CH Core (R4)
1.1.0 - CI build

CH Core (R4), published by HL7 Switzerland. This is not an authorized publication; it is the continuous build for version 1.1.0). This version is based on the current content of and changes regularly. See the Directory of published versions



This implementation guide is provided to support the use of FHIR®© in a Swiss context, realm.

This document is a working specification that is expected to be implemented and tested by FHIR®© system producers to enable feedback to improve the content of this guide. With this first Standard for Trial Use ballot version we are looking for feedback if the following goals are met:

Note: This implementation guide is not (yet) a FHIR API specification, this will be a goal for the next iteration.

Download: You can download this implementation guide in npm format from here.

Relation to the Swiss EPR

The Annexes in the Swiss Electronic Patient Record specify the technical and semantical requirements.

Metadata (Annex 3 and Annex 9)

In Annex 3 and 9 metadata in the context of the EPR is defined. The metadata in these Annexes is defined by the Ministry of Health, eHealth Suisse maintains the ValueSets with additional provided translations in ART-DECOR in the ch-epr project. All CodeSystems and ValueSets from this project are exported to the CH-EPR-TERM FHIR implementation guide. This implementation guide is dependent on CH-EPR-TERM.

Exchange formats (Annex 4)

In Annex 4 exchange formats will be listed. There are currently three CDA specifications exchange formats defined in the draft of Annex 4. Those three CDA specifications are based on CDA-CH V2. With FHIR, exchange formats in documents can also be defined. CH-Core defines the equivalent concepts to CDA-CH V2 so that in the future derived exchange formats can be represented and mapped between FHIR and CDA:

XDS (Annex 5, Amendment 1)

Annex 5 has requirements on IHE XDS. The CH Core DocumentReference Profile EPR defines a mapping to the XDS Metadata used in the EPR. Please note that the IHE MHD profile which includes the DocumentReference resource is not yet specified in the Annexes.

CH:ATC Profile (Annex 5, Amendment 2.2)

CH:ATC profile defines the audit trail consumption requirements a community has to provide for a patient’s audit trail. CH:ATC is also a FHIR implementation guide, based on FHIR STU3. There is no relation to this implementation guide currently.


This document presents Swiss use concepts defined via FHIR processable artefacts:

  • Profiles - are useful constraints of core FHIR resources and datatype for Swiss use
  • Extensions - are FHIR extensions that are added for local use, covering needed Swiss concepts
  • Terminologies - are defined or referenced code systems and value sets for Swiss context


The CH-Core implementation guide is managed by HL7 Switzerland in the HL7 Switzerland FHIR technical committee, see also source.


This guide is the product of collaborative work undertaken with participants from: