FHIR Document Resources in ESUS

ESUS implements the following resources for clinical and administrative documents:

ResourcePurpose
DocumentReferenceMetadata about a document and a pointer to its content
CompositionStructured clinical document (grouped sections)
DiagnosticReportLab, imaging, pathology, and other diagnostic reports
MediaClinical audio, video, and images

Document content (PDF, images, DICOM, etc.) is uploaded through the dedicated file-storage endpoints (/files/upload), and then referenced from a DocumentReference via content.attachment.url.

Document Lifecycle

  1. Upload the binary content to /files/upload.
  2. Create a DocumentReference (or Composition, DiagnosticReport, Media) that points to the uploaded file.
  3. Link the document to the relevant patient and encounter.
  4. Access through authorized reads; every access is audited.

Document Types

TypeTypical resource
Clinical notes — progress, consult, H&PDocumentReference + /files/upload
Structured clinical documentComposition
Lab, imaging, pathology reportsDiagnosticReport
Images and mediaMedia
Administrative (consent forms, referrals)DocumentReference

Common Standards

  • HL7 CDA — Clinical Document Architecture.
  • CCDA — Consolidated CDA.
  • FHIR Documents — a Composition that bundles references to other FHIR resources (typically packaged as a Bundle of type document).