Nepal HMIS FHIR Implementation Guide – 🚨 DRAFT VERSION
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Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

NP Core Encounter Profile

The NP Core Encounter Profile inherits from the FHIR Encounter resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Encounter resource to record, search, and fetch basic encounter information for an individual patient within the Nepal health system. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. By providing a standardized foundation for capturing encounters in Nepal (including OPD visits, outreach clinics, and home visits), this profile promotes interoperability, consistent data capture, and adoption across national health programs.

NP Core Immunization Profile

The NP Core Immunization Profile inherits from the FHIR Immunization resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Immunization resource to record, search, and fetch basic immunization information for an individual patient within the Nepal health system. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. By providing a standardized foundation for capturing immunization events in Nepal

NP Core Medication Dispense Profile

The NP Core MedicationDispense Profile inherits from the FHIR MedicationDispense resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the MedicationDispense resource to record, search, and fetch information about medications dispensed to a patient within the Nepal health system. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used.

NP Core Patient Profile

The NP Core Patient Profile inherits from the FHIR Patient resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Patient resource to record, search, and fetch core patient information within the Nepal health system. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. By providing a standardized foundation for capturing patient demographics, identifiers, and key health attributes, this profile promotes interoperability, consistent data capture, and adoption across national health programs

Nepal Person Profile

Foundational person registry profile for Nepal. Supports IDs, Name, and telecom.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Ethnic Code

Extension to capture जाति कोड (ethnicity) based on Nepali classification

Nepal Address

Extension to represent coded and textual forms of Nepal's administrative divisions (Province, District, Municipality, Ward).

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Administrative Gender

A value set containing administrative gender codes from the FHIR core.

Age Range

ValueSet including selected HMIS age ranges from the PeriodRangeCS CodeSystem

Child Nutritional Status (SNOMED CT)

Values representing a child's nutritional status

Condition / Diagnosis Severity

Preferred value set for Condition/Diagnosis severity grading

Condition/Problem/Diagnosis codes

Condition/Problem/Diagnosis codes

Dietary Supplements (SNOMED)

Vitamins, minerals, and other dietary supplements

District

All district used in administrative divisions

Educational Level

SNOMED CT for the highest level of education attained.

Employment (रोजगारी स्थिति)

Codes representing employment status of a person.

Ethnic Code

ValueSet for जाति कोड (Ethnic Codes in Nepal)

Free Cost

ValueSet for Free Cost

Free Service Eligibility

ValueSet representing individuals eligible for free health services

LocalBody

All LocalBody used in administrative divisions

Marital Status (वैवाहिक स्थिति)

Codes representing marital status of a person.

Option Set - Yes / No / Yes-only / Don't know / Not applicable

Master option set for Yes/No/Yes-only/Don't know/Not applicable, including Nepali designations:छ/छैन, हो/होइन, गराएको/नगराएको, लिएको/नलिएको, भएको/नभएको, पाएको/नपाएको

Used for:

  • Presumptive TB Case (सम्भावित क्षयरोग विरामी)
  • Gender Based Violence (लैंगिक हिंसा)
  • Exclusively Breastfeeding (शिशुलाइ जन्मेको ६ महिना सम्म स्तनपान मात्र गराएको)
  • Complementary Food (६ महिना पछि स्तनपान साथै ठोस, अर्धठोस र नरम खाना सुरू)
  • GDS Present (General Danger Sign Present)
  • Chest Indrawing (Yes only)
  • Stridor (Yes only)
  • Wheezing (Yes only)
  • Condom Use
  • Lab test results (Positive/Negative)
HL7 v2-0532 Code SNOMED CT Code English Meaning Nepali Variants
Y 373066001 Yes / Affirmative हो / गराएको / लिएको / भएको / पाएको
N 373067005 No / Negative होइन / नगराएको / नलिएको / नभएको / नपाएको
Patient Registration Type

Patient registration types mapped to SNOMED CT concepts with Nepali display.

Patient Visit Ordinal

ValueSet combining SNOMED CT codes for first and follow-up visits with local codes for second, third, and repeat visits.

Province

All provinces used in administrative divisions

Service Area Address Classification

Classification of address locations relative to the organization's service area and referral context, using SNOMED CT concepts to specify whether the address is inside or outside the service area and the type of location involved.

Service Type

Service Type

Vaccines (SNOMED CT)

ValueSet of routine vaccines in Nepal, based on SNOMED CT concepts.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Ethnic Code

जाति कोडहरू: दलित, जनजाती, मधेसी, मुस्लिम, ब्राह्मण/क्षेत्री, अन्य

Free Service Eligibility

Categories of individuals eligible for free health services (निशुल्क सेवा कोड)

Nepal Administrative Location Codes

Comprehensive code system for Nepals provinces, districts, and municipalities.

