FHIR Implementation Guide for ABDM CI Build v2.0.1
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This Implementation guide is published and maintained by NRCeS for NHA.
This version is based on the ABDM Health Data Interchange Specifications 1.0 and updated periodically.

Implementation Guide HomePage

Background

Enduring with the vision of National Health Policy (NHP) 2017, ‘Health and wellbeing for all at all ages’, Ministry of Health and Family Welfare (MoHFW), Government of India recognized the need for creating a framework for the evolution of a National Digital Health Eco-system (NDHE), which will support ‘Continuum of care’ for an individual.

To create and enable digital health ecosystem and prioritize digital health in India, and to develop an implementation framework for the National Health Stack, the committee constituted by MoHFW Government of India produced the National Digital Health Blueprint (NDHB), laying out the building blocks and an action plan to comprehensively and holistically implement digital health.

The Government has established the Ayushman Bharat Digital Mission (ABDM), with The Ministry of Health and Family Welfare defining the policy and regulatory frameworks with implementation by the National Health Authority (NHA).

The vision of ABDM is, to create a national digital health ecosystem that supports universal health coverage in an efficient, accessible, inclusive, affordable, timely and safe manner, that provides a wide-range of data, information and infrastructure services, duly leveraging open, interoperable, standards-based digital systems, and ensures the security, confidentiality and privacy of health-related personal information. This will include adoption of open standards by all the actors in the National Digital Health Eco‐system.

Introduction

The FHIR Implementation Guide for ABDM Health Data Interchange Specifications 1.0 is based on FHIR Version R4 and defines the minimum conformance requirements for accessing health data to achieve continuity of care in the Indian context.

Purpose and Scope

The purpose of this implementation guide is to provide essential and minimum health record artefacts that can be captured and exchanged as per ABDM Health Data Interchange Specifications 1.0.

This guide refers to relevant standards and coding systems as specified for implementation of ABDM envisaged under NDHB and other guidelines such as EHR Standards for India (2016), Medical Council of India (MCI), and Pharmacy Council of India (PCI).

ABDM Actors

  • Health information provider (HIP): Any entity that creates health information pertaining to a user and is ready to share it digitally with users by adopting to compliant software.
  • Health information user (HIU): Any entity that intends to view health records of an individual, with their informed consent using compliant software.

Technical details on the ABDM ecosystem can be found at the ABDM Sandbox at sandbox.abdm.gov.in

How to read this Guide

This Guide is divided into several pages which are listed at the top of each page in the menu bar.

  • Home: The home page provides the introduction, purpose, scope and list of ABDM profiles for ABDM Health Data Interchange Specifications 1.0.
  • FHIR Artefacts: These pages provide detailed descriptions and formal definitions for all the FHIR objects defined in this guide.
    • Profiles: This page lists the set of Profile that are defined in this guide to exchange quality data. Each page includes a narrative introduction, formal definition for each profile in FHIR Implementation Guide for ABDM.
    • Terminology: This page lists the value sets defined for FHIR Implementation Guide for ABDM profiles.
  • Examples: List of links to all the examples used in this guide.
  • Downloads: This page provides links to downloadable artefacts.
  • Things To Consider
    • The systems used in the examples are temporary place holders and the values may be different in actual implementation
    • The resource identifiers in the examples are simple number and instead, a point-in-time / system generated URN / UID can be used. The source may preserve the identifiers for referring the resource for later purposes
    • The terminology value set bindings and examples will be provided with subsequent updates in the IG
    • MUST Support Elements: The Receiver (HIU) MUST have a capacity to read the element though it is optional. The Sender (HIP) may opt not to fill the element while sending.

ABDM Profiles

The list of profiles below defines the minimum mandatory elements and terminology requirements that MUST be present. For each profile, requirements and guidance are given in a simple narrative summary. A formal hierarchical table that presents a logical view of the content in both a differential and snapshot view is also provided along with references to appropriate examples.

  • Clinical Artifacts
    Following clinical artifacts are profiles based on Composition resource of FHIR R4.0.1:

