Create an Azure Health Data Services workspace, then provision both a DICOM service and a FHIR service within it from the Azure portal or via az healthcareapis commands
Register a Microsoft Entra application and assign the DICOM Data Owner role on the DICOM service and FHIR Data Contributor on the FHIR service
Clone the dicom-server GitHub repository and deploy DICOMcast as an Azure Container Instance or Azure Function, supplying connection strings for both services via environment variables
Store a test DICOM instance via STOW-RS to the DICOM service at https://MY_DICOM.dicom.azurehealthcareapis.com/v1/studies and verify the instance is accepted
Query the FHIR service for ImagingStudy resources created by DICOMcast: GET https://MY_FHIR.fhir.azurehealthcareapis.com/ImagingStudy?identifier=urn:dicom:uid|{studyUID}
Known gotchas
DICOMcast is an open-source self-hosted component — it is not built into the Azure DICOM service itself; it must be deployed and operated separately
DICOMcast maps DICOM study-level metadata to FHIR ImagingStudy resources but does not sync pixel data; the FHIR ImagingStudy.endpoint references back to the DICOM service for retrieval
Token audience for the DICOM service and the FHIR service are different resource URIs; ensure the Entra app acquires tokens for the correct audience when calling each service
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