CH EPR FHIR (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 5.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-epr-fhir/ and changes regularly. See the Directory of published versions
Sequence Diagrams
Sample sequence diagrams to illustrate the usage for reading documents as a patient or healthcare professional:
Patient access from a portal
Patient Portal Community Components IdP Patient Patient App GUI App GUI Document Consumer (MHD) Document Consumer (MHD) Patient Identifier Cross-reference Consumer Patient Identifier Cross-reference Consumer Authorization Client (IUA) Authorization Client (IUA) Patient Identifier Cross-reference Manger Patient Identifier Cross-reference Manger Authorization Server (IUA) Authorization Server (IUA) Document Responder (MHD) Document Responder (MHD) User Authentication Provider User Authentication Provider [01] read doc [02] GET /.well-known/smart-configuration [03] Conformance statement incl. OAuth 2.1 endpoints alt [IUA JWT Token option] [04] Get Access Token [05] CH:XUA Authenticate User [06] [07] [ITI-71] Get Access Token Request [Basic access token] [08] Authorize App Access [09] [ITI-71] Get Access Token Response [Basic access token] [10] [11] query EPR-SPID from MPI using local ID and access token [12] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [13] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [14] [mTLS] [15] query EPR-SPID from MPI using local ID and mTLS [16] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [17] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [18] opt [IUA with JWT option] [19] Get Access Token [20] [ITI-71] Get Access Token [Extended access token] [21] [ITI-71] Get Access Token Response [Extended access token] [22] alt [IUA JWT Token option] [23] query documents with extended access token [24] query documents [ITI-67] with extended access token [25] [26] [27] retrieve documents with extended access token [28] retrieve document [ITI-68] with extended access token [29] [30] [mTLS] [31] query documents using XUA token and mTLS [32] query documents [ITI-67] with XUA token and mTLS [33] [34] [35] retrieve documents using XUA token and mTLS [36] retrieve document [ITI-68] with XUA token and mTLS [37] [38] [39] User Access from an integrated Primary System to read documents
Healthcare Professional Portal or Primary System Community Components IdP Healthcare Professional Healthcare Professional App GUI App GUI Document Consumer (MHD) Document Consumer (MHD) Patient Identifier Cross-reference Consumer Patient Identifier Cross-reference Consumer Authorization Client (IUA) Authorization Client (IUA) Patient Identifier Cross-reference Manger Patient Identifier Cross-reference Manger Authorization Server (IUA) Authorization Server (IUA) Document Responder (MHD) Document Responder (MHD) User Authentication Provider User Authentication Provider [01] read doc [02] GET /.well-known/smart-configuration [03] Conformance statement incl. OAuth 2.1 endpoints alt [IUA JWT Token option] [04] Get Access Token [05] CH:XUA Authenticate User [06] [07] [ITI-71] Get Access Token Request [Basic access token] [08] Authorize App Access [09] [ITI-71] Get Access Token Response [Basic access token] [10] [11] query EPR-SPID from MPI using local ID and access token [12] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [13] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [14] [mTLS] [15] query EPR-SPID from MPI using local ID and mTLS [16] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [17] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [18] opt [IUA with JWT option] [19] Get Access Token [20] [ITI-71] Get Access Token [Extended access token] [21] [ITI-71] Get Access Token Response [Extended access token] [22] alt [IUA JWT Token option] [23] query documents with extended access token [24] query documents [ITI-67] with extended access token [25] [26] [27] retrieve documents with extended access token [28] retrieve document [ITI-68] with extended access token [29] [30] [mTLS] [31] query documents using XUA token and mTLS [32] query documents [ITI-67] with XUA token and mTLS [33] [34] [35] retrieve documents using XUA token and mTLS [36] retrieve document [ITI-68] with XUA token and mTLS [37] [38] [39] User Access from an integrated Primary System to publish documents
Healthcare Professional Portal or Primary System Community Components IdP Healthcare Professional Healthcare Professional App GUI App GUI Document Source (MHD) Document Source (MHD) Patient Identifier Cross-reference Consumer Patient Identifier Cross-reference Consumer Authorization Client (IUA) Authorization Client (IUA) Patient Identifier Cross-reference Manger Patient Identifier Cross-reference Manger Authorization Server (IUA) Authorization Server (IUA) Document Recipient (MHD) Document Recipient (MHD) User Authentication Provider User Authentication Provider [01] write doc [02] GET /.well-known/smart-configuration [03] Conformance statement incl. OAuth 2.1 endpoints alt [IUA JWT Token option] [04] Get Access Token [05] CH:XUA Authenticate User [06] [07] [ITI-71] Get Access Token Request [Basic access token] [08] Authorize App Access [09] [ITI-71] Get Access Token Response [Basic access token] [10] [11] query EPR-SPID from MPI using local ID and access token [12] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [13] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [14] [mTLS] [15] query EPR-SPID from MPI using local ID and mTLS [16] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [17] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [18] opt [IUA with JWT option] [19] Get Access Token [20] [ITI-71] Get Access Token [Extended access token] [21] [ITI-71] Get Access Token Response [Extended access token] [22] alt [IUA JWT Token option] [23] publish document with extended access token loop [For the access decision enforcement, the EPR relies on the Confidentiality Code within the document metadata to be stored in the patient’s Health Record. A patient can set the default Confidentiality Code and a document source needs to iterate over the different confidentiality code until successful] [24] publish document [ITI-65] with extended access token [25] [26] [mTLS] [27] publish document with XUA token and mTLS loop [For the access decision enforcement, the EPR relies on the Confidentiality Code within the document metadata to be stored in the patient’s Health Record. A patient can set the default Confidentiality Code and a document source needs to iterate over the different confidentiality code until successful] [28] publish document [ITI-65] with extended access token [29] [30] [31] Writing documents from clinical archives