Nepal Health Facility Type

Types of health facilities in Nepal, based on Ministry of Health and Population classifications.

Period Range

HMIS period ranges codes based on IHE ADX Range Coding System. Reference: IHE QRPH Supplement ADX, CP-QRPH-238, https://www.ihe.net/uploadedFiles/Documents/QRPH/IHE_QRPH_Suppl_ADX.pdf#page=78

Durations define the amount if an intervening time between two time points. These durations are represented in the form P[n]Y[n]M[n]DT[n]H[n]M[n]S or P[n]W. The [n] is replaced by the value for each of the time elements that follow the [n] and the letters have the meaning:

P is the duration designator (for period) placed at the start of the duration representation. Y is the year designator that follows the value for the number of years. M is the month designator that follows the value for the number of months. W is the week designator that follows the value for the number of weeks. D is the day designator that follows the value for the number of days. T is the time designator that precedes the time components of the representation. H is the hour designator that follows the value for the number of hours. M is the minute designator that follows the value for the number of minutes. S is the second designator that follows the value for the number of seconds.

निशुल्क/शुल्क रू

निशुल्क/शुल्क रू

सेवाको किसिम कोड सिस्टम

स्वास्थ्य सेवाका विभिन्न किसिमहरूको कोड सूची

Terminology: Naming Systems

These define identifier and/or code system identities used by systems conforming to this implementation guide.

National Health ID

The official National Health Identification Number assigned by the Government of Nepal.

Nepal National Identity Number

Nepalese National Identity Number issued by the Ministry of Home Affairs.

Terminology: Concept Maps

These define transformations to convert between codes by systems conforming with this implementation guide.

HL7 Administrative Gender to SNOMED CT

Maps HL7 Administrative Gender codes to SNOMED CT concepts.

Yes / No Concept Map

Mapping between HL7 v2-0532, SNOMED CT, and Nepali Yes/No custom codes

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Encounter ANC Visit - Pregnant Woman

An antenatal care visit for a pregnant woman.

Immunization Record - BCG

An example of an immunization resource for BCG vaccine.

Immunization Record - DPT

An example of an immunization resource for Diphtheria, Pertussis, and Tetanus (DPT) vaccine.

Immunization Record - Fractional Injectable Polio Vaccine (fIPV)

Example immunization resource for fractional IPV, given intradermally at 14 weeks and 9 months (2 doses).

Immunization Record - HPV Vaccine

Example immunization resource for Human Papillomavirus vaccine, given intramuscularly to adolescent girls in grades 6-10 and out-of-school girls aged 10+.

Immunization Record - Japanese Encephalitis Vaccine

Example immunization resource for Japanese Encephalitis vaccine, given subcutaneously at 12 months.

Immunization Record - Measles-Rubella Vaccine

Example immunization resource for Measles-Rubella vaccine, given subcutaneously at 9 and 15 months.

Immunization Record - OPV

An example of an immunization resource for Oral Polio Vaccine (OPV).

Immunization Record - PCV

An example of an immunization resource for Pneumococcal Conjugate Vaccine (PCV).

Immunization Record - Pentavalent Vaccine

An example of an immunization resource for the Pentavalent vaccine (DPT-HepB-Hib).

Immunization Record - Polio

An example of an immunization resource for Poliomyelitis vaccine (IPV/OPV).

Immunization Record - Rotavirus

An example of an immunization resource for Rotavirus vaccine.

Immunization Record - Td

An example of an immunization resource for Tetanus and Diphtheria (Td) vaccine.

Immunization Record - Typhoid Vaccine

Example immunization resource for Typhoid vaccine, given intramuscularly at 15 months.

MedicationDispense - Albendazole

Example of albendazole to a pregnant woman according to NP Core MedicationDispense Profile.

MedicationDispense - Calcium Dispense

Example of dispensing 30 Calcium to a pregnant woman according to NP Core MedicationDispense Profile.

MedicationDispense - Iron Tablet Dispense

Example of dispensing 60 iron tablets to a pregnant woman according to NP Core MedicationDispense Profile.

Patient – Child

1-year-old Suman Thapa from Kathmandu Metropolitan City Ward No. 12 visiting the Health Facility for routine immunizations.

Patient – Pregnant Woman (Mom-to-Be)

21-year-old Hiramaya Tamang from Ilam Municipality Ward No. 5 visiting the district hospital for pregnancy-related care.