EHDS Logical Information Models
0.2.1 - qa-preview

EHDS Logical Information Models, published by Xt-EHR. This guide is not an authorized publication; it is the continuous build for version 0.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Xt-EHR/xt-ehr-common/ and changes regularly. See the Directory of published versions

## Logical Model: Patient summary model

Official URL: http://www.xt-ehr.eu/fhir/models/StructureDefinition/EHDSPatientSummary | Version: 0.2.1
Draft as of 2026-02-05 | Computable Name: EHDSPatientSummary

The model is a structured document designed to provide an overview of a patient’s most important health information. The model aims to be compatible with the ISO International Patient Summary standard.

Patient summary consists of several sections of which some are suggested to be mandatory to support. For each mandatory section, implementers should as a minimum be able to produce a generated narrative text of the content, as well as certain structured elements. There are only few elements that are suggested as required to support at this point.

While the overall use cases for exchanging a full Patient Summary (PS) remain consistent—typically aiming to support patients access to its own data, transfer of data between systems and cross-border care (both emergency access, and continuity of care)—it is acknowledged that, in practice, implementers will need to support multiple variants of these use cases, depending on the context. In some cases, only a subset of the PS (e.g. just medications, allergies, or vaccinations) will be relevant or exchanged. As such, each section of the Patient Summary is described and handled independently, with clear guidance on both the narrative and structured data elements expected for that section.

The information elements and value sets suggested are mainly taken from eHN Guideline, MyHealth@EU and HL7 FHIR IPS. Some additions or adjustments have been made, based on input from the working group of this deliverable. These are described in each section.

Usages:

- This Logical Model is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
EHDSPatientSummary |  | 0..* | EHDSDocument | Patient summary model Elements defined in Ancestors:header, header, presentedForm Instances of this logical model can be the target of a Reference
header |  | 1..1 | Base | Document header
subject |  | 1..1 | EHDSPatient | Patient/subject information
identifier |  | 1..* | Identifier | Unique identifier of the document
author[x] |  | 1..* |  | Author(s) of the document
authorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
authorEHDSOrganisation |  |  | EHDSOrganisation |
authorEHDSDevice |  |  | EHDSDevice |
date |  | 1..1 | dateTime | Date of finalising/issuing the document
status |  | 1..1 | CodeableConcept | Status of the document
source |  | 0..1 | CodeableConcept | Source of information (e.g. patient, patient's proxy). Used in case the patient has authored the information or the author has submitted patient-stated information.
language |  | 0..1 | CodeableConcept | Language in which the resource is written. Language is expressed by the IETF language tag. Binding Description: (preferred): BCP 47
documentType |  | 1..1 | CodeableConcept | Type of document at hand, e.g. 60591-5 Patient summary document. Binding Description: (preferred): LOINC
documentTitle |  | 1..1 | string | Human readable document title that can be displayed in search results, etc. This can be documentType's display name, or it can be assembled from multiple elements. Examples: 'Laboratory Result Report', 'Patient Summary of Jane Green 10.12.2024'
period |  | 0..1 | Period | Time period of information covered in the document
version |  | 0..1 | string | Business version of the document. The exact algorithm for versioning is decided by the producer/custodian.
attestation |  | 0..* | Base | Document attestation details
attester[x] |  | 1..1 |  | Attester who validated the document. Multiple attesters could be provided.
attesterEHDSHealthProfessional |  |  | EHDSHealthProfessional |
attesterEHDSDevice |  |  | EHDSDevice |
datetime |  | 1..1 | dateTime | Date and time of the approval of the document by Attester.
legalAuthentication |  | 0..* | Base | Document legal authentication details
legalAuthenticator[x] |  | 1..1 |  | The person or organisation taking responsibility for the medical content of the document (typically the person who signs it)
legalAuthenticatorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
legalAuthenticatorEHDSOrganisation |  |  | EHDSOrganisation |
datetime |  | 1..1 | dateTime | Date and time when the document was authorised.
eventType |  | 0..* | CodeableConcept | Categorisation of the event covered by the document (e.g. laboratory study types, imaging study types including modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. Binding Description: (preferred): LOINC, SNOMED CT, dicom-cid-33-Modality
serviceSpecialty |  | 0..* | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding Description: (preferred): SNOMED CT
custodian |  | 0..1 | EHDSOrganisation | Organisation that is in charge of maintaining the document/report.
presentedForm |  | 0..* | EHDSAttachment | A narrative easy-to-read representation of the full data set, e.g. PDF-version of a document
alerts |  | 0..1 | Base | Section: Alerts
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
