FHIR International Patient Summary
0.0.1-current - ci-build
FHIR International Patient Summary
0.0.1-current - ci-build
FHIR International Patient Summary, published by IHE Patient Care Coordination Committee. This guide is not an authorized publication; it is the continuous build for version 0.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/PCC.FIIO/ and changes regularly. See the Directory of published versions
The Patient Care Coordination registry of OIDs is located at https://wiki.ihe.net/index.php/PCC_Vocabulary_Registry_and_Data_Dictionary
This is not a CDA Profile
urn:ihe:pcc:fips:2025
The LOINC code for this document is 60591-5 "Patient summary Document"
This Conent Module Section deffines the technical requirements FHIR IPS Documents and Bundles
Table 6.6.1.X.1: FHIR Bundle Resource Optoinality Requirements This Table shows the differences in the Bundle Requirements for the Different Bundle Options.
Table XX.2-1: Table 6.6.1.X.1: FHIR Bundle Resource Optoinality Requirements
| Data Elements | FHIR Resource ID | HL7 IPS Optionality Carindality | ODH Option Optionality Carindality | Complete Option Optionality Carindality |
|---|---|---|---|---|
| Bundle | BundleUvIps | R [1..1] | R [1..1] | R [1..1] |
| Bundle.entry:composition | ||||
| Bundle.entry:patient | ||||
| Bundle.entry:allergyintolerance | ||||
| Bundle.entry:careplan | ||||
| Bundle.entry:clinicalimpression | ||||
| Bundle.entry:condition | ||||
| Bundle.entry:consent | ||||
| Bundle.entry:device | ||||
| Bundle.entry:deviceusestatement | ||||
| Bundle.entry:diagnosticreport | ||||
| Bundle.entry:documentreference | ||||
| Bundle.entry:flag | ||||
| Bundle.entry:imagingstudy | ||||
| Bundle.entry:immunization | ||||
| Bundle.entry:immunizationrecommendation | ||||
| Bundle.entry:medication | ||||
| Bundle.entry:medicationrequest | ||||
| Bundle.entry:medicationstatement | ||||
| Bundle.entry:practitioner | ||||
| Bundle.entry:practitionerrole | ||||
| Bundle.entry:procedure | ||||
| Bundle.entry:observation-pregnancy-edd | ||||
| Bundle.entry:observation-pregnancy-outcome | ||||
| Bundle.entry:observation-pregnancy-status | ||||
| Bundle.entry:observation-alcohol-use | ||||
| Bundle.entry:observation-tobacco-use | ||||
| Bundle.entry:observation-results-laboratory-pathology | ||||
| Bundle.entry:observation-results-radiology | ||||
| Bundle.entry:observation-vital-signs | ||||
| Bundle.entry:organization | ||||
| Bundle.entry:specimen | ||||
| Bundle.entry:past-or-present-job | ||||
| Bundle.entry:usual-work | ||||
| Bundle.entry:employment-status | ||||
| Bundle.entry:retirement-date | ||||
| Bundle.entry:combat-zone-period |
Note 1:
The HL7 FHIR IPS Bundle deffines the contraints applied to the Bundle resource by the HL7 International Patient Summary (IPS) FHIR Implementation Guide.
IHE does not further contrain the base standard outside of the specified options defined below.
For a valid example of the HL7 FHIR IPS Bundle review the Pandemic IPS Example Patient Patricia Jordana Bundle. This example patient Has entries for all deffined entries in the FHIR IPS bundle, including additional content that supports the ODH Option.
This Bundle Deffines the additional requirements of the Occupational Data For Health (ODH) Data Elements that may be incorperated into a patient's IPS Bundle. These data Elements utilize the International Labor Organization Codes for to Occupation and Industry.
In addition to the Entry requirments of IPS, this Bundle requires the support of at least 1 of the following ODH Data Elements:
It also allows optional support for the following ODH Data Elements:
The FHIR IPS ODH Option Bundle deffines the contraints applied to the Bundle Resource for this option.
TODO Replace with Genny Jobs or Jannet Guo For a valid example of the HL7 FHIR IPS Bundle review the Pandemic IPS Example Patient Patricia Jordana Example Bundle.
The FHiR IPS Complete Option Bundle Incorperates the Complete Testing option for IPS. This Structure definition binds the Complete Option Composition to the bundle, where all optional sections (e.g., Advanced Directives, Functional Status, History of Past Illnesses, History of Pregnancy, Plan of Care, Social History, and Vital Signs) are now Must Support sections.
TODO Replace with Genny Jobs or Jannet Guo For a valid example of the HL7 FHIR IPS Bundle review the Pandemic IPS Example Patient Patricia Jordana Example Bundle.