Clinical Archive Community Components Technical User Technical User Document Source (MHD) Document Source (MHD) Patient Identifier Cross-reference Consumer Patient Identifier Cross-reference Consumer Authorization Client (IUA) Authorization Client (IUA) Patient Identifier Cross-reference Manger Patient Identifier Cross-reference Manger Authorization Server (IUA) Authorization Server (IUA) Document Recipient (MHD) Document Recipient (MHD) [01] GET /.well-known/smart-configuration [02] Conformance statement incl. OAuth 2.1 endpoints opt [IUA JWT Token option] [03] Get Access Token [04] [ITI-71] Get Access Token Request Client Credential Grant Type - [Basic access token] [05] [ITI-71] Get Access Token Response Client Credential Grant Type -[Basic access token] [06] [07] query EPR-SPID from MPI using local ID and access token [08] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [09] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [10] opt [IUA with JWT option] [11] Get Access Token [12] [ITI-71] Get Access Token [Extended access token] [13] [ITI-71] Get Access Token Response [Extended access token] [14] alt [IUA JWT Token option] [15] publish document with extended access token loop [For the access decision enforcement, the EPR relies on the Confidentiality Code within the document metadata to be stored in the patient’s Health Record. A patient can set the default Confidentiality Code and a document source needs to iterate over the different confidentiality code until successful] [16] publish document [ITI-65] with extended access token [17] [18] [mTLS] [19] publish document with XUA token and mTLS loop [For the access decision enforcement, the EPR relies on the Confidentiality Code within the document metadata to be stored in the patient’s Health Record. A patient can set the default Confidentiality Code and a document source needs to iterate over the different confidentiality code until successful] [20] publish document [ITI-65] with extended access token [21] [22] Patient: get document with a SMART on FHIR app
Patient Portal SMART on FHIR App Community Components IdP Patient Patient App GUI IUA Authorization Client App GUI IUA Authorization Client Authorization Client (IUA) Authorization Client (IUA) Patient Identifier Cross-reference Consumer Patient Identifier Cross-reference Consumer App GUI IUA Authorization Client App GUI IUA Authorization Client Document Consumer (MHD) Document Consumer (MHD) Authorization Server (IUA) Authorization Server (IUA) Patient Identifier Cross-reference Mange Patient Identifier Cross-reference Mange Document Responder (MHD) Document Responder (MHD) User Authentication Provider User Authentication Provider [01] read doc [02] GET /.well-known/smart-configuration [03] Conformance statement incl. OAuth 2.1 endpoints alt [IUA JWT Token option] [04] Get Access Token [05] CH:XUA Authenticate User [06] [07] [ITI-71] Get Access Token Request [Basic access token] [08] Authorize App Access [09] [ITI-71] Get Access Token Response [Basic access token] [10] [11] query EPR-SPID from MPI using local ID and access token [12] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [13] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [14] [mTLS] [15] query EPR-SPID from MPI using local ID and mTLS [16] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [17] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [18] [19] launch app [20] GET /.well-known/smart-configuration [21] Conformance statement incl. OAuth 2.1 endpoints [22] CH:XUA Authenticate User [23] [24] [ITI-71] Get Access Token [Extended access token] [25] [ITI-71] Get Access Token Response [Extended access token] [26] query documents with extended access token [27] query documents [ITI-67] with extended access token [28] [29] [30] retrieve document with extended access token [31] retrieve document [ITI-68] with extended access token [32] [33] [34] [35] Healthcare professional: get document with a SMART on FHIR app (EHR Launch)
Healthcare Professional Portal or Primary System SMART on FHIR App Community Components IdP Healthcare Professional Healthcare Professional App GUI IUA Authorization Client App GUI IUA Authorization Client Authorization Client (IUA) Authorization Client (IUA) Patient Identifier Cross-reference Consumer Patient Identifier Cross-reference Consumer App GUI IUA Authorization Client App GUI IUA Authorization Client Document Consumer (MHD) Document Consumer (MHD) Authorization Server (IUA) Authorization Server (IUA) Patient Identifier Cross-reference Mange Patient Identifier Cross-reference Mange Document Responder (MHD) Document Responder (MHD) User Authentication Provider User Authentication Provider [01] read doc [02] GET /.well-known/smart-configuration [03] Conformance statement incl. OAuth 2.1 endpoints alt [IUA JWT Token option] [04] Get Access Token [05] CH:XUA Authenticate User [06] [07] [ITI-71] Get Access Token Request [Basic access token] [08] Authorize App Access [09] [ITI-71] Get Access Token Response [Basic access token] [10] [11] query EPR-SPID from MPI using local ID and access token [12] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [13] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [14] [mTLS] [15] query EPR-SPID from MPI using local ID and mTLS [16] [ITI-83] Mobile Patient Identifier Cross-reference Query [local ID] together with access token [17] [ITI-83] Mobile Patient Identifier Cross-reference Query Response [EPR-SPID] [18] [19] launch app [20] GET /.well-known/smart-configuration [21] Conformance statement incl. OAuth 2.1 endpoints [22] CH:XUA Authenticate User [23] [24] [ITI-71] Get Access Token [Extended access token] [25] [ITI-71] Get Access Token Response [Extended access token] [26] query documents with extended access token [27] query documents [ITI-67] with extended access token [28] [29] [30] retrieve document with extended access token [31] retrieve document [ITI-68] with extended access token [32] [33] [34] [35]
