Study Notes

The Study Notes extension allows AdvaPACS to uniquely identify individual study notes exchanged through the FHIR API. While the standard FHIR Annotation datatype supports note content, author, and timestamp, it does not provide a persistent identifier for each note.

AdvaPACS adds a custom extension to each note that exposes the internal note identifier. This identifier can be used by client applications to reliably reference specific study notes when synchronising or updating data.

Canonical URL

Property	Value
Extension URL	http://advapacs.com/fhir/note-identifier
Value Type	Identifier

Supported Resources

The extension is supported on the following FHIR resource:

FHIR Resource	Field	Description
ServiceRequest	note.extension	Provides the unique AdvaPACS identifier for each study note.

Standard FHIR Mapping

Study notes are represented using the standard FHIR Annotation datatype.

FHIR Field	Maps To	Description
note.text	Content	The study note text.
note.authorReference	Created By	The practitioner who created the note.
note.authorString	Created By	The display name of the note creator when a Practitioner reference is unavailable.
note.time	Date	The date and time the note was created.

Behaviour

Receiving Notes

When AdvaPACS receives a ServiceRequest containing one or more entries in the note array:

• Each Annotation is stored as an individual Study Note.
• note.text is stored as the note content.
• note.authorReference and/or note.authorString are stored as the note creator.
• note.time is stored as the creation timestamp.
• If both authorReference and authorString are supplied, both values are preserved.

Sending Notes

When AdvaPACS returns a ServiceRequest, each Study Note is represented as a standard FHIR Annotation.

In addition to the standard FHIR fields, each note includes the AdvaPACS note identifier extension.

• Each study note is returned as a separate entry in the note array.
• Notes are returned in the order they were created.
• The extension provides a unique identifier for each note.

Example

The following example shows a ServiceRequest containing three study notes. Each note includes the AdvaPACS note identifier extension.

{
  "note": [
    {
      "extension": [
        {
          "url": "http://advapacs.com/fhir/note-identifier",
          "valueIdentifier": {
            "value": "1041"
          }
        }
      ],
      "authorReference": {
        "reference": "Practitioner/ce10fdcd-74c7-4b36-87f3-dad7df01bc8b"
      },
      "time": "2025-08-06T05:30:45+00:00",
      "text": "FHIR note 1"
    },
    {
      "extension": [
        {
          "url": "http://advapacs.com/fhir/note-identifier",
          "valueIdentifier": {
            "value": "1042"
          }
        }
      ],
      "authorString": "Only Author",
      "time": "2025-08-06T05:30:45+00:00",
      "text": "FHIR note 2"
    },
    {
      "extension": [
        {
          "url": "http://advapacs.com/fhir/note-identifier",
          "valueIdentifier": {
            "value": "1043"
          }
        }
      ],
      "authorReference": {
        "reference": "Practitioner/ce10fdcd-74c7-4b36-87f3-dad7df01bc8b"
      },
      "authorString": "Both Author",
      "time": "2025-08-06T05:30:45+00:00",
      "text": "FHIR note 3"
    }
  ]
}

note

The note-identifier extension is generated by AdvaPACS and uniquely identifies each Study Note. Client applications can use this identifier when tracking or synchronising notes across multiple FHIR interactions.