Note: This profile is developed to be part of a production trial of the communication between the general practitioner and municipal acute care team.

Scope and use

This profile is a MedCom Core profile for media and is intended to represent relevant attachments for a variety cases including:

• laboratory observations
• observations performed by a municipal acute care team

Only an attachment of the permitted formats must be included. Click here to see the permitted formats of an attachment

The attached file shall be base64-encoded and added to the element MedComCoreMedia.content.data If the attached file is sent, it is a requirement that the ID and title of the attached file shall be sent. The ID of the attachment shall be expressed using Media.identifier element. The Media.content.titel element shall be used to express the titel of the attachment.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Media

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
identifier	S	1..1	MedComAssignedIdentifier	An identifier intended for computation
status	S	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
operator	SC	0..1	Reference(MedComCorePractitioner | MedComCorePractitionerRole)	The person who generated the image medcom-homecareReport-5: There shall exist a practitioner role when using a PractitionerRole as author of the attached file . medcom-homecareReport-6: There shall exist a name of the healtcare worker that performed the observations, as author of the attached file .
content
contentType	S	0..1	code	Mime type of the content, with charset etc. Binding: MedComCoreAttachmentMimeTypes (required)
data	S	0..1	base64Binary	Data inline, base64ed
title	S	1..1	string	Label to display in place of the data
creation	S	1..1	dateTime	Date attachment was first created
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Media.content.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-homecareReport-5	error	Media.operator	There shall exist a practitioner role when using a PractitionerRole as author of the attached file . : reference.resolve().code.coding.code.exists()
medcom-homecareReport-6	error	Media.operator	There shall exist a name of the healtcare worker that performed the observations, as author of the attached file . : reference.resolve().practitioner.resolve().name.exists()

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..1	MedComAssignedIdentifier	An identifier intended for computation
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event.
operator	SΣC	0..1	Reference(MedComCorePractitioner | MedComCorePractitionerRole)	The person who generated the image medcom-homecareReport-5: There shall exist a practitioner role when using a PractitionerRole as author of the attached file . medcom-homecareReport-6: There shall exist a name of the healtcare worker that performed the observations, as author of the attached file .
content	Σ	1..1	Attachment	Actual Media - reference or data
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
data	S	0..1	base64Binary	Data inline, base64ed
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	Date attachment was first created
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Media.status	required	EventStatus
Media.content.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Media	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Media	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 : 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()
dom-4	error	Media	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Media	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Media	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-5	error	Media.operator	There shall exist a practitioner role when using a PractitionerRole as author of the attached file . : reference.resolve().code.coding.code.exists()
medcom-homecareReport-6	error	Media.operator	There shall exist a name of the healtcare worker that performed the observations, as author of the attached file . : reference.resolve().practitioner.resolve().name.exists()

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..1	MedComAssignedIdentifier	An identifier intended for computation
basedOn	Σ	0..*	Reference(ServiceRequest | CarePlan)	Procedure that caused this media to be created
partOf	Σ	0..*	Reference(Resource)	Part of referenced event
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event.
type	Σ	0..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories.
modality	Σ	0..1	CodeableConcept	The type of acquisition equipment/process Binding: MediaModality (example): Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it.
view	Σ	0..1	CodeableConcept	Imaging view, e.g. Lateral or Antero-posterior Binding: MediaCollectionView/Projection (example): Imaging view (projection) used when collecting an image.
subject	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Group | Device | Specimen | Location)	Who/What this Media is a record of
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with media
created[x]	Σ	0..1		When Media was collected
createdDateTime			dateTime
createdPeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
operator	SΣC	0..1	Reference(MedComCorePractitioner | MedComCorePractitionerRole)	The person who generated the image medcom-homecareReport-5: There shall exist a practitioner role when using a PractitionerRole as author of the attached file . medcom-homecareReport-6: There shall exist a name of the healtcare worker that performed the observations, as author of the attached file .
reasonCode	Σ	0..*	CodeableConcept	Why was event performed? Binding: ProcedureReasonCodes (example): The reason for the media.
bodySite	Σ	0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
deviceName	Σ	0..1	string	Name of the device/manufacturer
device	Σ	0..1	Reference(Device | DeviceMetric | Device)	Observing Device
height	Σ	0..1	positiveInt	Height of the image in pixels (photo/video)
width	Σ	0..1	positiveInt	Width of the image in pixels (photo/video)
frames	Σ	0..1	positiveInt	Number of frames if > 1 (photo)
duration	Σ	0..1	decimal	Length in seconds (audio / video)
content	Σ	1..1	Attachment	Actual Media - reference or data
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Data inline, base64ed
url	Σ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	Date attachment was first created
note		0..*	Annotation	Comments made about the media
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Media.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Media.status	required	EventStatus
Media.type	extensible	MediaType
Media.modality	example	MediaModality
Media.view	example	MediaCollectionView/Projection
Media.reasonCode	example	ProcedureReasonCodes
Media.bodySite	example	SNOMEDCTBodyStructures
Media.content.contentType	required	MedComCoreAttachmentMimeTypes
Media.content.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Media	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Media	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 : 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()
dom-4	error	Media	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Media	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Media	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-5	error	Media.operator	There shall exist a practitioner role when using a PractitionerRole as author of the attached file . : reference.resolve().code.coding.code.exists()
medcom-homecareReport-6	error	Media.operator	There shall exist a name of the healtcare worker that performed the observations, as author of the attached file . : reference.resolve().practitioner.resolve().name.exists()