medicalAlert |  | 0..* | EHDSAlert | Description of medical alerts in textual format: any clinical information that is imperative to know so that the life or health of the patient does not come under threat.
note |  | 0..1 | string | Free text notes by the health professional
allergiesAndIntolerances |  | 1..1 | Base | Section: Allergies and intolerances
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
allergyIntolerance |  | 0..* | EHDSAllergyIntolerance | List of structured allergies and intolerances
emptyReason |  | 0..1 | CodeableConcept | Use if no Allergies are listed Binding Description: (preferred): 1.3.6.1.4.1.12559.11.10.1.3.1.42.47eHDSIAbsentOrUnknownAllergy; http://hl7.org/fhir/ValueSet/list-empty-reason
note |  | 0..1 | string | Free text notes by the health professional
problems |  | 1..1 | Base | Section: Medical problems
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no conditions are listed
problem |  | 0..* | EHDSCondition | Health conditions affecting the health of the patient.
note |  | 0..1 | string | Free text notes by the health professional
medicationSummary |  | 1..1 | Base | Section: Medication summary
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no medicines are listed
medicationUse |  | 0..* | EHDSMedicationStatement | Medication treatment/prescription relevant for this patient summary. Typically, medications whose period of time indicated for the treatment has not yet expired whether it has been dispensed or not.
note |  | 0..1 | string | Free text notes by the health professional
medicalDevicesAndImplants |  | 1..1 | Base | Section: Medical devices and implants
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
deviceUse |  | 0..* | EHDSDeviceUse | Describes the patient's implanted and external medical devices and equipment that their health status depends on. Includes devices (such as cardiac pacemakers, implantable defibrillator, prothesis, ferromagnetic bone implants etc.) that are important to know by the HP.
note |  | 0..1 | string | Free text notes by the health professional
procedures |  | 1..1 | Base | Section: Procedures
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
procedure |  | 0..* | EHDSProcedure | List of procedures
note |  | 0..1 | string | Free text notes by the health professional
immunisations |  | 0..1 | Base | Section: Immunisations
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
immunisation |  | 0..* | EHDSImmunisation | Immunisations given to the patient and their status at the point of care.
note |  | 0..1 | string | Free text notes by the health professional
functionalStatus |  | 0..1 | Base | Section: Functional status
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
condition |  | 0..* | EHDSCondition | Condition information describing patient's functional status or disability.
assessment |  | 0..* | EHDSObservation | Assessment results regarding functional status.
note |  | 0..1 | string | Free text notes by the health professional
socialHistory |  | 0..1 | Base | Section: Social history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
observation |  | 0..* | EHDSObservation | Social history observations related to health
note |  | 0..1 | string | Free text notes by the health professional
pregnancyHistory |  | 0..1 | Base | Section: Pregnancy history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
currentPregnancyStatus |  | 0..1 | EHDSCurrentPregnancy | Current pregnancy status
previousPregnancies |  | 0..* | EHDSPregnancyHistory | History of previous pregnancies
note |  | 0..1 | string | Free text notes by the health professional
travelHistory |  | 0..1 | Base | Section: Travel history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
travelHistory |  | 0..* | EHDSTravelHistory | Travel history for one country
note |  | 0..1 | string | Free text notes by the health professional
patientStory |  | 0..1 | Base | Section: Patient story
note |  | 0..1 | string | Free text notes by the health professional
advanceDirectives |  | 0..1 | Base | Section: Advance Directives
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
advanceDirective |  | 0..* | EHDSAdvanceDirective | Provision for healthcare decisions if, in the future, a person is unable to make those decisions
note |  | 0..1 | string | Free text notes by the health professional
observationResults |  | 0..1 | Base | Section: Observation results
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
result |  | 0..* | EHDSObservation | Observation results pertaining to the subject of care's health condition and which might have impact on future treatments
note |  | 0..1 | string | Free text notes by the health professional
carePlans |  | 0..1 | Base | Section: Care plans
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
carePlan |  | 0..* | EHDSCarePlan | Describes the intention of how one or more practitioners intend to deliver care for a particular patient for a period of time, possibly limited to care for a specific condition or set of conditions.
note |  | 0..1 | string | Free text notes by the health professional
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EHDSPatientSummary.header.​language | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​documentType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​eventType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​serviceSpecialty | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.allergiesAndIntolerances.​emptyReason | Base | preferred |  | Not State | Unknown

