International Patient Summary Implementation Guide
1.0.0 - CI Build

International Patient Summary Implementation Guide, published by Health Level Seven International - Patient Care Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-ips/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Resource Profiles

These define constraints on FHIR resources that need to be complied with by conformant implementations

Allergy Intolerance (IPS)

This profile represents the constraints applied to the AllergyIntolerance resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of an allergy or intolerance is represented in the patient summary as an instance of an AllergyIntolerance resource constrained by this profile. It documents the relevant allergies or intolerances (conditions) for a patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.

DiagnosticReport (IPS)

This profile constrains the DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary.

Observation (Pregnancy: status)

This profile constrains the Observation resource to represent the pregnancy status.

Observation (Pregnancy: outcome)

This profile constrains the Observation resource to represent the history of pregnancy outcomes (summary).

Device (IPS)

This profile represents the constraints applied to the Device resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A device used by or implanted on the patient is described in the patient summary as an instance of a Device resource constrained by this profile.

Observation (SH: alcohol use)

This profile constrains the Observation resource to represent alcohol use assessment in a patient summary.

Imaging Study (IPS)

This profile represents the constraints applied to the ImagingStudy resource by the IPS project, which specifies the information on a DICOM imaging study this imaging result is part of.

Organization (IPS)

This profile constrains the Organization resource to represent an organization that acts as performer or observer for a result observation (laboratory, pathology or imaging), or as performer for a procedure.

Device Use Statement (IPS)

This profile represents the constraints applied to the DeviceUseStatement resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A statement about a device used by or implanted on the patient is described in the patient summary as an instance of a DeviceUseStatement resource constrained by this profile.

Medication Statement (IPS)

This profile represents the constraints applied to the MedicationStatement resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A record of a medication statement is represented in the patient summary as an instance of a MedicationStatement resource constrained by this profile.

Observation (Pregnancy: EDD)

This profile constrains the Observation resource to represent the pregnancy expected delivery date.

Device (performer, observer)

This profile represents the constraints applied to the Device resource by the IPS project, which specifies an international patient summary based on the FHIR standard R4.; This profile describes a device that plays the role of observer or performer.

Media observation (Results: laboratory, media)

This profile constrains the Media resource (which is a specialized observation).

Specimen (IPS)

This profile constrains the Specimen resource to represent the characteristics of a biological specimens in the context of laboratory results integrated to a patient summary.

PractitionerRole (IPS)

This profile constrains the PractitionerRole resource to represent a practitioner acting as observer for observattion results for a specified organization.

Immunization (IPS)

This profile represents the constraints applied to the Immunization resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of an immunization is represented in the patient summary as an instance of an Immunization resource constrained by this profile. It describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party.

Observation (SH: tobacco use)

This profile constrains the Observation resource to represent Tobacco use assessment in a patient summary.

Practitioner (IPS)

This profile constrains the practitioner resource to represent a practitioner acting as observer for these imaging results.

Condition (IPS)

This profile represents the constraints applied to the Condition resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of a problem is represented in the patient summary as an instance of the Condition resource constrained by this profile.

Medication (IPS)

This profile represents the constraints applied to the Medication resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A medication is described in the patient summary as an instance of a Medication resource constrained by this profile.

Observation Results (IPS)

This profile constrains the Observation resource to represent various types of results and associated observations in a patient summary. This is the base profile from which the other results profiles are derived.

Observation Results: laboratory (IPS)

This profile constrains the Observation resource to represent results produced by laboratory tests or panels/studies in a patient summary. This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and or a global interpretation by the producer of the study, in the comment element; and references the atomic results of the study as “has-member” child observations.

Procedure (IPS)

This profile represents the constraints applied to the Procedure resource by the IPS project, which specifies an entry of the History of Procedure for the international patient summary based on the FHIR standard R4.

Composition (IPS)

Clinical document used to represent the International Patient Summary (IPS) data set. An International Patient Summary (IPS) document is an electronic health record extract containing essential healthcare information about a subject of care. The IPS dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant. As specified in EN 17269 and ISO/DIS 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. This profile is based on the ClinicalDocument profile.

Observation Results: pathology (IPS)

This profile constrains the Observation resource to represent results produced by pathology studies in a patient summary.

Observation Results: radiology (IPS)

This profile represents the constraints applied to the Observation resource by the IPS project, which specifies a radiology observation for the international patient summary based on the FHIR standard R4. This observation may represent the conclusions of a diagnostic procedure such a Chest RX, or it may group the set of results produced by that single or multi-modality procedure. In the latter case, the main observation (this one) carries the overall conclusion of the study and/or a global interpretation by the observer of the study as value of this observation; and may references the atomic results of the study as “child observations”. It allows also providing details about the related study using the partOf element referring to an ImagingStudy resource.

