4.0.1 - trial-use Switzerland flag

This page is part of the CH EMED (R4) (v4.0.1: STU 4) based on FHIR (HL7® FHIR® Standard) 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


Official URL: Version: 4.0.1
Active as of 2023-12-28 Computable Name: CH_EMED

Copyright/Legal: CC0-1.0


The CH EMED implementation guide describes the FHIR representation of the documents for the exchange of medication information in the context of the EPR (electronic patient record) in Switzerland. This implementation guide is dependent on CH Core and CH EPR Term, which describe the Swiss specific context, especially related to the Swiss EPR.

Initially this implementation guide was based on the CDA-CH-EMED eMedication ART-DECOR® specification which has been published by eHealth Suisse. CDA-CH-EMED defined the eMedication documents for the information exchange in the context of the EPR in Switzerland. The documents were based on the IHE Pharmacy Technical Framework modelled and specialized in the Building Block Repository CH-PHARM. Base for this modelling was the report from IPAG eMedikation, 7.6.2017 and the work of IPAG/eHealth Suisse.

Due to difficulties in modeling and mapping, the further development of the specifications, especially in the area of dosage, has been difficult. This and the fact that the format CDA-CH-EMED was only little in use, led then to the fact that the CDA format was abandoned and the exchange format on the basis of FHIR was developed further.


The following documents have been defined (and described in more detail on the respective subsections):

The use case (de, fr) illustrates the processes related to medication. In successive steps, situations are depicted in which the various eMedication documents are used. For each step, the structured FHIR examples are provided.

To explain the different focus areas in more detail, there is a guidance section with the following topics:

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


For all elements listed in the minimum data set in the IPAG report the corresponding FHIR elements ‘mustSupport’ flag have been set to true. ‘MustSupport’ flags are currently only defined for the Medication Card document.

Meaning of the Flag MustSupport for this Implementation Guide

The flag mustSupport follows the IHE use of R2 as defined in Appendix Z. It demands that the content creator must support these elements if they are known. If the sending application has data for the element, it is required to populate the element with a non-empty value. If the value is not known, the element may be omitted. A receiving application may ignore the information conveyed by the element. A receiving application shall not raise an error solely due to the presence or absence of the element.

Implication of MustSupport to the Original Representation

The original representation of the Medication Card document document must be embedded as a PDF in PDF/A-1 or PDF/A-2 format. If elements of the minimum data set in the IPAG report are provided in the bundle, they are also required to be represented in the original representation (PDF).


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

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.

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 ( and 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 ihe.formatcode.fhir#1.1.0

Implementation Guide for IHE defined FormatCode vocabulary. (built Thu, Feb 24, 2022 16:55-0600-06:00)


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, Dec 19, 2023 12:36+0100+01:00)


FHIR implementation guide CH Core (built Thu, Dec 28, 2023 08:42+0100+01:00)

Globals Table

There are no Global profiles defined