---
type: "example"
title: "DocumentReference Example: documentreference-example-dicom"
resource: "DocumentReference"
example: "documentreference-example-dicom"
---
# DocumentReference Example: documentreference-example-dicom

## Narrative

Ultrasound Image on patient "James Chalmers":  
![WADO reference to image](http://imaging.acme.com/wado/server?requestType=WADO&contentType=application%2Fdicom&studyUid=1.2.840.113619.2.21.848.34082.0.538976288.3&seriesUid=1.2.840.113619.2.21.3408.700.0.757923840.3.0&objectUid=1.2.840.11361907579238403408700.3.1.04.19970327150033)

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>
<DocumentReference xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/documentreference.xsd">
  <id value="1.2.840.11361907579238403408700.3.1.04.19970327150033"/>

  <!--
    This example demonstrates how to represent an image
    originally sourced by a DICOM acquisition device
    as a DocumentReference resource. Whether this is appropriate depends
    on the complexity of the image - the DocumentReference resource only
    contains crude metadata, and plain png/jpg (typically)
    pixels. This is suitable for the bulk of simple images
    shared as summaries with consumers, but not at all suitable
    for other kinds of images, or for internal radiology
    reporting usage
  -->
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      Ultrasound Image on patient "James Chalmers":<br/>
      <img src="http://imaging.acme.com/wado/server?requestType=WADO&amp;contentType=application%2Fdicom&amp;studyUid=1.2.840.113619.2.21.848.34082.0.538976288.3&amp;seriesUid=1.2.840.113619.2.21.3408.700.0.757923840.3.0&amp;objectUid=1.2.840.11361907579238403408700.3.1.04.19970327150033" alt="WADO reference to image"/>

    </div>
  </text>

  <!--
    this is added to demonstrate the use of DICOM extensions.
    0002,0010 is the DICOM transfer syntax of the referenced image
   -->
  <extension url="http://nema.org/fhir/extensions#0002-0010">
    <valueUri value="urn:oid:1.2.840.10008.1.2.1"/>
  </extension>

  <identifier>
    <type><text value="accessionNo"/></type>
    <!-- the imaging department accession number. (they recycle numbers each year) -->
    <system value="http://acme-imaging.com/accession/2012"/>
    <value value="1234567"/>
 </identifier>
  <identifier>
    <type><text value="studyId"/></type>
    <system value="urn:dicom:uid"/>
    <value value="urn:oid:1.2.840.113619.2.21.848.34082.0.538976288.3"/>
  </identifier>
  <identifier>
    <type><text value="seriesId"/></type>
    <system value="urn:dicom:uid"/>
    <value value="urn:oid:1.2.840.113619.2.21.3408.700.0.757923840.3.0"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <type><text value="InstanceUID"/></type>
    <system value="urn:dicom:uid"/>
    <value value="urn:oid:1.2.840.11361907579238403408700.3.1.04.19970327150033"/>
  </identifier>

  <status value="current"/>

  <modality>
      <!-- modality -->
      <coding>
        <system value="http://dicom.nema.org/resources/ontology/DCM"/>
        <code value="US"/>
      </coding>
  </modality>
  <subject>
    <reference value="Patient/example"/>
  </subject>

  <event>
    <concept>
    <!-- view -->
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="399067008"/>
        <display value="Lateral projection"/>
      </coding>
    </concept>
  </event>
  <bodySite>
	  <concept>
		  <coding>
			<!-- Added body site to support duplicate checking example -->
			<system value="http://snomed.info/sct"/>
			<code value="67734004"/>
			<display value="Upper Trunk Structure"/>
		  </coding>
	  </concept>
	</bodySite>  

  <author>
    <display value="G.E. Medical Systems"/>
  </author>

  <!-- and a reference to the image data -->
  <content>
    <attachment>
      <contentType value="application/dicom"/>
      <!-- The actual image could be anywhere. This is a WADO example -->
      <url value="http://imaging.acme.com/wado/server?requestType=WADO&amp;contentType=application%2Fdicom&amp;studyUid=1.2.840.113619.2.21.848.34082.0.538976288.3&amp;seriesUid=1.2.840.113619.2.21.3408.700.0.757923840.3.0&amp;objectUid=1.2.840.11361907579238403408700.3.1.04.19970327150033"/>
      <height value="480"/>
      <width value="640"/>
    </attachment>
  </content>
</DocumentReference>
```