CH Core (R4)
7.0.0-ballot - ballot Switzerland flag

This page is part of the CH Core (R4) (v7.0.0-ballot: STU 7 Ballot) 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

Changelog

All significant changes to this FHIR implementation guide will be documented on this page.

STU 7 Ballot (2026-06-10)

Added

  • #432:
    • Added the new extension ChEplRegulatedAuthorizationLimitationIndicationCode to convey the FOPH indication code for medicinal products subject to a price model. This new extension can be used at the ChargeItem, Immunization, ImmunizationRecommendation.recommendation, MedicationAdministration, MedicationRequest, MedicationDispense and MedicationStatement levels.
    • New examples for a medication request, a medication dispense and a medication statement using this extension have been added as well.
  • #291 Consent Profile for GeneralKonsent derived from new Consent Profile based on R5

Changed

  • #430: CH Core Immunization - ValueSet: CH VACD Swissmedic Authorized Immunsera Codes
  • #425: CH Core Immunization - add binding to NUVA CodeSystem for vaccineCode
  • Update dependency hl7.terminology.r4 from 7.0.1 to 7.1.0
  • Update dependency hl7.fhir.uv.extensions.r4 from 5.3.0-ballot-tc1 to 5.3.0
  • Add dependency hl7.fhir.uv.xver 0.1.0
  • Add dependency hl7.fhir.uv.xver-r5.r4 0.1.0

STU 6 (2025-12-16)

Added

  • #394: Guidance - Usage of Swiss Core Artifacts
  • #422: Add extensible binding to BFS country codes ValueSet for Address.country

Changed / Updated

  • #416: Relax HumanName rule for EPR Patient and Practitioner (require only family name, not given name)
  • #359: Updated ICD-10-GM CodeSystem URL from dimdi to bfarm (http://fhir.de/CodeSystem/bfarm/icd-10-gm)
  • #379: Allow multiple legal authenticators
  • #382: Allow multiple preferred languages by removing communication slicing constraint
  • #380: Add note to originalRepresentation section that approach may change in future version to align with European or universal approaches
  • #369: Updated scope note on index page (replaced outdated API specification note with links to CH EPR FHIR and IPA)
  • #370: Clarified CHCoreEPRConsent description (used in external systems to track EPR status, not for managing consent within EPR)
  • #377: Deprecate ch-ext-epr-dataenterer and ch-ext-epr-time extensions (CDA origin; will be removed in future version); remove usage from examples
  • #400: Deprecate ch-ext-epr-informationrecipient extension (CDA origin; will be removed in future version)
  • #339: Fix Immunization immunoglobulin valueset url
  • #316: Guidance - Narrative data idref invalid
  • #358: Entry Resource Cross References: Graphic added

Fixed

  • #398: Remove Coverage.class.type binding override (invalid to rebind extensible ValueSet to different extensible ValueSet)
  • #373: Require value[x] for simple extensions
  • #372: Update identifier validation constraints to align with eCH-0108 standard (BER, UIDB regex patterns made more restrictive; AHVN13, VEKA, EPR-SPID constraints consolidated into single regex patterns)
  • #381: Name extension binding strength changed from extensible to required (code data type cannot have extensible bindings)
  • #354/#368/#388: Replace deprecated extension iso21090-SC-coding with iso21090-codedString
  • #356: Invalid xhtml for UPI EPR Test Krcmarevic
  • #364: Add missing extension context for ch-ext-author
  • #363: Invalid extension context
  • #398: Fixed BFS Variable Encounter Type (Liegeklasse) which before was part of Coverage but has nothing to do with coverage, but where (in which class, german Leigeklasse) the patient was treated

Issues resolved without amendment (in IG)

  • #384: Keep ch-ext-author extension (needed for summary documents in vaccination and exchange formats; Provenance cannot directly solve it; the extension will likely not be needed anymore in R6)
  • #378: Keep confidentialityCode extension (required by Swiss EPR regulations Annex 4 EPDV-EDI; in R6 confidentialityCode may be moved to Bundle.meta.security)
  • #371: QA deprecation warnings from base FHIR spec (regex, maxValueSet extensions inherited from dependencies; added to ignoreWarnings.txt)
  • #360: CH Core Composition EPR: VS binding (Composition.category)
  • #308, #389: Keep the slicing discriminator $this for Organization.identifier to differentiate GLN's by type for insurance organizations
  • #385, #386: Decided to maintain existing OID-based system identifiers for GTIN and GLN codes instead of switching to HTTP URIs

STU 6 Ballot (2025-05-22)

Added

  • #333: Refactor binding of vaccineCode VS (Adapt Immunization to IPS (2.0.0))
  • #330: Add new VS immunoglobulins for vaccinecode to Immunization
  • #292: CH Core Claim profile, example, mapping to 'Forum Datenaustausch'
  • #309: Add warning to ZSR
  • #344: New base profile CH Core RelatedPerson

