HL7 Europe Hospital Discharge Report
0.1.0-ballot - draft 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Hospital Discharge Report

Hospital Discharge Report entry profiles.

Bundle (HDR)

Clinical document used to represent a Hospital Discharge Report for the scope of this guide.

Composition (HDR)

Clinical document used to represent a Hospital Discharge Report (HDR) for the scope of this guide.

eHN Hospital Discharge Report Guidelines (Informative)

Logical models representing the eHN Hospital Discharge Report Guidelines. This is informative material.

A - Hospital Discharge Report (eHN)

Hospital Discharge Report

A.1 - Hospital Discharge Report header data element

Hospital Discharge Report - Hospital Discharge Report header data element - A.1 eHN

A.1.1 - Identification and A.1.2 - related contact information of the Patient/subject

Hospital Discharge Report - Hospital Discharge Report subject data element - A.1.1 and A.1.2 eHN

A.2.1 - Advance Directives (eHN)

Hospital Discharge Report - Advance Directives - A.2.1 eHN

A.2.2 - Alerts (eHN)

Hospital Discharge Report - Alerts - A.2.2 eHN

A.2.3 - Encounter (eHN)

Hospital Discharge Report - Encounter - A.2.3 eHN

A.2.4 - Admission evaluation (eHN)

Hospital Discharge Report - Admission evaluation - A.2.4 eHN

A.2.5 - Patient history (eHN)

Hospital Discharge Report - Patient history - A.2.5 eHN

A.2.6 - Hospital stay (eHN)

Hospital Discharge Report - Hospital stay - A.2.6 eHN

A.2.7 - Discharge details (eHN)

Hospital Discharge Report - Discharge details - A.2.7 eHN

A.2.7.1 - Objective findings

Hospital Discharge Report - Objective Findings- A.2.7.1 eHN

A.2.7.2 - Functional status

Hospital Discharge Report - Functional status - A.2.7.2 eHN

A.2.8.1 - Care plan

Hospital Discharge Report - Care plan after discharge - A.2.8.1 eHN

A.2.8.2 - Medication summary

Hospital Discharge Report - Medication Summary after discharge - A.2.8.2 eHN

eHN Logical Model mappings (Informative)

Concept Maps describing how the data set specified by the eHN Laboratory Guidelines is supposed to be implemented by using this guide. Informative for this version of the guide.

eHN Advance Directives Model to this guide Map

eHN HDR Advance Directives Model to this guide mapping

eHN Alerts Model to this guide Map

eHN HDR Alerts Model to this guide mapping

eHN Encounter Model to this guide Map

eHN HDR Encounter Model to this guide mapping

eHN HDR Model to this guide Map

eHN Hospital Discharge Report Model to this guide mapping

eHN Header Model to this guide Map

eHN HDR Header Model to this guide mapping

eHN Medication Summary Model to this guide Map

eHN HDR Medication Summary Model to this guide Map

eHN Plan of Care Model to this guide Map

eHN HDR Plan of Care Model to this guide Map

eHN Subject Model to this guide Map

eHN HDR Subject Model to this guide mapping

Actors and Obligations (Informative)

Actors and Obligations used to describe the Hospital Discharge Report functional requirements for the specified data elements. Informative for this version of the guide.

Allergy Intolerance: obligations

This profile defines obligations for the AllergyIntolerance resource for the purpose of this project.

Bundle: obligations

This profile defines obligations for the Hospital Discharge Report for the scope of this guide.

Care Plan: obligations

This profile defines obligations for the CarePlan resource for the purpose of this guide.

Composition: obligations

This profile defines obligations for a Hospital Discharge Report (HDR) for the scope of this guide.

Condition: obligations

This profile defines obligations for the Condition in the scope of this guide. It support the Diagnostic summary part of the eHN data model adding two additional categories: First category distingueshes conditions present at admission and acquired during hospital stay, while second category is used to indicate impact of the condition to the treatement during hospital stay (treated, untreated).

Consent: obligations

This profile defines obligations for the Consent resource for the purpose representing Advance Directives for the scope of this guide.

Device: obligations

This profile represents the constraints applied to the Device resource for the purpose of this guide. A device used by or implanted on the patient is described in the hospital discharge report as an instance of a Device resource constrained by this profile.

DeviceUseStatement: obligations

This profile represents the constraints applied to the DeviceUseStatement resource for the purpose of this guide. A device used by or implanted on the patient is described in the hospital discharge report as an instance of a Device resource constrained by this profile.

Encounter: obligations

This profile defines obligations for Inpatient Encounter in HL7 FHIR for the scope of this guide.

FamilyMemberHistory: obligations

This profile represents the constraints applied to the FamilyMemberHistory resource by this guide.

Flag: obligations

This profile defines obligations for the Flag resource to represent alerts or warnings in FHIR for the purpose of this project.