Differential View

This structure is derived from Media

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
identifier	S	1..1	MedComAssignedIdentifier	An identifier intended for computation
status	S	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
operator	SC	0..1	Reference(MedComCorePractitioner | MedComCorePractitionerRole)	The person who generated the image medcom-homecareReport-5: There shall exist a practitioner role when using a PractitionerRole as author of the attached file . medcom-homecareReport-6: There shall exist a name of the healtcare worker that performed the observations, as author of the attached file .
content
contentType	S	0..1	code	Mime type of the content, with charset etc. Binding: MedComCoreAttachmentMimeTypes (required)
data	S	0..1	base64Binary	Data inline, base64ed
title	S	1..1	string	Label to display in place of the data
creation	S	1..1	dateTime	Date attachment was first created
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Media.content.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-homecareReport-5	error	Media.operator	There shall exist a practitioner role when using a PractitionerRole as author of the attached file . : reference.resolve().code.coding.code.exists()
medcom-homecareReport-6	error	Media.operator	There shall exist a name of the healtcare worker that performed the observations, as author of the attached file . : reference.resolve().practitioner.resolve().name.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..1	MedComAssignedIdentifier	An identifier intended for computation
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event.
operator	SΣC	0..1	Reference(MedComCorePractitioner | MedComCorePractitionerRole)	The person who generated the image medcom-homecareReport-5: There shall exist a practitioner role when using a PractitionerRole as author of the attached file . medcom-homecareReport-6: There shall exist a name of the healtcare worker that performed the observations, as author of the attached file .
content	Σ	1..1	Attachment	Actual Media - reference or data
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
data	S	0..1	base64Binary	Data inline, base64ed
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	Date attachment was first created
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Media.status	required	EventStatus
Media.content.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Media	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Media	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 : 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()
dom-4	error	Media	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Media	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Media	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-5	error	Media.operator	There shall exist a practitioner role when using a PractitionerRole as author of the attached file . : reference.resolve().code.coding.code.exists()
medcom-homecareReport-6	error	Media.operator	There shall exist a name of the healtcare worker that performed the observations, as author of the attached file . : reference.resolve().practitioner.resolve().name.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Media		0..*	Media	A photo, video, or audio recording acquired or used in healthcare. The actual content may be inline or provided by direct reference
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..1	MedComAssignedIdentifier	An identifier intended for computation
basedOn	Σ	0..*	Reference(ServiceRequest | CarePlan)	Procedure that caused this media to be created
partOf	Σ	0..*	Reference(Resource)	Part of referenced event
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): Codes identifying the lifecycle stage of an event.
type	Σ	0..1	CodeableConcept	Classification of media as image, video, or audio Binding: MediaType (extensible): Codes for high level media categories.
modality	Σ	0..1	CodeableConcept	The type of acquisition equipment/process Binding: MediaModality (example): Detailed information about the type of the image - its kind, purpose, or the kind of equipment used to generate it.
view	Σ	0..1	CodeableConcept	Imaging view, e.g. Lateral or Antero-posterior Binding: MediaCollectionView/Projection (example): Imaging view (projection) used when collecting an image.
subject	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Group | Device | Specimen | Location)	Who/What this Media is a record of
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with media
created[x]	Σ	0..1		When Media was collected
createdDateTime			dateTime
createdPeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
operator	SΣC	0..1	Reference(MedComCorePractitioner | MedComCorePractitionerRole)	The person who generated the image medcom-homecareReport-5: There shall exist a practitioner role when using a PractitionerRole as author of the attached file . medcom-homecareReport-6: There shall exist a name of the healtcare worker that performed the observations, as author of the attached file .
reasonCode	Σ	0..*	CodeableConcept	Why was event performed? Binding: ProcedureReasonCodes (example): The reason for the media.
bodySite	Σ	0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
deviceName	Σ	0..1	string	Name of the device/manufacturer
device	Σ	0..1	Reference(Device | DeviceMetric | Device)	Observing Device
height	Σ	0..1	positiveInt	Height of the image in pixels (photo/video)
width	Σ	0..1	positiveInt	Width of the image in pixels (photo/video)
frames	Σ	0..1	positiveInt	Number of frames if > 1 (photo)
duration	Σ	0..1	decimal	Length in seconds (audio / video)
content	Σ	1..1	Attachment	Actual Media - reference or data
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	0..1	code	Mime type of the content, with charset etc. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Data inline, base64ed
url	Σ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	Date attachment was first created
note		0..*	Annotation	Comments made about the media
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Media.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Media.status	required	EventStatus
Media.type	extensible	MediaType
Media.modality	example	MediaModality
Media.view	example	MediaCollectionView/Projection
Media.reasonCode	example	ProcedureReasonCodes
Media.bodySite	example	SNOMEDCTBodyStructures
Media.content.contentType	required	MedComCoreAttachmentMimeTypes
Media.content.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Media	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Media	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 : 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()
dom-4	error	Media	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Media	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Media	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-5	error	Media.operator	There shall exist a practitioner role when using a PractitionerRole as author of the attached file . : reference.resolve().code.coding.code.exists()
medcom-homecareReport-6	error	Media.operator	There shall exist a name of the healtcare worker that performed the observations, as author of the attached file . : reference.resolve().practitioner.resolve().name.exists()

This structure is derived from Media

Summary

Mandatory: 3 elements
Must-Support: 7 elements

Structures

This structure refers to these other structures:

• AssignedIdentifier (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-assigned-identifier)
• MedComCorePractitioner (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner)
• MedComCorePractitionerRole (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitionerrole)