description: Clinical document used to represent the International Patient Summary (IPS) data set. \r\nAn International Patient Summary (IPS) document is an electronic health record extract containing essential healthcare information about a subject of care. \r\nThe IPS dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent; but still clinically relevant. As specified in EN 17269 and ISO 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.\r\n\r\nThis profile is based on the ClinicalDocument profile. package_name: hl7.fhir.uv.ips derivation: constraint name: CompositionUvIps type: Composition elements: date: {mustSupport: true, index: 7} encounter: {index: 6} section: short: Sections composing the IPS mustSupport: true index: 26 elements: code: {type: CodeableConcept, mustSupport: true, index: 27} text: {mustSupport: true, index: 28} emptyReason: {mustSupport: false, index: 29} section: {mustSupport: false, index: 30} required: [text, code] slicing: rules: open ordered: false discriminator: - {path: code, type: pattern} min: 1 slices: sectionProblems: match: code: coding: - {code: 11450-4, system: 'http://loinc.org'} schema: short: IPS Problems Section mustSupport: true _required: true index: 42 elements: title: {mustSupport: true, index: 43} code: pattern: type: CodeableConcept value: coding: - {code: 11450-4, system: 'http://loinc.org'} index: 44 entry: short: Clinical problems or conditions currently being monitored for the patient. refers: ['http://hl7.org/fhir/StructureDefinition/Condition', 'http://hl7.org/fhir/StructureDefinition/DocumentReference'] type: Reference mustSupport: true index: 45 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: problem: match: {} schema: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Condition-uv-ips'] _required: true index: 46 min: 1 required: [entry, title] sectionProceduresHx: match: code: coding: - {code: 47519-4, system: 'http://loinc.org'} schema: short: IPS History of Procedures Section mustSupport: true index: 47 elements: title: {mustSupport: true, index: 48} code: pattern: type: CodeableConcept value: coding: - {code: 47519-4, system: 'http://loinc.org'} index: 49 entry: short: Patient past procedures pertinent to the scope of this document. refers: ['http://hl7.org/fhir/StructureDefinition/DocumentReference', 'http://hl7.org/fhir/StructureDefinition/Procedure'] type: Reference mustSupport: true index: 50 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: procedure: match: {} schema: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Procedure-uv-ips'] _required: true index: 51 min: 1 required: [entry, title] sectionPlanOfCare: match: code: coding: - {code: 18776-5, system: 'http://loinc.org'} schema: short: IPS Plan of Care Section index: 84 elements: title: {index: 85} code: pattern: type: CodeableConcept value: coding: - {code: 18776-5, system: 'http://loinc.org'} index: 86 entry: type: Reference short: Optional entry used to represent structured care plans refers: ['http://hl7.org/fhir/StructureDefinition/CarePlan', 'http://hl7.org/fhir/StructureDefinition/DocumentReference'] index: 87 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: null slices: carePlan: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/StructureDefinition/CarePlan'] index: 88 required: [title] sectionMedicalDevices: match: code: coding: - {code: 46264-8, system: 'http://loinc.org'} schema: short: IPS Medical Devices Section mustSupport: true index: 57 elements: title: {mustSupport: true, index: 58} code: pattern: type: CodeableConcept value: coding: - {code: 46264-8, system: 'http://loinc.org'} index: 59 entry: short: Patient history of medical device use. refers: ['http://hl7.org/fhir/StructureDefinition/DeviceUseStatement', 'http://hl7.org/fhir/StructureDefinition/DocumentReference'] type: Reference mustSupport: true index: 60 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: deviceStatement: match: {} schema: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/DeviceUseStatement-uv-ips'] _required: true index: 61 min: 1 required: [entry, title] sectionSocialHistory: match: code: coding: - {code: 29762-2, system: 'http://loinc.org'} schema: short: IPS Social History Section index: 89 elements: title: {index: 90} code: pattern: type: CodeableConcept value: coding: - {code: 29762-2, system: 'http://loinc.org'} index: 91 entry: type: Reference short: Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.) refers: ['http://hl7.org/fhir/StructureDefinition/DocumentReference', 'http://hl7.org/fhir/StructureDefinition/Observation'] index: 92 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: null slices: smokingTobaccoUse: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-tobaccouse-uv-ips'] index: 93 max: 1 alcoholUse: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-alcoholuse-uv-ips'] index: 