This page is part of the CH Core (R4) (v4.0.0-ballot: STU Ballot 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Official URL: http://fhir.ch/ig/ch-core/ImplementationGuide/ch.fhir.ig.ch-core				Version: 4.0.0-ballot
Active as of 2023-06-27				Computable Name: CH_Core
Copyright/Legal: CC0-1.0

Introduction

This implementation guide is provided to support the use of FHIR^®© in Switzerland.

This guide is a working specification. We anticipate that it will be implemented and tested by FHIR system producers whose feedback will help improve its content. With this standard for trial use, we are looking for feedback on whether the following goals have been met:

• The guide provides guidance on essential resources for identifiers, code systems, value sets and naming systems in Switzerland, specifically in relation to the Swiss Electronic Patient Record (EPR).
• The guide defines extensions that are necessary for local use in Switzerland.
• The guide covers the requirements for eCH-0010 postal address (V7.0), eCH-0046 contact (V5.0) and eCH-0011 personal data (V8.1) (including eCH-0007 municipality (V6.0) and eCH-0021 additional personal data (V7.0)).
• The guide incorporates Federal Statistics Office (BFS) variables for medical statistics. See BFS (available in German, French and Italian).

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 to the Swiss Electronic Patient Record (EPR) law specify the technical and semantic requirements for interoperability.

Metadata (Annex 3 and Annex 9)

Metadata relating to the Swiss EPR is defined in Annexes 3 and 9 by the Ministry of Health. eHealth Suisse maintains the value sets with additional provided translations in ART-DECOR in the CH-EPR project. All code systems and value sets from the CH-EPR project are exported to the FHIR implementation guide CH EPR Term, which forms the basis for CH Core.

Exchange formats (Annex 4)

Exchange formats for the Swiss EPR are defined in Annex 4. Exchange formats can be represented as FHIR documents.

• CH Core Document Profile EPR: the base definition for a structured document in the Swiss EPR.
• CH Core Composition Profile EPR: the base definition for a composition, providing the basic structure of the FHIR document.

XDS (Annex 5, Amendment 1)

Requirements for IHE XDS are given in Annex 5. The CH Core DocumentReference Profile EPR defines how metadata used in the EPR is to be mapped to XDS Metadata. Please note that the IHE MHD profile, which includes the document reference resource, is not yet specified in the Annexes, a draft implementation guide is CH EPR mHealth.

CH:ATC Profile (Annex 5, Amendment 2.2)

The CH ATC profile defines the requirements for a patient’s audit trail. CH ATC is a FHIR implementation guide based on FHIR STU3 and R4. There is currently no relationship between CH ATC and CH Core.

Scope

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

• Profiles - useful constraints of essential FHIR resources and data types for Swiss use.
• Extensions - FHIR extensions that are added for local use, covering necessary Swiss concepts.
• Terminologies - defined or referenced code systems and value sets for Switzerland.

Governance

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

Collaboration

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

• Swiss FHIR Implementers Community
• HL7 Switzerland
• eHealth Suisse

Safety Considerations

This implementation guide defines data elements, resources, formats, and methods for exchanging healthcare data between different participants in the healthcare process. As such, clinical safety is a key concern. Additional guidance regarding safety for the specification’s many and various implementations is available at: https://www.hl7.org/FHIR/safety.html.

Although the present specification does gives users the opportunity to observe data protection and data security regulations, its use does not guarantee compliance with these regulations. Effective compliance must be ensured by appropriate measures during implementation projects and in daily operations. The corresponding implementation measures are explained in the standard. In addition, the present specification can only influence compliance with the security regulations in the technical area of standardisation. It cannot influence organisational and contractual matters.

IP Statements

This document is licensed under Creative Commons “No Rights Reserved” (CC0).

HL7®, HEALTH LEVEL SEVEN®, FHIR® and the FHIR ® are trademarks owned by Health Level Seven International, registered with the United States Patent and Trademark Office.

This implementation guide contains and references intellectual property owned by third parties (“Third Party IP”). Acceptance of these License Terms does not grant any rights with respect to Third Party IP. The licensee alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize Third Party IP in connection with the specification or otherwise.

This publication includes IP covered under the following statements.

• CC0-1.0
  Show Usage
  • BFS Medizinische Statistik - 17 1.2.V02 - Aufenthaltsort vor dem Eintritt / Séjour avant l’admission / Luogo di soggiorno prima dell’ammissione: BfsMedstats17Admitsource, CHCoreEncounter, Encounter/EncounterAccidentBroennimann and Encounter/EncounterAmbulantBroennimann
  • BFS Medizinische Statistik - 18 1.2.V03 - Eintrittsart / Mode d’admission / Genere di ricovero: BfsMedstats18Admittype, CHCoreEncounter, Encounter/EncounterAccidentBroennimann and Encounter/EncounterAmbulantBroennimann
  • BFS Medizinische Statistik - 19 1.2.V04 - Einweisende Instanz / Décision d’envoi / Istanza ricoverante: BfsMedstats19Admitrole, BfsMsAdmitRole, Encounter/EncounterAccidentBroennimann and Encounter/EncounterAmbulantBroennimann
  • BFS Medizinische Statistik - 20 1.3.V01 - Behandlungsart / Type de prise en charge / Genere di trattamento: BfsMedstats20Encounterclass
  • BFS Medizinische Statistik - 21 1.3.V02 - Klasse / Classe / Classe: BfsMedstats21Encountertype
  • BFS Medizinische Statistik - 27 1.5.V02 - Entscheid für Austritt / Décision de sortie / Décisione dell’uscita: BfsDischargeDecision, BfsMedstats27Dischargedecision, Encounter/EncounterAccidentBroennimann and Encounter/EncounterAmbulantBroennimann
  • BFS Medizinische Statistik - 28 1.5.V03 - Aufenthalt nach Austritt / Séjour après la sortie / Destinazione dopo l’uscita: BfsDischargeDestination, BfsMedstats28Dischargedestination, Encounter/EncounterAccidentBroennimann and Encounter/EncounterAmbulantBroennimann
  • BFS Medizinische Statistik - 29 1.5.V04 - Behandlung nach Austritt / Prise en charge après la sortie / Trattamento dopo l’uscita: BfsMedstats29Dischargeencounter, CHCoreEncounter, Encounter/EncounterAccidentBroennimann and Encounter/EncounterAmbulantBroennimann
  • eCH-010 Types: ECH0010AddressLineType and ECH10AddressLine
  • eCH-011 Types: CHCorePatient, CHCorePatientEPR... Show 5 more, ECH011FirstName, ECH011Name, ECH11FirstNameDataTypes, ECH11NameDataTypes and Patient/PersonEch011
  • eCH-011 MaritalData Separation: ECH011MaritalDataSeparation, ECH11MaritaldataSeparation and Patient/PersonEch011
  • eCH-011 MaritalStatus: CHCorePatient, ChCoreMaritalStatus... Show 6 more, ECH11MaritalStatus, Patient/ElisabethBroennimannByBFH, Patient/FranzMuster, Patient/ManuelaMuster, Patient/MarvinMuster and Patient/PersonEch011
  • eCH-011 Sex: ECH11Sex
  • eCH-0046 Email Category: Bundle/1-ZuweisungZurRadiologischenDiagnostik-FHIR, ECH46EmailCategory and Patient/MaxMuster
  • eCH-0046 Internet Category: Bundle/1-ZuweisungZurRadiologischenDiagnostik-FHIR, ECH46InternetCategory and Patient/MaxMuster
  • eCH-0046 Phone Category: Bundle/1-ZuweisungZurRadiologischenDiagnostik-FHIR, ECH46PhoneCategory and Patient/MaxMuster
  • ch-ehealth-codesystem-language: CHCoreDocumentReference and CHCoreDocumentReferenceEPR
  • ch-ehealth-codesystem-medreg: CHCorePractitionerRole, CHCorePractitionerRoleEpr and PractitionerRole/HPWengerRole
• Copyright HL7. Licensed under creative commons public domain
  Show Usage
  • identifierType: AHVN13, Bundle/1-ZuweisungZurRadiologischenDiagnostik-FHIR... Show 9 more, Bundle/CdaContainingOriginalRepresentationAsPdfA, CHCoreEncounter, CHCorePatient, CHCorePatientEPR, EPR_SPID, Encounter/EncounterAccidentBroennimann, Encounter/EncounterAmbulantBroennimann, Patient/FranzMuster and Patient/MaxMuster
• ISO Maintains the copyright on the country codes, and controls it's use carefully. For futher details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
