CH EMR (R4)
0.1.0 - ci-build Switzerland flag

CH EMR (R4), published by HL7 Switzerland. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-emr/ and changes regularly. See the Directory of published versions

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Official URL: http://fhir.ch/ig/ch-emr/ImplementationGuide/ch.fhir.ig.ch-emr Version: 0.1.0
Draft as of 2025-06-05 Computable Name: CH_EMR

Copyright/Legal: CC0-1.0

Introduction

The emergency record contains all the important medical information needed in situations in which quick access or a quick overview of medical data is required. For example, in cases of unconsciousness, language barriers or limited health literacy.
The emergency record combines key administrative and clinical data such as patient details, emergency contacts, medication, allergies, vaccinations, implants, diagnose, CPR status and references to living wills and other relevant documents.

The CH EMR implementation guide describes the FHIR representation of the electronic emergency record in Switzerland. It is dependent on CH Core and CH Term, which describe the Swiss-specific context, particularly in relation to the Swiss Electronic Patient Record (EPR).
This implementation guide is based on the concept for the exchange format of the electronic emergency record (de, fr).

Dependencies Overview

The CH EMR (Emergency Record) implementation guide builds upon several Swiss FHIR specifications. The following diagram illustrates the relationships between these implementation guides:

Core IGsIPS IGsEMR IGCH CoreSwiss core profiles,EPR conceptsCH Termterminology  CH IPS  IPS CH EMREmergency Record derivedderivedimposeProfileExtensionderived

Fig. 1: Schematic representation of the dependency mechanism of the implementation guides

The CH EMR is primarily derived from the CH IPS (International Patient Summary), which provides the foundational clinical profiles for patient summaries in Switzerland. CH IPS itself is based on the international IPS UV specification by HL7, ensuring cross-border interoperability.

Both CH EMR and CH IPS depend on CH Core, which defines the Swiss-specific base profiles (e.g. patient, practitioner, organization) including Swiss identifiers such as AHV, GLN and EPR-SPID. CH Term provides the shared Swiss terminologies, value sets and code systems used across all Swiss FHIR implementation guides.

Where CH IPS profiles were available and applicable, CH EMR profiles inherit from them (e.g. Patient, Medication, AllergyIntolerance, Condition, Immunization). For emergency-specific content not covered by IPS, such as resuscitation status, emergency contacts, risk factors and disabilities, CH EMR defines its own profiles based on CH Core or FHIR base resources.

This implementation guide is under STU ballot by HL7 Switzerland until September 30th, 2025 midnight.
Please add your feedback via the ‘Propose a change’-link in the footer on the page where you have comments.

Changelog with significant changes, open and closed issues.

Download: You can download this implementation guide in the npm package format from here.

Objective

The emergency report is designed to give medical professionals quick and structured access to a patient's most important medical information in emergency situations. However, this medical information can also be used in unforeseen patient contacts where, for example, language barriers exist or health literacy is limited.

Content scope

Core units

  • Patient information: Demographic data and contact information
  • Emergency contacts: Family and trusted persons
  • Care Team: Treating Health care professional
  • Resuscitation status: Patient's wishes regarding resuscitation measures in emergency situations
  • Current medication: Information and dosage of medications
  • Vaccinations: Current vaccinations
  • Allergies and intolerances: Known allergic reactions and intolerances
  • Risk factors: Risks relevant to treatment
  • Problem list: Diagnoses and problems
  • Advance directive: Information on advance directives or medical directives
  • Other documents: Other documents like organ donor cards
  • Implants: Medical devices
  • Pregnancy: Current pregnancy information
  • Disability: Information about disabilities

Profiles

The Implementation Guide defines the following main profiles:

Profile Description Parent
ChEmrComposition Document composition CH IPS Composition
ChEmrBundle Document bundle CH Core Document
ChEmrPatient Demographic data and contact information CH IPS Patient
ChEmrRelatedPerson Family and trusted persons CH Core RelatedPerson
ChEmrPractitioner Healthcare practitioner information CH IPS Practitioner
ChEmrObservationResuscitationStatus Observation profile for documenting the patient's resuscitation status Observation
ChEmrObservationCognitiveDisability Observation profile for cognitive disability Observation
ChEmrObservationPhysicalDisability Observation profile for physical disability in the Emergency Record Observation
ChEmrConditionHealthcareProfessionalsRiskFactors Riskfactors for healthcare professionals CH IPS Condition
ChEmrMedication Medication details CH IPS Medication
ChEmrMedicationStatement Current medication CH IPS MedicationStatement
ChEmrImmunization Immunization records CH IPS Immunization
ChEmrAllergyIntolerance Allergies and intolerances CH IPS AllergyIntolerance
ChEmrCondition Problems and diagnoses CH IPS Condition
ChEmrDocumentReferenceAdvanceDirective Reference to advance directives and emergency medical CH Core DocumentReference
ChEmrDocumentReference Reference to documents CH Core DocumentReference
ChEmrDevice Implants Device
ChEmrObservationPregnancyStatus Profile for documenting pregnancy status in the emergency record IPS Observation Pregnancy - Status

IP Statements

This document is licensed under Creative Commons "No Rights Reserved" (CC0).

HL7®, HEALTH LEVEL SEVEN®, FHIR® and the FHIR ® are trademarks owned by Health Level Seven International, registered with the United States Patent and Trademark Office.

This implementation guide contains and references intellectual property owned by third parties ("Third Party IP"). Acceptance of these License Terms does not grant any rights with respect to Third Party IP. The licensee alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize Third Party IP in connection with the specification or otherwise.

This publication includes IP covered under the following statements.

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 (ch.fhir.ig.ch-emr.r4) and R4B (ch.fhir.ig.ch-emr.r4b) are available.

Dependency Table

IGPackageFHIR
.. CH EMR (R4)ch.fhir.ig.ch-emr#0.1.0R4
... HL7 Terminology (THO)hl7.terminology.r4#7.1.0R4
.... FHIR Extensions Packhl7.fhir.uv.extensions.r4#5.2.0R4
... CH Core (R4)ch.fhir.ig.ch-core#6.0.0R4
.... HL7 Terminology (THO)hl7.terminology.r4#7.0.1R4
.... FHIR Extensions Packhl7.fhir.uv.extensions.r4#5.3.0-ballot-tc1R4
..... HL7 Terminology (THO)hl7.terminology.r4#6.5.0R4
... CH Term (R4)ch.fhir.ig.ch-term#3.3.0R4
.... IHE FormatCode Vocabularyihe.formatcode.fhir#1.4.0R4
..... HL7 Terminology (THO)hl7.terminology.r4#6.3.0R4
.... International Patient Summary Implementation Guidehl7.fhir.uv.ips#2.0.0R4
..... International Patient Accesshl7.fhir.uv.ipa#1.1.0R4
...... HL7 Terminology (THO)hl7.terminology.r4#6.2.0R4
...... SMART App Launchhl7.fhir.uv.smart-app-launch#2.0.0R4
... FHIR Tooling Extensions IGhl7.fhir.uv.tools.r4#1.1.2R4

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 ch.fhir.ig.ch-core#6.0.0

FHIR implementation guide CH Core (built Tue, Dec 16, 2025 07:58+0000+00:00)

Package ihe.formatcode.fhir#1.4.0

Implementation Guide for IHE defined FormatCode vocabulary. (built Tue, May 20, 2025 09:01-0500-05:00)

Package ch.fhir.ig.ch-term#3.3.0

Implementation Guide for Swiss Terminology (built Mon, Dec 15, 2025 10:36+0000+00:00)

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 ch.fhir.ig.ch-ips#2.0.0

The FHIR implementation guide CH IPS is derived from the Swiss Core IG (CH Core) and ensures conformity with the International Patient Summary (IPS). (built Tue, Dec 16, 2025 11:58+0000+00:00)

Package hl7.fhir.uv.tools.r4#1.1.2

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 Tue, Mar 24, 2026 11:13+1100+11:00)

Globals Table

There are no Global profiles defined