CH Health Dossier (R4)
1.0.0-preview - draft Switzerland flag

CH Health Dossier (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 1.0.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-health-dossier/ 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 PortalCommunity ComponentsIdPApp GUIDocument ConsumerDocument ConsumerDocument ConsumerDocument ConsumerAuthorization ClientAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderDocument ResponderDocument ResponderPatientApp GUIDocument ConsumerAuthorization ClientAuthorization ServerDocument ResponderUser PatientPatientApp GUIApp GUIDocument Consumer(MHD)Document Consumer(MHD)Authorization Client(IUA)Authorization Client(IUA)Authorization Server(IUA)Authorization Server(IUA)Document Responder(MHD)Document Responder(MHD)UserAuthenticationProviderUserAuthenticationProviderApp GUIDocument ConsumerDocument ConsumerDocument ConsumerDocument ConsumerAuthorization ClientAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderDocument ResponderDocument Responder[01]read doc[02]GET /.well-known/smart-configuration[03]Conformance statement incl. OAuth 2.1 endpointsopt[IUA with JWT option][04]Get Access Token[05][ITI-71] Get Access Token[Extended access token][06][ITI-71] Get Access Token Response[Extended access token][07] alt[IUA JWT Token option][08]query documentswith extended access token[09]query documents [ITI-67] with extended access token[10] [11] [12]retrieve documentswith extended access token[13]retrieve document [ITI-68] with extended access token[14] [15] [mTLS][16]query documentsusing XUA token and mTLS[17]query documents [ITI-67] with XUA token and mTLS[18] [19] [20]retrieve documentsusing XUA token and mTLS[21]retrieve document [ITI-68] with XUA token and mTLS[22] [23] [24] 

User Access from an integrated Primary System to read documents

Healthcare Professional Portal or Primary SystemCommunity ComponentsIdPApp GUIDocument ConsumerDocument ConsumerDocument ConsumerDocument ConsumerAuthorization ClientAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderDocument ResponderDocument ResponderHealthcare App GUIDocument ConsumerAuthorization ClientAuthorization ServerDocument ResponderUser HealthcareProfessionalHealthcareProfessionalApp GUIApp GUIDocument Consumer(MHD)Document Consumer(MHD)Authorization Client(IUA)Authorization Client(IUA)Authorization Server(IUA)Authorization Server(IUA)Document Responder(MHD)Document Responder(MHD)UserAuthenticationProviderUserAuthenticationProviderApp GUIDocument ConsumerDocument ConsumerDocument ConsumerDocument ConsumerAuthorization ClientAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderDocument ResponderDocument Responder[01]read doc[02]GET /.well-known/smart-configuration[03]Conformance statement incl. OAuth 2.1 endpointsopt[IUA with JWT option][04]Get Access Token[05][ITI-71] Get Access Token[Extended access token][06][ITI-71] Get Access Token Response[Extended access token][07] alt[IUA JWT Token option][08]query documentswith extended access token[09]query documents [ITI-67] with extended access token[10] [11] [12]retrieve documentswith extended access token[13]retrieve document [ITI-68] with extended access token[14] [15] [mTLS][16]query documentsusing XUA token and mTLS[17]query documents [ITI-67] with XUA token and mTLS[18] [19] [20]retrieve documentsusing XUA token and mTLS[21]retrieve document [ITI-68] with XUA token and mTLS[22] [23] [24] 

User Access from an integrated Primary System to publish documents

Healthcare Professional Portal or Primary SystemCommunity ComponentsIdPApp GUIDocument SourceDocument SourceAuthorization ClientAuthorization ServerAuthorization ServerDocument RecipientDocument RecipientHealthcare App GUIDocument SourceAuthorization ClientAuthorization ServerDocument RecipientUser HealthcareProfessionalHealthcareProfessionalApp GUIApp GUIDocument Source(MHD)Document Source(MHD)Authorization Client(IUA)Authorization Client(IUA)Authorization Server(IUA)Authorization Server(IUA)Document Recipient(MHD)Document Recipient(MHD)UserAuthenticationProviderUserAuthenticationProviderApp GUIDocument SourceDocument SourceAuthorization ClientAuthorization ServerAuthorization ServerDocument RecipientDocument Recipient[01]write doc[02]GET /.well-known/smart-configuration[03]Conformance statement incl. OAuth 2.1 endpointsopt[IUA with JWT option][04]Get Access Token[05][ITI-71] Get Access Token[Extended access token][06][ITI-71] Get Access Token Response[Extended access token][07] alt[IUA JWT Token option][08]publish documentwith extended access tokenloop[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][09]publish document [ITI-65] with extended access token[10] [11] [mTLS][12]publish documentwith XUA token and mTLSloop[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][13]publish document [ITI-65] with extended access token[14] [15] [16] 