Table 6.6.1.X.2-1: FHIR Composition Resource Optoinality Requirements This Table shows the differences in the Composition Requirements for the Different Implementation Options.
Table XX.2-1: Table 6.6.1.X.2-1: FHIR Composition Resource Optoinality Requirements
| Data Elements | FHIR Resource ID | HL7 IPS Optionality Carindality | ODH Option Optionality Carindality | Complete Option Optionality Carindality |
|---|---|---|---|---|
| Composition | CompositionUvIps | R [1..1] | R [1..1] | R [1..1] |
| Composition.section:sectionProblems | ||||
| Composition.section:sectionAllergies | ||||
| Composition.section:sectionMedications | ||||
| Composition.section:sectionImmunizations | ||||
| Composition.section:sectionResults | ||||
| Composition.section:sectionProceduresHx | ||||
| Composition.section:sectionMedicalDevices | ||||
| Composition.section:sectionAdvanceDirectives | ||||
| Composition.section:sectionAlerts | ||||
| Composition.section:sectionFunctionalStatus | ||||
| Composition.section:sectionPastProblems | ||||
| Composition.section:sectionPregnancyHx | ||||
| Composition.section:sectionPatientStory | ||||
| Composition.section:sectionPlanOfCare | ||||
| Composition.section:sectionSocialHistory | ||||
| Composition.section:sectionVitalSigns | ||||
| Composition.section: | ||||
| Composition.section: | ||||
| Composition.section: | ||||
| Composition.section: | ||||
| Composition.section: | ||||
| Composition.section: | ||||
| Composition.section: | ||||
| Composition.section: |
Note 1:
The HL7 FHIR IPS Composition deffines the contraints applied to the Composition resource by the HL7 International Patient Summary (IPS) FHIR Implementation Guide.
IHE does not further contrain the base HL7 Implementation Guide requirements outside of the specified options defined below.
IHE has added further clarification on the expected behavior for implementaion with regaurds to missing data and provides guidence on incorperating additional standard content within the IPS Section Requirements below.
TODO Replace with valid composition example for Jannet Guo or Frank(Missing data) For a valid example of the HL7 FHIR IPS Bundle review the Pandemic IPS Example Patient Patricia Jordana Example Bundle.
In order to support the meanings of Absent Data described by ISO 27269:2025: Health informatics — International Patient Summary Standard Immunization Section 17.2.4 Missing: "These two situations should be explicitly documented in the IPS section: — known absence of vaccinations; — no information available about vaccinations", the emptyReason data elemnt SHOULD Be supported for this section. Open issue FIPS_023 documents the misalignment between the HL7 and ISO Standard.
If the Immunization data is not available or supported by the Content Creator system then the IPS Immunizations Section SHALL have an appropriate emptyReason.
If there is a knowm absence of Immunization data then this May be represented in the IPS Immunizations Section with an emptyReason of 787482006 "No known immunizations" SNOMED-CT, OR Represented in the Immunization Entry as a vaccineCode of 787482006 "No known immunizations". A Content Creator SHALL support at least one of these approaches
TODO Review patient bundle Jannet Guo for valid Immunization section structure, Frank(Missing data) for representation of missing data at the section level, ex patient xyz for no known immunizaiton at the section level, and xyz patient for no known immunizations at the entry level
TODO insert fragment view of each of the valid data representations
In order to support the meanings of Absent Data described by ISO 27269:2025: Health informatics — International Patient Summary Standard Histrory of Procedures Section 16.2.4 Missing - "Required if available, if not then a reason shall be given.", the emptyReason data elemnt SHOULD Be supported for this section. Open issue FIPS_023 documents the misalignment between the HL7 and ISO Standard.
If the Histrory of Procedures data is not available or supported by the Content Creator system then the IPS Histrory of Procedures Section SHALL have an appropriate emptyReason.
If there is a knowm absence of Procedure data then this May be represented in the IPS Histrory of Procedures Section with an emptyReason of 787480003 "No known procedures" SNOMED-CT, OR a data-absent-reason of not-applicable, OR Represented in the Procedure Entry as a Procedure Code of 787480003 "No known procedures". A Content Creator SHALL support at least one of these approaches
TODO Review patient bundle Jannet Guo for valid History of Procedures section structure, Frank(Missing data) for representation of missing data at the section level, ex patient xyz for no known Procedures at the section level, and xyz patient for no known Procedures at the entry level
TODO insert fragment view of each of the valid data representations
In order to support the meanings of Absent Data described by ISO 27269:2025: Health informatics — International Patient Summary Standard Medical Devices Section 18.2.4 Missing - "If missing then the reason should be declared", the emptyReason data elemnt SHOULD Be supported for this section. Open issue FIPS_023 documents the misalignment between the HL7 and ISO Standard.
