FHIR Implementation Guide for ABDM
6.5.0 - active
FHIR Implementation Guide for ABDM
6.5.0 - active
FHIR Implementation Guide for ABDM - Local Development build (v6.5.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
The International Patient Summary (IPS) is a standardized, minimal, and non-exhaustive set of clinical data intended to support continuity of care and patient safety across healthcare systems and borders. Defined by [Health Level Seven (HL7)] and [International Organization for Standardization (ISO)], it is a key artifact that enables safe, efficient exchange of health information, particularly during unplanned or cross-jurisdictional care.
A patient summary is not a complete health record but rather the essential minimum dataset required to ensure safe and effective care. By making critical health information readily available, patient summaries improve patient safety and support consistent, informed decision-making by clinicians across different sectors and domains.
An IPS bundle is an electronic health record extract containing essential healthcare information about the patient, including at least the mandatory elements defined in the IPS dataset. The dataset is:
As described in EN 17269 and ISO 27269, the IPS was developed to support use cases such as unplanned, cross-border care.
The IN Patient Summary (IN PS) is an implementable FHIR specification based on the International Patient Summary (IPS) as defined by [Health Level Seven (HL7)] and [International Organization for Standardization (ISO)]. The IN PS profile set is closely aligned with the HL7 IPS-UV specification while addressing localized requirements for the [Ayushman Bharat Digital Mission (ABDM)], this ensures international interoperability while reducing barriers to early adoption.
To achieve this:
imposeProfile extension.The IN PS follows the general principles and design conventions of the International Patient Summary Implementation Guide. Full details are available in the IPS IG.
The Indian Patient Summary (IN PS) profiles are designed to ensure consistency with both national and international standards. All profiles defined in IN PS are derived from the [Ayushman Bharat Digital Mission (ABDM)] base profiles published for India, thereby aligning with the [Ayushman Bharat Digital Mission (ABDM)] ecosystem. At the same time, they are also made conformant to the International Patient Summary (IPS) profiles, ensuring global interoperability. To achieve this, the IN PS makes use of the imposeProfile extension, which allows implementers and validators to enforce dual conformance: the resource instance must be valid against both the [Ayushman Bharat Digital Mission (ABDM)] profile (national compliance) and the IPS profile (international compliance). This ensures that while the national constraints are fully respected, the IPS constraints are not restated in the IN PS profile but are still enforced at validation time.
Key aspects of the profiling approach are as follows:
Composition, Bundle, Patient, Observation) without restating IPS constraints.
The Problem List section records clinical problems or conditions currently being monitored for the patient. If no problems are known or documented, this is indicated using emptyReason (at Composition.section) or a referenced resource (at Composition.section.entry).
This section captures relevant allergies or intolerances, including the type of reaction (e.g., rash, anaphylaxis), the causative agents when known, and optionally the severity and certainty of the allergy. At a minimum, it should document currently active and relevant historical allergies or adverse reactions. If no information is available, emptyReason or a referenced resource should be used.
The Medication Summary provides details of medications relevant to the patient summary. Depending on jurisdiction, it may include:
Medications are represented as MedicationStatement or MedicationRequest. This section can be populated as:
emptyReasonThis section records the patient’s current immunization status and clinically pertinent immunization history, primarily to facilitate communication of immunization information.
This section aggregates relevant observation results obtained from the patient or in vitro specimens, including laboratory, pathology, and radiology results. Observations may be included directly or referenced via DiagnosticReport.
Documents past procedures relevant to the patient summary, including:
Includes narrative text and coded entries describing the patient’s history of medical device use.
Contains a narrative description of the patient’s advance directives, including links to supporting documents and consents.
Conveys information flagged to raise awareness of potential concerns or risks to/from the patient.
Describes the patient’s ability to perform activities of daily living and any needs for continuous assessment by third parties. Disability or functional status may influence treatment decisions. Future profiles may further formalize functional assessments.
Documents conditions that the patient experienced previously but are no longer tracked in the current Problem List.
Captures pregnancy status and history, including:
Includes narrative text and optional resources to capture what matters to the patient, such as needs, strengths, values, concerns, and preferences. Examples include:
Describes care expectations, goals, proposals, and orders for monitoring, tracking, or improving the patient’s condition.
Covers relevant social factors, including:
Includes vital signs such as blood pressure, body temperature, heart rate, and respiratory rate, along with other clinical findings like height, weight, BMI, head circumference, and pulse oximetry. Notable measurements (e.g., most recent, maximum, minimum, baseline, or trends) may also be recorded.
The IN PS exchange format is represented as a FHIR Bundle of type document. Bundle contains a collection of entries, with the first entry always being a Composition resource. All other entries within the Bundle are referenced from this Composition, providing a structured and complete representation of the patient summary.
In the IN PS document:
