International Patient Summary (IPS), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 1.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-IPS/ and changes regularly. See the Directory of published versions

Index page

Official URL: http://hl7.org/cda/uv/cda-ips/ImplementationGuide/hl7.cda.uv.ips				Version: 1.1.0-ballot
Draft as of 2024-08-19				Computable Name: InternationalPatientSummaryCDAIG

This Implementation Guide is in a provisional state and purely for information.

As a pilot, efforts have been made to convert the definitions of the HL7 CDA® R2 Implementation Guide of the International Patient Summary, that were done in ART-DECOR® using the former HL7 Templates Standard: Specification and Use of Reusable Information Constraint Templates, in short Templates ITS, into FHIR Structure Definitions and to use the exposed Templtaes, Value Sets, Code Systems etc. with the FHIR IG publisher for the CDA Implementation Guide. This is a continous process until the conversion is error-free.

An International Patient Summary (IPS) document is an electronic health record extract containing essential healthcare information about a subject of care. As specified in EN 17269 and ISO 27269, it is designed for supporting the use case scenario for ‘unplanned, cross border care’, but it is not limited to it. It is intended to be international, i.e., to provide generic solutions for global application beyond a particular region or country.

The IPS dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant.

The IPS document is composed by a set of robust, well-defined and potentially reusable sets of core data items (indicated as IPS library in the figure below). The tight focus of the IPS on unplanned care is in this case not a limitation, but, on the contrary, facilitates their potential re-use beyond the IPS scope.

Figure 1: The IPS product and by-products

Purpose

The goal of this Implementation Guide is to specify how to represent in HL7 CDA R2 the International Patient Summary (IPS) ( see also the ART DECOR repository). An alternative representation as HL7 FHIR is also provided (see the HL7 build site).

The initial focus of the International Patient Summary (IPS) was the unplanned care across national borders. This specification can be used and be useful also in local applications and be supportive of planned care.

Project Background

Details on the project background are available in the IPS Website.

Project Scope

As specified in EN 17269 and ISO 27269, the IPS dataset is a “minimal, non-exhaustive set of data elements required for the international patient summary”. A Patient Summary is defined by ISO/TR 12773-1:2009 as a “Health record extract comprising a standardized collection of clinical and contextual information (retrospective, concurrent, prospective) that provides a snapshot in time of a subject of care’s health information and healthcare.”

‘Minimal’ reflects the ideas of ‘summary’ and the need to be concise, but also alludes to the existence of a core set of data elements that all health care professionals can use; it is intended to be a speciality agnostic and condition independent set. It does not imply that all the items in the data set will be used in every summary. It is also possible to refine the extract from a record such that the content of the summary is more relevant to a particular condition (e.g. asthma) but no asthma-specific elements will be specified in this standard. The IPS Document or IPS can be extended by non-IPS standard condition-specific data. ‘Non-exhaustive’ recognizes that the ideal data set is not closed, and is likely to be extended, not just in terms of requirement evolution, but also pragmatically in instances of use. [EN 17269; ISO 27269].

Furthermore the scope of the IPS is global. Although this is a major challenge, this implementation guide takes various experiences and newer developments (e.g. US Core Implementation Guide (FHIR IG)) into account to address, as far as possible, global feasibility.

The following picture provides an overview of the current IPS content.

Figure 2: The IPS composition

Relationships with Other Projects and Guidelines

Further details on the IPS project relationships with other projects and guidelines are available in the IPS Website.

Ballot Status

This Implementation Guide has been balloted as STU with the intention to go normative in a subsequent ballot cycle.

Audience

The audience for this Implementation Guide includes:

Public

• Citizens who want to carry or access their healthcare data for emergency or unplanned care purposes.

Regulatory

• Policy makers such as healthcare payers or government agencies.
• Healthcare information governance authorities and regulatory bodies.

Clinical

• Healthcare providers that offer unscheduled and emergency care.
• Healthcare providers that populate regional and national patient summaries.

Technical

• Vendors of EHR systems for unplanned care management, personal health records and mobile health data applications.
• System integrators.
• Organizations that manage regional and national patient summaries.

Dependencies

Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.uv.extensions.r5#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+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.cda.uv.ips.r4) and R4B (hl7.cda.uv.ips.r4b) are available.

Global Profiles

There are no Global profiles defined

Authors and Contributors

Role	Name	Organization	Contact
Primary Editor	Giorgio Cangioli	Consultant, HL7 Italy	giorgio.cangioli@gmail.com
Primary Editor	Rob Hausam	Hausam Consulting LLC	rob@hausamconsulting.com
Primary Editor	Dr Kai U. Heitmann	Heitmann Consulting and Services, ART-DECOR Open Tools GmbH, HL7 Germany	info@kheitmann.de
Primary Editor	François Macary	Phast	francois.macary@phast.fr
Contributor	Dr Philip Scott	HL7 UK	philip.scott@uwtsd.ac.uk
Contributor	Dr Christof Geßner	HL7 Germany	christof.gessner@mxdx.de
Contributor	Dr Stefan Sabutsch	ELGA, HL7 Austria	stefan.sabutsch@elga.gv.at
Contributor	Gary Dickinson	CentriHealth	gary.dickinson@ehr-standards.com
Contributor	Catherine Chronaki	HL7 International Foundation	chronaki@gmail.com
Contributor	Dr Stephen Chu	HL7 Australia	chuscmi88@gmail.com
Contributor	Didi Davis	The Sequoia Project	ddavis@sequoiaproject.org
Contributor	George Dixon	Allscripts LLC	george.dixon@allscripts.com
Contributor	Kenneth Sinn	Ontario Health Digital Services	ken.sinn@ontariohealth.ca
Contributor	John D’Amore	More Informatics	johnd@moreinformatics.com

Thanks to Alexander Berler (a.berler@gnomon.com.gr) ; Carina Seerainer (carina.seerainer@elga.gv.at); John Roberts (John.A.Roberts@tn.gov); Julie James (julie_james@bluewaveinformatics.co.uk); Mark Shafarman (mark.shafarman@earthlink.net); Fernando Portilla (fportila@gmail.com); Ed Hammond (william.hammond@duke.edu); Steve Kay (s.kay@histandards.net)