This section describes the expected capabilities of the IPS Server actor which is responsible for providing responses to the queries submitted for IPS documents. The list of FHIR profiles and operations supported by IPS Servers are defined.

This operation is used to return a patient summary using the IPS profile.

This profile represents the constraints applied to the AllergyIntolerance resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of an allergy or intolerance is represented in the patient summary as an instance of an AllergyIntolerance resource constrained by this profile. It documents the relevant allergies or intolerances (conditions) for a patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.

This profile represents the constraints applied to the Bundle resource by the International Patient Summary (IPS) FHIR Implementation Guide.

Clinical document used to represent the International Patient Summary (IPS) data set. An International Patient Summary (IPS) document is an electronic health record extract containing essential healthcare information about a subject of care. The IPS dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant. As specified in EN 17269 and ISO 27269, it is designed for supporting the use case scenario for ‘unplanned, cross border care’, but it is not limited to it. It is intended to be international, i.e., to provide generic solutions for global application beyond a particular region or country. This profile is based on the ClinicalDocument profile.

This profile represents the constraints applied to the Condition resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of a problem is represented in the patient summary as an instance of the Condition resource constrained by this profile.

This profile represents the constraints applied to the Device resource by the IPS project, which specifies an international patient summary based on the FHIR standard R4.; This profile describes a device that plays the role of observer or performer.

This profile represents the constraints applied to the Device resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A device used by or implanted on the patient is described in the patient summary as an instance of a Device resource constrained by this profile.

This profile represents the constraints applied to the DeviceUseStatement resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A statement about a device used by or implanted on the patient is described in the patient summary as an instance of a DeviceUseStatement resource constrained by this profile.

This profile constrains the DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary.

This profile represents the constraints applied to the ImagingStudy resource by the IPS project, which specifies the information on a DICOM imaging study this imaging result is part of.

This profile represents the constraints applied to the Immunization resource by the International Patient Summary (IPS) FHIR Implementation Guide. A record of an immunization is represented in the patient summary as an instance of an Immunization resource constrained by this profile. It describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party.

This profile constrains the Media resource (which is a specialized observation).

This profile represents the constraints applied to the Medication resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A medication is described in the patient summary as an instance of a Medication resource constrained by this profile.

This profile represents the constraints applied to the MedicationRequest resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A record of a medication request is represented in the patient summary as an instance of a MedicationRequest resource constrained by this profile.

This profile represents the constraints applied to the MedicationStatement resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A record of a medication statement is represented in the patient summary as an instance of a MedicationStatement resource constrained by this profile.

This profile constrains the Observation resource to represent alcohol use assessment in a patient summary.

This profile constrains the Observation resource to represent the pregnancy expected delivery date.

This profile constrains the Observation resource to represent the history of pregnancy outcomes (summary).

This profile constrains the Observation resource to represent the pregnancy status.

This profile constrains the Observation resource to represent results produced by laboratory tests or panels/studies in a patient summary. This observation may represent the result of a simple laboratory test such as hematocrit or it may group the set of results produced by a multi-test study or panel such as a complete blood count, a dynamic function test, a urine specimen study. In the latter case, the observation carries the overall conclusion of the study and or a global interpretation by the producer of the study, in the comment element; and references the atomic results of the study as “has-member” child observations.

This profile constrains the Observation resource to represent results produced by pathology studies in a patient summary.

This profile represents the constraints applied to the Observation resource by the IPS project, which specifies a radiology observation for the international patient summary based on the FHIR standard R4. This observation may represent the conclusions of a diagnostic procedure such a Chest RX, or it may group the set of results produced by that single or multi-modality procedure. In the latter case, the main observation (this one) carries the overall conclusion of the study and/or a global interpretation by the observer of the study as value of this observation; and may references the atomic results of the study as “child observations”. It allows also providing details about the related study using the partOf element referring to an ImagingStudy resource.

This profile constrains the Observation resource to represent various types of results and associated observations in a patient summary. This is the base profile from which the other results profiles are derived.

This profile constrains the Observation resource to represent Tobacco use assessment in a patient summary.

This profile constrains the Organization resource to represent an organization that acts as performer or observer for a result observation (laboratory, pathology or imaging), or as performer for a procedure.

This profile represents the constraints applied to the Patient resource by the International Patient Summary (IPS) FHIR Implementation Guide and describes the minimum expectations for the Patient resource when used in the IPS composition or in one of the referred resources.

This profile constrains the practitioner resource to represent a practitioner acting as observer for these imaging results.

This profile constrains the PractitionerRole resource to represent a practitioner acting as observer for observation results for a specified organization.

This profile represents the constraints applied to the Procedure resource by the IPS project, which specifies an entry of the History of Procedure for the international patient summary based on the FHIR standard R4.

This profile constrains the Specimen resource to represent the characteristics of a biological specimens in the context of laboratory results integrated to a patient summary.

This profile represents the constraint applied to the CodeableConcept data type by the International Patient Summary (IPS) FHIR Implementation Guide to use the Coding-uv-ips data type profile.

This profile extends the capabilities of the coding data type to support multi-language designations (display). It relies on the Translation extension.

Data type Quantity constrained to use UCUM as the code system for units

Range constrained to UCUM as the code system for units.

Ratio data type, constrained to use UCUM as the code system for units.

Data type profile SimpleQuantity constrained to use UCUM as the code system for units

Extension defined by the IPS project to describe the abatement date for allergies

Absent or Unknown Allergies

Absent or Unknown Devices

Absent or Unknown Immunization

Absent or Unknown Medication

Absent or Unknown Problems

Absent or Unknown Procedures

This value set includes the codes for allergy or intolerance findings from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that are included in: 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)|.

IPS Allergy intolerance substance condition 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)|

IPS 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.

IPS allergy reaction value set. This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that may be used to represent allergy or intolerance reactions.

IPS body site value set. This value set includes a set of codes from SNOMED CT that may be used to represent body sites (e.g., for laboratory specimen collection).

Problem Severity. The condition-severity value set from the base Condition resource is now the preferred binding for IPS. This value set of LOINC answer codes is retained as an additional binding for backward compatibility with the prior IPS release.

HL7 LOINC value set for smoking status. Based on the HL7 Vocab and Structured Doc WG (formerly TC) consensus - per US CDC submission 7/12/2012 for smoking status terms.

IPS Expected Delivery Date Method

IPS Healthcare Professional Roles

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.

This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that are included in: descendants of 49062001 |Device (physical object)|.

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

This value set provides an example of possible medication coded concepts. This value set will be removed in a future release and has been replaced with medication-snomed-uv-ips.

This value set includes the codes from SNOMED CT that are included in: descendants of 373873005 |Pharmaceutical / biologic product (product)|, excluding the descendants of 787859002 |Vaccine product (medicinal product)|, plus IPS codes for absent/unknown medications.

This value set includes codes from SNOMED Clinical Terms®: descendants of 373873005 |Pharmaceutical / biologic product (product)| excluding the descendants of 787859002 |Vaccine product (medicinal product)|.

This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that are included in: descendants of 373873005 |Pharmaceutical / biologic product (product)| excluding the descendants of 787859002 |Vaccine product (medicinal product)|.

This value set includes codes from SNOMED Clinical Terms®: all descendants of 410942007 | Drug or medicament (substance)|.
Future implementations should consider ISO 11238 Health informatics – Identification of medicinal products – Data elements and structures for the unique identification and exchange of regulated information on substances.

EDQM (European Directorate for the Quality of Medicines and Healthcare) Dose Form codes. This Value Set includes all the EDQM Standard Terms having:
[Concept Status] = ‘Current’ AND
[Concept Class] IN (‘PDF’, ‘CMT’, ‘CDF’, ‘PFT’) AND
[Domain] = ‘Human and Veterinary’

PDF = ‘Pharmaceutical dose form’; CMT = ‘Combined terms’; CDF = ‘Combined pharmaceutical dose form’; PFT = ‘Patient Friendly’

EDQM (European Directorate for the Quality of Medicines and Healthcare) Route of Administration codes. This Value Set includes all the EDQM Standard Terms having:
[Concept Status] = ‘Current’ AND
[Concept Class] = ‘ROA’ AND
[Domain] = ‘Human and Veterinary’

ROA = ‘Route of administration’

The Value Set is used (optionally) to code the type of contact relationship between a person and the patient. This value set has been deprecated and will be removed in a future release. It has been replaced with PersonalRelationshipRoleType

IPS Pregnancies Summary

IPS Pregnancy Status

This value set indicates the level of medical judgment used to determine the existence of a problem.

This value set provides a category for the condition as a clinical problem for inclusion in the patient summary.

This value set includes codes from SNOMED Clinical Terms®: descendants of 404684003 |Clinical finding (finding) |, descendants of 243796009 |Situation with explicit context (situation)| and descendants of 272379006 |Event (event)| but excludes descendants of 71388002 |Procedure (procedure)|, as they are expected to be represented separately in the History of Procedures Section.

This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that are included in: descendants of 404684003 |Clinical finding (finding) |, descendants of 243796009 |Situation with explicit context (situation)| and descendants of 272379006 |Event (event)|. The descendants of 71388002 |Procedure (procedure)| (which were included in the CORE problem list) are not included, as they are expected to be represented separately in the History of Procedures Section.

This value set includes codes from SNOMED Clinical Terms®: descendants of 404684003 |Clinical finding (finding) |, descendants of 243796009 |Situation with explicit context (situation)| and descendants of 272379006 |Event (event)|. The descendants of 71388002 |Procedure (procedure)| (which were included in the CORE problem list) are not included, as they are expected to be represented separately in the History of Procedures Section.

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.

This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that are included in: descendants of 71388002 |Procedure (procedure)|, but excludes descendants of 14734007 |Administrative procedure (procedure)|, 59524001 |Blood bank procedure (procedure)|, 389067005 |Community health procedure (procedure)|, 442006003 |Determination of information related to transfusion (procedure)|, 225288009 |Environmental care procedure (procedure)|, 308335008 |Patient encounter procedure (procedure)|, 710135002 |Promotion (procedure)|, and 389084004 |Staff related procedure (procedure)|.