This structure is derived from EHDSDocument

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
EHDSPatientSummary |  | 0..* | EHDSDocument | Patient summary model Elements defined in Ancestors:header, header, presentedForm Instances of this logical model can be the target of a Reference
header |  |  |  |
period |  | 0..1 | Period | Time period of information covered in the document
alerts |  | 0..1 | Base | Section: Alerts
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
medicalAlert |  | 0..* | EHDSAlert | Description of medical alerts in textual format: any clinical information that is imperative to know so that the life or health of the patient does not come under threat.
note |  | 0..1 | string | Free text notes by the health professional
allergiesAndIntolerances |  | 1..1 | Base | Section: Allergies and intolerances
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
allergyIntolerance |  | 0..* | EHDSAllergyIntolerance | List of structured allergies and intolerances
emptyReason |  | 0..1 | CodeableConcept | Use if no Allergies are listed Binding Description: (preferred): 1.3.6.1.4.1.12559.11.10.1.3.1.42.47eHDSIAbsentOrUnknownAllergy; http://hl7.org/fhir/ValueSet/list-empty-reason
note |  | 0..1 | string | Free text notes by the health professional
problems |  | 1..1 | Base | Section: Medical problems
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no conditions are listed
problem |  | 0..* | EHDSCondition | Health conditions affecting the health of the patient.
note |  | 0..1 | string | Free text notes by the health professional
medicationSummary |  | 1..1 | Base | Section: Medication summary
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no medicines are listed
medicationUse |  | 0..* | EHDSMedicationStatement | Medication treatment/prescription relevant for this patient summary. Typically, medications whose period of time indicated for the treatment has not yet expired whether it has been dispensed or not.
note |  | 0..1 | string | Free text notes by the health professional
medicalDevicesAndImplants |  | 1..1 | Base | Section: Medical devices and implants
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
deviceUse |  | 0..* | EHDSDeviceUse | Describes the patient's implanted and external medical devices and equipment that their health status depends on. Includes devices (such as cardiac pacemakers, implantable defibrillator, prothesis, ferromagnetic bone implants etc.) that are important to know by the HP.
note |  | 0..1 | string | Free text notes by the health professional
procedures |  | 1..1 | Base | Section: Procedures
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
procedure |  | 0..* | EHDSProcedure | List of procedures
note |  | 0..1 | string | Free text notes by the health professional
immunisations |  | 0..1 | Base | Section: Immunisations
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
immunisation |  | 0..* | EHDSImmunisation | Immunisations given to the patient and their status at the point of care.
note |  | 0..1 | string | Free text notes by the health professional
functionalStatus |  | 0..1 | Base | Section: Functional status
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
condition |  | 0..* | EHDSCondition | Condition information describing patient's functional status or disability.
assessment |  | 0..* | EHDSObservation | Assessment results regarding functional status.
note |  | 0..1 | string | Free text notes by the health professional
socialHistory |  | 0..1 | Base | Section: Social history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
observation |  | 0..* | EHDSObservation | Social history observations related to health
note |  | 0..1 | string | Free text notes by the health professional
pregnancyHistory |  | 0..1 | Base | Section: Pregnancy history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
currentPregnancyStatus |  | 0..1 | EHDSCurrentPregnancy | Current pregnancy status
previousPregnancies |  | 0..* | EHDSPregnancyHistory | History of previous pregnancies
note |  | 0..1 | string | Free text notes by the health professional
travelHistory |  | 0..1 | Base | Section: Travel history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
travelHistory |  | 0..* | EHDSTravelHistory | Travel history for one country
note |  | 0..1 | string | Free text notes by the health professional
patientStory |  | 0..1 | Base | Section: Patient story
note |  | 0..1 | string | Free text notes by the health professional
advanceDirectives |  | 0..1 | Base | Section: Advance Directives
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
advanceDirective |  | 0..* | EHDSAdvanceDirective | Provision for healthcare decisions if, in the future, a person is unable to make those decisions
note |  | 0..1 | string | Free text notes by the health professional
observationResults |  | 0..1 | Base | Section: Observation results
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
result |  | 0..* | EHDSObservation | Observation results pertaining to the subject of care's health condition and which might have impact on future treatments
note |  | 0..1 | string | Free text notes by the health professional
carePlans |  | 0..1 | Base | Section: Care plans
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
carePlan |  | 0..* | EHDSCarePlan | Describes the intention of how one or more practitioners intend to deliver care for a particular patient for a period of time, possibly limited to care for a specific condition or set of conditions.
note |  | 0..1 | string | Free text notes by the health professional
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
EHDSPatientSummary.allergiesAndIntolerances.​emptyReason | Base | preferred |  | Not State | Unknown