Changed / Updated

  • #318: Relax minimum cardinality of Location.name from 1 to 0
  • #328: Deprecate CH Core DocumentReference EPR
  • #323: Clarification of the correct use of the Patient Citizenship Extension for Staatsangehörigkeit/Nationalité (eCH)

Fixed

  • #302: Allow all possible references for Encounter.subject and Encounter.participant.individual
  • #313: Add expansion-parameter for the usage of SNOMED CT Swiss Extension
  • #329: Fix (and update) terminology dependency to avoid version mismatch: hl7.terminology#6.1.0 -> hl7.terminology.r4#6.2.0
  • #339: Fix URL values which should resolve, add the other to the suppressed messages
  • #338: Add pin-canonicals parameter to define the handling of unversioned canonical references
  • #346: Add new sub-extension 'key' to extension 'additional-binding'
  • #329: Fix (and update) terminology dependency to avoid version mismatch: hl7.terminology#6.1.0 -> hl7.terminology.r4#6.3.0
  • #315: CH Core Patient - citizenship binding extensible as required, reduce to warning
  • #337: Homepage CH ATC and MHD: adapt the text

STU 5 (2024-12-17)

Open Issues

During the ballot, the following comments came in, which will be taken into account in the further development of CH Core:

See also open issues on GitHub.

Changed / Updated

  • #303: Entry Resource Cross References, Usage/Description
  • #294: Differentiation of severity of constraint ch-pat-1 for CH Core Patient (warning) and CH Core Patient EPR (error)
  • #293: Clarification of the description for Patient.gender
  • #300: Add guidance for readable representation of EPR documents and update example

Fixed

  • #306: Replace deprecated discriminator (pattern -> value)

Issues resolved without amendment (in IG)

  • #289: Validation issue with display values; fixed with new version of IG publisher

STU 5 Ballot (2024-05-16)

Added

  • #284: Check BER/UIDB identifiers
  • #119: Introduce base profiles (from exchange formats) in CH Core
    • CH Core MedicationStatement, CH Core MedicationAdministration, CH Core MedicationDispense, CH Core MedicationRequest, CH Core Medication
    • CH Core Condition
    • CH Core AllergyIntolerance
    • CH Core Immunization, CH Core ImmunizationRecommendation
    • CH Core ServiceRequest
  • #116: Add value set bindings to these elements:
    • Coverage.type -> http://fhir.ch/ig/ch-term/ValueSet/mainguarantor (preferred)
    • Coverage.class.type -> http://fhir.ch/ig/ch-core/ValueSet/bfs-medstats-21-encountertype (extensible)

Changed / Updated

  • #272: Update the CHCoreDocumentReference EPR-XDS mapping
  • #269: max cardinality for only one gln for practitioner
  • CH Term #23: Changes according to the renaming of CH EPR Term to CH Term
  • #274: Move terminology to CH Term
  • #287: Unified identifier slicing (Coverage, Practitioner)

Fixed

  • #277: update the expression of constraints ch-docref-1/2

STU 4 (2023-12-28)

  • #270: 4.0.1 Technical correction for invalid package

Added

  • #233: CH Core Address: Include eCH-0007 cantonAbbreviation
  • #244: Guidance how to use SNOMED CT codes from the Swiss Extension
  • #254: Separate data type profile for identifiers (ZSR, UIDB, BER)
  • #262: New extension to reference entries in i.e. other documents

Changed / Updated

  • #242: Update the description for type of CH Core Composition EPR
  • #238: Update context of Extension EPR Time with MedicationRequest.requester
  • #246: Only allow an UUID as Bundle.identifier in the EPR context
  • #181: Change slicing from Patient.contact:nameOfFahter/nameOfMother to Patient.contact:nameOfParent according to eCH RFC 2019-9: geschlechtsneutrale Bezeichnung für Namen der Eltern and remove chapter numbers in mapping of eCH
  • #252: Technical Correction of FHIRPath constraints with .value

Fixed

  • #235/#265: Fix GLN constraint/adapt Practitioner.identifier in example
  • #247: Fix constraint text and refactor expression (ch-core-doc-1)
  • #256: Fix references in example with UUID as fullUrl based on rules around matching relative references
  • #257: Warning instead of errors for GLN, EPR-SPID, AHVN13 and VEKA datatype profiles
  • #266: Fix error with ConceptMap

STU 4 Ballot (2023-06-27)

Added

  • #196: Data type profile VEKAIdentifier for Coverage.identifier and new also for Patient.identifier
  • #204: Introduce data type profiles for ContactPoints (email, phone, internet) according eCH-0046 (including extensions and terminology) and add them to the telecom element of Patient, Practitioner, Organization, Location
  • #224: Forum Datenaustausch tariff Naming System