If the Medical Devices data is not available or supported by the Content Creator system then the IPS Medical Devices Section SHALL have an appropriate emptyReason.
If there is a knowm absence of Device data then this May be represented in the IPS Medical Devices Section with an emptyReason of 787480003 "No known procedures" SNOMED-CT, OR a data-absent-reason of not-applicable, OR Represented in the Procedure Entry as a Procedure Code of 787480003 "No known procedures". A Content Creator SHALL support at least one of these approaches
TODO Review patient bundle Jannet Guo for valid History of Procedures section structure, Frank(Missing data) for representation of missing data at the section level, ex patient xyz for no known Procedures at the section level, and xyz patient for no known Procedures at the entry level
TODO insert fragment view of each of the valid data representations
In order to support the meanings of Absent Data described by ISO 27269:2025: Health informatics — International Patient Summary Standard Lab Results Section 2.2.2.4 Missing "The implication is that no findings or results have been observed that are relevant to the present summary.", the emptyReason data elemnt SHOULD Be supported for this section. Open issue FIPS_023 documents the misalignment between the HL7 and ISO Standard.
If the Lab Results data is not available or supported by the Content Creator system then the IPS Results Section SHALL have an appropriate emptyReason.
If there is a knowm absence of Results data then this May be represented in the IPS Results Section with an emptyReason of 787480003 "No known procedures" SNOMED-CT, OR a data-absent-reason of not-applicable, OR Represented in the Procedure Entry as a Procedure Code of 787480003 "No known procedures". A Content Creator SHALL support at least one of these approaches
TODO Review patient bundle Jannet Guo for valid Results section structure, Frank(Missing data) for representation of missing data at the section level, ex patient xyz for no known Procedures at the section level, and xyz patient for no known Procedures at the entry level
TODO insert fragment view of each of the valid data representations
While the Structure definition does not slice the entry specifically for this, the IPS Social Histroy Section does allow for a large variety of Social history Observations to be documented in this section.
These Observations include:
TODO Fregment/reference Amanda Alvarez/jannet Guo social history section for reference view
While the Structure definition does not slice the entry specifically for this, the IPS Pregnancy Histroy Section does allow for a large variety of Pregnancy Observations to be documented in this section.
These Observations include:
TODO Proper References for structure defintions, should use the IPS Observation Strucutre definition as parent.
TODO Fregment/reference Amanda Alvarez/jannet Guo social history section for reference view
This Section Does not permit the use of the Observation resource to indicate if a patient does or does ont have an Advance directive available to them.
If the Advanced Directive data is not available or supported by the Content Creator system then the IPS Results Section SHOULD have an appropriate emptyReason.
If there is a knowm absence of Advanced healthcare Directives for the patient, then this May be represented in the IPS Advanced Directives with an emptyReason of 787480003 "No known procedures" SNOMED-CT, OR the Section may be ommited.
TODO Review patient bundle Jannet Guo for valid Results section structure, Frank(Missing data) for representation of missing data at the section level, ex patient xyz for no known Procedures at the section level, and xyz patient for no known Procedures at the entry level
TODO insert fragment view of each of the valid data representations
Table 6.6.1.X.2.7.1-1: Data Element and Path Mapping for CEN/ISO Advance Directives Section Attributes The following table shows the mapping of the FHIR Resources supporting the content for International Patient Summary data Elements/Attributes defined by CEN.
Table XX.2-1: Table 6.6.1.X.2-1: Data Element and Path Mapping for CEN/ISO Advance Directives Section Attributes
| Cen/ISO Data Elements | CEN/ISO Cardinality | HL7 IPS Cardinality | FHIR Resource Reference | FHIR Mapping Path |
|---|---|---|---|---|
| Advance Directives Section | Composition.section:sectionAdvanceDirectives | |||
| Advance Directives | Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent | |||
| Person Authorizing Directive | Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer:Patient | |||
| Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer:RelatedPerson | ||||
| Person Authorizing Name | Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer.name | |||
| Person Authorizing Role | Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer:RelatedPerson.relationship | |||
| Person Authorizing Telecoms | Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer.telecom | |||
| Directive Category | Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.category | |||
| Directive Description | Composition.section:sectionAdvanceDirectives.text | |||
| Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.text | ||||
| Reference to Legal Document | Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.sourceReference:DocumentReference |
Note 1:
If the person authorizing the Advanced directive is the patient then the Person Authorizing Directive element should be found in: Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer:Patient
If the person authorizing the Advanced directive is a patient representative then the Person Authorizing Directive element should be found in: Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer:RelatedPerson
Table 6.6.1.X.2.1.1-1: Data Element and Path Mapping for CEN/ISO Immunization Attributes The following table shows the mapping of the FHIR Resources supporting the content for International Patient Summary data Elements/Attributes defined by CEN.
