Introduction

The goal of this standard is to deliver a single, common International Patient Summary (IPS), comprising core content.

The scope of this standard is to achieve that goal by defining a minimal yet non-exhaustive data set and its associated business rules. This document is intended to be implementation independent yet still supportive of any implementation by providing formal definition and clear description of a small data set. The primary input to the data set is the second revision of the European eHealth Network’s data set [1], which, in turn, builds upon significant clinical input from the European Patients-Smart Open Services (epSOS) pilot project [2].

This document defines the International Patient Summary (IPS), with the initial focus upon unplanned care across national borders. Starting from this focus, the specification is intended to be used and be useful in local applications and also to be supportive of planned care. It emphasizes the data required and the associated business rules to support use and the necessary conformance of the use case for an international patient summary.

The data set described is intended for global use beginning with a shared vision1 from a collaboration between CEN /TC 251 and HL7. CEN has produced a separate Technical Specification (CEN/TS 17288) that provides a European-specific guideline for IPS implementation. HL7 have produced CDA and HL7 FHIR2 templates for realizing implementations of the IPS.

The ‘International’ element of the IPS emphasizes the need to provide generic solutions for global application moving beyond a particular region or country; consequently, wherever possible, reference is made to international standards, rather than local ones. However, different international contexts will offer a variety of requirements that need to be considered to ensure that patient safety is not compromised. The IPS is underpinned by the ISO standard “System of concepts to support continuity of care” [3] and uses those concepts in the initial IPS scenario, which is fully described in Annex A.

This standard focuses upon the overall structure of the patient summary as well as the individual data elements that comprise it. The layout of this document uses a hierarchy of levels (H0 to H7) to facilitate more detailed description with the purpose of supporting consistent implementation of the data set. The level ‘H0’ describes the IPS Document as a whole, whilst levels H1-H7 describe the IPS Data Blocks with attributes. Descriptors are added to each data element to better define the characteristics. The ‘H0’ level document structure and constraints will be described first, the components start with H1 (e.g. IPS Sections, IPS Attribute Collections).

Table 1 — Description of IPS Data Set concepts and their hierarchical relationships

Descriptive hierarchy	H0	H1	H2 – H7
IPS Data Transfer Object	IPS Document	All possible IPS and the Non-IPS components are identified	Further detail is provided within the IPS Data Blocks’ clauses
IPS Data Blocks	-	Individual IPS Sections, IPS Attribute collections, and IPS Metadata	Hierarchical description of data elements

The ordering of the IPS Data Blocks in this standard is alphabetic within three broad categories of Non-Clinical Data, Clinical Data and Metadata. This follows the eHDSI patient summary deployment project [4] and here is used purely to help presentation. However, in practice it is recognised that individual attributes might appear in different categories depending on dynamic use rather than static classification.

As the amount of information for each data element is variable, and can be extensive, this standard presents the information using a table with descriptors for each IPS Data Block; the table provides an overview of the hierarchical structure and its requirement with explicit links to more details using a consistent set of descriptors. Those attributes in the table that do not have a link to further detail are either self-explanatory or explained by the hierarchical context. Note, the order of sibling attributes is arbitrary and has no implication for any implementation. The name of the element is given in full, if the hierarchical arrangement in the description with the term is still open to ambiguous interpretation. This has been done to avoid any misunderstanding. For example, the term ‘Device Type’ will be used rather than just “Type” albeit that it refers to a data element positioned within the Medical Device IPS Data Block.

BS EN 17269:2019

Health informatics. The International Patient Summary

Published:

31 Dec 2019

Withdrawn:

17 Jun 2022