Writing documents from clinical archives

Clinical ArchiveCommunity ComponentsTechnical UserDocument SourceDocument SourcePatient IdentifierAuthorization ClientAuthorization ClientPatient IdentifierAuthorization ServerAuthorization ServerAuthorization ServerDocument RecipientDocument RecipientTechnical UserDocument SourcePatient IdentifierAuthorization ClientPatient IdentifierAuthorization ServerDocument RecipientTechnical UserTechnical UserDocument Source(MHD)Document Source(MHD)Patient IdentifierCross-referenceConsumerPatient IdentifierCross-referenceConsumerAuthorization Client(IUA)Authorization Client(IUA)Patient IdentifierCross-referenceMangerPatient IdentifierCross-referenceMangerAuthorization Server(IUA)Authorization Server(IUA)Document Recipient(MHD)Document Recipient(MHD)Technical UserDocument SourceDocument SourcePatient IdentifierAuthorization ClientAuthorization ClientPatient IdentifierAuthorization ServerAuthorization ServerAuthorization ServerDocument RecipientDocument Recipient[01]GET /.well-known/smart-configuration[02]Conformance statement incl. OAuth 2.1 endpointsopt[IUA JWT Token option][03]Get Access Token[04][ITI-71] Get Access Token RequestClient Credential Grant Type - [Basic access token][05][ITI-71] Get Access Token ResponseClient Credential Grant Type -[Basic access token][06] [07]query EPR-SPIDfrom MPI using localID and access token[08][ITI-83] Mobile Patient Identifier Cross-referenceQuery [local ID] together with access token[09][ITI-83] Mobile Patient Identifier Cross-referenceQuery 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 documentwith extended access tokenloop[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 documentwith XUA token and mTLSloop[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 PortalSMART on FHIR AppCommunity ComponentsIdPApp GUIApp GUIDocument ConsumerDocument ConsumerAuthorization ServerAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderUserPatientApp GUIAuthorization ClientApp GUIDocument ConsumerAuthorization ServerDocument ResponderUserPatientPatientApp GUIIUA Authorization ClientApp GUIIUA Authorization ClientAuthorization Client(IUA)Authorization Client(IUA)App GUIIUA Authorization ClientApp GUIIUA Authorization ClientDocument Consumer(MHD)Document Consumer(MHD)Authorization Server(IUA)Authorization Server(IUA)Document Responder(MHD)Document Responder(MHD)UserAuthenticationProviderUserAuthenticationProviderApp GUIApp GUIDocument ConsumerDocument ConsumerAuthorization ServerAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderUser[01]read doc[02]GET /.well-known/smart-configuration[03]Conformance statement incl. OAuth 2.1 endpoints[04]launch app[05]GET /.well-known/smart-configuration[06]Conformance statementincl. OAuth 2.1 endpoints[07]CH:XUA Authenticate User[08] [09][ITI-71] Get Access Token[Extended access token][10][ITI-71] Get Access Token Response[Extended access token][11]query documentswith extended access token[12]query documents [ITI-67] with extended access token[13] [14] [15]retrieve documentwith extended access token[16]retrieve document [ITI-68] with extended access token[17] [18] [19] [20] 

Healthcare professional: get document with a SMART on FHIR app (EHR Launch)

Healthcare Professional Portal or Primary SystemSMART on FHIR AppCommunity ComponentsIdPApp GUIApp GUIAuthorization ServerAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderUserdocconsumerdocconsumerHealthcare App GUIAuthorization ClientPatient IdentifierApp GUIAuthorization ServerDocument ResponderUserdocconsumerHealthcareProfessionalHealthcareProfessionalApp GUIIUA Authorization ClientApp GUIIUA Authorization ClientAuthorization Client(IUA)Authorization Client(IUA)Patient IdentifierCross-referenceConsumerPatient IdentifierCross-referenceConsumerApp GUIIUA Authorization ClientApp GUIIUA Authorization ClientAuthorization Server(IUA)Authorization Server(IUA)Document Responder(MHD)Document Responder(MHD)UserAuthenticationProviderUserAuthenticationProviderdocconsumerdocconsumerApp GUIApp GUIAuthorization ServerAuthorization ServerAuthorization ServerDocument ResponderDocument ResponderUserdocconsumerdocconsumer[01]read doc[02]GET /.well-known/smart-configuration[03]Conformance statement incl. OAuth 2.1 endpoints[04]launch app[05]GET /.well-known/smart-configuration[06]Conformance statementincl. OAuth 2.1 endpoints[07]CH:XUA Authenticate User[08] [09][ITI-71] Get Access Token[Extended access token][10][ITI-71] Get Access Token Response[Extended access token][11]query documentswith extended access token[12]query documents [ITI-67] with extended access token[13] [14] [15]retrieve documentwith extended access token[16]retrieve document [ITI-68] with extended access token[17] [18] [19] [20]