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
EHDSPatientSummary |  | 0..* | EHDSDocument | Patient summary model Elements defined in Ancestors:header, header, presentedForm Instances of this logical model can be the target of a Reference
header |  | 1..1 | Base | Document header
subject |  | 1..1 | EHDSPatient | Patient/subject information
identifier |  | 1..* | Identifier | Unique identifier of the document
author[x] |  | 1..* |  | Author(s) of the document
authorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
authorEHDSOrganisation |  |  | EHDSOrganisation |
authorEHDSDevice |  |  | EHDSDevice |
date |  | 1..1 | dateTime | Date of finalising/issuing the document
status |  | 1..1 | CodeableConcept | Status of the document
source |  | 0..1 | CodeableConcept | Source of information (e.g. patient, patient's proxy). Used in case the patient has authored the information or the author has submitted patient-stated information.
language |  | 0..1 | CodeableConcept | Language in which the resource is written. Language is expressed by the IETF language tag. Binding Description: (preferred): BCP 47
documentType |  | 1..1 | CodeableConcept | Type of document at hand, e.g. 60591-5 Patient summary document. Binding Description: (preferred): LOINC
documentTitle |  | 1..1 | string | Human readable document title that can be displayed in search results, etc. This can be documentType's display name, or it can be assembled from multiple elements. Examples: 'Laboratory Result Report', 'Patient Summary of Jane Green 10.12.2024'
period |  | 0..1 | Period | Time period of information covered in the document
version |  | 0..1 | string | Business version of the document. The exact algorithm for versioning is decided by the producer/custodian.
attestation |  | 0..* | Base | Document attestation details
attester[x] |  | 1..1 |  | Attester who validated the document. Multiple attesters could be provided.
attesterEHDSHealthProfessional |  |  | EHDSHealthProfessional |
attesterEHDSDevice |  |  | EHDSDevice |
datetime |  | 1..1 | dateTime | Date and time of the approval of the document by Attester.
legalAuthentication |  | 0..* | Base | Document legal authentication details
legalAuthenticator[x] |  | 1..1 |  | The person or organisation taking responsibility for the medical content of the document (typically the person who signs it)
legalAuthenticatorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
legalAuthenticatorEHDSOrganisation |  |  | EHDSOrganisation |
datetime |  | 1..1 | dateTime | Date and time when the document was authorised.
eventType |  | 0..* | CodeableConcept | Categorisation of the event covered by the document (e.g. laboratory study types, imaging study types including modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. Binding Description: (preferred): LOINC, SNOMED CT, dicom-cid-33-Modality
serviceSpecialty |  | 0..* | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding Description: (preferred): SNOMED CT
custodian |  | 0..1 | EHDSOrganisation | Organisation that is in charge of maintaining the document/report.
presentedForm |  | 0..* | EHDSAttachment | A narrative easy-to-read representation of the full data set, e.g. PDF-version of a document
alerts |  | 0..1 | Base | Section: Alerts
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
medicalAlert |  | 0..* | EHDSAlert | Description of medical alerts in textual format: any clinical information that is imperative to know so that the life or health of the patient does not come under threat.
note |  | 0..1 | string | Free text notes by the health professional
allergiesAndIntolerances |  | 1..1 | Base | Section: Allergies and intolerances
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
allergyIntolerance |  | 0..* | EHDSAllergyIntolerance | List of structured allergies and intolerances
emptyReason |  | 0..1 | CodeableConcept | Use if no Allergies are listed Binding Description: (preferred): 1.3.6.1.4.1.12559.11.10.1.3.1.42.47eHDSIAbsentOrUnknownAllergy; http://hl7.org/fhir/ValueSet/list-empty-reason
note |  | 0..1 | string | Free text notes by the health professional
problems |  | 1..1 | Base | Section: Medical problems
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no conditions are listed
problem |  | 0..* | EHDSCondition | Health conditions affecting the health of the patient.
note |  | 0..1 | string | Free text notes by the health professional
medicationSummary |  | 1..1 | Base | Section: Medication summary
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no medicines are listed
medicationUse |  | 0..* | EHDSMedicationStatement | Medication treatment/prescription relevant for this patient summary. Typically, medications whose period of time indicated for the treatment has not yet expired whether it has been dispensed or not.
note |  | 0..1 | string | Free text notes by the health professional
medicalDevicesAndImplants |  | 1..1 | Base | Section: Medical devices and implants
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
deviceUse |  | 0..* | EHDSDeviceUse | Describes the patient's implanted and external medical devices and equipment that their health status depends on. Includes devices (such as cardiac pacemakers, implantable defibrillator, prothesis, ferromagnetic bone implants etc.) that are important to know by the HP.
note |  | 0..1 | string | Free text notes by the health professional
procedures |  | 1..1 | Base | Section: Procedures
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
procedure |  | 0..* | EHDSProcedure | List of procedures
note |  | 0..1 | string | Free text notes by the health professional
immunisations |  | 0..1 | Base | Section: Immunisations
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
immunisation |  | 0..* | EHDSImmunisation | Immunisations given to the patient and their status at the point of care.
note |  | 0..1 | string | Free text notes by the health professional
functionalStatus |  | 0..1 | Base | Section: Functional status
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
condition |  | 0..* | EHDSCondition | Condition information describing patient's functional status or disability.
assessment |  | 0..* | EHDSObservation | Assessment results regarding functional status.
note |  | 0..1 | string | Free text notes by the health professional
socialHistory |  | 0..1 | Base | Section: Social history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
observation |  | 0..* | EHDSObservation | Social history observations related to health
note |  | 0..1 | string | Free text notes by the health professional
pregnancyHistory |  | 0..1 | Base | Section: Pregnancy history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
currentPregnancyStatus |  | 0..1 | EHDSCurrentPregnancy | Current pregnancy status
previousPregnancies |  | 0..* | EHDSPregnancyHistory | History of previous pregnancies
note |  | 0..1 | string | Free text notes by the health professional
travelHistory |  | 0..1 | Base | Section: Travel history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
travelHistory |  | 0..* | EHDSTravelHistory | Travel history for one country
note |  | 0..1 | string | Free text notes by the health professional
patientStory |  | 0..1 | Base | Section: Patient story
note |  | 0..1 | string | Free text notes by the health professional
advanceDirectives |  | 0..1 | Base | Section: Advance Directives
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
advanceDirective |  | 0..* | EHDSAdvanceDirective | Provision for healthcare decisions if, in the future, a person is unable to make those decisions
note |  | 0..1 | string | Free text notes by the health professional
observationResults |  | 0..1 | Base | Section: Observation results
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
result |  | 0..* | EHDSObservation | Observation results pertaining to the subject of care's health condition and which might have impact on future treatments
note |  | 0..1 | string | Free text notes by the health professional
carePlans |  | 0..1 | Base | Section: Care plans
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
carePlan |  | 0..* | EHDSCarePlan | Describes the intention of how one or more practitioners intend to deliver care for a particular patient for a period of time, possibly limited to care for a specific condition or set of conditions.
note |  | 0..1 | string | Free text notes by the health professional
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EHDSPatientSummary.header.​language | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​documentType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​eventType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​serviceSpecialty | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.allergiesAndIntolerances.​emptyReason | Base | preferred |  | Not State | Unknown

