Medizininformatik Initiative - ImplementationGuide - Pathologie-Befund EN v2026
Attached Image (Media)
Description
The MII PR Patho Attached Image profile of the Media resource is used to describe images embedded in the MII PR Patho Report. To include images in MII PR Patho Finding, a reference to an imaging study must be used. This profile should preferably only be used to "illustrate" a pathology report.
| Name | Canonical |
|---|---|
| MII_PR_Patho_Attached_Image | https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/StructureDefinition/mii-pr-patho-attached-image |
| MII_PR_Patho_Attached_Image (Media) | C | Media | |
| id | S Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| versionId | Σ | 0..1 | id |
| lastUpdated | S Σ | 0..1 | instant |
| source | Σ | 0..1 | uri |
| profile | S Σ | 0..* | canonical(StructureDefinition) |
| security | Σ | 0..* | CodingBinding |
| tag | Σ | 0..* | Coding |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | S | 0..1 | Narrative |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| basedOn | Σ C | 0..* | Reference(CarePlan | ServiceRequest) |
| partOf | S Σ C | 0..* | Reference(Media) |
| status | S Σ ?! | 1..1 | codeBinding |
| type | S Σ | 1..1 | CodeableConceptBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 1..* | Coding |
| image | Σ | 1..1 | CodingPattern |
| text | Σ | 0..1 | string |
| modality | S Σ | 0..1 | CodeableConceptBinding |
| view | Σ | 0..1 | CodeableConcept |
| subject | S Σ C | 0..1 | Reference(MII_PR_Patho_Specimen) |
| encounter | Σ C | 0..1 | Reference(Encounter) |
| created[x] | Σ | 0..1 | |
| createdDateTime | dateTime | ||
| createdPeriod | Period | ||
| issued | Σ | 0..1 | instant |
| operator | Σ C | 0..1 | Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) |
| reasonCode | Σ | 0..* | CodeableConcept |
| bodySite | Σ | 0..1 | CodeableConcept |
| deviceName | Σ | 0..1 | string |
| device | Σ C | 0..1 | Reference(Device | Device | DeviceMetric) |
| height | Σ | 0..1 | positiveInt |
| width | Σ | 0..1 | positiveInt |
| frames | Σ | 0..1 | positiveInt |
| duration | Σ | 0..1 | decimal |
| content | S Σ C | 1..1 | Attachment |
| note | 0..* | Annotation |
| MII_PR_Patho_Attached_Image (Media) | C | Media | |
| id | S Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| versionId | Σ | 0..1 | id |
| lastUpdated | S Σ | 0..1 | instant |
| source | Σ | 0..1 | uri |
| profile | S Σ | 0..* | canonical(StructureDefinition) |
| security | Σ | 0..* | CodingBinding |
| tag | Σ | 0..* | Coding |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | S | 0..1 | Narrative |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| basedOn | Σ C | 0..* | Reference(CarePlan | ServiceRequest) |
| partOf | S Σ C | 0..* | Reference(Media) |
| status | S Σ ?! | 1..1 | codeBinding |
| type | S Σ | 1..1 | CodeableConceptBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 1..* | Coding |
| image | Σ | 1..1 | CodingPattern |
| text | Σ | 0..1 | string |
| modality | S Σ | 0..1 | CodeableConceptBinding |
| view | Σ | 0..1 | CodeableConcept |
| subject | S Σ C | 0..1 | Reference(MII_PR_Patho_Specimen) |
| encounter | Σ C | 0..1 | Reference(Encounter) |
| created[x] | Σ | 0..1 | |
| createdDateTime | dateTime | ||
| createdPeriod | Period | ||
| issued | Σ | 0..1 | instant |
| operator | Σ C | 0..1 | Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) |
| reasonCode | Σ | 0..* | CodeableConcept |
| bodySite | Σ | 0..1 | CodeableConcept |
| deviceName | Σ | 0..1 | string |
| device | Σ C | 0..1 | Reference(Device | Device | DeviceMetric) |
| height | Σ | 0..1 | positiveInt |
| width | Σ | 0..1 | positiveInt |
| frames | Σ | 0..1 | positiveInt |
| duration | Σ | 0..1 | decimal |
| content | S Σ C | 1..1 | Attachment |
| note | 0..* | Annotation |
| MII_PR_Patho_Attached_Image (Media) | C | Media | |
| id | S Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| versionId | Σ | 0..1 | id |
| lastUpdated | S Σ | 0..1 | instant |
| source | Σ | 0..1 | uri |
| profile | S Σ | 0..* | canonical(StructureDefinition) |
| security | Σ | 0..* | CodingBinding |
| tag | Σ | 0..* | Coding |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | S | 0..1 | Narrative |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| basedOn | Σ C | 0..* | Reference(CarePlan | ServiceRequest) |
| partOf | S Σ C | 0..* | Reference(Media) |
| status | S Σ ?! | 1..1 | codeBinding |
| type | S Σ | 1..1 | CodeableConceptBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 1..* | Coding |
| image | Σ | 1..1 | CodingPattern |
| text | Σ | 0..1 | string |
| modality | S Σ | 0..1 | CodeableConceptBinding |
| view | Σ | 0..1 | CodeableConcept |
| subject | S Σ C | 0..1 | Reference(MII_PR_Patho_Specimen) |
| encounter | Σ C | 0..1 | Reference(Encounter) |
| created[x] | Σ | 0..1 | |
| createdDateTime | dateTime | ||
| createdPeriod | Period | ||
| issued | Σ | 0..1 | instant |
| operator | Σ C | 0..1 | Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) |
| reasonCode | Σ | 0..* | CodeableConcept |
| bodySite | Σ | 0..1 | CodeableConcept |
| deviceName | Σ | 0..1 | string |
| device | Σ C | 0..1 | Reference(Device | Device | DeviceMetric) |
| height | Σ | 0..1 | positiveInt |
| width | Σ | 0..1 | positiveInt |
