CH eTOC (R4)
0.1.0 - STU 1 Ballot

This page is part of the CH eTOC (R4) (v0.1.0: STU 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions


This Implementation Guide is under STU ballot by HL7 Switzerland until September 24th, 2021 midnight. Please add your feedback via the ‘Propose a change’-link in the footer on the page where you have comments.


The CH eTransition of Care (CH eTOC) Implementation Guide defines the content of a referral from a GP to the hospital, to a specialist, from one hispital to another etc.

CH eTOC is intended for use in directional communiation as well as for the use in the SWISS EPR.


This Implementation Guide uses FHIR defined resources. For details on HL7 FHIR R4 see

Because the Implementation Guide relies heavily on the FHIR Resources Questionnaire and QuestionnaireResponse, forms are addressed here as Questionnaires.

This Implementation Guide is derived from the Order & Referral by Form (ORF) Implementation Guide CH-ORF which relies on HL7 Structured Data Capture Implementation Guide, see SDC IG and uses the Swiss Core Profiles, see CH Core

Applications claiming for conformance with the CH eTOC Implementation Guide shall:

  • Render (and in case of the Questionnaire filler allow for data entry) all elements of a questionnaire in the user interface (e.g. on screen, in print).
  • For Clinical Information: Grouping of items and the order of items within shall be adequately reproduced according to the Questionnaire.

This Implementation Guide adheres to the FHIR International Patient Summary (IPS) Implementation Guide. Clinical content uses mostly the same resources as th IPS; some minor differences are explained in comments to the resources affected. The resouce definitions are however constrained from FHIR base definitions and Swiss Core definitions and NOT from UVIPS. This decision was made in order to minimize unexpected impact of future changes in IPS and for compatibility with Swiss Core. eToc adds a ServiceReequest resource to the clinical content (according to the IPS) in order to depict the reason for a referral, the requested service and some additional information (e.g. coverage, room preferance etc.). Resources for such purpose are referenced by the ServiceRequest resource. Header information such as sender, receiver etc. are condsidered as Generic Elements (to all sorts of referral, orders etc.) and follow the definition in the ORF Implementation Guide. This IG follows the Swiss eHealth Exchange Format Handbook Part I: Service Requests V 0.13. The Questionnaire resource gives gudiance for the implementaion of the user interface.

As a consequence of this decision, the first version of CH eTOC does not claim to be confromant to IPS.

Actors, transcations and security considerations are covered in the corresponding sections of CH-ORF


Value sets and coding are preliminary and not yet approved by eHealth Suisse.