Table XX.2-1: Table 6.6.1.X.2-1: Data Element and Path Mapping for CEN/ISO Immunization Attributes
The FHIR IPS ODH Option Composition deffines the contraints applied to the Bundle Resource for this bundle.
TODO Replace with Jenny Jobs or Jannet Guo For a valid example of the HL7 FHIR IPS Bundle review the Pandemic IPS Example Patient Patricia Jordana Example Bundle.
For the FHIR IPS ODH Option, this is now a Must Support section. The Patient's Occupation and Industry Data Elements SHALL Be Documented in the IPS if it is known.
This Section SHALL support the the ODH Past or Present Job and the Usual Work Data Elements to document the patient's Occupationa and Injustry.
Table 6.6.1.X.3.1.1-1: Data Element and Path Mapping for CEN/ISO Patient Attributes The following table shows the mapping of the FHIR Resources supporting the content for International Patient Summary data Elements/Attributes defined by CEN.
Table XX.2-1: Table 6.6.1.X.2-1: Data Element and Path Mapping for CEN/ISO Patient Attributes
| Cen/ISO Data Elements | CEN/ISO Cardinality | HL7 IPS Cardinality | FHIR Resource Reference | FHIR Mapping Path |
|---|---|---|---|---|
| Patient Attributes | Patient:PatientUvIps | |||
| Patient’s name | Patient:PatientUvIps.name | |||
| Address | Patient:PatientUvIps.address | |||
| Telecoms | Patient:PatientUvIps.telecom | |||
| Administrative gender | Patient:PatientUvIps.gender | |||
| Date of birth | Patient:PatientUvIps.birthDate | |||
| Patient’s preferred language | Patient:PatientUvIps.communication.language | |||
| Healthcare related identifiers | Patient:PatientUvIps.identifier | |||
| Patient identifier | Patient:PatientUvIps.identifier | |||
| Insurance information | Patient:PatientUvIps.identifier | |||
| Insurance identifier | Patient:PatientUvIps.identifier |
Note 1:
link to example IPS Bundle/composition for IPS Doc with missing data
Review TODO Paitent Link and include Fragment for example view of how data absent SHall be represented
COmposition ststeentst for the different options should have a clearer overview here.
TODO: Write up description of the expected behavior of the the Must support and requireed if known sections for each of the options, including hl7's IPS to ensure that it is dicussed and noted for conformance testing.
Create open issue about the dicussion on omitting data that is considered relivant JIra ticket - https://jira.hl7.org/browse/FHIR-53720 Rob also sending email about it 1/15/2026 1:08pm
The following sections document the optionality of the data elements within the Composition cooresposning to each Implementation option
The following table shows the mapping of the FHIR Resources supporting the content for International Patient Summary data Elements/Attributes defined by CEN.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Patient Attributes Section.
If the person authorizing the Advanced directive is the patient then the Person Authorizing Directive element should be found in: Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer:Patient
If the person authorizing the Advanced directive is a patient representative then the Person Authorizing Directive element should be found in: Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent.performer:RelatedPerson
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Allergy and Intolerance Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Functional Status Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 History of Past Problems Section.
In addition to the HL7 http://terminology.hl7.org/CodeSystem/condition-category extensible value set the following additional problem types may also be documented: • 148006 Preliminary diagnosis (contextual qualifier) (qualifier value) • 5558000 Working diagnosis (contextual qualifier) (qualifier value) • 30207005 Risk of (contextual qualifier) (qualifier value)1180 • Medical Alert SNOMED-CT qualifier value is pending (see open issues)
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 History of Pregnancy Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 History of Procedures Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Immunizations Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Medical Devices Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Medication Summary Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Plan of Care Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Problems Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Results Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Social History Section.
Content Creators implementing the Occupational Data for Health Option SHALL include one or more of the following work related observations as a Social History Section entry as defined by the structured definition in the reference column:
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Vital Signs Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Cross Border Section.
The following table provides guidance on the FHIR Resource locations of the CEN/ISO data elements within the EN 17269 Provenance Metadata.
Data element Requirements mappings
IG © 2021+ IHE Patient Care Coordination Committee. Package ihe.pcc.fiio#0.0.1-current based on FHIR 4.0.1. Generated 2026-02-05
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