CH Core (R4)
1.3.0 - CI build

CH Core (R4), published by HL7 Switzerland. This is not an authorized publication; it is the continuous build for version 1.3.0). This version is based on the current content of and changes regularly. See the Directory of published versions


This implementation guide is under ballot for STU 2 by HL7 Switzerland and has all open comments for this ballot resolved. If there is no objection till Monday 19.4.2021, 24.00 this is the version which will be published:

resolved issues:

  • #57 cardinality 0..1 for ch-ext-epr-versionNumber in Composition
  • #58 IMP instead of INP in encounter
  • #59 adapt extension EPR Information Recipient for ch-core
  • #60 relax card. in CH Core Organization
  • #61 slice setup incorrect on address lines
  • #63 PractitionerRole example HPWengerRole has an invalid speciality coding
  • #65 CH-Core dependsOn CH-EPR-TERM current
  • #66 Encounter: specify a type for the visit number Fallnummer
  • #67 Add CC license to ch-core implementation guide
  • #70 fix resource narrative status if narrative text has been defined
  • #77 ch-core-document: add check that fullUrl exists and is an absolute url
  • #85 EPRDataEnterer: valueReference only to Practitioner (not Person)
  • #90 description callName in eCH-011 Types
  • #91 dataenterer as PractitionerRole
  • #92 PDF requirements for CH Core Composition
  • #93 EPR Data Enterer map to PractitionerRole instead of Practitioner
  • #94 Precise description for salutation, title in HumanName
  • #95 EPR Document fix Bundler.identifier to uuid
  • #96, #97 Composition.identifier instead of setId Extension
  • #98 renamed Composition Patient Profile EPR to Patient Profile EPR
  • #100, #101, #102, #103 Reference to CH Core profiles
  • #104 CH Core Consent Profile naming


This implementation guide is provided to support the use of FHIR®© FHIR in Switzerland.

This guide is a working specification. We anticipate that it will be implemented and tested by FHIR system producers whose feedback will help improve its content. With this standard for trial use, we are looking for feedback on whether the following goals have been met:

  • The guide provides guidance on essential resources for identifiers, code systems, value sets and naming systems in Switzerland, specifically in relation to the Swiss Electronic Patient Record (EPR).
  • The guide defines extensions that are necessary for local use in Switzerland.
  • The guide covers the requirements for eCH-0010 postal address and eCH-0011 personal data.
  • The guide defines data elements from CDA-CH V2.1 (2020) document standard document standard in FHIR CH Core profiles.
  • The guide incorporates Federal Statistics Office (BFS) variables for medical statistics. See BFS (available in German, French, and Italian).

Note: This implementation guide is not (yet) a FHIR API specification, this will be a goal for the next iteration.

Download: You can download this implementation guide in npm format from here.

Relation to the Swiss EPR

The Annexes to the Swiss Electronic Patient Record (EPR) law specify the technical and semantic requirements for interoperability.

Metadata (Annex 3 and Annex 9)

Metadata relating to the Swiss EPR is defined in Annexes 3 and 9 by the Ministry of Health. eHealth Suisse maintains the value sets with additional provided translations in ART-DECOR in the ch-epr project. All code systems and value sets from the CH-EPR project are exported to the FHIR implementation guide, CH EPR Term, which forms the basis for CH Core.

Exchange formats (Annex 4)

There are currently three exchange formats defined in the draft of Annex 4. Those three exchange formats are based on CDA-CH V2. Exchange formats can also be represented with FHIR documents.

XDS (Annex 5, Amendment 1)

Requirements for IHE XDS are given in Annex 5. The CH Core DocumentReference Profile EPR defines how metadata used in the EPR is to be mapped to XDS Metadata. Please note that the IHE MHD profile, which includes the document reference resource, is not yet specified in the Annexes, a draft implementation guide is CH EPR mHealth

CH:ATC Profile (Annex 5, Amendment 2.2)

The CH ATC profile defines the requirements for a patient’s audit trail. CH ATC is a FHIR implementation guide based on FHIR STU3 and R4. There is currently no relationship between CH ATC and CH Core.


This document presents Swiss use concepts defined via FHIR processable artefacts.

  • Profiles - useful constraints of essential FHIR resources and data types for Swiss use.
  • Extensions - FHIR extensions that are added for local use, covering necessary Swiss concepts.
  • Terminologies - defined or referenced code systems and value sets for Switzerland.


The CH-Core implementation guide is managed by HL7 Switzerland in the HL7 Switzerland FHIR technical committee, see also source.


This guide is the product of collaborative work undertaken with participants from:

Safety considerations

This implementation guide defines data elements, resources, formats, and methods for exchanging healthcare data between different participants in the healthcare process. As such, clinical safety is a key concern. Additional guidance regarding safety for the specification’s many and various implementations is available at:

Although the present specification does gives users the opportunity to observe data protection and data security regulations, its use does not guarantee compliance with these regulations. Effective compliance must be ensured by appropriate measures during implementation projects and in daily operations. The corresponding implementation measures are explained in the standard. In addition, the present specification can only influence compliance with the security regulations in the technical area of standardisation. It cannot influence organisational and contractual matters.

This document is licensed under Creative Commons “No Rights Reserved” (CC0).

HL7®, HEALTH LEVEL SEVEN®, FHIR® and the FHIR ® are trademarks owned by Health Level Seven International, registered with the United States Patent and Trademark Office.

This Implementation Guide contains and references intellectual property owned by third parties (“Third Party IP”). Acceptance of these License Terms does not grant any rights with respect to Third Party IP. The licensee alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize Third Party IP in connection with the specification or otherwise.

Following is a non-exhaustive list of third-party artifacts and terminologies that may require a separate license:

SNOMED Clinical Terms® (SNOMED CT®) This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of SNOMED International (former known as International Health Terminology Standards Development Organisation IHTSDO). All rights reserved. SNOMED CT®, was originally created by The College of American Pathologists. “SNOMED” and “SNOMED CT” are registered trademarks of SNOMED International.

Logical Observation Identifiers Names and Codes LOINC This material contains content from LOINC® ( The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2013, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at