description: Provides guidance as to which ImagingStudy attributes should be present and considerations as to how each attribute should be valued in all [FHIR resource]-open events.\n\nAt least one business identifier of the ImagingStudy SHALL be provided in a [FHIR resource]-open request.  Two business identifiers are typically associated with an image study.  Imaging systems such as a PACS viewer, advanced visualization workstation, etc. typically identify an image study by its DICOM Study Instance UID (which in DICOM is identified with a (0020,000D) tag).  Likewise, information systems often identify an image study through the accession number of the order which triggered the image procedure to be performed.\n\nThe Study Instance UID SHALL be included as a business identifier if it is known.  In FHIR, the Study Instance UID of an ImagingStudy is provided in the `identifier` array using the identifier system of `urn:dicom:uid` and prefixing the UID value with `urn:oid:`.\n\nThe accession number SHALL be included as a business identifier if it is known.\n\n**FHIR R4 versus FHIR R5**\n\nRelative to FHIR R4, the ImagingStudy resource's change relevant to FHIRcast is the guidance FHIR R5 provides in specifying the accession number.  In FHIR R4, the guidance is to provide the accession number in the `identifier` array.  In FHIR R5, the accession number is provided in the ImagingStudy's `basedOn` array as a reference using a ServiceRequest reference type.\n\nSince this version of FHIRcast promotes the use of FHIR R4 resources, the guidance to provide the accession number in the `identifier` array SHOULD be used and this approach is shown in all ImagingStudy examples in the FHIRcast specification.  However, if Subscribers agree to use FHIR R5 resources, the FHIR R5 recommendation MAY be used.\n\nFor a more detailed explanation of these business identifiers, see the [FHIR R4 implementation notes of the FHIR ImagingStudy resource](https://hl7.org/fhir/R4B/imagingstudy.html) (and the [FHIR R5 implementation notes of the FHIR ImagingStudy resource](https://hl7.org/fhir/R5/imagingstudy.html)). Ideally both the accession number and Study Instance UID are available and present in an ImagingStudy resource used in FHIRcast.  The presence of both business identifiers ensures that all Subscribers will be able to be able to identify the appropriate imaging study.
package_name: hl7.fhir.uv.fhircast
derivation: constraint
name: FHIRcastImagingStudyOpen
type: ImagingStudy
elements:
  id: {short: A logical id of the resource SHALL be provided., index: 0}
  identifier: {short: 'At least one business identifier of the ImagingStudy SHALL be provided in a [FHIR resource]-open request (see this event''s detailed description for more information).', index: 1}
  status: {short: 'Status of the ImagingStudy, note this may not be known and hence have a value of `unknown`; however, `status` is included since it is required by the FHIR standard', index: 2}
  subject:
    type: Reference
    short: Reference to the Patient resource associated with the ImagingStudy (see detailed description if the image study's subject is not a patient)
    refers: ['http://hl7.org/fhir/StructureDefinition/Device', 'http://hl7.org/fhir/StructureDefinition/Group', 'http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-patient-open']
    index: 3
package_version: 3.0.0-ballot
class: profile
kind: resource
url: http://hl7.org/fhir/uv/fhircast/StructureDefinition/fhircast-imaging-study-open
base: http://hl7.org/fhir/StructureDefinition/ImagingStudy
version: 3.0.0-ballot
required: [id, identifier]