HL7 Czech Shared Health Record Implementation Guide
0.0.1 - ci-build

HL7 Czech Shared Health Record Implementation Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/szz/ and changes regularly. See the Directory of published versions

Plain Language Summary goes here

## Home

Official URL: https://hl7.cz/fhir/szz/ImplementationGuide/hl7.fhir.cz.szz | Version: 0.0.1
Draft as of 2025-12-22 | Computable Name: HL7CzSZZImplementationGuide

## Introduction

This implementation specification is based on the FHIR version R4, and defines a unified framework for representing the Shared Health Record in the Czech national context. The specification defines the content and structural components of the document and ensures their compliance with the legal requirements of the Czech Republic as well as with European initiatives in the field of electronic health record interoperability.

The main objective is to create a standardized form of the Shared Health Record as part of the patient’s medical documentation, which will be used for the electronic exchange of health information between healthcare providers, the patient, and the national infrastructure.

### Scope

This guide is divided into several pages, which are listed in the menu bar at the top of each page.

- Home: This page provides introductory information, a brief scope of use, references, dependencies, version difference analysis, and intellectual property statements.
- Introduction:
  - Scope and Content: This section contains introductory general information about the Shared Health Record.
  - Background: This section provides general information on the origins of the definition of the Shared Health Record.
- Functional:
  - Use Cases: This section contains information about use cases.
  - Workflow: This segment contains information about workflow.
  - Logical Models: This section contains information about logical models.
- Implementation:
  - Mapping to profiles: This section contains information on mapping the logical model to the Shared Health Record profiles.
  - Examples: This section contains examples.
- About:
  - Authors: This section contains information about the authors.
  - Downloads: This section provides information about available downloads of the implementation specification.
  - Dependencies: This section provides information about dependencies.
  - Copyright: This section provides information about copyright.
- Artifacts: This page provides a list of FHIR artifacts defined as part of this implementation guide.

### References

- Related specifications:
  - EHDS Logical Information Models
    - This specification has inspired many of the design patterns defined in this IG.
  - HL7 Czech Base and Core Implementation Guide
    - Where possible this specification has been aligned with choices made in CZ core.

### Dependencies

IG | Package | FHIR | Comment
--- | --- | --- | ---
HL7 Czech Shared Health Record Implementation Guide | hl7.fhir.cz.szz#0.0.1 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.0.1 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 |
International Patient Summary Implementation Guide | hl7.fhir.uv.ips#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.0.0 | R4 |
fhir.dicom | fhir.dicom#2022.4.20221006 | R4 |
HL7 Czech Base and Core Implementation Guide | hl7.fhir.cz.core#current | R4 |
HL7 Europe Base and Core FHIR IG | hl7.fhir.eu.base#0.1.0-ballot | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.3.0 | R4 |
HL7 Europe Extensions | hl7.fhir.eu.extensions.r4#0.1.1-ballot | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.2.0 | R4 |
HL7 Czech Terminology Implementation Guide | hl7.fhir.cz.terminology#current | R4 |
HL7 Europe Base and Core FHIR IG | hl7.fhir.eu.base#0.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.5.0 | R4 |
International Patient Summary Implementation Guide | hl7.fhir.uv.ips#2.0.0 | R4 |
International Patient Access | hl7.fhir.uv.ipa#1.1.0 | R4 |
SMART App Launch | hl7.fhir.uv.smart-app-launch#2.0.0 | R4 |
HL7 Europe Extensions | hl7.fhir.eu.extensions.r4#0.1.1 | R4 |
HL7 Europe Extensions | hl7.fhir.eu.extensions#0.1.1 | R5 |
HL7 Terminology (THO) | hl7.terminology.r5#6.5.0 | R5 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#0.9.0 | R4 | for example references

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.ips#1.1.0 International Patient Summary (IPS) FHIR Implementation Guide (built Tue, Nov 22, 2022 03:24+0000+00:00)

Package hl7.fhir.eu.extensions.r4#0.1.1-ballot This guide lists the extensions speciifed for the European REALM. (built Wed, Apr 30, 2025 13:56+0200+02:00)

Package hl7.fhir.eu.base#0.1.0-ballot This guide collects base and core profiles to be used in the European context. It also includes common artifacts, such as the profiles describing the European Health Insurance Card. (built Mon, May 5, 2025 21:42+0200+02:00)

Package hl7.fhir.cz.terminology#current HL7 Czech Terminology Implementation Guide (built Fri, Dec 19, 2025 09:15+0000+00:00)

Package hl7.fhir.cz.core#current HL7 Czech Base and Core Resources Implementation Guide (built Fri, Dec 19, 2025 09:24+0000+00:00)