94 max: 1 required: [title] sectionFunctionalStatus: match: code: coding: - {code: 47420-5, system: 'http://loinc.org'} schema: short: IPS Functional Status index: 78 elements: title: {index: 79} code: pattern: type: CodeableConcept value: coding: - {code: 47420-5, system: 'http://loinc.org'} index: 80 entry: type: Reference short: Optional entry used to represent disabilities and functional assessments refers: ['http://hl7.org/fhir/StructureDefinition/ClinicalImpression', 'http://hl7.org/fhir/StructureDefinition/Condition', 'http://hl7.org/fhir/StructureDefinition/DocumentReference'] index: 81 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: null slices: disability: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Condition-uv-ips'] index: 82 functionalAssessment: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/StructureDefinition/ClinicalImpression'] index: 83 required: [title] sectionAllergies: match: code: coding: - {code: 48765-2, system: 'http://loinc.org'} schema: short: IPS Allergies and Intolerances Section mustSupport: true _required: true index: 37 elements: title: {mustSupport: true, index: 38} code: pattern: type: CodeableConcept value: coding: - {code: 48765-2, system: 'http://loinc.org'} index: 39 entry: short: Relevant allergies or intolerances (conditions) for that patient. refers: ['http://hl7.org/fhir/StructureDefinition/AllergyIntolerance', 'http://hl7.org/fhir/StructureDefinition/DocumentReference'] type: Reference mustSupport: true index: 40 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: allergyOrIntolerance: match: {} schema: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/AllergyIntolerance-uv-ips'] _required: true index: 41 min: 1 required: [entry, title] sectionPregnancyHx: match: code: coding: - {code: 10162-6, system: 'http://loinc.org'} schema: short: IPS History of Pregnancy Section index: 95 elements: title: {index: 96} code: pattern: type: CodeableConcept value: coding: - {code: 10162-6, system: 'http://loinc.org'} index: 97 entry: type: Reference short: Current pregnancy status and, optionally, information about the outcome of earlier pregnancies. refers: ['http://hl7.org/fhir/StructureDefinition/DocumentReference', 'http://hl7.org/fhir/StructureDefinition/Observation'] index: 98 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: null slices: pregnancyStatus: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-status-uv-ips'] index: 99 pregnancyOutcomeSummary: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-pregnancy-outcome-uv-ips'] index: 100 required: [title] sectionAdvanceDirectives: match: code: coding: - {code: 42348-3, system: 'http://loinc.org'} schema: short: IPS Advance Directives Section index: 101 elements: title: {index: 102} code: pattern: type: CodeableConcept value: coding: - {code: 42348-3, system: 'http://loinc.org'} index: 103 entry: type: Reference short: Narrative description of the patient's advance directive. refers: ['http://hl7.org/fhir/StructureDefinition/Consent', 'http://hl7.org/fhir/StructureDefinition/DocumentReference'] index: 104 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: null slices: advanceDirectivesConsent: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/StructureDefinition/Consent'] index: 105 required: [title] sectionVitalSigns: match: code: coding: - {code: 8716-3, system: 'http://loinc.org'} schema: label: Vital signs short: IPS Vital Signs Section index: 68 elements: title: {index: 69} code: pattern: type: CodeableConcept value: coding: - {code: 8716-3, system: 'http://loinc.org'} index: 70 entry: type: Reference short: Notable vital signs or physical findings. refers: ['http://hl7.org/fhir/StructureDefinition/DocumentReference', 'http://hl7.org/fhir/StructureDefinition/Observation'] index: 71 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: null slices: vitalSign: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/StructureDefinition/vitalsigns'] index: 72 required: [title] sectionImmunizations: match: code: coding: - {code: 11369-6, system: 'http://loinc.org'} schema: short: IPS Immunizations Section mustSupport: true index: 52 elements: title: {mustSupport: true, index: 53} code: pattern: type: CodeableConcept value: coding: - {code: 11369-6, system: 'http://loinc.org'} index: 54 entry: short: Patient's immunization status and pertinent history. refers: ['http://hl7.org/fhir/StructureDefinition/DocumentReference', 'http://hl7.org/fhir/StructureDefinition/Immunization'] type: Reference mustSupport: true index: 55 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: immunization: match: {} schema: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Immunization-uv-ips'] _required: true index: 56 min: 1 required: [entry, title] sectionResults: match: code: coding: - {code: 30954-2, system: 'http://loinc.org'} schema: short: IPS Results Section mustSupport: true index: 62 elements: title: {mustSupport: true, index: 63} code: pattern: type: CodeableConcept value: coding: - {code: 30954-2, system: 'http://loinc.org'} index: 64 entry: short: Relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. refers: ['http://hl7.org/fhir/StructureDefinition/DiagnosticReport', 'http://hl7.org/fhir/StructureDefinition/DocumentReference', 'http://hl7.org/fhir/StructureDefinition/Observation'] type: Reference mustSupport: true index: 65 slicing: rules: open discriminator: - {path: resolve(), type: type} - {path: resolve(), type: profile} min: 1 slices: results-observation: match: {} schema: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Observation-results-uv-ips'] index: 66 results-diagnosticReport: match: {} schema: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/DiagnosticReport-uv-ips'] index: 67 required: [entry, title] sectionMedications: match: code: coding: - {code: 10160-0, system: 'http://loinc.org'} schema: short: IPS Medication Summary Section mustSupport: true _required: true index: 31 elements: title: {short: Medication Summary section, mustSupport: true, index: 32} code: pattern: type: CodeableConcept value: coding: - {code: 10160-0, system: 'http://loinc.org'} index: 33 entry: short: Medications relevant for the scope of the patient summary refers: ['http://hl7.org/fhir/StructureDefinition/DocumentReference', 'http://hl7.org/fhir/StructureDefinition/MedicationAdministration', 'http://hl7.org/fhir/StructureDefinition/MedicationDispense', 'http://hl7.org/fhir/StructureDefinition/MedicationRequest', 'http://hl7.org/fhir/StructureDefinition/MedicationStatement'] type: Reference mustSupport: true index: 34 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: medicationStatement: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/MedicationStatement-uv-ips'] index: 35 medicationRequest: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/MedicationRequest-uv-ips'] index: 36 required: [entry, title] sectionPastIllnessHx: match: code: coding: - {code: 11348-0, system: 'http://loinc.org'} schema: short: IPS History of Past Illness Section index: 73 elements: title: {index: 74} code: pattern: type: CodeableConcept value: coding: - {code: 11348-0, system: 'http://loinc.org'} index: 75 entry: type: Reference short: Conditions the patient suffered in the past. refers: ['http://hl7.org/fhir/StructureDefinition/Condition', 'http://hl7.org/fhir/StructureDefinition/DocumentReference'] index: 76 slicing: rules: open discriminator: - {path: resolve(), type: profile} min: 1 slices: pastProblem: match: {} schema: type: Reference refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Condition-uv-ips'] _required: true index: 77 min: 1 required: [entry, title] attester: mustSupport: true index: 11 elements: mode: {mustSupport: true, index: 12} time: {mustSupport: true, index: 13} party: {mustSupport: true, index: 14} type: type: CodeableConcept short: Kind of composition ("Patient Summary") mustSupport: true pattern: type: CodeableConcept value: coding: - {code: 60591-5, system: 'http://loinc.org'} index: 3 title: {short: International Patient Summary, mustSupport: true, index: 9} author: {short: Who and/or what authored the IPS, mustSupport: true, index: 8} event: index: 22 slicing: rules: open discriminator: - {path: code, type: pattern} min: null slices: careProvisioningEvent: match: code: coding: - {code: PCPR, system: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'} schema: short: The care provisioning being documented mustSupport: true index: 23 elements: code: mustSupport: true pattern: type: CodeableConcept value: coding: - {code: PCPR, system: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'} index: 24 period: {mustSupport: true, index: 25} required: [code] custodian: {mustSupport: true, index: 15} status: {mustSupport: true, index: 2} identifier: {mustSupport: true, index: 1} relatesTo: index: 16 elements: code: {index: 17} target: choices: [targetIdentifier, targetReference] index: 19 targetIdentifier: {type: Identifier, choiceOf: target, index: 20} targetReference: type: Reference choiceOf: target refers: ['http://hl7.org/fhir/StructureDefinition/Composition', 'http://hl7.org/fhir/uv/ips/StructureDefinition/Composition-uv-ips'] index: 21 subject: type: Reference mustSupport: true refers: ['http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips'] index: 4 elements: reference: {mustSupport: true, index: 5} required: [reference] confidentiality: {index: 10} text: {mustSupport: true, index: 0} package_version: 1.1.0 class: profile kind: resource url: http://hl7.org/fhir/uv/ips/StructureDefinition/Composition-uv-ips base: http://hl7.org/fhir/StructureDefinition/clinicaldocument version: 1.1.0 required: [section, subject]