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  • ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: AHVN13, AHVN13Identifier... Show 85 more, Accident, Author, BER, BfsDischargeDecision, BfsDischargeDestination, BfsEncounterClassToFhir, BfsMedstats17Admitsource, BfsMedstats17Admittype, BfsMedstats18Admittype, BfsMedstats19Admitrole, BfsMedstats20Encounterclass, BfsMedstats21Encountertype, BfsMedstats27Dischargedecision, BfsMedstats28Dischargedestination, BfsMedstats29Dischargeencounter, BfsMsAdmitRole, CHCoreAddress, CHCoreAddressECH10, CHCoreAddressECH11PlaceOfOrigin, CHCoreAddressEch11PlaceOfBirth, CHCoreComposition, CHCoreCompositionEPR, CHCoreContactPointECH46Email, CHCoreContactPointECH46Internet, CHCoreContactPointECH46Phone, CHCoreCoverage, CHCoreDocument, CHCoreDocumentEPR, CHCoreDocumentReference, CHCoreDocumentReferenceEPR, CHCoreEPRConsent, CHCoreEncounter, CHCoreHumanName, CHCoreLocation, CHCoreOrganization, CHCoreOrganizationEPR, CHCorePatient, CHCorePatientEPR, CHCorePractitioner, CHCorePractitionerEPR, CHCorePractitionerRole, CHCorePractitionerRoleEpr, CH_Core, ChCoreEncounterParticipationType, ChCoreMaritalStatus, ChCorePatientEch11PlaceOfBirth, ChCorePatientEch11PlaceOfOrigin, DocumentEntryConfidentialityCodeToFHIRMapping, ECH0010AddressLineType, ECH007MunicipalityId, ECH011FirstName, ECH011MaritalDataSeparation, ECH011Name, ECH10AddressLine, ECH11CodeSystem, ECH11FirstNameDataTypes, ECH11MaritalStatus, ECH11MaritaldataSeparation, ECH11NameDataTypes, ECH11Sex, ECH11maritalstatus, ECH11sex, ECH46EmailCategory, ECH46EmailCategoryToFHIRMapping, ECH46InternetCategory, ECH46InternetCategoryToFHIRMapping, ECH46PhoneCategory, ECH46PhoneCategoryToFHIRMapping, EPRConfidentialityCode, EPRDataEnterer, EPRInformationRecipient, EPRSPIDIdentifier, EPRTime, EPR_SPID, EncounterSupsectedReadmission, ForumDatenaustauschTariffType, GLN, GLNIdentifier, MaritalStatusECH011ToFHIRMapping, Patient/PersonEch011, Patient/UpiEprTestKrcmarevic, SexECH011ToFHIRMapping, UIDB, VEKAIdentifier and ZSR
• Some content from IHE® Copyright © 2015 IHE International, Inc.
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  • IHE Format Code set for use with Document Sharing: CHCoreDocumentReference and CHCoreDocumentReferenceEPR
• This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyright of the International Health Terminology Standards Development Organisation (IHTSDO). Implementers of these artefacts must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/getsnomed-ct or info@snomed.org.
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  • ch-ehealth-codesystem-format: CHCoreDocumentReference and CHCoreDocumentReferenceEPR
  • ch-ehealth-codesystem-hpd: CHCorePractitionerRole and CHCorePractitionerRoleEpr
• This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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  • LOINC: Bundle/1-ZuweisungZurRadiologischenDiagnostik-FHIR, Bundle/CdaContainingOriginalRepresentationAsPdfA, CHCoreCompositionEPR and Composition/ZuweisungZurRadiologischenDiagnostik
• This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org.
  Show Usage
  • SNOMED Clinical Terms® (SNOMED CT®): Bundle/1-ZuweisungZurRadiologischenDiagnostik-FHIR, Bundle/CdaContainingOriginalRepresentationAsPdfA... Show 13 more, CHCoreCompositionEPR, CHCoreDocumentReference, CHCoreDocumentReferenceEPR, CHCoreOrganization, CHCoreOrganizationEPR, CHCorePractitionerRole, CHCorePractitionerRoleEpr, Composition/ZuweisungZurRadiologischenDiagnostik, DocumentReference/Docu, EPRConfidentialityCode, PractitionerRole/HPWengerRole, RoDiag Radiologieinstitut and Spital Seeblick

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (ch.fhir.ig.ch-core.r4) and R4B (ch.fhir.ig.ch-core.r4b) are available.

Dependency Table

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Package ihe.formatcode.fhir#1.1.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Thu, Feb 24, 2022 16:55-0600-06:00)

Package ch.fhir.ig.ch-epr-term#2.0.9 Implementation guide for the meta data specified in the framework of Annex 3 and 9 of the FDHA Ordinance on the electronic patient record in Switzerland (built Tue, Jun 27, 2023 08:13+0200+02:00)

Globals Table

There are no Global profiles defined