DICOM/DICOMweb™ is used for Imaging-centric workflows. e.g. PACS, Post-processing applications.
FHIR is used for information centric workflows. e.g. EMRs, EHRs.
DICOM and FHIR Connectathon track is about integrating FHIR with medical imaging and DICOMweb™. In this track, the focus will be on contributing towards mapping of DICOM SR to FHIR and DICOM image sharing in ABDM context.
The goals of the Connectathon are:
• Integrating FHIR® with medical imaging and DICOMweb™
• Extract key content from DICOM SR ( AI Result , measurement report, etc) into FHIR resources, Observation
• Review and contribute to Mapping of DICOM SR to FHIR IG proposal
• Generate DICOM SR to FHIR mapping using TID 1500 as described in IHE AIR
• Demonstrate an integrated workflow of storing DICOM SR based AI results into FHIR Server and display in a FHIR based client application.
• Proposal for DICOM image sharing using ABDM in India context.
Test and Implementation Guide
Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group
Arunachalam Annamalai and Muralidhar Chowdary, N
Track Lead Email(s)
Specification(s) this track uses
Connectathon Orientation call
Friday, Nov 20th @ 1730 IST
Preconnectathon sessions / webinars:
Roles: like Architects, Product Managers / Product Owner , Developers , Testers, Research Scientist, Interoperability SMEs
Companies: like AliveCore India, Frappe, Healthcare Technology SolutionsSiemens Healthineers , forgeahead, Philips, Medsynaptic Pvt Ltd, PhilipsXYRAM, Siemens Healthineers CitiusTech
· Systems and Software
· Acquisition system: Use DICOM for communication with other systems like PACS
· AI based Imaging analysis software:
· Capture measurements, derived measurements and qualitative evaluations in a DICOM structured report(SR) format.
· In this Connectathon, TID 1500 based DICOM SR format will be used.
· Radiologist will review content provided in the SR and may include the results in the report as observations.
· Use case : Imaging measurements transformed to FHIR observations
· Measurements are made from the acquired images.
· Imaging analysis systems ( AI Machines) use TID 1500 and map the imaging measurements in the DICOM structured report.
· Mapping from each measurement from the SR to an individual FHIR observation.
· Use case : Image distribution in ABDM system ( analysis in progress)
Integrating AI workflow in Connectathon:
Pneumothorax is an example of how AI is used in a clinical environment for a potentially life-threatening but readily treated emergency
· A patient presents in an emergency room after a motor vehicle accident and has an x-ray.
· The image is obtained from the modality
· The images are sent to the PACS and AI algorithm.
· Before a Radiologist sees the results, an AI algorithm detects and estimates pneumothorax size. The AI algorithm sends the report to the PACS as a DICOM SR with the information, identification, and graphic highlighting the pneumothorax.
· The AI findings, while captured as DICOM SR for the Radiologist read, the AI Findings need to be encoded as a FHIR observation to interact with systems that are non-imaging.
· “DICOM to FHIR Converter” component to be developed will:
Fetch DICOM images and SR from PACS using DICOMWeb interface
Parses the DICOM Study to generate FHIR ImagingStudy resource
Parses the DICOM SR, applies mapping to create FHIR Observation resource.
· The FHIR resources ( ImagingStudy, Observation) will be sent to FHIR server for storing
· Referring physician reads patient clinical data along with data converted from DICOM for further patient care process.
o Sessions/Webinars on DICOM, DICOMWeb communication, FHIR Observation resources
o Understand TID 1500, IHE AIR to map the DICOM SR to FHIR
o Hands-on trainings on tools required for the workflow integration:
Orthanc DICOM server, Dcmtk tools, AX DICOM tools, Liquid templating language
· Connectathon Output
1. Report for review and improvement done for the DICOM SR to FHIR IG proposal
2. Liquid template for DICOM SR to FHIR (based on TID 1500) mapping stored in Github
3. End2End integration using several opensource tools to demonstrate the integrated AI workflow
4. Recommendation to ABDM on the image sharing workflow - concept proposal
Tools/Opensource to be used during connectathon
· AX DICOM Tools
· Fo-Dicom library
· Orthanc DICOM Server
· Hapi FHIR Server
· Scriban templating language
Schedule for Connectathon