Creating a Medical Imaging Workflow Based on FHIR, DICOMweb, and SVG

Article by Shih‐Tsang Tang · Victoria Tjia · Thalia Noga · Jeshika Febri · Chung‐Yueh Lien · Woei‐Chyn Chu · Chin‐Yu Chen · Chia‐Hung Hsiao

Abstract

This paper proposes a web-based workflow scheme for the organization of medical images using FHIR and DICOM servers equipped with standard RESTful APIs. In our integrated workflow, the client systems (including order placer, scheduler, imaging modality, viewer, and report creator) use standard FHIR and DICOMweb APIs. The proposed scheme also facilitates the creation of reports formatted as standard FHIR resources. This paper leverages W3C Scalable Vector Graphics (SVG) to record the image graphic annotations, and encapsulates the SVG image annotation in FHIR observation. FHIR Diagnos- ticReports and Observations are used to encapsulate reports, findings, and annotations, thereby facilitating the implementa- tion and integration of the scheme within existing structures. The proposed scheme also provides the potential to make it possible to convert results of Computer Aided Detection/Diagnosis from medical images into FHIR DiagnosticReports and Observations to be stored on a FHIR server. The resulting web-based solution uses…