International Patient Summary Implementation Guide
2.0.0 - STU 2

International Patient Summary Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-ips/ and changes regularly. See the Directory of published versions

## IG Analysis

Page standards status: Informative

### Ballot Status

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

### Dependencies and Related Guides

IG | Package | FHIR | Comment
--- | --- | --- | ---
International Patient Summary Implementation Guide | hl7.fhir.uv.ips#2.0.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.5.0 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.3.0-ballot-tc1 | R4 |
International Patient Access | hl7.fhir.uv.ipa#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.2.0 | R4 |
SMART App Launch | hl7.fhir.uv.smart-app-launch#2.0.0 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#0.7.1 | 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.extensions.r4#5.3.0-ballot-tc1 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Aug 3, 2025 06:28+1000+10:00)

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.uv.tools.r4#0.7.1 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 Sat, Jul 26, 2025 06:59+1000+10:00)

#### Relationship to International Patient Access

Profiles in IPS generally seek to conform to profiles as defined in the International Patient Access (IPA) Implementation Guide.

Generally IPS specifies a more extensive set of rules about the content that clinical systems may conform to than IPA. These specifications are complementary and doing different things - IPA is making provision for RESTful access to a record using modern authorization standards; the other is making rules about the content found in a summary of the record. Although some considerations are appropriately given to these distinct use-cases, systems that meet the information requirements in IPS will typically conform to IPA and can also provide access to the patient record as specified in IPA.

#### Patient profile Differences between IPA and IPS

IPS documents may be generated and shared synchronously or asynchronously among providers who have direct FHIR interface as well as other modalities for exchange (e.g. patient mediated, IHE, SMART Health Link). The IPS FHIR Implementation Guide requires `Patient.name` and `Patient.birthDate` since this provides critical information as specified in the ISO 27269 specification and for patient care. `Patient.identifier` may be quite valuable in resolving patient identities but is not a required field in ISO 27269 and some nations have expressed concern in sending this information.

The scenario for cross-border exchange of a document is different than the direct accessing of FHIR servers as covered in the IPA guide. Therefore IPA requires `Patient.identifier` while IPS only requires `Patient.name` or `Patient.birthDate`. IPS supports the active use of identifiers when legally permitted and reasonable but notes that this remains a cardinality difference between the IPS Patient profile and the IPA Patient profiles.

#### Alignment to FHIR Clinical Documents

This specification previously derived its IPS Composition from the Clinical Document profile in FHIR, which has since been deprecated. A new implementation guide ("FHIR Clinical Documents") is now available to replace this profile and assist with the alignment/transition between CDA and FHIR documents. Future versions of this IPS Implementation Guide will review the FHIR Clinical Documents Implementation Guide for future compatibility and may align our guidance. We recommend implementers consider this guide when implementing IPS (noting that it may change further given its lower maturity).

#### Alignment to HL7 Cross Paradigm Implementation Guide: Gender Harmony - Sex and Gender Representation

This specification generally seeks to align with guidance from the HL7 Cross Paradigm Implementation Guide: Gender Harmony. This includes non-required extensions and guidance within the IPS Patient profile.

### 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.uv.ips.r4) and R4B (hl7.fhir.uv.ips.r4b) are available.

### Global Profiles

There are no Global profiles defined