Package hl7.fhir.uv.ipa#1.1.0 This IG describes how an application acting on behalf of a patient can access information about the patient from an clinical records system using a FHIR based API. The clinical records system may be supporting a clinical care provider (e.g. a hospital, or a general practitioner), or a health data exchange, including a national health record system. (built Wed, Mar 19, 2025 14:34+0000+00:00)

Package hl7.fhir.eu.extensions.r4#0.1.1 This guide lists the extensions specified for the European REALM. (built Sun, Oct 26, 2025 20:13+0100+01:00)

Package hl7.fhir.eu.base#0.1.0 This guide collects base and core profiles to be used in the European context. It also includes common artifacts, such as the profiles describing the European Health Insurance Card. (built Sun, Oct 26, 2025 21:01+0100+01:00)

Package hl7.fhir.eu.extensions#0.1.1 This guide lists the extensions specified for the European REALM. (built Sun, Oct 26, 2025 20:13+0100+01:00)

Package hl7.fhir.uv.tools.r4#0.9.0 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Dec 16, 2025 23:18+1100+11:00)

### Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (hl7.fhir.cz.szz.r4) and R4B (hl7.fhir.cz.szz.r4b) are available.

### IP statements

This publication includes IP covered under the following statements.

- ISO maintains the copyright on the country codes, and controls its use carefully. For further details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
  Show Usage
  - ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: AbdominaAorticAneurysmsResultCS, AbdominaAorticAneurysmsResultVs... Show 132 more, AllergyIntoleranceTypeSzzCs, AllergyIntoleranceTypeSzzVs, AllergyReactionCategorySzzVs, BiradsDensityCS, BiradsDensityVS, BloodPressureCodeSzzVs, BloodTypeEhdsiVs, BloodTypeLaboratoryCodeSzzVs, Bundle/cz-example-bundle-emergencyrecord, Bundle/cz-example-bundle-screeningrecord, Bundle/cz-example-bundle-screeningrecord-2, CZ_AdverseEvent, CZ_AllergyIntoleranceSzz, CZ_BodyHeight, CZ_BodyWeight, CZ_BundleSzz, CZ_ColonoscopyAbnormalFindingsCS, CZ_ColonoscopyAbnormalFindingsVS, CZ_ColonoscopyInterpretation, CZ_ColonoscopyInterpretationVS, CZ_ColonoscopyTypeCS, CZ_ColonoscopyTypeVS, CZ_CompositionSzz, CZ_HpvVaccineCodeVs, CZ_ImmunizationHPV, CZ_ObservationAbdominaAorticAneurysms, CZ_ObservationBloodPressure, CZ_ObservationBloodType, CZ_ObservationColonoscopy, CZ_ObservationColorectalCancer, CZ_ObservationColposcopyCervicalCancer, CZ_ObservationCytologyCervicalCancer, CZ_ObservationHPVCervicalCancer, CZ_ObservationLungCancer, CZ_ObservationMRIProstateCancer, CZ_ObservationMammography, CZ_ObservationMammographyBiopsy, CZ_ObservationProstateCancer, CZ_ObservationPulmonology, CZ_ObservationUnitsHeightVs, CZ_ObservationUnitsWeightVs, CZ_ObservationUrology, CZ_ObservationUrologyBiopsy, CZ_WaistCircumference, CervicalCancerColposcopyResultCS, CervicalCancerColposcopyResultVS, CervicalCancerCytologyResultCS, CervicalCancerCytologyResultVS, CervicalCancerHPVResultCS, CervicalCancerHPVResultVS, ClinicalSeverityOfSymptomsSzzCs, ClinicalSeverityOfSymptomsSzzVs, ColorectalCancerResultAlternateVS, ColorectalCancerResultCS, ColorectalCancerResultVS, DensityTypeCs, DocumentSectionCzSzzCs, EmergencyRecord2FHIR, FunctionalExaminationPulmonologyResultCS, FunctionalExaminationPulmonologyResultVS, HL7CzSZZImplementationGuide, Header2FHIR, LogCzAngiologyCz, LogCzBiochemistryLabCz, LogCzDigitalSignatureCz, LogCzEmergencyRecordCz, LogCzGastroenterologyCz, LogCzGeneralPractitionerCz, LogCzGynecologyCz, LogCzHeaderSzzCz, LogCzPreventiveAndScreeningRecordCz, LogCzPulmonologyCz, LogCzRadiologyCz, LogCzSubjectCz, LogCzSzzCz, LogCzUrologyCz, LogEnAngiologyCz, LogEnBiochemistryLabCz, LogEnDigitalSignatureCz, LogEnEmergencyRecordCz, LogEnGastroenterologyCz, LogEnGeneralPractitionerCz, LogEnGynecologyCz, LogEnHeaderSzzCz, LogEnPreventiveAndScreeningRecordCz, LogEnPulmonologyCz, LogEnRadiologyCz, LogEnSubjectCz, LogEnSzzCz, LogEnUrologyCz, LungCancerInterpretationCS, LungCancerInterpretationVS, MRIProstateCancerCodeVs, Patient/142534ac-0274-4a16-b6a2-d4d4f24ff67b, Patient/cb1344a1-ee6e-45b3-a6b4-c3eacae4ddec, Patient/fe858e7c-ba5f-4641-9878-7c6c4790634f, PhysicalExaminationPulmonologyResultCS, PhysicalExaminationPulmonologyResultVS, ProstateCancerResultCS, ProstateCancerResultVS, PulmonologyInterpretationCS, PulmonologyInterpretationVS, PulmonologyResultCS, PulmonologyResultVS, RegionOfProstateVS, ResultBiopsyBreastCS, ResultBiopsyBreastVS, ResultBiopsyProstateCS, ResultBiopsyProstateVS, ResultLungCancerCS, ResultLungCancerVs, ResultMRIProstateCancerCS, ResultMRIProstateCancerVS, ResultMamographyCS, ResultMamographyVs, ScreeningRecord2FHIR, TabarDensityCS, TabarDensityVS, TobaccoHistoryCS, TobaccoHistoryVS, TypeBiopsyBreastCS, TypeBiopsyBreastVS, TypeBiopsyProstateCS, TypeBiopsyProstateVS, TypeLungCancerObservationCS, TypeLungCancerObservationVS, TypeOfAdverseEventSzzCS, TypeOfAdverseEventSzzVS, UrologyInterpretationCS, UrologyInterpretationVS, UrologyResultCS and UrologyResultVS
- The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
  Show Usage
  - Unified Code for Units of Measure (UCUM): Bundle/cz-example-bundle-screeningrecord, Bundle/cz-example-bundle-screeningrecord-2... Show 13 more, CZ_BodyHeight, CZ_BodyWeight, CZ_ObservationUnitsHeightVs, CZ_ObservationUnitsWeightVs, Observation/02f3d1a4-4a5c-42ae-9f68-ba2f7dfe88a8, Observation/31e1de93-1c46-4f9e-849c-c46f8c7f1496, Observation/5031be23-9628-49af-8cac-d23ea87cb8e0, Observation/504f3628-9a5e-4a1a-83b0-418c4b8dc38b, Observation/824055fa-6107-49c8-b217-f029aa7b8872, Observation/82451f85-ee50-4367-b809-0511ea469269, Observation/8a6733be-e107-44b6-99a8-77869faea42a, Observation/bc143cd8-4638-4823-87d5-6bc16ce68e85 and Observation/d87b5700-f89c-444b-8360-29c9f7673bf1
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  - LOINC: BloodPressureCodeSzzVs, Bundle/cz-example-bundle-emergencyrecord... Show 28 more, Bundle/cz-example-bundle-screeningrecord, Bundle/cz-example-bundle-screeningrecord-2, CZ_BodyHeight, CZ_BodyWeight, CZ_CompositionSzz, CZ_ObservationBloodPressure, CZ_ObservationColorectalCancer, CZ_ObservationColposcopyCervicalCancer, CZ_ObservationCytologyCervicalCancer, CZ_ObservationHPVCervicalCancer, CZ_ObservationProstateCancer, CZ_ObservationUrology, CZ_WaistCircumference, Composition/91795ef9-ba97-4712-95b4-177f1d784066, Composition/930ca243-d3aa-4b38-9737-3c2e48000f74, Composition/f711d704-df5c-4599-ac80-e8636e0f9931, Observation/02f3d1a4-4a5c-42ae-9f68-ba2f7dfe88a8, Observation/180d74d4-fe14-408c-a3a8-07da4e3b8fcd, Observation/1d79f716-c583-4e42-a68f-bc8c9bb2781d, Observation/31e1de93-1c46-4f9e-849c-c46f8c7f1496, Observation/40ee0269-0027-4e7b-b061-e039c06cf988, Observation/5031be23-9628-49af-8cac-d23ea87cb8e0, Observation/504f3628-9a5e-4a1a-83b0-418c4b8dc38b, Observation/824055fa-6107-49c8-b217-f029aa7b8872, Observation/82451f85-ee50-4367-b809-0511ea469269, Observation/8a6733be-e107-44b6-99a8-77869faea42a, Observation/bc143cd8-4638-4823-87d5-6bc16ce68e85 and Observation/d87b5700-f89c-444b-8360-29c9f7673bf1