HDR Consumer

Hospital Discharge Report Report Consumer: a system receiving/querying and using a Hospital Discharge Report.

HDR Creator

Hospital Discharge Report Creator: a system generating and sending/providing a Hospital Discharge Report to a Consumer or to a Repository for report storage and sharing.

HDR Repository

Hospital Discharge Report Report Repository: a system maintaining a copy of the received Hospital Discharge Report, to store and make it available for the consumers.

Human Name: obligations

This profile defines obligations for an human Patient name in FHIR for the purpose of this guide.

Immunization: obligations

This profile defines obligations for the Immunization resource for the purpose of this guide.

ImmunizationRecommendation: obligations

This profile defines how to represent Immunization Recommandations for the purpose of this guide.

Medication: obligations

This profile defines obligations for the Medication resource for the purpose of this guide, adapted from the MPD work.

MedicationAdministration: obligations

This profile defines obligations for the MedicationAdministration resource for the purpose of this guide, adapted from the MPD work.

MedicationDispense: obligations

This profile defines obligations for the MedicationDispense resource for the purpose of this guide, adapted from the MPD work.

MedicationRequest: obligations

This profile defines obligations for the MedicationRequest resource for the purpose of this guide, adapted from the MPD work.

MedicationStatement: obligations

This profile defines obligations for the MedicationStatement resource for the purpose of this guide, adapted from the MPD work.

Observation: country visited: obligations

This profile sets minimum expectations for the Observation resource to record, search, and fetch travel history.

Observation: Infectious Contact: obligations

This profile defines obligations for the Infectious Contact profile.

Observation: SDOH: obligations

Profile for Social Determinants of Health (SDOH) observations that involve assessment (e.g., by a provider, payer, etc.) as opposed to being derived only from screening surveys (as is the case for the SDOHCC Screening Response Observation).

Patient: obligations

This profile defines obligations for an human Patient in FHIR for the purpose of this guide.

Procedure: obligations

This profile defines obligations for the Procedure resource by this guide.

Specimen: obligations

This profile defines obligations for Specimen in FHIR for the purpose of this guide.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Allergy Intolerance (HDR)

This profile constrains the AllergyIntolerance resource for the purpose of this project.

Care Plan (HDR)

This profile constrains the CarePlan resource for the purpose of this guide.

Condition (HDR)

This profile represents the constraint applied to the Condition in the scope of this guide. It support the Diagnostic summary part of the eHN data model adding two additional categories: First category distingueshes conditions present at admission and acquired during hospital stay, while second category is used to indicate impact of the condition to the treatement during hospital stay (treated, untreated).

Consent (Advance Directives HDR)

This profile constrains the Consent resource for the purpose representing Advance Directives for the scope of this guide.

Device (HDR)

This profile represents the constraints applied to the Device resource for the purpose of this guide. A device used by or implanted on the patient is described in the hospital discharge report as an instance of a Device resource constrained by this profile.

DeviceUseStatement (HDR)

This profile represents the constraints applied to the DeviceUseStatement resource for the purpose of this guide. A device used by or implanted on the patient is described in the hospital discharge report as an instance of a Device resource constrained by this profile.

Encounter (HDR)

This profile defines how to represent Inpatient Encounter in HL7 FHIR for the scope of this guide.

FamilyMemberHistory (HDR)

This profile represents the constraints applied to the FamilyMemberHistory resource by this guide.

Flag (HDR)

This profile constrains the Flag resource to represent alerts or warnings in FHIR for the purpose of this project.

Immunization (HDR)

This profile constrains the Immunization resource for the purpose of this guide.

ImmunizationRecommendation (HDR)

This profile defines how to represent Immunization Recommandations for the purpose of this guide.

Medication (HDR)

This profile constrains the Medication resource for the purpose of this guide, adapted from the MPD work.

MedicationAdministration (HDR)

This profile constrains the MedicationAdministration resource for the purpose of this guide, adapted from the MPD work.

MedicationDispense (HDR)

This profile constrains the MedicationDispense resource for the purpose of this guide, adapted from the MPD work.

MedicationRequest (HDR)

This profile constrains the MedicationRequest resource for the purpose of this guide, adapted from the MPD work.

MedicationStatement (HDR)

This profile constrains the MedicationStatement resource for the purpose of this guide, adapted from the MPD work.

Observation: Imaging Finding (HDR)

This profile constrains the Observation resource to represent a finding during imaging procedure for the purpose of this guide, adapted from the Imaging Study Report work.

Observation: Infectious Contact (HDR)

This profile constrains the Observation resource to represent an infectious contact as potential patient exposure to an agent (exposure source).

Observation: SDOH (HDR)

Profile for Social Determinants of Health (SDOH) observations that involve assessment (e.g., by a provider, payer, etc.) as opposed to being derived only from screening surveys (as is the case for the SDOHCC Screening Response Observation).

