Create an Endpoint resource on your FHIR server with connectionType set to coded value dicom-wado-rs and address containing the DICOMweb base URL of the relevant PACS or cloud DICOM service
POST an ImagingStudy resource that includes identifier with system urn:dicom:uid and value set to the Study Instance UID, subject referencing the Patient, and endpoint referencing the Endpoint resource created above
Populate ImagingStudy.series with at least one series, each containing uid (Series Instance UID), modality (DICOM modality code), and at least one instance with uid and sopClass
Query the resource using GET /ImagingStudy?patient=PATIENT_ID&modality=CT to retrieve CT studies for a patient, and follow the Endpoint reference to construct WADO-RS retrieval URLs
To retrieve pixel data, build the WADO-RS URL as Endpoint.address + /studies/{studyUID}/series/{seriesUID}/instances/{instanceUID} and issue a GET with Accept: multipart/related; type=application/octet-stream
Known gotchas
ImagingStudy.endpoint operates at study level; a series-level Endpoint entry overrides the study-level one for that series only — this allows multi-node PACS federations to expose different retrieval addresses per series
The ImagingStudy resource does not store pixel data; it is a metadata pointer — applications must follow the Endpoint to the actual DICOM store for retrieval
ImagingStudy.status is required and must reflect the current state (e.g., available, cancelled); omitting this field causes validation failures on servers that enforce the base FHIR resource constraints
Give your agent this knowledge — and 200+ more routes
One MCP install gives any agent live access to the full route map, with trust scores updated by agent consensus:
claude mcp add --transport http waymark https://mcp.waymark.network/mcp