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
  Show Usage
  - SNOMED Clinical Terms&reg; (SNOMED CT&reg;): AllergyIntolerance/4b343429-16da-4a5b-be80-17e4122f5956, AllergyReactionCategorySzzVs... Show 35 more, BloodTypeEhdsiVs, Bundle/cz-example-bundle-emergencyrecord, Bundle/cz-example-bundle-screeningrecord, Bundle/cz-example-bundle-screeningrecord-2, CZ_AllergyIntoleranceSzz, CZ_ObservationAbdominaAorticAneurysms, CZ_ObservationBloodType, CZ_ObservationColonoscopy, CZ_ObservationLungCancer, CZ_ObservationMRIProstateCancer, CZ_ObservationMammography, CZ_ObservationMammographyBiopsy, CZ_ObservationPulmonology, CZ_ObservationUrology, CZ_ObservationUrologyBiopsy, ColorectalCancerResultAlternateVS, MRIProstateCancerCodeVs, Observation/0a3b5d6a-e9a8-4aa2-bcff-7c916540bf08, Observation/31e1de93-1c46-4f9e-849c-c46f8c7f1496, Observation/407b583e-4c05-47eb-b0df-6d8166c0d4f1, Observation/5031be23-9628-49af-8cac-d23ea87cb8e0, Observation/504f3628-9a5e-4a1a-83b0-418c4b8dc38b, Observation/57838f4e-238c-43e4-9088-42971d8171a6, Observation/5da80cc6-b699-42dc-aeba-86e229063975, Observation/76879fde-d561-4435-b119-6bb579bea0f5, Observation/8a6733be-e107-44b6-99a8-77869faea42a, Observation/bc143cd8-4638-4823-87d5-6bc16ce68e85, Observation/cd2b65ad-9926-4589-98c9-7e581e21602a, Observation/dd8033d4-d1c9-48e8-8edd-c0dda913678d, Observation/f564cd9a-422f-439b-ae17-b2c0a1311ead, Observation/fa768d55-f16c-457b-8bdc-1d0b1c9e24fa, PractitionerRole/2a06ef57-f377-4031-a098-612aa44f54b2, PractitionerRole/38e5929e-afe4-40bc-ba9d-c0a80549791e, PractitionerRole/428025b5-e328-4542-8812-dd6a874c44f9 and RegionOfProstateVS
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  Show Usage
  - AllergyIntolerance Clinical Status Codes: AllergyIntolerance/4b343429-16da-4a5b-be80-17e4122f5956 and Bundle/cz-example-bundle-emergencyrecord
  - AllergyIntolerance Verification Status: AllergyIntolerance/4b343429-16da-4a5b-be80-17e4122f5956 and Bundle/cz-example-bundle-emergencyrecord
  - Observation Category Codes: Bundle/cz-example-bundle-screeningrecord, Bundle/cz-example-bundle-screeningrecord-2... Show 20 more, Observation/02f3d1a4-4a5c-42ae-9f68-ba2f7dfe88a8, Observation/0a3b5d6a-e9a8-4aa2-bcff-7c916540bf08, Observation/180d74d4-fe14-408c-a3a8-07da4e3b8fcd, Observation/1d79f716-c583-4e42-a68f-bc8c9bb2781d, Observation/31e1de93-1c46-4f9e-849c-c46f8c7f1496, Observation/407b583e-4c05-47eb-b0df-6d8166c0d4f1, Observation/40ee0269-0027-4e7b-b061-e039c06cf988, Observation/5031be23-9628-49af-8cac-d23ea87cb8e0, Observation/504f3628-9a5e-4a1a-83b0-418c4b8dc38b, Observation/57838f4e-238c-43e4-9088-42971d8171a6, Observation/76879fde-d561-4435-b119-6bb579bea0f5, Observation/824055fa-6107-49c8-b217-f029aa7b8872, Observation/82451f85-ee50-4367-b809-0511ea469269, Observation/8a6733be-e107-44b6-99a8-77869faea42a, Observation/bc143cd8-4638-4823-87d5-6bc16ce68e85, Observation/cd2b65ad-9926-4589-98c9-7e581e21602a, Observation/d87b5700-f89c-444b-8360-29c9f7673bf1, Observation/dd8033d4-d1c9-48e8-8edd-c0dda913678d, Observation/f564cd9a-422f-439b-ae17-b2c0a1311ead and Observation/fa768d55-f16c-457b-8bdc-1d0b1c9e24fa