International Patient Summary

The International Patient Summary (IPS) is an HL7 Implementation Guide that defines a minimal, specialty-agnostic patient summary for cross-border use. It is the technical basis for the EHDS Patient Summary dataset mandated from 2027.

Document Bundle — a new Bundle type

An IPS is not a transaction or searchset Bundle — it is a document Bundle (type: "document"). Document Bundles have two rules that transaction Bundles do not:

• First entry must be Composition: the Composition is the document header — it defines sections, author, date, and subject.
• All referenced resources must be in the Bundle: a document is self-contained. You cannot reference a Patient that lives on a separate server.

References inside a document Bundle use urn:uuid: identifiers — the same pattern as transaction Bundles.

The Composition resource

Composition is the document header. It carries the document type code, the subject (Patient), author (Practitioner), date, and a list of sections. Each section has a LOINC code identifying the clinical category, narrative text, and entries (references to clinical resources).

{
  "resourceType": "Composition",
  "status": "final",
  "type": {
    "coding": [{
      "system": "http://loinc.org",
      "code": "60591-5",
      "display": "Patient summary Document"
    }]
  },
  "subject": { "reference": "urn:uuid:patient-001" },
  "date": "2024-03-15T10:30:00+01:00",
  "author": [{ "reference": "urn:uuid:practitioner-001" }],
  "title": "Patient Summary — Jana Horváth",
  "section": [
    {
      "title": "Allergies and Intolerances",
      "code": { "coding": [{ "system": "http://loinc.org", "code": "48765-2" }] },
      "entry": [{ "reference": "urn:uuid:allergy-001" }]
    },
    ...
  ]
}

Required sections

IPS defines three required sections and several recommended ones. Required sections must be present even if they are empty — in that case they use an emptyReason.

Narrative text in sections

Each section in an IPS Composition must have a narrative text block — an XHTML summary of the section for human display. This is the IPS requirement that triggers the dom-6 best-practice warning in HAPI when you validate documents: resources in a document Bundle should have narrative text.

"text": {
  "status": "generated",
  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">
    High-criticality allergy to amoxicillin — skin rash (confirmed, active).
  </div>"
}