HL7 Europe Patient Summary
1.0.0-ci-build - ci-build 150

HL7 Europe Patient Summary, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/eps/ and changes regularly. See the Directory of published versions

EU Variance Statement

This page documents how the HL7 Europe Patient Summary (EPS) relates to the specifications it builds on, and where it adds to or differs from them:

In this page:

  • No variance means that every instance conformant with an EPS profile is also conformant with the referenced profile.
  • Additional requirements are constraints that EPS adds on top of the referenced profile (for example, a narrower cardinality, an additional obligation, a stronger terminology binding). They do not break conformance with the referenced profile.
  • Variance means a difference that can make an EPS instance non-conformant with the referenced profile, or that changes the meaning of what is required.

Variance from HL7 Europe Base and Core

This implementation guide has no variance from the HL7 Europe Base and Core Implementation Guide version 2.0.1 (current).

When a corresponding EU Core profile exists, the EPS profile is derived from it. The EPS profiles impose requirements additional to EU Core, mainly:

  • the obligations defined for the IPS actors;
  • the patient summary specific constraints (e.g. Composition sections, Bundle entries);
  • the alignment with the EHDS Patient Summary logical model (see the Model Map).
EPS profile Derived from (EU Core)
Composition (EPS) Composition (EU core)
Patient (EPS) Patient (EU core)
AllergyIntolerance - Obligations (EPS) AllergyIntolerance (EU core)
Condition - Obligations (EPS) Condition (EU core)
Flag: Alert - Obligations (EPS) Flag (EU core)
Immunization - Obligations (EPS) Immunization (EU core)
Medication - Obligations (EPS) Medication (EU core)
MedicationStatement (EPS) MedicationStatement (EU core)
DiagnosticReport (EPS) DiagnosticReport (EU core)
Procedure (EPS) Procedure (EU core)
Organization - Obligations (EPS) Organization (EU core)
Practitioner - Obligations (EPS) Practitioner (EU core)
PractitionerRole - Obligations (EPS) PractitionerRole (EU core)

Laboratory and other test results use the Observation: Medical Test Result (EU core) profile directly.

Additionally Profiled Resources

This implementation guide profiles the following resources that are not profiled in EU Base and Core:

Variance from IPS

This implementation guide aims for conformance with the HL7 FHIR International Patient Summary Implementation Guide version 2.0.1 (current). Through that conformance, it also aims for compliance with the ISO/EN 27269 – International Patient Summary standard.

The EPS document is a specialisation of the IPS document. The Bundle (EPS) and the Composition (EPS) declare that they also conform to the corresponding IPS profiles (Bundle (IPS), Composition (IPS)).

Note that while the intent is to have no variance, this implementation guide imposes requirements additional to IPS, as described below.

Profile Conformance

The EPS profiles are derived from EU Core (see above) rather than from the IPS profiles. Conformance with the IPS profiles is declared using the imposeProfile extension.

EPS profile Also conforms to (IPS)
Bundle (EPS) Bundle (IPS)
Composition (EPS) Composition (IPS)
Patient (EPS) Patient (IPS)
MedicationStatement (EPS) MedicationStatement (IPS)
DiagnosticReport (EPS) DiagnosticReport (IPS)
Procedure (EPS) Procedure (IPS)
Device (EPS) Device (IPS)
DeviceUseStatement (EPS) DeviceUseStatement (IPS)
Observation: Pregnancy - Expected Delivery Date (EPS) Observation - Pregnancy: EDD (IPS)
Observation: Pregnancy - Outcome (EPS) Observation - Pregnancy: Outcome (IPS)
Observation: Pregnancy - Status (EPS) Observation - Pregnancy: Status (IPS)

The following EPS profiles derive from EU Core and add the IPS obligations, but do not formally declare conformance with the corresponding IPS profile:

EPS profile Corresponding IPS profile
AllergyIntolerance - Obligations (EPS) AllergyIntolerance (IPS)
Condition - Obligations (EPS) Condition (IPS)
Flag: Alert - Obligations (EPS) Flag - Alert (IPS)
Immunization - Obligations (EPS) Immunization (IPS)
Medication - Obligations (EPS) Medication (IPS)
Organization - Obligations (EPS) Organization (IPS)
Practitioner - Obligations (EPS) Practitioner (IPS)
PractitionerRole - Obligations (EPS) PractitionerRole (IPS)

The following IPS profiles are used directly in the EPS Bundle: ImagingStudy (IPS), Specimen (IPS), Observation - SH: alcohol use (IPS) and Observation - SH: tobacco use (IPS).

Must Support, Obligations and Actors

This version of the guide adopts the IPS actors (Creator, Consumer and Server) and the IPS obligations, with no variance.

Following the HL7 Europe approach, EPS does not use the mustSupport flag on its own: Must Support is derived from the obligations defined for the relevant actors. See Obligations for details.

Sections

Each of the IPS required sections (Problems, Allergies and Intolerances, Medication Summary) is also required in EPS.

EPS imposes the following requirements additional to IPS:

  • The History of Procedures and the Medical Devices sections are required (1..1) in EPS, to align with the EHDS Patient Summary model. They are optional in IPS.

EPS introduces the following sections that are not defined in IPS:

  • Travel History (LOINC 10182-4)
  • Patient History (LOINC 11329-0)

The IPS History of Past Illness section is not profiled in this guide.

Additionally Profiled Resources

This implementation guide profiles the following resources that are not profiled in IPS: