HL7 Europe Hospital Discharge Report
1.0.0 - trial-use 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0 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

Change Log

This page summarises the main changes applied to this version of the guide.

From 0.1.0-ballot to 1.0.0

🔧 Alignment with the EHDS logical models and HL7 Europe Base

  • Aligned with the Xt-EHR EHDS logical models v1.0.0 (FHIR-51927).
  • Adopted the Xt-EHR Producer and Consumer actors for the obligations (FHIR-51864, FHIR-57650), and fixed the unresolved actor references (FHIR-57700).
  • Updated the dependency to the HL7 Europe Base and Core FHIR IG 2.0.1 (FHIR-59075).
  • Replaced the HDR Medication and MedicationRequest profiles with MedicationEuCore and MedicationRequestEuCore (FHIR-52119).
  • Replaced the HDR AllergyIntolerance, Condition, Flag, Immunization, MedicationStatement and Procedure profiles with the corresponding EU Core profiles.
  • Removed the Consent, FamilyMemberHistory and Observation (imaging finding, infectious contact, SDOH, travel history) profiles, no longer needed after the section changes (FHIR-51923).
  • Removed the eHN logical model and the associated ConceptMaps; the eHN guidelines and logical model pages are replaced by the Logical Models page (FHIR-57649).

📄 Document structure (Bundle and Composition)

  • Bundle.language is required (1..1) and represents the main language of the report; the warning-severity invariant bdl-hdr-2 checks that the languages of the individual resources, if populated, match it (FHIR-51899).
  • Bundle.entry:patient is 1..* (FHIR-51618); Composition.encounter is 1..1 (FHIR-52114).
  • Composition.type: the fixed display was removed (FHIR-52113). Composition.category is an optional element, with the LOINC code to be used for the HDR classification (FHIR-52117).
  • Section descriptions updated (FHIR-52116).
  • The Hospital course section is 0..1 and a new Discharge summary section (LOINC 18842-5) was added; the invariant cmp-hdr-2 requires at least one of the two (FHIR-52414).
  • Added the History of procedures section (FHIR-57684). The Medical devices section now covers patientHistory.devicesAndImplants, and a new section covers courseOfEncounter.medicalDevicesAndImplants (FHIR-57685).
  • Removed the constraints on sub-sections (FHIR-52095); the invariant cmp-hdr-1 ("A section SHALL have text, sub-sections, or both") applies to every section and sub-section.
  • Added notes on determining whether a condition was present on admission (FHIR-52090) and on the timing of observations relative to the admission (FHIR-51634).
  • Removed the sections no longer referenced by the model (FHIR-51923): Infectious contacts, Travel history, Family history, Social history, Substance use (alcohol, tobacco, drugs), Advance directives, Care team, Payers and Past illness history.
  • BundleEuHdr entry slices aligned with the structural and obligation profiles (FHIR-59479): relatedPerson, binary and serviceRequest slices added; the unreachable immunizationRecommendation and familyMemberHistory slices removed.
  • CompositionEuHdr: author and informationRecipient reference DeviceEuHdr; the section entries use the EU Core profiles; the information-recipient slice is renamed informationRecipient, as in the EU Core profiles.
  • Invariants renamed to the <resource>-hdr-<n> pattern: bdl-language-main-match → bdl-hdr-2, text-or-section → cmp-hdr-1, discharge-summary-or-hospital-course → cmp-hdr-2.

🧩 Other profiles

  • EncounterEuHdr: added an Admission diagnosis slice on Encounter.diagnosis (FHIR-57323).
  • CarePlanEuHdr revised, and a simple GoalEuHdr profile added (FHIR-57698); CarePlan.activity.detail is flagged as deprecated in R5/R6, with activity.reference recommended instead. GoalEuHdr.subject is restricted to PatientEuCore.
  • Body site laterality without pre-coordination (FHIR-53428): DeviceUseStatementEuHdr.bodySite carries the R5 backport extension for DeviceUsage.bodySite, constrained to Reference(BodyStructureEuCore), and BundleEuHdr has a bodyStructure entry slice. The invariant dus-hdr-1 mirrors eu-bodysite-1: either a body site code or a reference to a BodyStructure, not both (FHIR-58916).
  • DeviceUseStatementEuHdr and DeviceEuHdr aligned with the corresponding European Patient Summary profiles.
  • All HDR profiles and value sets are FMM 2 / trial-use; profile texts, descriptions and titles harmonised.

📋 Obligations

  • Added obligations for the EHDS Organisation, HealthProfessional, Condition, Observation, Procedure, MedicationUse, DeviceUse, Device, RelatedPerson and LaboratoryObservation models, and updated the references between the obligation profiles (FHIR-57644).
  • The Bundle and Composition obligation profiles are listed as top-level items on the artifacts page (FHIR-57653).
  • Obligation profiles renamed to the <Resource>EuHdrObligation pattern (ids and canonical URLs are unchanged); all are FMM 0 / informative.
  • ObservationEuHdrObligation derives from Observation; the results slice of the Significant results section uses LaboratoryObservationEuHdrObligation.
  • Removed the unused HumanNameEuObligations profile, the obligations on the deprecated CarePlan.activity.detail, and obligation paths on non-existent elements.

🏷️ Terminology

  • Value set ids and descriptions harmonised (FHIR-57680).
  • Removed the temporary code system (FHIR-51921).
  • Removed unused value sets: admission status, allergens, allergy substances, eHDSI condition present on admission and treatment class, exposure agents, selected SDOH value sets, and the document category value set.

🧪 Examples

  • Example titles and descriptions harmonised (FHIR-57680); all are in English and declare the EU Core or HDR profile they conform to.
  • Added the language of the Bundle and of the resources to the examples (FHIR-51899).
  • Added examples for post-coordinated body site laterality: a BodyStructure with a laterality-free structure code and a separate laterality, referenced from a Condition, a Procedure and a DeviceUseStatement (FHIR-53428).
  • Added a Bundle example with sub-sections, referenced from the Composition profile (FHIR-51635).

📚 Narrative pages

  • Home page: removed the "Design approach" paragraph (FHIR-57645) and improved the purpose text (FHIR-57678).
  • Background page updated, including the participant statistics (FHIR-57646).
  • Challenges page updated (FHIR-52091), with a new section on Hospital Discharge Report vs discharge report (FHIR-57647).
  • References page updated (FHIR-57648); authors page updated (FHIR-57652).
  • Implementation menu and Model Map Overview page revised (FHIR-57651); description columns removed from the model map tables (FHIR-57693).
  • Typos fixed (FHIR-52170, FHIR-52171).
  • Removed ballot and preview wording; links point to HL7 Europe Base 2.0.1, the Xt-EHR models 1.0.0 and the adopted EHDS Regulation (EU) 2025/327; editorial improvements and British spelling across the pages.