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)|].

Extensible value set including SNOMED CT and DICOM concepts for Linear, Area and Volume Measurements

This value set includes the codes for blood group findings from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).

Blood group [Type]

This value set is defined as the union of: (a) Blood group [Type]; (b) Presence/Absence Indicators (2.16.840.1.113883.11.22.52) (c) Microorganisms (2.16.840.1.113883.11.22.49)

This value set includes codes from SNOMED Clinical Terms (SNOMED CT®) that are included in: all descendants of 106253005 |Histologic grading differentiation AND/OR behavior (qualifier value)|, all descendants of 373369003 |Finding of histologic grading differentiation AND/OR behavior (finding)|, all descendants of 399981008 |Neoplasm and/or hamartoma (disorder)|.

Value Set Definition: LOINC {STATUS in {ACTIVE}, CLASSTYPE in {1}, CLASS exclude {CHALSKIN, H&P.HX.LAB, LABORDERS, NR STATS, PATH, PATH.*, MOLPATH, MOLPATH.*, CYTO, HL7.CYTOGEN, HL7.GENETICS}}

This value set includes the codes for microorganisms from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).

This is a value set of the SNOMED CT microorganism concepts for use in the Results section observation values.

Value Set Definition:

LOINC {STATUS in {ACTIVE}, CLASSTYPE in {1}, CLASS in {CYTO, HL7.CYTOGEN, HL7.GENETICS, MOLPATH, MOLPATH.*, PATH, PATH.*}}

This value set includes the codes for presence and absence findings (qualifier values) from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).

Presence/Absence value set

Value Set Definition: LOINC {CLASS in {RAD}}

IPS Results Radiology Textual Observations

IPS Specimen Collection Method

This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that are included in: all descendants of 123038009 |Specimen (specimen)|.

IPS Specimen Type value set. This value set includes a set of codes from SNOMED CT that may be used to represent specimen types.

This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) describing Vaccine Target Diseases.

This value set includes the codes from SNOMED CT describing Vaccine Target Diseases.

This value set includes the codes from SNOMED CT describing Vaccine Target Diseases. To follow a consistent value set naming pattern, this value set has been deprecated and will be removed in a future release. It has been replaced with target-diseases-uv-ips

This value set includes the codes from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) that are included in: all descendants of 71181003 |Product containing vaccine (product)|.

This value set provides a list of types of vaccine, plus IPS codes for absent/unknown immunizations. It includes codes from SNOMED Clinical Terms®: all descendants of 787859002 |Vaccine product (product)|.

World Health Organization Anatomical Therapeutic Chemical (ATC) classification system. Note: The currently implemented code system and the value set expansion contain only a set of example ATC codes, not the complete code system content.

World Health Organization Anatomical Therapeutic Chemical (ATC) classification system. Note: The currently implemented code system and the value set expansion contain only a set of example ATC codes, not the complete code system content.

International Patient Summary (IPS) codes for “known absent” and “not known” data.

Absence of Information Mappings - IPS to SNOMED CT

Pregnancy Status: LOINC Answers to SNOMED CT concepts. This is an informative map and may be subject to future change.

Smoking Status: LOINC Answers to SNOMED CT concepts. Note that concepts in this map include SNOMED concepts from US Edition. This is an informative map and may be subject to future change.

Severity Value Set Mappings - SNOMED CT to FHIR

IPS Bundle example

IPS Bundle example with Immunization section

IPS Bundle example - no information in required sections

IPS Bundle example - minimal

IPS Composition example - minimal

Medication : Simvastatin 40 MG Disintegrating Oral Tablet

MedicationStatement: on-going Simvastatin treatment

MedicationRequest: Simvastatin request

Immunization: Vaccin anti diphtérie-coqueluche-tétanos-poliomyélite (Luxembourg)

AllergyIntolerance: No known allergies

AllergyIntolerance: resolved allergy

AllergyIntolerance: multiple codings

Condition: Acute myocardial infarction of anterior wall

Procedure: Surgical procedure

Practitioner example

Very Simple PractitionerRole example

Patient: male patient

Patient: minimal example

Patient: female patient

DeviceUseStatement: No known devices in use

Device: No known devices in use

Device: device observer example

Observation: imaging CT Abdomen W contrast IV

Observation: imaging CT Abdomen W contrast IV,sub-observations

ImagingStudy: referred DICOM study

Organization: example

Very Simple Organization example

Best Hospital Lab Organization example

Observation: pregnancy edd example

Observation: pregnancy status example

Observation: pregnancy outcome example

Observation: SH tobacco use example

Observation: SH alcohol use example

Specimen: example

Observation: serum creatinine example

Observation: hemoglobin example

Observation: urine wbc range example

Observation: estrogen receptor in tissue example

DiagnosticReport: hemoglobin example

Media: example