Tiro.health Implementation Guide
0.1.0 - ci-build

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Resource Profile: ImagingMeasurement - Mappings

Draft as of 2026-06-09

Mappings for the ImagingMeasurement resource profile.

Mappings to Structures in this Implementation Guide

No Mappings Found

Mappings to other Structures

No Mappings Found

Other Mappings

NameopenEHR Imaging examination result (v1)openEHR Imaging examination of a body structure (CLUSTER, v1)Workflow PatternFiveWs Pattern MappingSNOMED CT Concept Domain BindingHL7 V2 MappingRIM MappingSNOMED CT Attribute Bindingdoco
.. Observation
Event
clinical.diagnostics
< 363787002 |Observable entity|
OBX
  • Entity
  • Role
  • or Act
  • Observation[classCode=OBS
  • moodCode=EVN]
... id
... meta
... implicitRules
... language
... text
Act.text?
... contained
N/A
... extension
N/A
... modifierExtension
N/A
... identifier
Event.identifier
FiveWs.identifier
1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 3) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
id
... instantiates[x]
Event.instantiatesCanonical
.outboundRelationship[typeCode=DEFN].target
... basedOn
Event.basedOn
ORC
.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
... triggeredBy
ORC
.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... observation
outBoundRelationship
.... type
code
.... reason
annotation
... partOf
Event.partOf
Varies by domain
.outboundRelationship[typeCode=FLFS].target
... status
  • data/events/data/items[at0072]/value
  • data/events/data/items[at0071]/value (not represented)
openEHR 'Overall result status' (DV_CODED_TEXT: registered|partial|preliminary|final|amended|corrected|appended|cancelled|unknown) → FHIR Observation.status. 'partial' / 'appended' have no exact FHIR code and collapse to 'preliminary' / 'amended' respectively. openEHR carries this at report level — FHIR repeats it on each Observation.
Event.status
FiveWs.status
< 445584004 |Report by finality status|
OBX-11
status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
... Slices for category
(implicit)
No equivalent on the openEHR side — the imaging context is implicit in the archetype identity. FHIR makes it explicit and we fix it to 'imaging'.
FiveWs.class
  • .outboundRelationship[typeCode="COMP].target[classCode="LIST"
  • moodCode="EVN"].code
.... category:imaging
FiveWs.class
  • .outboundRelationship[typeCode="COMP].target[classCode="LIST"
  • moodCode="EVN"].code
... code
(archetype node identity)
openEHR encodes the kind of measurement in the at-code of the ELEMENT node within a specialisation (e.g. items[at0.2] 'Diameter' on imaging_exam-lymph_node.v0). FHIR makes the measurement kind explicit on Observation.code (CodeableConcept), bound to a measurement-property value set.
Event.code
FiveWs.what[x]
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
OBX-3
code
116680003 |Is a|
... subject
Event.subject
FiveWs.subject[x]
PID-3
participation[typeCode=RTGT]
... focus
items[at0003] (Structured body site → CLUSTER.anatomical_location.v1 / .anatomical_location_relative.v2 / .anatomical_location_circle.v1)
openEHR uses a CLUSTER slot for structured anatomy (relative location, circle, etc.). FHIR points Observation.focus at a BodyStructure resource for the same purpose — and uses focus rather than bodySite for tracked-over-time lesions.
FiveWs.subject[x]
OBX-3
participation[typeCode=SBJ]
... encounter
Event.encounter
FiveWs.context
PV1
  • inboundRelationship[typeCode=COMP].source[classCode=ENC
  • moodCode=EVN]
... effective[x]
data/events/data/items[at0070]/value
openEHR 'Study date' (DV_DATE_TIME) → FHIR Observation.effective[x]. Both denote when the image was acquired, not when it was interpreted.
Event.occurrence[x]
FiveWs.done[x]
  • OBX-14
  • and/or OBX-19 after v2.4 (depends on who observation made)
effectiveTime
... issued
FiveWs.recorded
  • OBR-22 (or MSH-7)
  • or perhaps OBX-19 (depends on who observation made)
participation[typeCode=AUT].time
... performer
Event.performer.actor
FiveWs.actor
  • OBX-15 / (Practitioner) OBX-16
  • PRT-4='RO' / (Device) OBX-18
  • PRT-4='EQUIP' / (Organization) OBX-23
  • PRT-4='PO'