This structure is derived from EHDSDocument

Summary

Mandatory: 0 element(5 nested mandatory elements)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
EHDSPatientSummary |  | 0..* | EHDSDocument | Patient summary model Elements defined in Ancestors:header, header, presentedForm Instances of this logical model can be the target of a Reference
header |  | 1..1 | Base | Document header
subject |  | 1..1 | EHDSPatient | Patient/subject information
identifier |  | 1..* | Identifier | Unique identifier of the document
author[x] |  | 1..* |  | Author(s) of the document
authorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
authorEHDSOrganisation |  |  | EHDSOrganisation |
authorEHDSDevice |  |  | EHDSDevice |
date |  | 1..1 | dateTime | Date of finalising/issuing the document
status |  | 1..1 | CodeableConcept | Status of the document
source |  | 0..1 | CodeableConcept | Source of information (e.g. patient, patient's proxy). Used in case the patient has authored the information or the author has submitted patient-stated information.
language |  | 0..1 | CodeableConcept | Language in which the resource is written. Language is expressed by the IETF language tag. Binding Description: (preferred): BCP 47
documentType |  | 1..1 | CodeableConcept | Type of document at hand, e.g. 60591-5 Patient summary document. Binding Description: (preferred): LOINC
documentTitle |  | 1..1 | string | Human readable document title that can be displayed in search results, etc. This can be documentType's display name, or it can be assembled from multiple elements. Examples: 'Laboratory Result Report', 'Patient Summary of Jane Green 10.12.2024'
period |  | 0..1 | Period | Time period of information covered in the document
version |  | 0..1 | string | Business version of the document. The exact algorithm for versioning is decided by the producer/custodian.
attestation |  | 0..* | Base | Document attestation details
attester[x] |  | 1..1 |  | Attester who validated the document. Multiple attesters could be provided.
attesterEHDSHealthProfessional |  |  | EHDSHealthProfessional |
attesterEHDSDevice |  |  | EHDSDevice |
datetime |  | 1..1 | dateTime | Date and time of the approval of the document by Attester.
legalAuthentication |  | 0..* | Base | Document legal authentication details
legalAuthenticator[x] |  | 1..1 |  | The person or organisation taking responsibility for the medical content of the document (typically the person who signs it)
legalAuthenticatorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
legalAuthenticatorEHDSOrganisation |  |  | EHDSOrganisation |
datetime |  | 1..1 | dateTime | Date and time when the document was authorised.
eventType |  | 0..* | CodeableConcept | Categorisation of the event covered by the document (e.g. laboratory study types, imaging study types including modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. Binding Description: (preferred): LOINC, SNOMED CT, dicom-cid-33-Modality
serviceSpecialty |  | 0..* | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding Description: (preferred): SNOMED CT
custodian |  | 0..1 | EHDSOrganisation | Organisation that is in charge of maintaining the document/report.
presentedForm |  | 0..* | EHDSAttachment | A narrative easy-to-read representation of the full data set, e.g. PDF-version of a document
alerts |  | 0..1 | Base | Section: Alerts
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
medicalAlert |  | 0..* | EHDSAlert | Description of medical alerts in textual format: any clinical information that is imperative to know so that the life or health of the patient does not come under threat.
note |  | 0..1 | string | Free text notes by the health professional
allergiesAndIntolerances |  | 1..1 | Base | Section: Allergies and intolerances
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
allergyIntolerance |  | 0..* | EHDSAllergyIntolerance | List of structured allergies and intolerances
emptyReason |  | 0..1 | CodeableConcept | Use if no Allergies are listed Binding Description: (preferred): 1.3.6.1.4.1.12559.11.10.1.3.1.42.47eHDSIAbsentOrUnknownAllergy; http://hl7.org/fhir/ValueSet/list-empty-reason
note |  | 0..1 | string | Free text notes by the health professional
problems |  | 1..1 | Base | Section: Medical problems
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no conditions are listed
problem |  | 0..* | EHDSCondition | Health conditions affecting the health of the patient.
note |  | 0..1 | string | Free text notes by the health professional
medicationSummary |  | 1..1 | Base | Section: Medication summary
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no medicines are listed
medicationUse |  | 0..* | EHDSMedicationStatement | Medication treatment/prescription relevant for this patient summary. Typically, medications whose period of time indicated for the treatment has not yet expired whether it has been dispensed or not.
note |  | 0..1 | string | Free text notes by the health professional
medicalDevicesAndImplants |  | 1..1 | Base | Section: Medical devices and implants
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
deviceUse |  | 0..* | EHDSDeviceUse | Describes the patient's implanted and external medical devices and equipment that their health status depends on. Includes devices (such as cardiac pacemakers, implantable defibrillator, prothesis, ferromagnetic bone implants etc.) that are important to know by the HP.
note |  | 0..1 | string | Free text notes by the health professional
procedures |  | 1..1 | Base | Section: Procedures
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
procedure |  | 0..* | EHDSProcedure | List of procedures
note |  | 0..1 | string | Free text notes by the health professional
immunisations |  | 0..1 | Base | Section: Immunisations
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
immunisation |  | 0..* | EHDSImmunisation | Immunisations given to the patient and their status at the point of care.
note |  | 0..1 | string | Free text notes by the health professional
functionalStatus |  | 0..1 | Base | Section: Functional status
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
condition |  | 0..* | EHDSCondition | Condition information describing patient's functional status or disability.
assessment |  | 0..* | EHDSObservation | Assessment results regarding functional status.
note |  | 0..1 | string | Free text notes by the health professional
socialHistory |  | 0..1 | Base | Section: Social history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
observation |  | 0..* | EHDSObservation | Social history observations related to health
note |  | 0..1 | string | Free text notes by the health professional
pregnancyHistory |  | 0..1 | Base | Section: Pregnancy history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
currentPregnancyStatus |  | 0..1 | EHDSCurrentPregnancy | Current pregnancy status
previousPregnancies |  | 0..* | EHDSPregnancyHistory | History of previous pregnancies
note |  | 0..1 | string | Free text notes by the health professional
travelHistory |  | 0..1 | Base | Section: Travel history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
travelHistory |  | 0..* | EHDSTravelHistory | Travel history for one country
note |  | 0..1 | string | Free text notes by the health professional
patientStory |  | 0..1 | Base | Section: Patient story
note |  | 0..1 | string | Free text notes by the health professional
advanceDirectives |  | 0..1 | Base | Section: Advance Directives
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
advanceDirective |  | 0..* | EHDSAdvanceDirective | Provision for healthcare decisions if, in the future, a person is unable to make those decisions
note |  | 0..1 | string | Free text notes by the health professional
observationResults |  | 0..1 | Base | Section: Observation results
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
result |  | 0..* | EHDSObservation | Observation results pertaining to the subject of care's health condition and which might have impact on future treatments
note |  | 0..1 | string | Free text notes by the health professional
carePlans |  | 0..1 | Base | Section: Care plans
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
carePlan |  | 0..* | EHDSCarePlan | Describes the intention of how one or more practitioners intend to deliver care for a particular patient for a period of time, possibly limited to care for a specific condition or set of conditions.
note |  | 0..1 | string | Free text notes by the health professional
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EHDSPatientSummary.header.​language | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​documentType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​eventType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​serviceSpecialty | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.allergiesAndIntolerances.​emptyReason | Base | preferred |  | Not State | Unknown

