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Patient $summary

The $summary operation generates an International Patient Summary (IPS) document for a patient. This creates a comprehensive clinical summary following the IPS Implementation Guide.

Use Cases​

  • Care Transitions and Referrals: Generate standardized clinical summaries when patients move between care settings or providers
  • Patient Portal Health Summaries: Provide patients with comprehensive, readable summaries of their health record
  • Emergency Department Quick Views: Give ED clinicians rapid access to essential patient information during emergencies
  • Cross-Border Health Record Sharing: Share patient data internationally using the standardized IPS format

Invocation​

GET [base]/Patient/[id]/$summary
POST [base]/Patient/[id]/$summary

Input Parameters​

ParameterCardinalityTypeDescription
author0..1ReferenceReference to Practitioner, PractitionerRole, or Organization to list as the composition author. Defaults to the current user.
authoredOn0..1instantThe date/time the summary was authored. Defaults to current time.
start0..1dateStart date for filtering resources
end0..1dateEnd date for filtering resources
_since0..1instantOnly include resources modified since this date
identifier0..1stringIdentifier for the composition
profile0..1canonicalProfile to validate against

Output​

Returns a Bundle of type document containing:

  1. Composition - The IPS Composition resource organizing all sections
  2. Patient - The patient resource
  3. Author - The author (Practitioner/PractitionerRole/Organization)
  4. Clinical Resources - All relevant clinical data organized into sections

IPS Sections​

The summary includes the following sections (when data is available):

SectionLOINC CodeResources
Allergies48765-2AllergyIntolerance
Immunizations11369-6Immunization
Medications10160-0MedicationRequest
Problem List11450-4Condition
Results30954-2DiagnosticReport, Observation
Social History29762-2Observation (social-history category)
Vital Signs8716-3Observation (vital-signs category)
Procedures47519-4Procedure
Encounters46240-8Encounter
Devices46264-8DeviceUseStatement
Assessments51848-0ClinicalImpression
Plan of Treatment18776-5CarePlan, Goal, ServiceRequest
Goals61146-7Goal
Health Concerns75310-3Condition (health-concern category)
Functional Status47420-5Observation (survey category)
Notes34109-9ClinicalImpression (note type)
Reason for Referral42349-1ServiceRequest (referral type)
Insurance48768-6Account

Example​

Request​

GET /fhir/R4/Patient/patient123/$summary

Response​

{
  "resourceType": "Bundle",
  "type": "document",
  "timestamp": "2026-01-08T15:30:00.000Z",
  "entry": [
    {
      "resource": {
        "resourceType": "Composition",
        "id": "composition123",
        "status": "final",
        "type": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "60591-5",
              "display": "Patient Summary"
            }
          ]
        },
        "subject": {
          "reference": "Patient/patient123"
        },
        "date": "2026-01-08T15:30:00.000Z",
        "author": [
          {
            "reference": "Practitioner/practitioner456"
          }
        ],
        "title": "Medical Summary",
        "section": [
          {
            "title": "Allergies",
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "48765-2"
                }
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">...</div>"
            },
            "entry": [
              {
                "reference": "AllergyIntolerance/allergy789"
              }
            ]
          }
        ]
      }
    },
    {
      "resource": {
        "resourceType": "Patient",
        "id": "patient123"
      }
    },
    {
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "allergy789"
      }
    }
  ]
}

Resource Types Included​

The operation collects and organizes the following resource types:

  • Account
  • AllergyIntolerance
  • CarePlan
  • ClinicalImpression
  • Condition
  • Coverage
  • DeviceUseStatement
  • DiagnosticReport
  • Encounter
  • Goal
  • Immunization
  • MedicationRequest
  • Observation
  • Procedure
  • RelatedPerson
  • ServiceRequest

Behavior​

  1. Data Collection: Uses the $everything operation internally to gather all patient-related resources
  2. Section Assignment: Automatically assigns resources to appropriate IPS sections based on resource type and category codes
  3. Nested Resources: Handles nested resources (e.g., Observations that are members of other Observations) appropriately
  4. HTML Generation: Generates human-readable HTML tables for each section
  5. Event Period: Calculates the composition event period from resource timestamps

Error Responses​

Status CodeDescription
404 Not FoundPatient not found
403 ForbiddenInsufficient permissions