Changed / Updated

  • #206: Improve acronyms definition
  • #191: CH Core Patient - Relax max cardinality to * for EPR-SPID and AHVN13
  • #195: CH Core Address - Add extension iso21090-ADXP-streetName to CH Core Address line
  • #198: CH Core Composition EPR - Relax information recipient cardinality to zero
  • #194: CH Core Composition EPR - Relax attester:legalAuthenticator.time cardinality to zero
  • #200: Remove display values from patternCodeableConcepts or fixedValues, remove minimum cardinality = 1 for display values, using official display values in examples (valid with http://tx.fhir.org/r4).
  • #193: Remove CDA elements (mapping, ch-ext-epr-sectionid, ch-ext-epr-versionnumber, adapt descriptions)
  • #31: Improve profiling for identifiers to avoid duplicated elements in the snapshot table
  • #205: Concretization of the mapping of Patient.telecom for versions as of HL7 v2.7
  • #181: Updated used eCH standards (incl. versions) to introduction (home) (standards themselves currently have no updates)
  • #217: Add language tag to instances, to be able to validate the translation of codes
  • #215: Relax binding strength to value sets from 'required' to 'extensible'
  • #225: Fix FHIRPath expression
  • #226: Change license for ImplementationGuide / StructureDefinition to CC0 1.0 Universal (CC0 1.0)
  • #222: PractitionerRole EPR: code binding

STU 3 (2022-12-20)

Added

  • #172: Generic CH Core extension Author of the content (fusion of the extensions from CH EMED and CH VACD)
  • #158, #189: Include new IG fragments (IP Statements, Cross Version Analysis, Dependency Table, Globals Table); CH Core can be used for both R4 and R4B, packages are available for both versions

Changed / Updated

  • #150: Expansion of the context of the extension EPR Time
  • #160: Slicing on repeating element
  • #154: Improve description of example instances, see Artifacts
  • #162: Update narrative text in examples
  • #176: Clean up differentials
  • #175: Rename the profile CH Core EPR-Consent
  • #173: Define aggregation mode (contained, referenced) for Coverage.payor
  • #170: Check the slicing and update suppressed messages
  • #153: Rephrasing of the sentence for the exchange formats (current and general validity)

Fixed

  • #163: Typo
  • #159: Add element 'experimental' (false) to CS/VS
  • #161: Use 'patternCodeableConcept' instead of 'fixedCodeableConcept' for Consent.policyRule
  • #167: Fix URIs in ConceptMaps 'MaritalStatus eCH-011 to FHIR mapping', 'Sex eCH-011 to FHIR mapping'
  • #152: Changes status form 'draft' to 'active'

Issues resolved without amendment (in IG)

  • #39: Consent code for ch-epr has been added in hl7.terminology published 2022-09-14 (version 4.0.0)
  • #174: Verification/confirmation that the eCH-011 values for gender are still up-to-date
  • #157: Fixed dead link on the HL7.ch FHIR IG Balloting page
  • #156: Change default branch from 'master' to 'main' to postponed to a later publication due to dependence on IG Publisher

STU 3 Ballot (2022-06-29)

Added

  • #123 (#137, #140): GLN and EPR-SPID checks
  • #135: Add an Identifier data type for AHVN13 with check for correctness
  • #131: Update change log/STU note box according to the latest requirements

Changed / Updated

  • #133: Fix example OIDs
  • #129: Wrong slicing for Composition.author.extension:ch-ext-epr-time profiles/structures
  • #144: Improve slicing that info entry[x] warnings are not shown (CH Core Document, CH Core Document EPR)
  • #122: No fixed value for Status of Composition EPR
  • #121: Relax Custodian cardinality in CH Core Composition EPR
  • #118, #127, #142: Typos
  • #132: Fix link of concept map
  • #124: Fix description for a least one given/family HumanName if provided
  • #145: Update title of the profiles

STU 2 (2021-04-24)

  • #57 cardinality 0..1 for ch-ext-epr-versionNumber in Composition
  • #58 IMP instead of INP in encounter
  • #59 adapt extension EPR Information Recipient for ch-core
  • #60 relax card. in CH Core Organization
  • #61 slice setup incorrect on address lines
  • #63 PractitionerRole example HPWengerRole has an invalid specialty coding
  • #65 CH-Core dependsOn CH-EPR-TERM current
  • #66 Encounter: specify a type for the visit number Fallnummer
  • #67 Add CC license to ch-core implementation guide
  • #70 fix resource narrative status if narrative text has been defined
  • #77 ch-core-document: add check that fullUrl exists and is an absolute url
  • #85 EPRDataEnterer: valueReference only to Practitioner (not Person)
  • #90 description callName in eCH-011 Types
  • #91 dataenterer as PractitionerRole
  • #92 PDF requirements for CH Core Composition
  • #93 EPR Data Enterer map to PractitionerRole instead of Practitioner
  • #94 Precise description for salutation, title in HumanName
  • #95 EPR Document fix Bundler.identifier to uuid
  • #96, #97 Composition.identifier instead of setId Extension
  • #98 renamed Composition Patient Profile EPR to Patient Profile EPR
  • #100, #101, #102, #103 Reference to CH Core profiles
  • #104 CH Core Consent Profile naming

STU 1 (2020-04-21)