Differential View

This structure is derived from EHDSDocument

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
EHDSPatientSummary |  | 0..* | EHDSDocument | Patient summary model Elements defined in Ancestors:header, header, presentedForm Instances of this logical model can be the target of a Reference
header |  |  |  |
period |  | 0..1 | Period | Time period of information covered in the document
alerts |  | 0..1 | Base | Section: Alerts
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
medicalAlert |  | 0..* | EHDSAlert | Description of medical alerts in textual format: any clinical information that is imperative to know so that the life or health of the patient does not come under threat.
note |  | 0..1 | string | Free text notes by the health professional
allergiesAndIntolerances |  | 1..1 | Base | Section: Allergies and intolerances
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
allergyIntolerance |  | 0..* | EHDSAllergyIntolerance | List of structured allergies and intolerances
emptyReason |  | 0..1 | CodeableConcept | Use if no Allergies are listed Binding Description: (preferred): 1.3.6.1.4.1.12559.11.10.1.3.1.42.47eHDSIAbsentOrUnknownAllergy; http://hl7.org/fhir/ValueSet/list-empty-reason
note |  | 0..1 | string | Free text notes by the health professional
problems |  | 1..1 | Base | Section: Medical problems
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no conditions are listed
problem |  | 0..* | EHDSCondition | Health conditions affecting the health of the patient.
note |  | 0..1 | string | Free text notes by the health professional
medicationSummary |  | 1..1 | Base | Section: Medication summary
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no medicines are listed
medicationUse |  | 0..* | EHDSMedicationStatement | Medication treatment/prescription relevant for this patient summary. Typically, medications whose period of time indicated for the treatment has not yet expired whether it has been dispensed or not.
note |  | 0..1 | string | Free text notes by the health professional
medicalDevicesAndImplants |  | 1..1 | Base | Section: Medical devices and implants
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
deviceUse |  | 0..* | EHDSDeviceUse | Describes the patient's implanted and external medical devices and equipment that their health status depends on. Includes devices (such as cardiac pacemakers, implantable defibrillator, prothesis, ferromagnetic bone implants etc.) that are important to know by the HP.
note |  | 0..1 | string | Free text notes by the health professional
procedures |  | 1..1 | Base | Section: Procedures
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
procedure |  | 0..* | EHDSProcedure | List of procedures
note |  | 0..1 | string | Free text notes by the health professional
immunisations |  | 0..1 | Base | Section: Immunisations
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
immunisation |  | 0..* | EHDSImmunisation | Immunisations given to the patient and their status at the point of care.
note |  | 0..1 | string | Free text notes by the health professional
functionalStatus |  | 0..1 | Base | Section: Functional status
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
condition |  | 0..* | EHDSCondition | Condition information describing patient's functional status or disability.
assessment |  | 0..* | EHDSObservation | Assessment results regarding functional status.
note |  | 0..1 | string | Free text notes by the health professional
socialHistory |  | 0..1 | Base | Section: Social history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
observation |  | 0..* | EHDSObservation | Social history observations related to health
note |  | 0..1 | string | Free text notes by the health professional
pregnancyHistory |  | 0..1 | Base | Section: Pregnancy history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
currentPregnancyStatus |  | 0..1 | EHDSCurrentPregnancy | Current pregnancy status
previousPregnancies |  | 0..* | EHDSPregnancyHistory | History of previous pregnancies
note |  | 0..1 | string | Free text notes by the health professional
travelHistory |  | 0..1 | Base | Section: Travel history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
travelHistory |  | 0..* | EHDSTravelHistory | Travel history for one country
note |  | 0..1 | string | Free text notes by the health professional
patientStory |  | 0..1 | Base | Section: Patient story
note |  | 0..1 | string | Free text notes by the health professional
advanceDirectives |  | 0..1 | Base | Section: Advance Directives
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
advanceDirective |  | 0..* | EHDSAdvanceDirective | Provision for healthcare decisions if, in the future, a person is unable to make those decisions
note |  | 0..1 | string | Free text notes by the health professional
observationResults |  | 0..1 | Base | Section: Observation results
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
result |  | 0..* | EHDSObservation | Observation results pertaining to the subject of care's health condition and which might have impact on future treatments
note |  | 0..1 | string | Free text notes by the health professional
carePlans |  | 0..1 | Base | Section: Care plans
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
carePlan |  | 0..* | EHDSCarePlan | Describes the intention of how one or more practitioners intend to deliver care for a particular patient for a period of time, possibly limited to care for a specific condition or set of conditions.
note |  | 0..1 | string | Free text notes by the health professional
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
EHDSPatientSummary.allergiesAndIntolerances.​emptyReason | Base | preferred |  | Not State | Unknown