Patient (IPS)

This profile represents the constraints applied to the Patient resource by the International Patient Summary (IPS) FHIR Implementation Guide and describes the minimum expectations for the Patient resource when used in the IPS composition or in one of the referred resources.

Structures: Data Type Profiles

These define constraints on FHIR data types that need to be complied with by conformant implementations

Coding with translations

This profile extends the capabilities of the coding data type to support multi-language designations (display). It relies on the Translation extension.

Ratio (IPS)

Ratio data type, constrained to use UCUM as the code system for units.

Codeable Concept (IPS)

This profile represents the constraint applied to the CodeableConcept data type by the International Patient Summary (IPS) FHIR Implementation Guide to use the Coding-uv-ips data type profile.

Range (IPS)

Range constrained to UCUM as the code system for units.

Quantity (IPS)

Data type Quantity constrained to use UCUM as the code system for units

SimpleQuantity (IPS)

Data type profile SimpleQuantity constrained to use UCUM as the code system for units

Structures: Extension Definitions

These define constraints on FHIR data types that need to be complied with by conformant implementations

Condition abatement date

Extension defined by the IPS project to describe the abatement date for allergies

Terminology: Value Sets

These define sets of codes used by systems conforming with this implementation guide

Medical Devices - IPS
This value set includes codes from SNOMED Clinical Terms®: all descendants of 49062001 Device (physical object) .
Results Radiology Observation - IPS

Value Set Definition: LOINC {CLASS in {RAD}}

Personal Relationship - IPS

The Value Set is used (optionally) to code the type of contact relationship between a person and the patient.

Pregnancy Expected Delivery Date Method - IPS

IPS Expected Delivery Date Method

Absent or Unknown Procedures - IPS

Absent or Unknown Procedures

Problem Severity - IPS

Problem Severity

Results Laboratory Observation - IPS

Value Set Definition: LOINC {STATUS in {ACTIVE}, CLASSTYPE in {1}, CLASS exclude {CHALSKIN, H&P.HX.LAB, LABORDERS, NR STATS, PATH, PATH.*, MOLPATH, MOLPATH.*, CYTO, HL7.CYTOGEN, HL7.GENETICS}}

CORE Problem List Finding/Situation/Event (GPS) - IPS

This value set is a special subset for the International Patient Summary of the concepts in the CORE Problem List Subset of SNOMED CT® which are also contained in the SNOMED CT Global Patient Set (GPS). This value set includes the concepts which are in the Clinical finding, Situation with explicit context and Event hierarchies, but excludes the concepts from the Procedure hierarchy, as they are expected to be represented separately in the History of Procedures Section. The CORE Problem List Subset includes SNOMED CT concepts that can be used for the problem list, discharge diagnoses, or reason for encounter. The concepts currently included in the value set are the set contained in both the November 2019 release of the CORE Problem List Subset and the September 2019 release of the GPS, both of which are based on the July 2019 SNOMED CT International Edition release. The value set additionally contains three recently added SNOMED CT concepts for Coronavirus from the March 2020 Interim International Release.

The CORE Problem List Subset is updated regularly by the NLM for new SNOMED CT releases. https://www.nlm.nih.gov/research/umls/Snomed/core_subset.html

Target Site - IPS
This value set includes codes from SNOMED Clinical Terms®: all descendants of 442083009 Anatomical or acquired body structure (body structure) .
Allergy intolerance substance condition (GPS) - IPS
IPS Allergy intolerance substance condition GPS value set. This value set includes the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that are included in: all descendants of 762766007 Edible substance (substance); all descendants of 406455002 Allergen class (substance); all descendants of 425620007 Metal (substance); all descendants of 373873005 Pharmaceutical / biologic product (product); all descendants of 410942007 Drug or medicament (substance). The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
Results Radiology Textual Observations (GPS-DICOM-LOINC) - IPS

IPS Results Radiology Textual Observations

Results Laboratory Presence/Absence (GPS) - IPS

Presence/Absence value set

Medications (example) - IPS

This value set provides an example of possible coded concepts representing:

  • medicinal products
  • packaged medicinal products
  • medications based on their generic composition of:
    • active substance(s) (e.g. IDMP PhPID Active Substance Stratum Level 1)
    • active substance(s) with strength (e.g. IDMP PhPID Active Substance Stratum Level 2)
    • active substance(s) with administrable dose form (e.g. IDMP PhPID Active Substance Stratum Level 3)
    • active substance(s) with strength and administrable dose form (e.g. IDMP PhPID Active Substance Stratum Level 4)

Please note that this Value set is not representing any IDMP identifier. It is envisioned that a future version will be based on the IDMP IDs when available for actual use.

