International Patient Summary Implementation Guide
1.0.0 - STU 1

This page is part of the International Patient Summary Implementation Guide (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Artifacts Summary

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

Structures: Resource Profiles

These define constraints on FHIR resources that need to be complied with by conformant implementations

Allergy Intolerance (IPS) 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.
Composition (IPS) 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/DIS 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.
Condition (IPS) 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.
Device (performer, observer) 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.
Device (IPS) 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.
Device Use Statement (IPS) 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.
DiagnosticReport (IPS) This profile constrains the DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary.
Imaging Study (IPS) 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.
Immunization (IPS) 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.
Media observation (Results: laboratory, media) This profile constrains the Media resource (which is a specialized observation).
Medication (IPS) 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.
Medication Statement (IPS) 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.
Observation (SH: alcohol use) This profile constrains the Observation resource to represent alcohol use assessment in a patient summary.
Observation (Pregnancy: EDD) This profile constrains the Observation resource to represent the pregnancy expected delivery date.
Observation (Pregnancy: outcome) This profile constrains the Observation resource to represent the history of pregnancy outcomes (summary).
Observation (Pregnancy: status) This profile constrains the Observation resource to represent the pregnancy status.
Observation Results: laboratory (IPS) 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.
Observation Results: pathology (IPS) This profile constrains the Observation resource to represent results produced by pathology studies in a patient summary.
Observation Results: radiology (IPS) 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.
Observation Results (IPS) 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.
Observation (SH: tobacco use) This profile constrains the Observation resource to represent Tobacco use assessment in a patient summary.
Organization (IPS) 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.
Patient (IPS) 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.
Practitioner (IPS) This profile constrains the practitioner resource to represent a practitioner acting as observer for these imaging results.
PractitionerRole (IPS) This profile constrains the PractitionerRole resource to represent a practitioner acting as observer for observattion results for a specified organization.
Procedure (IPS) 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.
Specimen (IPS) 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.

Structures: Data Type Profiles

These define constraints on FHIR data types that need to be complied with by conformant implementations

Codeable Concept (IPS) 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.
Coding with translations This profile extends the capabilities of the coding data type to support multi-language designations (display). It relies on the Translation extension.
Quantity (IPS) Data type Quantity constrained to use UCUM as the code system for units
Range (IPS) Range constrained to UCUM as the code system for units.
Ratio (IPS) Ratio data type, constrained to use UCUM as the code system for units.
SimpleQuantity (IPS) Data type profile SimpleQuantity constrained to use UCUM as the code system for units

Structures: Extension Definitions

These define constraints on FHIR data types that need to be complied with by conformant implementations

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

Terminology: Value Sets

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

Absent or Unknown Allergies - IPS Absent or Unknown Allergies
Absent or Unknown Devices - IPS Absent or Unknown Devices
Absent or Unknown Immunization - IPS Absent or Unknown Immunization
Absent or Unknown Medication - IPS Absent or Unknown Medication
Absent or Unknown Problems - IPS Absent or Unknown Problems
Absent or Unknown Procedures - IPS Absent or Unknown Procedures
Allergy intolerance substance condition (GPS) - IPS IPS Allergy intolerance substance condition GPS value set. This value set includes the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that are included in: all descendants of 762766007 | Edible substance (substance); all descendants of 406455002 | Allergen class (substance); all descendants of 425620007 | Metal (substance); all descendants of 373873005 | Pharmaceutical / biologic product (product); all descendants of 410942007 |Drug or medicament (substance). The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
Allergy intolerance substance condition - IPS IPS Allergy intolerance substance condition value set. This value set includes codes from SNOMED Clinical Terms®: all descendants of 762766007 | Edible substance (substance); all descendants of 406455002 | Allergen class (substance); all descendants of 425620007 | Metal (substance); all descendants of 373873005 | Pharmaceutical / biologic product (product); all descendants of 410942007 |Drug or medicament (substance)
Allergy Reaction (GPS) - IPS IPS Allergy reaction GPS value set. This value set includes a set of codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that may be used to represent allergy or intolerance reactions. The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
Problem Severity - IPS Problem Severity
CORE Problem List Finding/Situation/Event (GPS) - IPS This value set is a special subset for the International Patient Summary of the concepts in the CORE Problem List Subset of SNOMED CT® which are also contained in the SNOMED CT Global Patient Set (GPS). This value set includes the concepts which are in the Clinical finding, Situation with explicit context and Event hierarchies, but excludes the concepts from the Procedure hierarchy, as they are expected to be represented separately in the History of Procedures Section. The CORE Problem List Subset includes SNOMED CT concepts that can be used for the problem list, discharge diagnoses, or reason for encounter. The concepts currently included in the value set are the set contained in both the November 2019 release of the CORE Problem List Subset and the September 2019 release of the GPS, both of which are based on the July 2019 SNOMED CT International Edition release. The value set additionally contains three recently added SNOMED CT concepts for Coronavirus from the March 2020 Interim International Release. The CORE Problem List Subset is updated regularly by the NLM for new SNOMED CT releases. https://www.nlm.nih.gov/research/umls/Snomed/core_subset.html
Current Smoking Status - IPS Value Set based on HL7 Vocab TC and Structured Doc consensus (per CDC submission 7/12/2012 for smoking status term)
Pregnancy Expected Delivery Date Method - IPS IPS Expected Delivery Date Method
Healthcare Professional Roles - IPS IPS Healthcare Professional Roles
Medical Devices - IPS This value set includes codes from SNOMED Clinical Terms®: all descendants of 49062001 | Device (physical object)|.
Medications (example) - IPS This value set provides an example of possible coded concepts representing: * medicinal products * packaged medicinal products * medications based on their generic composition of: * active substance(s) (e.g. IDMP PhPID Active Substance Stratum Level 1) * active substance(s) with strength (e.g. IDMP PhPID Active Substance Stratum Level 2) * active substance(s) with administrable dose form (e.g. IDMP PhPID Active Substance Stratum Level 3) * active substance(s) with strength and administrable dose form (e.g. IDMP PhPID Active Substance Stratum Level 4) Please note that this Value set is not representing any IDMP identifier. It is envisioned that a future version will be based on the IDMP IDs when available for actual use.
Medications (SNOMED CT) - IPS This value set includes codes from SNOMED Clinical Terms®: all descendants of 373873005 |Pharmaceutical / biologic product (product)|.
Medicine Active Substances - IPS 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.
Medicine Doseform - IPS EDQM 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'.
Medicine Route of Administration - IPS EDQM Route of Administration codes. This Value Set includes all the EDQM Standard Terms having: [Concept Status] = ‘Current’ AND [Concept Class] = 'route of administration' AND [Domain] = 'Human and Veterinary'
Personal Relationship - IPS The Value Set is used (optionally) to code the type of contact relationship between a person and the patient.
Pregnancies Summary - IPS IPS Pregnancies Summary
Pregnancy Status - IPS IPS Pregnancy Status
Problem Type - IPS This value set indicates the level of medical judgment used to determine the existence of a problem.
Procedures - IPS This value set includes codes from SNOMED Clinical Terms®: all descendants of 71388002 | Procedure (procedure)|, excluding [all subtypes of 14734007, all subtypes of 59524001, all subtypes of 389067005, all subtypes of 442006003, all subtypes of 225288009, all subtypes of 308335008, all subtypes of 710135002, all subtypes of 389084004].
Results Radiology Measurement Observation (GPS-DICOM) - IPS Extensible value set including SNOMED CT GPS and DICOM concepts for Linear, Area and Volume Measurements
Results Coded Values Laboratory (GPS) - IPS This Value set is defined as the union of: (a) ABO and Rh group [Type] in Blood (2.16.840.1.113883.11.22.51); (b) Presence/Absence Indicators (2.16.840.1.113883.11.22.52) (c) Organisms (2.16.840.1.113883.11.22.49)
Results Coded Values Pathology (GPS) - IPS IPS Pathology observation coded results GPS value set. the codes from the SNOMED International Global Patient Set (GPS) subset of 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)|. The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
Results Laboratory ABO+RH Group (GPS) - IPS ABO and Rh group [Type] in Blood
Results Laboratory Observation - IPS 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}}
Results Laboratory Presence/Absence (GPS) - IPS Presence/Absence value set
Results Organism (GPS) - IPS This is a value set of the SNOMED CT organism concepts contained in the SNOMED CT Global Patient Set (GPS) for use in the Results section observation values. The concepts currently included in the value set are from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release. This value set additionally contains the recently added SNOMED CT concept for the Coronavirus organism from the March 2020 Interim International Release.
Results Pathology Observation - IPS Value Set Definition: LOINC {STATUS in {ACTIVE}, CLASSTYPE in {1}, CLASS in {CYTO, HL7.CYTOGEN, HL7.GENETICS, MOLPATH, MOLPATH.\*, PATH, PATH.\*}}
Results Radiology Observation - IPS Value Set Definition: LOINC {CLASS in {RAD}}
Results Radiology Textual Observations (GPS-DICOM-LOINC) - IPS IPS Results Radiology Textual Observations
Results Specimen Collection Method (GPS) - IPS IPS Specimen Collection Method
Results Specimen Type (GPS) - IPS IPS Specimen Type GPS value set. This value set includes a set of codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that may be used to represent specimen types. The current value set contains concepts from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
SNOMED International Global Patient Set (GPS) SNOMED International Global Patient Set (GPS) value set. The value set includes all of the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT. The current version of the value set contains all concepts (21,782) from the September 2019 release of the GPS (based on the July 2019 SNOMED CT International Edition release) plus seven recently added concepts for Coronavirus (from the March 2020 Interim International Release) (total 21,789 concepts). This value set is provided in this IG as a FHIR ValueSet resource instance for the convenience of implementers.
Target Site - IPS This value set includes codes from SNOMED Clinical Terms®: all descendants of 442083009 | Anatomical or acquired body structure (body structure)|.
Vaccine Target Diseases (GPS) - IPS This value set includes the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT describing Vaccine Target Diseases. The concepts currently included in the value set are from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
Vaccine Target Diseases - IPS This value set includes the codes from SNOMED CT describing Vaccine Target Diseases.
Vaccines (GPS) - IPS This value set includes the codes from the SNOMED International Global Patient Set (GPS) subset of SNOMED CT that are included in: all descendants of 71181003 |Product containing vaccine (product)|. The concepts currently included in the value set are from the September 2019 release of the GPS, which is based on the July 2019 SNOMED CT International Edition release.
Vaccines - IPS This value set provides a list of types of vaccine. It includes codes from SNOMED Clinical Terms®: all descendants of 787859002 |Vaccine product (product)|.
WHO ATC - IPS 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.

