HL7 FHIR Malaysia Core (MY Core) Implementation Guide
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HL7 FHIR Malaysia Core (MY Core) Implementation Guide - Local Development build (v2.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Imaging Services

The HIE portal provides an imaging module to order Imaging investigations, as well as create and review the imaging report. This function is available for both internal and external orders.

Sample Data and API

[base] = address url e.g. "https://fhir.hie.moh.gov.my/baseR4/"
[type] = resource type e.g. "ServiceRequest | DiagnosticReport | ImagingStudy"
@patientIdentifier = unique patient identifier defined from source system e.g "HIE-00000003"
@recordId = unique record ID defined from source system e.g. "dr-imaging-sample"
@recordIdentifier = record identifier defined from source system e.g. "HTJ-IMO-2307000046" | "00021"

Sample Description Sample Body API Method API
Create/Update imaging order

1. Imaging Order Bundle

2. Imaging Order Bundle No ID

 POST [base]
Create/Update imaging report and result Imaging Report PUT [base]/DiagnosticReport
Retrieve imaging report and result by patient identifier - GET [base]/DiagnosticReport?subject.identifier=@patientIdentifier&_include=DiagnosticReport:result
Retrieve any record by ID - GET [base]/[type]/@recordId
Retrieve any record by identifier - GET [base]/[type]?identifier=@recordIdentifier


Resource Breakdown

In HIE, FHIR resources are used to store details of the ordering process up to the result and reporting process.

The diagram below shows how the FHIR resources are broken down and used:

Imaging

Imaging HealthcareService

Using HealthcareService (MY Core), each facility will define what Imaging orderables are available for their users to request.

Imaging Request List | Phlebotomy Station

When a request is made, it will be stored using ServiceRequest (MY Core) and ImagingStudy (MY Core). The ServiceRequest status will be "draft" ServiceRequest.status:"draft".

Once the user confirms and intiates their request, a Task (MY Core) will be created.

  • The ServiceRequest status will be updated to "active" ServiceRequest.status:"active"
  • The Task status will be "draft" Task.status:"draft" and businessStatus will be "initiate" Task.businessStatus:"initiate"

Imaging Console

The Task (MY Core) will then track and execute the operational business flow up until its intended or alternate destination is achieved.

As the Task moves to each checkpoint it will update its businessStatus as defined in the diagram.

Report Form

Once a report is ready to be stored in HIE, it will use the DiagnosticReport (MY Core). The image itself is stored in DICOM format at the source where the user can view the result using a DICOM link.

Source System Integration Point

There are 2 possible use cases where a source system exchanges imaging data with HIE:

  1. During external ordering
  2. When retrieving results & formal reports

For further details on the flow of sending and/or retrieving data, please refer to Integration Overview under Care Coordination (CC).

External Order (Integration Point 1)

An external order directed to or received from another facility/source system can be done through HIE using the MY Core Standard. The profile used for imaging ordering is ServiceRequest (MY Core). The record must have:

  1. A status fixed as "active" status:"active"
  2. An intent intent
  3. The category fixed as "363679005" (imaging order) category.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/servicerequest-category-my-core').code:"363679005"
  4. The imaging modality category.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/imaging-modality-my-core').code
  5. The imaging region category.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/imaging-region-my-core').code
  6. The imaging code code.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/imaging-my-core').code
  7. A subject referenced subject
  8. An encounter referenced encounter
  9. Date order authored authoredOn
  10. Type of performer fixed as "affiliate" performerType:"affiliate"
  11. Practitioner who requested requester
  12. Requesting Organization referenced performer.where (identifier.value = 'requester-facility').reference
  13. Performing Organization performer.where (identifier.value = 'requester-facility').reference

Imaging Report & Result (Integration Point 2)

An imaging report and result can be sent to HIE for record exchange or to fulfil another requesting source system order (Integration Point 1). The profile related to imaging reporting is DiagnosticReport (MY Core).

The imaging report (DiagnosticReport) must have:

  1. A status fixed as "final" status:"final"
  2. The category fixed as "363679005" (imaging order) category.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/servicerequest-category-my-core').code:"363679005"
  3. The imaging modality category.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/imaging-modality-my-core').code
  4. The imaging region category.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/imaging-region-my-core').code
  5. The imaging code code.coding.where (system = 'http://fhir.hie.moh.gov.my/CodeSystem/imaging-my-core').code
  6. A subject referenced subject
  7. An encounter referenced encounter
  8. A report conclusion conclusion