Candidate Euridice Specification
Review of the MADO Profile along with the Xt-EHR D7.2 Deliverable Public Consultation
Please find here the link to the draft for review of the MADO profile.
Reviewers should note that the specification of the FHIR-based Imaging Study Manifest that forms Chapter 8 is integral to the MADO Profile.
The EURIDICE Initiative and the IHE MADO Profile
The European Health Data Space (EHDS) requires robust, interoperable, and testable technical specifications. To meet this need, HL7 Europe and IHE-Europe have partnered to create the EURIDICE Initiative. This collaboration leverages the strengths of both organizations: the agility and community of HL7 FHIR and the established methodology and testability of IHE. The goal of EURIDICE is to take proposals and turn them into trusted, EHDS-ready technical artifacts that are endorsed by both communities and can be tested.
The MADO Profile in the context of EHDS and EURIDICE
The need for the IHE MADO profile has been championed by the Xt-EHR Project that is tasked with the scoping and the development of the EHDS specifications for the Exchange of Imaging Studies and related Imaging Reports. The IHE Radiology domain has agreed to further its development as an internationally adopted profile over the next few months. The current draft, prepared by this joint IHE-Europe and HL7 collaboration as EURIDICE, is part of the Xt-EHR project stakeholder consultation on the D7.2 Specification between September 28th and November 11th 2025. The current draft of the MADO profile is included in this review and may be accessed below.
It will also be the basis of a public comment by IHE Radiology to be issued early November. It is planned that the European comments and the IHE international comments will be jointly resolved to produce, by February 2026, a trial implementation version of the MADO Profile ready for reference by the Xt-EHR released specifications in the spring of 2026.
Scope of the Manifest-Based Access to DICOM Objects (MADO) Profile
The Manifest-Based Access to DICOM Objects (MADO) is a new IHE profile for accessing DICOM instances based on an imaging study manifest. The MADO profile is designed to support a common and effective way to retrieve medical imaging studies, whether through existing or emerging standards.
While a similar concept was introduced almost 20 years ago by a part of the XDS-I.b profile, the MADO profile aims to create a second-generation solution. It provides a more precise and flexible approach that can be combined with various document sharing infrastructures such as those based on XDS or the newer FHIR-based document sharing profiles, like MHD/MHDS, which are critical for meeting the requirements of the EHDS regulation.
Two formats of imaging study manifest are offered alongside with the mapping between them:
- The DICOM KOS-Based Manifest format
- The HL7 FHIR-Based Manifest format
Based on the information and addressing recorded in either manifests, remotely stored DICOM Objects are accessed through the DICOM WADO-RS based transaction thus allowing the imaging document consumer user the flexibility to access the entire content of an imaging study, the content of a specific series, specific instances or only the imaging instances that may have been flagged as significant.