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
EHDSPatientSummary |  | 0..* | EHDSDocument | Patient summary model Elements defined in Ancestors:header, header, presentedForm Instances of this logical model can be the target of a Reference
header |  | 1..1 | Base | Document header
subject |  | 1..1 | EHDSPatient | Patient/subject information
identifier |  | 1..* | Identifier | Unique identifier of the document
author[x] |  | 1..* |  | Author(s) of the document
authorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
authorEHDSOrganisation |  |  | EHDSOrganisation |
authorEHDSDevice |  |  | EHDSDevice |
date |  | 1..1 | dateTime | Date of finalising/issuing the document
status |  | 1..1 | CodeableConcept | Status of the document
source |  | 0..1 | CodeableConcept | Source of information (e.g. patient, patient's proxy). Used in case the patient has authored the information or the author has submitted patient-stated information.
language |  | 0..1 | CodeableConcept | Language in which the resource is written. Language is expressed by the IETF language tag. Binding Description: (preferred): BCP 47
documentType |  | 1..1 | CodeableConcept | Type of document at hand, e.g. 60591-5 Patient summary document. Binding Description: (preferred): LOINC
documentTitle |  | 1..1 | string | Human readable document title that can be displayed in search results, etc. This can be documentType's display name, or it can be assembled from multiple elements. Examples: 'Laboratory Result Report', 'Patient Summary of Jane Green 10.12.2024'
period |  | 0..1 | Period | Time period of information covered in the document
version |  | 0..1 | string | Business version of the document. The exact algorithm for versioning is decided by the producer/custodian.
attestation |  | 0..* | Base | Document attestation details
attester[x] |  | 1..1 |  | Attester who validated the document. Multiple attesters could be provided.
attesterEHDSHealthProfessional |  |  | EHDSHealthProfessional |
attesterEHDSDevice |  |  | EHDSDevice |
datetime |  | 1..1 | dateTime | Date and time of the approval of the document by Attester.
legalAuthentication |  | 0..* | Base | Document legal authentication details
legalAuthenticator[x] |  | 1..1 |  | The person or organisation taking responsibility for the medical content of the document (typically the person who signs it)
legalAuthenticatorEHDSHealthProfessional |  |  | EHDSHealthProfessional |
legalAuthenticatorEHDSOrganisation |  |  | EHDSOrganisation |
datetime |  | 1..1 | dateTime | Date and time when the document was authorised.
eventType |  | 0..* | CodeableConcept | Categorisation of the event covered by the document (e.g. laboratory study types, imaging study types including modality, etc.). Selection of such tags or labels depends on the use case and agreement between data sharing parties. This meta-data element serves primarily for searching and filtering purposes. Binding Description: (preferred): LOINC, SNOMED CT, dicom-cid-33-Modality
serviceSpecialty |  | 0..* | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding Description: (preferred): SNOMED CT
custodian |  | 0..1 | EHDSOrganisation | Organisation that is in charge of maintaining the document/report.
presentedForm |  | 0..* | EHDSAttachment | A narrative easy-to-read representation of the full data set, e.g. PDF-version of a document
alerts |  | 0..1 | Base | Section: Alerts
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
medicalAlert |  | 0..* | EHDSAlert | Description of medical alerts in textual format: any clinical information that is imperative to know so that the life or health of the patient does not come under threat.
note |  | 0..1 | string | Free text notes by the health professional
allergiesAndIntolerances |  | 1..1 | Base | Section: Allergies and intolerances
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
allergyIntolerance |  | 0..* | EHDSAllergyIntolerance | List of structured allergies and intolerances
emptyReason |  | 0..1 | CodeableConcept | Use if no Allergies are listed Binding Description: (preferred): 1.3.6.1.4.1.12559.11.10.1.3.1.42.47eHDSIAbsentOrUnknownAllergy; http://hl7.org/fhir/ValueSet/list-empty-reason
note |  | 0..1 | string | Free text notes by the health professional
problems |  | 1..1 | Base | Section: Medical problems
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no conditions are listed
problem |  | 0..* | EHDSCondition | Health conditions affecting the health of the patient.
note |  | 0..1 | string | Free text notes by the health professional
medicationSummary |  | 1..1 | Base | Section: Medication summary
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Use if no medicines are listed
medicationUse |  | 0..* | EHDSMedicationStatement | Medication treatment/prescription relevant for this patient summary. Typically, medications whose period of time indicated for the treatment has not yet expired whether it has been dispensed or not.
note |  | 0..1 | string | Free text notes by the health professional
medicalDevicesAndImplants |  | 1..1 | Base | Section: Medical devices and implants
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
deviceUse |  | 0..* | EHDSDeviceUse | Describes the patient's implanted and external medical devices and equipment that their health status depends on. Includes devices (such as cardiac pacemakers, implantable defibrillator, prothesis, ferromagnetic bone implants etc.) that are important to know by the HP.
note |  | 0..1 | string | Free text notes by the health professional
procedures |  | 1..1 | Base | Section: Procedures
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
emptyReason |  | 0..1 | CodeableConcept | Reason for absence of data
procedure |  | 0..* | EHDSProcedure | List of procedures
note |  | 0..1 | string | Free text notes by the health professional
immunisations |  | 0..1 | Base | Section: Immunisations
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
immunisation |  | 0..* | EHDSImmunisation | Immunisations given to the patient and their status at the point of care.
note |  | 0..1 | string | Free text notes by the health professional
functionalStatus |  | 0..1 | Base | Section: Functional status
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
condition |  | 0..* | EHDSCondition | Condition information describing patient's functional status or disability.
assessment |  | 0..* | EHDSObservation | Assessment results regarding functional status.
note |  | 0..1 | string | Free text notes by the health professional
socialHistory |  | 0..1 | Base | Section: Social history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
observation |  | 0..* | EHDSObservation | Social history observations related to health
note |  | 0..1 | string | Free text notes by the health professional
pregnancyHistory |  | 0..1 | Base | Section: Pregnancy history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
currentPregnancyStatus |  | 0..1 | EHDSCurrentPregnancy | Current pregnancy status
previousPregnancies |  | 0..* | EHDSPregnancyHistory | History of previous pregnancies
note |  | 0..1 | string | Free text notes by the health professional
travelHistory |  | 0..1 | Base | Section: Travel history
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
travelHistory |  | 0..* | EHDSTravelHistory | Travel history for one country
note |  | 0..1 | string | Free text notes by the health professional
patientStory |  | 0..1 | Base | Section: Patient story
note |  | 0..1 | string | Free text notes by the health professional
advanceDirectives |  | 0..1 | Base | Section: Advance Directives
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
advanceDirective |  | 0..* | EHDSAdvanceDirective | Provision for healthcare decisions if, in the future, a person is unable to make those decisions
note |  | 0..1 | string | Free text notes by the health professional
observationResults |  | 0..1 | Base | Section: Observation results
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
result |  | 0..* | EHDSObservation | Observation results pertaining to the subject of care's health condition and which might have impact on future treatments
note |  | 0..1 | string | Free text notes by the health professional
carePlans |  | 0..1 | Base | Section: Care plans
generatedNarrative |  | 0..1 | string | Narrative, potentially formatted, content of the whole section.
carePlan |  | 0..* | EHDSCarePlan | Describes the intention of how one or more practitioners intend to deliver care for a particular patient for a period of time, possibly limited to care for a specific condition or set of conditions.
note |  | 0..1 | string | Free text notes by the health professional
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EHDSPatientSummary.header.​language | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​documentType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​eventType | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.header.​serviceSpecialty | Base | preferred |  | Not State | Unknown
EHDSPatientSummary.allergiesAndIntolerances.​emptyReason | Base | preferred |  | Not State | Unknown