participation[typeCode=PRF]
... value[x]
  • items[at0.N]/value (on a specialisation
  • e.g. imaging_exam-lymph_node.v0/items[at0.2])
openEHR DV_QUANTITY on a structure-specific specialisation ELEMENT → FHIR Observation.valueQuantity. The base CLUSTER.imaging_exam.v1 has no native measurement node; the quantity always lives on a specialisation.
< 441742003 |Evaluation finding|
  • OBX-2
  • OBX-5
  • OBX-6
value
363714003 |Interprets|
.... id
n/a
.... extension
n/a
.... value
SN.2 / CQ - N/A
  • PQ.value
  • CO.value
  • MO.value
  • IVL.high or IVL.low depending on the value
.... comparator
SN.1 / CQ.1
IVL properties
.... unit
(see OBX.6 etc.) / CQ.2
PQ.unit
.... system
(see OBX.6 etc.) / CQ.2
  • CO.codeSystem
  • PQ.translation.codeSystem
.... code
(see OBX.6 etc.) / CQ.2
  • PQ.code
  • MO.currency
  • PQ.translation.code
... dataAbsentReason
N/A
value.nullFlavor
... interpretation
< 260245000 |Findings values|
OBX-8
interpretationCode
363713009 |Has interpretation|
... note
  • NTE-3 (partner NTE to OBX
  • or sometimes another (child?) OBX)
subjectOf.observationEvent[code="annotation"].value
... bodySite
items[at0001]/value + items[at0002]/value
openEHR splits anatomy across 'Body structure' (at0001, DV_TEXT, the organ/structure) and 'Body site' (at0002, DV_TEXT, the area). FHIR collapses both into Observation.bodySite (CodeableConcept). Coding with SNOMED CT is recommended on both sides.
< 123037004 |Body structure|
OBX-20
targetSiteCode
718497002 |Inherent location|
... bodyStructure
targetSiteCode
... method
data/events/data/items[at0091]/value
openEHR 'Modality' (DV_TEXT, at report level) → FHIR Observation.method (CodeableConcept). openEHR also has a 'Technique' element on protocol/items[at0087] for finer detail; that lands on Observation.method as well or is moved to ImagingStudy.series.modality if referenced.
OBX-17
methodCode
... specimen
< 123038009 |Specimen|
SPM segment
participation[typeCode=SPC].specimen
704319004 |Inherent in|
... device
< 49062001 |Device|
OBX-17 / PRT -10
participation[typeCode=DEV]
424226004 |Using device|
... referenceRange
OBX-7
  • outboundRelationship[typeCode=REFV]/target[classCode=OBS
  • moodCode=EVN]
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... low
OBX-7
IVL_PQ.low
.... high
OBX-7
IVL_PQ.high
.... normalValue
OBX-7
IVL_PQ.normal
.... type
< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
OBX-10
interpretationCode
.... appliesTo
< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
OBX-10
interpretationCode
.... age
outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
.... text
OBX-7
ST
... hasMember
Relationships established by OBX-4 usage
outBoundRelationship
... derivedFrom
  • protocol/items[at0106]/value (Image details
  • DV_URI
  • 0..*) + protocol/items[at0092] (Study instance identifier)
openEHR holds image URIs on the protocol section and a separate Study instance identifier element. FHIR references the whole ImagingStudy / Media / DocumentReference resource instead, where the URIs and identifiers live.
Relationships established by OBX-4 usage
.targetObservation
... component
  • items[at0.N] (multiple occurrences on the same specialisation
  • e.g. imaging_exam-lymph_node.v0/items[at0.2] occurrences 0..3 for three axes)
openEHR allows the same measurement ELEMENT to occur multiple times on a structure-specific cluster (e.g. Diameter 0..3 on lymph_node, one per axis). FHIR captures sibling axes as component entries on the same Observation, with each component.code naming the axis.
containment by OBX-4?
outBoundRelationship[typeCode=COMP]
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... code
FiveWs.what[x]
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
OBX-3
code
.... value[x]
363714003 |Interprets| < 441742003 |Evaluation finding|
  • OBX-2
  • OBX-5
  • OBX-6
value
363714003 |Interprets|
.... dataAbsentReason
N/A
value.nullFlavor
.... interpretation
< 260245000 |Findings values|
OBX-8
interpretationCode
363713009 |Has interpretation|
.... referenceRange
OBX-7
  • outboundRelationship[typeCode=REFV]/target[classCode=OBS
  • moodCode=EVN]

doco Documentation for this format