Praxis Patient Summary

Praxis Patient Summary

The Praxis patient summary is a provisional implementation aligned with EPS 1.0.0-ballot and IPS 2.0.1. It provides stable Bundle and Composition entry points in the Praxis package. It is not a claim of conformance to a future gematik or KBV ePKA specification. There are no Germany-specific clinical constraints in this release.

The document profiles derive from the EPS Bundle and Composition. EPS already imposes the corresponding IPS document profiles, so the Praxis profiles inherit that claim without redeclaring or copying upstream constraints. Local entry overlays exist only where an EPS entry target needs a parallel IPS entry-profile claim.

Document entry points

Praxis profile	Base	IPS disposition
patient-summary-bundle-praxis-de	http://hl7.eu/fhir/eps/StructureDefinition/bundle-eu-eps	Inherits the EPS imposition of Bundle-uv-ips
patient-summary-composition-praxis-de	http://hl7.eu/fhir/eps/StructureDefinition/composition-eu-eps	Inherits the EPS imposition of Composition-uv-ips

Supported section contract

The local Composition retains the open EPS section slicing. All 17 EPS sections remain available for authoring. The required and optional classification below is verified from the pinned EPS snapshot.

Section	EPS slice	LOINC code	Cardinality	Disposition
Problems	sectionProblems	11450-4	1..1	local overlay for the problem entry
Allergies and Intolerances	sectionAllergies	48765-2	1..1	local overlay for the allergy entry
Medication Summary	sectionMedications	10160-0	1..1	reuse EPS medication target
History of Procedures	sectionProceduresHx	47519-4	1..1	reuse EPS procedure target
Medical Devices	sectionMedicalDevices	46264-8	1..1	reuse EPS device-use target
Immunizations	sectionImmunizations	11369-6	0..1	local overlay for the immunization entry
Results	sectionResults	30954-2	0..1	local overlays for EU Core laboratory and radiology observations; reuse EPS DiagnosticReport
Advance Directives	sectionAdvanceDirectives	42348-3	0..1	reuse EPS Consent target
Alerts	sectionAlert	104605-1	0..1	local overlay for the alert entry
Functional Status	sectionFunctionalStatus	47420-5	0..1	reuse the Condition overlay and core ClinicalImpression target
History of Pregnancy	sectionPregnancyHx	10162-6	0..1	reuse IPS pregnancy targets and EPS gestational-age target
Patient Story	sectionPatientStory	81338-6	0..1	reuse EPS narrative-only section
Plan of Care	sectionPlanOfCare	18776-5	0..1	reuse core CarePlan and ImmunizationRecommendation targets
Social History	sectionSocialHistory	29762-2	0..1	reuse IPS tobacco-use and alcohol-use targets
Vital Signs	sectionVitalSigns	8716-3	0..1	reuse core vital-signs target
Travel History	sectionTravelHx	10182-4	0..1	reuse EPS travel-observation target
Patient History	sectionPatientHx	11329-0	0..1	reuse EPS narrative-only section

All codes in this table use http://loinc.org.

Entry-profile disposition matrix

Section and entry slice	Upstream target	Praxis disposition
Problems / problem	condition-eu-core	patient-summary-condition-praxis-de, imposing Condition-uv-ips
Allergies / allergyOrIntolerance	allergyIntolerance-eu-core	patient-summary-allergy-intolerance-praxis-de, imposing AllergyIntolerance-uv-ips
Medications / medicationStatementOrRequest	MedicationStatement-eu-eps	reuse; EPS target already imposes IPS MedicationStatement
Immunizations / immunization	immunization-eu-core	patient-summary-immunization-praxis-de, imposing IPS Immunization
Results / results-medicalTestResult	medicalTestResult-eu-core	laboratory and radiology Praxis overlays, each imposing its matching IPS Observation
Results / results-diagnosticReport	diagnosticReport-eu-eps	reuse; EPS target already imposes IPS DiagnosticReport
Procedures / procedure	procedure-eu-eps	reuse; EPS target already imposes IPS Procedure
Medical Devices / deviceStatement	deviceUseStatement-eu-eps	reuse; EPS target already imposes IPS DeviceUseStatement
Advance Directives / advanceDirectivesConsent	consent-eu-eps	reuse; the corresponding IPS target is core Consent
Alerts / flag	flag-patient-eu-core	patient-summary-alert-praxis-de, imposing Flag-alert-uv-ips
Functional Status / disability	condition-eu-core	reuse patient-summary-condition-praxis-de
Functional Status / functionalAssessment	core ClinicalImpression	reuse
Pregnancy / pregnancyStatus	IPS pregnancy-status Observation	reuse
Pregnancy / pregnancyOutcome	IPS pregnancy-outcome Observation	reuse
Pregnancy / gestationalAge	EPS gestational-age Observation	reuse; EPS-only family
Plan of Care / carePlan	core CarePlan	reuse
Plan of Care / immunizationRecommendation	core ImmunizationRecommendation	reuse
Social History / smokingTobaccoUse	IPS tobacco-use Observation	reuse
Social History / alcoholUse	IPS alcohol-use Observation	reuse
Vital Signs / vitalSign	core vital-signs profile	reuse
Travel History / travelObservation	EPS travel Observation	reuse; EPS-only family

The IPS-only sectionPastProblems (http://loinc.org#11348-0) and its pastProblem entry targeting Condition-uv-ips are import-only. They remain possible because both upstream Composition profiles use open section slicing, but they are not added to the narrower 17-section Praxis authoring contract.

The Germany-specific clinical-constraint set is intentionally empty. Local wrappers provide stable package entry points and combined conformance claims; they do not add German clinical semantics.

Missing information

An explicitly empty required Problems section uses http://terminology.hl7.org/CodeSystem/list-empty-reason#nilknown, contains a human-readable narrative, and has no clinical entry. Optional sections such as Travel History may be omitted. The package examples demonstrate both cases.

Import validation

Validate unmodified third-party documents against their declared upstream canonicals. An IPS document is validated against its declared IPS profiles; an EPS document is validated against its declared EPS and IPS profiles. Such a document does not acquire local Praxis conformance merely because the Praxis package is installed. Claim the local Praxis profiles only after explicitly localizing the document to their entry targets.

Migration and privacy boundary

The package moves its IPS baseline from STU1 1.1.0 to STU2 errata 2.0.1. Existing imaging and radiology references continue to use the unversioned IPS Patient canonical. SmokingStatusDE keeps LOINC 72166-2 while its preferred value set changes to the SNOMED-based IPS 2.0.1 value set. Because the binding is preferred, existing LOINC answer values remain valid.

Patient summaries contain sensitive health information. Authorization, consent, data minimization, retention, transport to an AI or remote system, and free-text summarization are consumer responsibilities outside this profile contract. A consumer needs a separate human-reviewed security and privacy decision before processing live patient data.