Observation: country visited (HDR)

This profile sets minimum expectations for the Observation resource to record, search, and fetch travel history.

Procedure (HDR)

This profile represents the constraints applied to the Procedure resource by this guide.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Immunization AdministeredProduct

This extension references the Medication administered during the vaccination. It simulates the beahviour of the reference part of the administeredProduct R5 element

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Admission Urgency Value Set

Hospital Discharge Report Admission Urgency value set includes selected codes from HL7 v3-ActPriority code system.

Allergens Value Set

List of substances that can cause an allergic reactions or an Intolerance. This Values Set is a composition of the eHDSI Value Set:

  • eHDSIAllergenNoDrug
  • eHDSIActiveIngredient
  • eHDSISubstance
Allergy Intolerance

Allergy intolerance substances value set. This value set includes codes from SNOMED Clinical Terms®: all descendants of 373873005 |Pharmaceutical / biologic product (product)|; all descendants of 105590001 |Substance (substance)|; all descendants of 418038007 |Propensity to adverse reactions to substance (finding)|

Allergy Intolerance (with exceptions)

Allergy intolerance codes value set. This value set includes codes from SNOMED Clinical Terms®: all descendants of 373873005 |Pharmaceutical / biologic product (product)|; all descendants of 105590001 |Substance (substance)|; all descendants of 418038007 |Propensity to adverse reactions to substance (finding)| plus codes for absent and unknown allergies.

Condition Value Set

Hospital Discharge Report Condition value set includes selected codes from recommended EU code systems for health conditions (WHO-ICD-10, SNOMED CT and Orphacodes).

Encounter Class Value Set

Hospital Discharge Report Encounter Class specifies a general class of inpatient encounter as being accute, nonaccute, emergency, short stay …

Encounter Voluntary Status Value Set

Value set of voluntary nature of the encounter.

Exposure of transmissible agents

HDR exposure agent value set. This value set includes codes from SNOMED Clinical Terms®: all descendants of 40733004 "Infectious disease (disorder)" and ICD-10 all descendants of chapter I: "Certain infectious and parasitic diseases"

In-patient Encounter Status Value Set

Hospital Discharge Report Encounter Type allows to classify encounter using general type of care provision regimen during the inpatient encounter. Value set includes concepts from the SNOMED CT descendants of 225351009 (Care provision regime) but needs to be further dicsussed

In-patient Encounter Type Value Set

Hospital Discharge Report Encounter Type allows to classify encounter using general type of care provision regimen during the inpatient encounter. Value set includes concepts from the SNOMED CT descendants of 225351009 (Care provision regime) but needs to be further dicsussed

Medical Devices (SNOMED CT)

This value set includes codes from SNOMED Clinical Terms®: all descendants of 49062001 |Device (physical object)|.

Medical Devices - SNOMED CT + Absent/Unknown - IPS

This value set includes codes from SNOMED Clinical Terms (SNOMED CT®) that are included in: all descendants of 49062001 |Device (physical object)|, plus IPS codes for absent/unknown devices.

Procedure codes: Snomed CT

This value set includes codes from SNOMED Clinical Terms®: descendants of 71388002 |Procedure (procedure)|, excluding [all subtypes of 14734007 |Administrative procedure (procedure)|, all subtypes of 59524001 |Blood bank procedure (procedure)|, all subtypes of 389067005 |Community health procedure (procedure)|, all subtypes of 442006003 |Determination of information related to transfusion (procedure)|, all subtypes of 225288009 |Environmental care procedure (procedure)|, all subtypes of 308335008 |Patient encounter procedure (procedure)|, all subtypes of 710135002 |Promotion (procedure)|, all subtypes of 389084004 |Staff related procedure (procedure)|].

Procedures - SNOMED CT + Absent/Unknown - IPS

This value set includes codes from SNOMED Clinical Terms®: descendants of 71388002 |Procedure (procedure)|, excluding [all subtypes of 14734007 |Administrative procedure (procedure)|, all subtypes of 59524001 |Blood bank procedure (procedure)|, all subtypes of 389067005 |Community health procedure (procedure)|, all subtypes of 442006003 |Determination of information related to transfusion (procedure)|, all subtypes of 225288009 |Environmental care procedure (procedure)|, all subtypes of 308335008 |Patient encounter procedure (procedure)|, all subtypes of 710135002 |Promotion (procedure)|, all subtypes of 389084004 |Staff related procedure (procedure)|], plus IPS codes for absent/unknown procedures.

SDOH Observation codes

This value set contains all of LOINC and SNOMED CT.

eHDSI Condition Present On Admission

The Value Set is used to assert if a condition is Present on Admission

eHDSI Treatment Class

The Value set is used to encode category of treatment of the condition during encounter

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Temporary HDR Code System

This is a temporary code system defined to collect concepts expected required by this project, but for which international coded concepts have not been identified yet.