Absent or Unknown Problems - IPS

Absent or Unknown Problems

Results Radiology Measurement Observation (GPS-DICOM) - IPS

Extensible value set including SNOMED CT GPS and DICOM concepts for Linear, Area and Volume Measurements

Current Smoking Status - IPS

Value Set based on HL7 Vocab TC and Structured Doc consensus (per CDC submission 7/12/2012 for smoking status term)

Problem Type - IPS

This value set indicates the level of medical judgment used to determine the existence of a problem.

Results Laboratory ABO+RH Group (GPS) - IPS

ABO and Rh group [Type] in Blood

Procedures - IPS
This value set includes codes from SNOMED Clinical Terms®: all descendants of 71388002 Procedure (procedure) , excluding [all subtypes of 14734007, all subtypes of 59524001, all subtypes of 389067005, all subtypes of 442006003, all subtypes of 225288009, all subtypes of 308335008, all subtypes of 710135002, all subtypes of 389084004].
Results Specimen Collection Method (GPS) - IPS

IPS Specimen Collection Method

Vaccines - IPS
This value set provides a list of types of vaccine. It includes codes from SNOMED Clinical Terms®: all descendants of 787859002 Vaccine product (product) .
Results Coded Values Laboratory (GPS) - IPS

This Value set is defined as the union of: (a) ABO and Rh group [Type] in Blood (2.16.840.1.113883.11.22.51); (b) Presence/Absence Indicators (2.16.840.1.113883.11.22.52) (c) Organisms (2.16.840.1.113883.11.22.49)

Medicine Doseform - IPS

EDQM Dose Form codes. This Value Set includes all the EDQM Standard Terms having:
[Concept Status] = ‘Current’ AND
[Concept Class] IN (‘PDF’, ‘CMT’, ‘CDF’, ‘PFT’) AND
[Domain] = ‘Human and Veterinary’

PDF = ‘Pharmaceutical dose form’; CMT = ‘Combined terms’; CDF = ‘Combined pharmaceutical dose form’; PFT = ‘Patient Friendly’.

Results Specimen Type (GPS) - IPS

IPS Specimen Type GPS value set. This value set includes a set of codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that may be used to represent specimen types. The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.

Vaccine Target Diseases (GPS) - IPS

This value set includes the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT describing Vaccine Target Diseases. The concepts currently included in the value set are from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.

Pregnancies Summary - IPS

IPS Pregnancies Summary

Healthcare Professional Roles - IPS

IPS Healthcare Professional Roles

SNOMED International Global Patient Set (GPS)

SNOMED International Global Patient Set (GPS) value set. The value set includes all of the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT. The current version of the value set contains all concepts (21,782) from the September 2019 release of the GPS (based on the July 2019 SNOMED CT International Edition release) plus seven recently added concepts for Coronavirus (from the March 2020 Interim International Release) (total 21,789 concepts).

This value set is provided in this IG as a FHIR ValueSet resource instance for the convenience of implementers.

Absent or Unknown Allergies - IPS

Absent or Unknown Allergies

Results Coded Values Pathology (GPS) - IPS
IPS Pathology observation coded results GPS value set. the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that are included in: all descendants of 106253005 Histologic grading differentiation AND/OR behavior (qualifier value) , all descendants of 373369003 Finding of histologic grading differentiation AND/OR behavior (finding) , all descendants of 399981008 Neoplasm and/or hamartoma (disorder) . The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
Absent or Unknown Medication - IPS

Absent or Unknown Medication

Results Organism (GPS) - IPS

This is a value set of the SNOMED CT organism concepts contained in the SNOMED CT Global Patient Set (GPS) for use in the Results section observation values. The concepts currently included in the value set are from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release. This value set additionally contains the recently added SNOMED CT concept for the Coronavirus organism from the March 2020 Interim International Release.

Absent or Unknown Devices - IPS

Absent or Unknown Devices

Medicine Active Substances - IPS

This value set includes codes from SNOMED Clinical Terms®: all descendants of 410942007 | Drug or medicament (substance)|.
Future implementations should consider ISO 11238 Health informatics – Identification of medicinal products – Data elements and structures for the unique identification and exchange of regulated information on substances.

Pregnancy Status - IPS

IPS Pregnancy Status

Vaccine Target Diseases - IPS

This value set includes the codes from SNOMED CT describing Vaccine Target Diseases.

Vaccines (GPS) - IPS
This value set includes the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that are included in: all descendants of 71181003 Product containing vaccine (product) . The concepts currently included in the value set are from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
WHO ATC - IPS

World Health Organization Anatomical Therapeutic Chemical (ATC) classification system. Note: The currently implemented code system and the value set expansion contain only a set of example ATC codes, not the complete code system content.

Results Pathology Observation - IPS

Value Set Definition:

LOINC {STATUS in {ACTIVE}, CLASSTYPE in {1}, CLASS in {CYTO, HL7.CYTOGEN, HL7.GENETICS, MOLPATH, MOLPATH.*, PATH, PATH.*}}

Medications (SNOMED CT) - IPS
This value set includes codes from SNOMED Clinical Terms®: all descendants of 373873005 Pharmaceutical / biologic product (product) .
Allergy Reaction (GPS) - IPS

IPS Allergy reaction GPS value set. This value set includes a set of codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that may be used to represent allergy or intolerance reactions. The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.

Allergy intolerance substance condition - IPS
IPS Allergy intolerance substance condition value set. This value set includes codes from SNOMED Clinical Terms®: all descendants of 762766007 Edible substance (substance); all descendants of 406455002 Allergen class (substance); all descendants of 425620007 Metal (substance); all descendants of 373873005 Pharmaceutical / biologic product (product); all descendants of 410942007 Drug or medicament (substance)
Absent or Unknown Immunization - IPS

Absent or Unknown Immunization

Medicine Route of Administration - IPS

EDQM Route of Administration codes. This Value Set includes all the EDQM Standard Terms having:
[Concept Status] = ‘Current’ AND
[Concept Class] = ‘route of administration’ AND
[Domain] = ‘Human and Veterinary’

Terminology: Code Systems

These define new code systems used by systems conforming with this implementation guide

Absent and Unknown Data - IPS

International Patient Summary (IPS) codes for “known absent” and “not known” data.

Terminology: Concept Maps

These define transformations to convert between codes by systems conforming with this implementation guide

Severity Value Set Mappings - LOINC to FHIR

Severity Value Set Mappings - LOINC to FHIR

Absence of Information Mappings - IPS to SNOMED CT

Absence of Information Mappings - IPS to SNOMED CT

Severity Value Set Mappings - SNOMED CT to FHIR

Severity Value Set Mappings - SNOMED CT to FHIR

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like

IPS Bundle example

IPS Bundle example

Medication : Simvastatin 40 MG Disintegrating Oral Tablet

Medication : Simvastatin 40 MG Disintegrating Oral Tablet

MedicationStatement: on-going Simvastatin treatment

MedicationStatement: on-going Simvastatin treatment

Immunization: Vaccin anti diphtérie-coqueluche-tétanos-poliomyélite (Luxembourg)

Immunization: Vaccin anti diphtérie-coqueluche-tétanos-poliomyélite (Luxembourg)

AllergyIntolerance: No known allergies

AllergyIntolerance: No known allergies

AllergyIntolerance: resolved allergy

AllergyIntolerance: resolved allergy

Condition: Acute myocardial infarction of anterior wall

Condition: Acute myocardial infarction of anterior wall

Procedure: Surgical procedure

Procedure: Surgical procedure

Practitioner example

Practitioner example

PractitionerRole: simple example

Very Simple PractitionerRole example

Patient: male patient

Patient: male patient

Patient: minimal example

Patient: minimal example

Patient: female patient

Patient: female patient

DeviceUseStatement: No known devices in use

DeviceUseStatement: No known devices in use

Device: No known devices in use

Device: No known devices in use

Device: device observer example

Device: device observer example

Observation: imaging CT Abdomen W contrast IV

Observation: imaging CT Abdomen W contrast IV

Observation: imaging CT Abdomen W contrast IV, sub-observations

Observation: imaging CT Abdomen W contrast IV,sub-observations

ImagingStudy: referred DICOM study

ImagingStudy: referred DICOM study

Organization: example

Organization: example

Organization: simple example

Very Simple Organization example

Organization: lab example

Best Hospital Lab Organization example

Observation: pregnancy edd example

Observation: pregnancy edd example

Observation: pregnancy status example

Observation: pregnancy status example

Observation: pregnancy outcome example

Observation: pregnancy outcome example

Observation: SH tobaccouse example

Observation: SH tobaccouse example

Observation: SH alcoholuse example

Observation: SH alcoholuse example

Specimen: example

Specimen: example

Observation: serum creatinine example

Observation: serum creatinine example

Observation: hemoglobin example

Observation: hemoglobin example

Observation: estrogen receptor in tissue example

Observation: estrogen receptor in tissue example

DiagnosticReport: hemoglobin example

DiagnosticReport: hemoglobin example

Media: example

Media: example