Ontario Medical Imaging DICOM® Implementation Guide v1.0.0-ballot

This document is based on the DICOM 3.0 (PS 3.1 – PS 3.20 series) maintained by the DICOM® Standards Committee and National Electrical Manufacturers Association (NEMA). It defines baseline rules for data integrity such as proper Patient → Study → Series → Instance hierarchy, globally unique identifiers (UIDs), and mandatory patient and order identifiers.

These requirements ensure studies can be ingested, stored, and retrieved consistently across Picture Archiving and Communication System​ (PACS), DIRs, Vendor Neutral Archive (VNA), and clinical viewers in Ontario.

The aim of the guide is to reduce onboarding challenges for Health Information Custodians and vendors and to ensure reliable linkage of imaging studies to the correct patient.

Scope

This implementation guide is developed to support the exchange of medical imaging data through regional DIRs and the future provincial Enterprise Imaging VNA.

It defines the minimum DICOM® behaviors required to ensure imaging studies can be reliably ingested, stored, and retrieved across Ontario’s enterprise imaging environment.

It applies to imaging vendors, PACS administrators, modality integrators, and technical teams responsible for onboarding imaging workflows from hospitals and Integrated Community Health Services Centres.

Status

The provincial open review period starts April 24, 2026, and runs to May 25, 2026.

The following webinar materials are available for downloading:

• Comment spreadsheet to provide feedback
• Webinar presentation
• Webinar Questions & Answers
• Link to Ontario Medical Imaging HL7® FHIR® Implementation Guide v1.0.0-ballot | eHealth Ontario | It's Working For You for your reference
• To access the specification: Ontario Medical Imaging DICOM® Implementation Guide v1.0.0-ballot