Terminology: Concept Maps

These define transformations to convert between codes by systems conforming with this implementation guide.

eHN Admission Evaluation Model to this guide Map

eHN HDR Admission Evaluation Model to this guide Map

eHN Functional Status Model to this guide Map

eHN HDR Functional Status Model to this guide Map

eHN Hospital Stay Model to this guide Map

eHN HDR Hospital Stay Model to this guide Map

eHN Objective Findings Model to this guide Map

eHN HDR Objective Findings Model to this guide Map

eHN Patient History Model to this guide Map

eHN HDR Hospital Stay Model to this guide Map

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

AllergyIntolerance: Critical Allergy to Penicillin

A high-priority allergy to Penicillin, with a specific reaction and severity.

Bundle: complete HL7 Europe Hospital Discharge Report (1)

HL7 FHIR Bundle example for HL7 Europe Hospital Discharge Report (HDR) Luigi De Luca

Bundle: complete HL7 Europe Hospital Discharge Report (2)

HL7 FHIR Bundle example for HL7 Europe Hospital Discharge Report (HDR) Reijer Wolff

Bundle: complete HL7 Europe Hospital Discharge Report (3)

HL7 FHIR Bundle example for HL7 Europe Hospital Discharge Report (HDR) Paolo Marcheschi

Bundle: complete HL7 Europe Hospital Discharge Report (4)

HL7 FHIR Bundle example for HL7 Europe Hospital Discharge Report (HDR) Fiona Swart

CarePlan: Diabetes Management Care Plan

Care plan for diabetes including referrals and HbA1c measurement.

Composition: HDR (1)

HL7 FHIR Composition example for HL7 Europe Hospital Discharge Report (HDR) Luigi De Luca

Condition: Type 2 Diabetes Mellitus

Condition for Type 2 Diabetes Mellitus, double coding with ICD-10 and SNOMED CT.

Consent: Advance Directive DNR

A Consent resource representing a Living Will with Do Not Resuscitate directive.

Device: Implantable Pacemaker

A sample Device resource for an implantable pacemaker, referenced in a DeviceUseStatement.

DeviceUseStatement: Implanted Pacemaker

A DeviceUseStatement documenting the use of an implanted pacemaker in the hospital discharge report.

Encounter: Hospital Admission and Discharge

A sample Encounter resource for a hospital admission and discharge.

FamilyMemberHistory: Family History of Type 2 Diabetes Mellitus - Mother

Mother has a history of type 2 diabetes mellitus.

Flag: Critical Allergy to Penicillin

A high-priority allergy alert referencing the specific AllergyIntolerance resource.

Flag: Do Not Use Left Arm

A clinical flag advising care teams to avoid using the patient's left arm for procedures.

Immunization: COVID-19

An example record of an administered COVID-19 vaccine dose.

ImmunizationRecommendation: COVID-19

A recommendation for COVID-19 vaccination.

Medication: 01A-Cefuroxime1500GenericExplicit

1A. Cefuroxime 1500mg (1.5g) powder for solution in a vial. Generic product, defined by attributes.

Medication: 01C-Cefuroxime1500Branded

1C. Cefuroxime 1500mg (1.5g) powder for solution in a vial (10 vials per package). Branded packaged product, defined by attributes.

MedicationAdministration: Paracetamol

A sample MedicationAdministration resource for Paracetamol.

MedicationDispense: 400D-dispense-1

400D-1. Medication dispense fulfilling the first part of the order: 1 package containing 10 vials

MedicationRequest: 400C-prescription-cefuroxime-singleline

400C. A prescription/request with one medication and changing dosaging. Uses 'actionable' tag. Cefuroxime sodium.

MedicationStatement: Enalapril

A sample MedicationStatement for a patient taking Enalapril, used in the context of the European Hospital Discharge Report.

Observation: ABO group

ABO blood group type in blood.

Observation: Body weight

Vital Signs observation representng the Body weight of the patient.

Observation: Imaging Finding

An imaging finding from a CT scan of the chest identifying a solitary pulmonary nodule.

Observation: Infectious Contact: COVID-19 Exposure

Example of an infectious contact observation representing a patient's known exposure to a COVID-19 case.

Observation: SDOH Transportation Insecurity

An observation documenting the patient's lack of reliable transportation to attend medical appointments.

Observation: Travel History

An observation recording that Fiona Swart visited Italy in November 2023.

Organization: Erasmus MC

Organization representing the Erasmus MC, Sophia kinderziekenhuis.

Patient: Dutch Patient

Patine reosurce representing Fiona Swart, a Dutch patient.

Procedure: Sectio caesarea

A planned cesarean section procedure.