Terminology: Code Systems

These define new code systems used by systems conforming with this implementation guide

Absent and Unknown Data - IPS International Patient Summary (IPS) codes for "known absent" and "not known" data.

Terminology: Concept Maps

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

Absence of Information Mappings - IPS to SNOMED CT Absence of Information Mappings - IPS to SNOMED CT
Severity Value Set Mappings - LOINC to FHIR Severity Value Set Mappings - LOINC to FHIR
Severity Value Set Mappings - SNOMED CT to FHIR Severity Value Set Mappings - SNOMED CT to FHIR

Example: Example Instances

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

IPS Bundle example IPS Bundle example
Medication : Simvastatin 40 MG Disintegrating Oral Tablet Medication : Simvastatin 40 MG Disintegrating Oral Tablet
MedicationStatement: on-going Simvastatin treatment MedicationStatement: on-going Simvastatin treatment
Immunization: Vaccin anti diphtérie-coqueluche-tétanos-poliomyélite (Luxembourg) Immunization: Vaccin anti diphtérie-coqueluche-tétanos-poliomyélite (Luxembourg)
AllergyIntolerance: No known allergies AllergyIntolerance: No known allergies
AllergyIntolerance: resolved allergy AllergyIntolerance: resolved allergy
Condition: Acute myocardial infarction of anterior wall Condition: Acute myocardial infarction of anterior wall
Procedure: Surgical procedure Procedure: Surgical procedure
Practitioner example Practitioner example
PractitionerRole: simple example Very Simple PractitionerRole example
Patient: male patient Patient: male patient
Patient: minimal example Patient: minimal example
Patient: female patient Patient: female patient
DeviceUseStatement: No known devices in use DeviceUseStatement: No known devices in use
Device: No known devices in use Device: No known devices in use
Device: device observer example Device: device observer example
Observation: imaging CT Abdomen W contrast IV Observation: imaging CT Abdomen W contrast IV
Observation: imaging CT Abdomen W contrast IV, sub-observations Observation: imaging CT Abdomen W contrast IV,sub-observations
ImagingStudy: referred DICOM study ImagingStudy: referred DICOM study
Organization: example Organization: example
Organization: simple example Very Simple Organization example
Organization: lab example Best Hospital Lab Organization example
Observation: pregnancy edd example Observation: pregnancy edd example
Observation: pregnancy status example Observation: pregnancy status example
Observation: pregnancy outcome example Observation: pregnancy outcome example
Observation: SH tobaccouse example Observation: SH tobaccouse example
Observation: SH alcoholuse example Observation: SH alcoholuse example
Specimen: example Specimen: example
Observation: serum creatinine example Observation: serum creatinine example
Observation: hemoglobin example Observation: hemoglobin example
Observation: estrogen receptor in tissue example Observation: estrogen receptor in tissue example
DiagnosticReport: hemoglobin example DiagnosticReport: hemoglobin example
Media: example Media: example