Imaging Diagnostic Report (IHE IDR)

The Integrating the Healthcare Enterprise Radiology profile that specifies how a diagnostic imaging report and the findings inside it are encoded as FHIR resources. Phase II went out for public comment in March 2026.¹ The deck names the connection from the OIDM side: an Exam Finding List “connects to IHE Imaging Diagnostic Report (IDR) FHIR representation.”²

IDR’s information model, “heavily influenced by modelling in SNOMED and DICOM,” defines three terms OIDM must map onto. Body Structure “encompasses both anatomical structures and morphologic abnormalities (like a lesion, cyst, inflammation, aneurysm, fracture or abscess).” An imaging observation is “a feature or characteristic that is visible in an image,” encoded as a FHIR Observation. A clinical finding is “the determination that a clinical entity is present or absent,” with positive findings encoded as FHIR Condition and negative ones as Observations.³

The observation shape separates anatomy, laterality, morphology, property, and value into distinct slots, with anatomy “fully pre-coordinated except for the laterality.” Where a CDE set is encoded, “it is preferred to use the CDE Set code” as the root Observation.code, with elements reached by hasMember.³

Synonyms and near-synonyms

• IDR is the abbreviation; IHE Radiology is the domain that publishes it.
• FHIR DiagnosticReport is a resource IDR constrains, not the profile.
• Finding Set is IDR’s name for a grouped observation, the counterpart of a CDE set instance.

Identifier form

None. IDR constrains FHIR resources and reuses their identifiers.

Where it is used

IHE IDR alignment and FHIR mapping.

Conflicts

IDR and OIDM disagree in three recorded places, all listed as items to raise during public comment. IDR’s “finding” is the presence determination, not the named entity, and its “observation” is closer to what the next-generation vocabulary calls a data element value. IDR routes positive diagnoses to Condition while the OIDM working default is that every assertion in a report is an Observation. And IDR states that Observation.component “is not used,” which is the mechanism every current OIDM encoding relies on.³ The IDR profile is not mentioned anywhere in the imaging-problem-list repository, so the alignment exists in the vocabulary work and the deck, not in code.

Footnotes

1. IHE Imaging Diagnostic Report Phase II public comment draft ↩

2. Open Imaging Data Model 2026 Status Update, January 2026 ↩

3. IHE IDR Phase II extract ↩ ↩² ↩³