName of the device/manufacturerThe name of the device / manufacturer of the device that was used to make the recording.
deviceObserving DeviceThe device used to collect the media.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.
heightHeight of the image in pixels (photo/video)Height of the image in pixels (photo/video).
widthWidth of the image in pixels (photo/video)Width of the image in pixels (photo/video).
framesNumber of frames if > 1 (photo)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.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.
durationLength in seconds (audio / video)The duration of the recording in seconds - for audio and video.The duration might differ from occurrencePeriod if recording was paused.
contentActual Media - reference or dataThe actual content of the media - inline or by direct reference to the media source file.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.
noteComments made about the mediaComments made about the media by the performer, subject or other participants.Not to be used for observations, conclusions, etc. Instead use an [Observation](observation.html) based on the Media/ImagingStudy resource.

Scope and Usage

[%stu-note%] The Orders and Observations workgroups wants to make the balloter aware than observations that require the attachment data types are represented by the Media resource instead of Observation. There have been several significant changes to the Media resource in order to align it with Observation and the workflow event pattern including:

  1. The addition of the partOf and issued elements.
  2. The required type was changed an optional category and the subtype element was renamed to modality.
  3. Additional reference targets added to the subject,operator, and basedOn elements
  4. The additions of several standard event extensions.
[%end-note-np%]

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:

Boundaries and Relationships

This resource captures a specific type of Observation - an Observation whose value is audio, video or image data. This resource is the preferred representation of such forms of information as it exposes the metadata relevant for interpreting the information. However, in some legacy environments, media information may occasionally appear in Observation instead. Systems should be aware of this possibility.

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.

Implementation Notes

The media resource contains several date/times:

This resource can embed the image information directly through the attachment.data element. However, good practice is generally to use the attachment.url element to point to a Binary resource. Servers will frequently be able to persist Binary resources in purpose-dedicated repositories more suitable to potentially large artifacts.

Search Parameters

based-onProcedure that caused this media to be createdMedia.basedOn
createdWhen Media was collectedMedia.created
deviceObserving DeviceMedia.device
encounterEncounter associated with mediaMedia.encounter
identifierIdentifier(s) for the imageMedia.identifier
modalityThe type of acquisition equipment/processMedia.modality
operatorThe person who generated the imageMedia.operator
patientWho/What this Media is a record ofMedia.subject.where(resolve() is Patient)
siteObserved body partMedia.bodySite
statuspreparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknownMedia.status
subjectWho/What this Media is a record ofMedia.subject
typeClassification of media as image, video, or audioMedia.type
viewImaging view, e.g. Lateral or Antero-posteriorMedia.view

Extension Definitions

These are extension definitions for this resource defined by the spec