A.5.1.4.1 Subject Context

Subject Context, Patient

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Figure A.5.1.3-4: PATIENT CONTEXT

DICOM template 2000 (PS 3.16) constrains the multiplicity of the patient subject to one per document. Attributes of the Patient Module (PS 3.3) and the Patient Subject Context (Template 1007, PS 3.16) are mapped to the recordTarget participation, associated roles and entities, if the Subject Class Code (Template 1006, PS 3.16) equals "Patient”.

Table A.5.1.3-7

PATIENT ROLE

Attribute Data Type Multiplicity Value
classCode CS 1..1 PAT
id SET<II> 1..* “Subject ID”: Defaults to value of Patient ID(0010,0020) in Patient Module. Other Patient IDs (0010,1000): may be mapped if appropriate infrastructure (master person index) and policies for domain identifier assignment are in place. The SET <II> data type does not provide use codes to distinguish multiple patient identifiers.
addr SET<AD> 0..* Patient’s Address (0010,1040) in Patient Demographic Module.
telecom SET<TEL> 0..* Patient’s Telephone Numbers (0010,2154) ) in Patient Demographic Module.

Note: If information on Issuer of Patient ID is available from the DICOM SR document (Patient Module), Universal Entity ID (0040,0032) of the Issuer of Patient ID Qualifiers Sequence (0010,0024) are mapped to PatientRole.id II root and Patient ID (0010,0020) to PatientRole.id II extension. Otherwise a globally unique identifier (ISO Object Identifier) may be generated for the PatientRole.id II root portion. If available Issuer of Patient ID (0010,0021) shall be mapped to PatientRole.id assigningAuthorityName.

Table A.5.1.3-8

PATIENT ENTITY

Attribute Data Type Multiplicity Value
classCode CS 1..1 PSN
determinerCode CS 1..1 INSTANCE
name SET<PN> 0..* "Subject Name”: Defaults to value of Patient’s Name (0010,0010) in Patient Module. Other Patient Names (0010,1001) may be mapped , appropriate infrastructure (master person index) and policies for domain identifier assignment are in place. No specific use codes are provided by DICOM.
administrativeGenderCode CE 0..1 "Subject Sex”: Defaults to value equivalent to Patient’s Sex (0010,0040) in Patient Module. The DICOM coded string (CS) values maps to HL7 V3 administrativeGenderCode values (codeSystem="2.16.840.1.113883.5.1") as follows:
DICOM HL7 V3
CS Meaning Concept Code Print Name
F Female F Female
M Male M Male
O Undetermined sex Use “UNK” (unknown) null flavour value
“Subject Sex” value not available Use appropriate null flavour value
birthTime TS 0..1 "Subject Birth Date”: Defaults to value of Patient’s Birth Date (0010,0030) in Patient Module.
maritalStatusCode CE 0..1 Shall not be sent.
religiousAffiliationCode CE 0..1 Shall not be sent.
raceCode CE 0..1 Shall not be sent.
ethnicGroupCode CE 0..1 Ethnic Group (0010,2160) of Patient Module if present. (DICOM short string: SH shall be converted to the appropriate ethnicGroupCode attribute code)

Subject Context, Fetus

Document Level

The header attributes shall contain values for mother as specified in Table A.5.1.3-7 and A.5.1.3-8. Refer to figure A.5.1.3-4 for an overview on the recordTarget participation. The mother of the fetus is considered the patient and is therefore the recordTarget. Patient.name (Patient Entity, Table A.5.1.3-8) or "Subject Name”: Defaults to value of Patient’s Name (0010,0010) in Patient Module, which shall be identical to TID 1008 PNAME (“Mother of fetus”).

Section Level

The fetus subject is specified at section level.

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Figure A.5.1.3-5: SUBJECT CONTEXT, FETUS

Table A.5.1.3-9

RELATED SUBJECT, FETUS

Attribute Data Type Multiplicity Value
classCode CS 1..1 PRS (Personal Relationship)
code CE 1..1 “Fetus” code (CID 271) extends value domain PersonalRelationshipRoleType <121026> as code property, 1.2.840.10008.2.16.4 as codeSystem property, DCM as codeSystemName property, “Fetus” as displayName property>
templateId LIST<II> 1..* Set root portion of II to “2.16.840.1.113883.10.20.6.2.3” (identifies the template that defines constraints on “Fetus Subject Context” of CDA Diagnostic Imaging Reports as specified by CDA R2 DIR IG).
administrativeGenderCode CE 0..1 Shall not be sent.
birthTime TS 0..0 Shall not be sent.

Table A.5.1.3-10

SUBJECT PERSON, FETUS

Attribute Data Type Multiplicity Value
classCode CS 1..1 PSN
determinerCode CS 1..1 INSTANCE
name SET<PN> 1..1 Subject ID or Fetus ID (TID 1008)
telecom SET<TEL> 0..* Shall not be sent.

CDA Release 2 does not specify a subject ID for mapping of Fetus Subject UID. Also the DICOM SR NUM content item that conveys the number of fetuses cannot be mapped because CDA Release 2 does not specify such an attribute. The fetus subject is always mapped in combination with the mother record target artifacts.