| frames | Σ | 0..1 | positiveInt |
| duration | Σ | 0..1 | decimal |
| content | S Σ C | 1..1 | Attachment |
| note | 0..* | Annotation |
{
"url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/StructureDefinition/mii-pr-patho-attached-image",
{
{
},
{
}
],
},
{
{
},
{
}
],
}
]
},
],
{
{
},
{
}
],
},
{
{
},
{
}
],
}
]
},
{
"short": "A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference",
"definition": "A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference.",
},
{
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
{
},
{
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
},
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
{
{
}
],
}
],
},
{
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
},
],
"ele-1"
],
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
"comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
},
],
"ele-1"
],
{
}
],
]
},
{
"comment": "This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http.html#read) interaction.",
},
],
"ele-1"
],
{
}
],
]
},
{
"definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
"comment": "In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.",
},
],
"ele-1"
],
{
}
],
]
},
{
"definition": "A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).",
"comment": "It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.",
},
{
"http://hl7.org/fhir/StructureDefinition/StructureDefinition"
]
}
],
"ele-1"
],
{
}
],
]
},
{
"definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
"comment": "The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
},
],
"ele-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
"comment": "The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
},
],
"ele-1"
],
{
}
],
{
}
],
"description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\".",
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
},
],
"ele-1"
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
]
},
{
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
},
],
"ele-1"
],
{
}
],
{
},
{
}
],
},
]
},
{
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
"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.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
"fulfills"
],
},
{
"http://hl7.org/fhir/StructureDefinition/ServiceRequest",
"http://hl7.org/fhir/StructureDefinition/CarePlan"
]
}
],
"ele-1"
],
{
},
{
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
}
],
{
},
{
},
{
},
{
}
]
},
{
{
],
},
{
],
}
]
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
]
},
"comment": "Not to be used to link an event to an Encounter - use Media.encounter for that.\n\n[The allowed reference resources may be adjusted as appropriate for the event resource].",
"requirements": "E.g. Drug administration as part of a procedure, procedure as part of observation, etc.",
"container"
],
},
],
"ele-1"
],
{
},
{
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
}
],
{
},
{
},
{
},
{
}
]
},
{
{
],
},
{
],
}
]
},
{
],
},
{
{
},
{
}
],
}
]
},
"comment": "A nominal state-transition diagram can be found in the [[event.html#statemachine | Event pattern]] documentation\n\nUnknown 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.",
},
],
"ele-1"
],
{
}
],
"isModifierReason": "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",
{
}
],
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
],
},
{
],
}
]
},
{
],
},
{
],
}
]
},
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
},
],
"ele-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
},
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
},
],
},
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
}
],
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
{
],
},
{
],
}
]
},
{
{
},
{
}
],
},
{
],
}
]
},
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
},
],
"ele-1"
],
{
}
],
{
}
],
"description": "Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it.",
"valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/ValueSet/mii-vs-patho-media-modality-snomed-ct"
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
},
],
"ele-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
],
},
{
],
}
]
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
]
},
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
},
{
"https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/StructureDefinition/mii-pr-patho-specimen"
]
}
],
"ele-1"
],
{
},
{
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"context"
],
},
],
"ele-1"
],
{
},
{
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"timing"
],
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "The date and time this version of the media was made available to providers, typically after having been reviewed.",
"comment": "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.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
},
{
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
"ele-1"
],
{
},
{
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
},
],
"ele-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
"comment": "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. \n\nIf 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).",
},
],
"ele-1"
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The name of the device / manufacturer of the device that was used to make the recording.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
