FHIR Chat · Where to best place clinical photos? · implementers

Stream: implementers

Topic: Where to best place clinical photos?

David Teirney (Oct 27 2016 at 03:49):

Hello, we're trying to determine which FHIR API best fits the home for a photograph relevant to the care of the patient, e.g. perhaps of a patient wound, perhaps of a rash, perhaps of ???, basically anything a clinician could photograph on their mobile phone.

Some options are:

• Perhaps FHIR Media using a DICOM code of XC.
• Perhaps FHIR Observation with a yet to be determined LOINC code
• Somewhere else?

Has anyone already solved this problem?

Thanks!
David

Brian Postlethwaite (Oct 27 2016 at 03:52):

What you've described to me seems to make sense as an Observation with valueAttachment populated with the details of the photo (either locally encoded, or referenced to an external data source - security following it of course)
Really depends on the scale of the content.
(For a nurse doing would management as part of a post acute care treatment, taking a photo using a mobile phone and uploading as an observation makes a lot of sense)

David Teirney (Oct 27 2016 at 04:08):

We've been debating the whole base64encoded content vs URI challenge. Is there anything in FHIR that says that the URI needs to be long lived? Our security implementation is easy if that URI is generated and only valid for the same authenticated user.

David Teirney (Oct 27 2016 at 04:10):

Also, based on our reading of the spec it's fine to have the POST of content support the base64encoded content within Attachment, which is turned into a URI for subsequent GETs.

Brian Postlethwaite (Oct 27 2016 at 04:43):

Yes to the conversion of the content from base64 encoded, to externalize as a URI for subsequent gets. (unless its digitally signed, but I expect not an issue in your situation)

Brian Postlethwaite (Oct 27 2016 at 04:47):

If you are referring to the URL referenced by the observation that you requested, that's not defined as a FHIR location, so I don't believe we've said anything specific about that.

David Teirney (Oct 27 2016 at 08:36):

Yes, was referring to the URL referenced by the observation (in the Attachment). Thanks for the help @Brian Postlethwaite. Much appreciated.

Grahame Grieve (Oct 27 2016 at 11:16):

there's no rule about longevity for this reason. You can use a uri that is good for 1 second, if you want. The only rule is that you can't reuse the URL for different content

Abbie Watson (Dec 09 2016 at 01:54):

So, a minimalist implementation might look like this? This would be valid?

{
  “resourceType” : “Observation”,
  “component” : [{
    “valueAttachment” : {
      “url” : “http://somewhere.com/image.jpg”
    }
  }]
}

Grahame Grieve (Dec 09 2016 at 01:59):

usually yes.

Grahame Grieve (Dec 09 2016 at 01:59):

need a little more metadata

Grahame Grieve (Dec 09 2016 at 02:38):

@James Agnew and @Josh Mandel we kind of invented our own for this. DDL looks much more... sophisticated.... Opinions?

Josh Mandel (Dec 09 2016 at 15:12):

Do you have a link to a DDL approach? This is the first time "DDL" has appeared in the Zulip chat.

Abbie Watson (Dec 09 2016 at 20:02):

I think Grahame meant to type DDP, in reference to the Subscription Connectathon?

Grahame Grieve (Dec 09 2016 at 20:08):

y. this was the wrong topic

Last updated: Apr 12 2022 at 19:14 UTC