    NameBased OnDefinition
    DiagnosticReportRecordCompositionThe Clinical Artifact represents diagnostic reports including Radiology and Laboratory reports that can be shared across the health ecosystem.
    DischargeSummaryRecordCompositionClinical document used to represent the discharge summary record for ABDM HDE data set.
    HealthDocumentRecordCompositionThe Clinical Artifact represents the unstructured historical health records as a single of multiple Health Record Documents generally uploaded by the patients through the Health Locker and can be shared across the health ecosystem.
    ImmunizationRecordCompositionThe Clinical Artifact represents the Immunization records with any additional documents such as vaccine certificate, the next immunization recommendations, etc. This can be further shared across the health ecosystem.
    OPConsultRecordCompositionThe Clinical Artifact represents the outpatient visit consultation note which may include clinical information on any OP examinations, procedures along with medication administered, and advice that can be shared across the health ecosystem.
    PrescriptionRecordCompositionThe Clinical Artifact represents the medication advice to the patient in compliance with the Pharmacy Council of India (PCI) guidelines, which can be shared across the health ecosystem.
    WellnessRecordCompositionThe Clinical Artifact represents regular wellness information of patients typically through the Patient Health Record (PHR) application covering clinical information such as vitals, physical examination, general wellness, women wellness, etc., that can be shared across the health ecosystem.
  • Other Resource Profiles
    NameBased OnDefinition
    DocumentBundleBundleThis profile sets minimum expectations for the DocumentBundle that includes all resources into a single instance with containing context to act as an exchangeable clinical document.
    AllergyIntoleranceAllergyIntoleranceThis profile sets minimum expectations for the AllergyIntolerance resource to record, search, and fetch allergies/adverse reactions associated with a patient.
    AppointmentAppointmentThis profile sets minimum expectations for the Appointment resource to searching for and fetching information about a booking of a healthcare event among patient(s), practitioner(s), related person(s), and/or device(s) for a specific date/time for a patient.
    BinaryBinaryThis profile sets minimum expectations for the Binary resource to searching for and fetching the data of a single raw artifact as digital content accessible in its native format of a patient.
    CarePlanCarePlanThis profile sets minimum expectations for the CarePlan resource to record, search, and fetch assessment and plan of treatment data associated with a patient.
    ConditionConditionThis profile sets minimum expectations for the Condition resource to record, search, and fetch a list of conditions associated with a patient.
    DiagnosticReportImagingDiagnosticReportThis profile represents the set of information related to the Imaging diagnosis report generated by imaging services like Radiology, Cardiology, Endoscopy, etc. are ordered for the patient.
    DiagnosticReportLabDiagnosticReportThis profile represents the set of information related to the Laboratory diagnosis report generated by the laboratory services like Complete Blood Count, Basic Metabolic Panel, Lipid Panel, Urinalysis, etc. are ordered for the patient.
    DocumentReferenceDocumentReferenceThis profile sets minimum expectations for searching and fetching patient documents including the Clinical Notes using the DocumentReference resource.
    EncounterEncounterThis profile sets minimum expectations for the Encounter resource to record, search, and fetch basic encounter information for an individual patient.
    FamilyMemberHistoryFamilyMemberHistoryThis profile sets minimum expectations for the FamilyMemberHistory resource for searching and fetching significant health conditions of a person related to the patient in the context of care.
    ImagingStudyImagingStudyThis profile sets minimum expectations for the ImagingStudy resource to searching for and fetching the content produced in a DICOM imaging study.
    ImmunizationImmunizationThis profile sets minimum expectations for the Immunization resource to record, fetch and search immunization history associated with a patient.
    ImmunizationRecommendationImmunizationRecommendationThis profile sets minimum expectations for the ImmunizationRecommendation resource to support the next immunization to be taken by the patient.
    MediaMediaThis profile sets minimum expectations for the Media resource to searching for and fetching media like a photo, video, or audio recording acquired or used in healthcare, associated with a patient or provider.
    MedicationRequestMedicationRequestThe MedicationRequest resource can be used to record a patient’s medication prescription or order. This profile sets minimum expectations for the MedicationRequest resource to record, search, and fetch medications associated with a patient.
    MedicationStatementMedicationStatementThe MedicationStatement resource can be used to record a patient’s medication information. It is used to record the information about the medications consumed by the patient in the past, present, or future.
    ObservationObservationObservation resource represents an individual laboratory test and result value, a “nested” panel (such as a microbial susceptibility panel) which references other observations, or rarely a laboratory test with component result values. This profile sets minimum expectations for the Observation resource to record, search, and fetch laboratory test results associated with a patient.
    ObservationBodyMeasurementObservationThis profile sets minimum expectations for the ObservationBodyMeasurement to record, search, and fetch the details of the body measurements of the patient.
    ObservationGeneralAssessmentObservationThis profile sets minimum expectations for the ObservationGeneralAssessment to record, search, and fetch the details of the general health assessment of a patient.
    ObservationLifestyleObservationThis profile sets minimum expectations for the ObservationLifestyle to record, search, and fetch the details of the lifestyle of the patient.
    ObservationPhysicalActivityObservationThis profile sets minimum expectations for the ObservationPhysicalActivity to record, search, and fetch the details of the physical activities of a patient.
    ObservationVitalSignsObservationThis profile sets minimum expectations for the ObservationVitalSigns to record, search, and fetch the details of the vital signs of a patient.
    ObservationWomenHealthObservationThis profile sets minimum expectations for ObservationWomenHealth to record, search, and fetch the details of women’s health.
    OrganizationOrganizationThis profile sets minimum expectations for the Organization resource to searching for and fetching an Organization associated with a patient or provider.
    PatientPatientThis profile sets minimum expectations for the Patient resource to record, search, and fetch basic demographics and other administrative information about an individual patient.
    PractitionerPractitionerThis profile sets minimum expectations for the Practitioner resource to record, search, and fetch basic demographics and other administrative information about an individual practitioner.
    PractitionerRolePractitionerRoleThis profile sets minimum expectations for the PractitionerRole resource to record, search, and fetch the practitioner role for a practitioner.
    ProcedureProcedureThis profile sets minimum expectations for the Procedure resource to record, search, and fetch procedures associated with a patient.
    ServiceRequestServiceRequestThis profile sets minimum expectations for the ServiceRequest resource to searching for and fetching information about services like a request for a procedure or diagnostic or other services to be planned, proposed, or performed associated with a patient or provider.
    SpecimenSpecimenThis profile sets minimum expectations for the Specimen resource to searching for and fetching information regarding a sample to be used for the analysis of a patient.