This structure is derived from EHDSDocument

Summary

Mandatory: 0 element(5 nested mandatory elements)

Other representations of profile: CSV, Excel

### Notes:

#### Differences and relationship to eHN Guidelines

The main proposed changes of the proposed EEHRxF logical model, compared with the eHN Guideline are:

- The structure has been flattened to facilitate implementation of only parts of the Patient summary and better support a data centric approach. The result is that all sections are at the same level, not having the grouper-sections "Alerts", "Medical problems", "Medical history", and "Patient provided data" that the eHN GL does.

- All content sections are kept the same as in the Guideline. However, we do suggest that the two problem sections are combined into one. This is to better support different use cases and current available data. See under the section "Problems" for more information.

- In line with the International Patient Summary and MyHealth@EU specifications, there is an empty list reason elements for all sections that are suggested to be mandatory

- Each section has a Generated narrative text element. This is in line with the FHIR International Patient Summary implementation guide, and supports the right for natural persons to get the content in an easily readable format (Article 3 in the EHDS regulation).

- Instead of top level preferred code systems, which in many cases are not meant to be implemented in full, we have added value sets that are in use in the MyHealth@EU and HL7 Europe specifications as examples. We also include some value sets based on suggestions from participating Member states.

- The logical models have cardinality, and repeatable elements are split into their own models, which is often reused between different priority categories (e.g. problems, procedures). The individual information elements in these reusable models are based on the eHN Guideline, unless otherwise stated.