}
]
},
{
"comment": "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.",
},
{
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/DeviceMetric",
"http://hl7.org/fhir/StructureDefinition/Device"
]
}
],
"ele-1"
],
{
},
{
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
},
],
"ele-1"
],
{
}
],
{
},
{
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"OBS\", moodCode=\"EVN\",code=\"<CODE>\"].value"
},
{
}
]
},
{
},
],
"ele-1"
],
{
}
],
{
},
{
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"OBS\", moodCode=\"EVN\",code=\"<CODE>\"].value"
},
{
}
]
},
{
"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.",
"comment": "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.",
},
],
"ele-1"
],
{
}
],
{
},
{
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"OBS\", moodCode=\"EVN\",code=\"<CODE>\"].value"
}
]
},
{
},
],
"ele-1"
],
{
}
],
{
},
{
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"OBS\", moodCode=\"EVN\",code=\"<CODE>\"].value"
},
{
}
]
},
{
{
],
},
{
],
}
]
},
{
],
},
{
],
}
]
},
"comment": "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.",
},
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"comment": "Not to be used for observations, conclusions, etc. Instead use an [Observation](observation.html) based on the Media/ImagingStudy resource.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
"map": ".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]"
}
]
}
]
},
{
},
{
},
{
},
{
},
{
{
],
},
{
],
}
]
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
]
},
],
},
{
{
],
},
{
],
}
]
},
{
],
},
{
{
},
{
}
],
}
]
},
},
{
{
],
},
{
],
}
]
},
{
],
},
{
],
}
]
},
},
{
},
},
{
}
},
{
{
],
},
{
],
}
]
},
{
{
},
{
}
],
},
{
],
}
]
},
"valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/ValueSet/mii-vs-patho-media-modality-snomed-ct"
}
},
{
{
],
},
{
],
}
]
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
]
},
{
"https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/StructureDefinition/mii-pr-patho-specimen"
]
}
],
},
{
{
],
},
{
],
}
]
},
{
],
},
{
],
}
]
},
}
]
}
}
List of all must-support data elements
| FHIR element | Explanation |
|---|---|
| Media.id | Must-support, but optional |
| Media.meta.lastUpdated | Must-support, but optional |
| Media.meta.profile | Must-support, but optional |
| Media.partOf | Reference to medium |
| Media.status | Event status |
| Media.text | Textual description of the recording |
| Media.type | Media type (Image) |
| Media.subject | Reference to sample |
| Media.content | Media attachment |
Reference to the Logical Model
| FHIR Element | Logical Data Model |
|---|---|
| Media.id | EmbeddedImage.ID |
| Media.partOf | Media |
| Media.status | EmbeddedImage.Status |
| Media.type | EmbeddedImage.Type |
| Media.subject | Sample |
| Media.content | EmbeddedImage.Content |
Search Parameters
The following search parameters are relevant for the Pathology Reports module, even in combination:
- The search parameter ```_id`` MUST be supported:
Examples:
``GET [base]/Media?_id=103270```
Usage Notes: Further information on searching for ```_id`` can be found in the FHIR Base Specification - Section "Parameters for all resources".
- The search parameter
_lastUpdatedMUST be supported:
Examples:
GET [base]/Media?_lastUpdated=2021-12-08
Usage Notes: For more information on searching for ```_lastUpdated``, see the FHIR Base Specification - Section "Parameters for all resources".
- The search parameter ```_profile`` MUST be supported:
Examples:
GET [base]/Media?_profile=https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/StructureDefinition/mii-pr-patho-attached-image
Usage Notes: Further information on searching for ```_profile`` can be found in the FHIR Base Specification - Section "Parameters for all resources".
- The search parameter ```created`` MUST be supported:
Examples:
``GET [base]/Media?created=2021-06-08```
Usage Notes: Further information on searching for ```Media.created`` can be found in the FHIR Base Specification - "date" section.
- The search parameter ```status`` MUST be supported:
Examples:
GET [base]/Media?status=completed
Usage Notes: Further information on searching for ```Media.status`` can be found in the FHIR Base Specification - "token" section.
- The search parameter "subject" MUST be supported:
Examples:
GET [base]/Media?subject=Specimen/ex-mii-patho-prostate-tru-cut-biopsy-sample
Usage Notes: For more information on searching for "Media.subject," see the FHIR Base Specification - Reference Section.
- The search parameter ```type`` MUST be supported:
Examples:
GET [base]/Media?type=image
GET [base]/Media?type=http://terminology.hl7.org/CodeSystem/media-type|image
Usage Notes: For more information on searching for ```Media.type``, see the FHIR Base Specification - "token" section.
- The search parameter ```part-of`` MUST be supported:
Examples:
GET [base]/Media?part-of=Media/9878097
Usage Notes: For more information on searching for (Media.partOf as Media), see the FHIR Base Specification - Reference Section.
Example
{
"https://www.medizininformatik-initiative.de/fhir/ext/modul-patho/StructureDefinition/mii-pr-patho-attached-image|2026.0.0"
]
},
},
},
}
}