Nepal HMIS FHIR Implementation Guide – 🚨 DRAFT VERSION
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Nepal HMIS FHIR Implementation Guide – 🚨 DRAFT VERSION - Local Development build (v0.0.1-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Health Journey Opd

This use case describes the process of capturing and exchanging data related to Outpatient Department (OPD) services in health facilities using FHIR.

Objective

To ensure standardized data capture and reporting for OPD consultations across public health facilities, aligning with EHMIS reporting requirements.

Actors

  • Patient
  • Health Worker (e.g., Medical Officer, Health Assistant, ANM)
  • OPD Registration Clerk

Workflow Steps

  1. Registration at OPD Desk
    • Capture patient demographic info
    • FHIR Resource: Patient
    • Optional linking to previous visit using Encounter
  2. OPD Encounter Starts
    • FHIR Resource: Encounter
    • Type: OPD Visit
    • Status: in-progress → finished
  3. Chief Complaints and History Taking
    • FHIR Resource: Observation (e.g., symptoms, duration)
    • May also use Condition for known diseases
  4. Physical Examination
    • Vitals: BP, temperature, pulse, weight
    • FHIR Resource: Observation
  5. Diagnosis
    • Primary and secondary diagnosis
    • ICD-10/ICPC coding recommended
    • FHIR Resource: Condition
  6. Treatment/Prescription
    • Medications prescribed (with dosage, frequency, duration)
    • FHIR Resource: MedicationRequest
  7. Referral or Advice
    • If referred to specialist or hospital
    • FHIR Resource: ReferralRequest or ServiceRequest
  8. OPD Visit Completion
    • Encounter.status = finished

FHIR Resources Used

Resource Purpose
Patient To capture demographic info
Encounter To record the OPD consultation
Observation Vitals, symptoms, lab values
Condition Diagnoses
MedicationRequest Prescriptions
ServiceRequest Diagnostic or specialist referral

Example: OPD for a 45-Year-Old Male with Fever

  • Patient: Registered with demographics
  • Encounter: OPD visit on 2025-08-08
  • Observation:
    • Temperature: 101°F
    • Blood pressure: 130/85
  • Condition: Acute febrile illness
  • MedicationRequest: Paracetamol 500mg TID × 3 days

Reporting Considerations

  • Monthly OPD data can be aggregated using:
    • Condition types
    • Age/sex disaggregation
    • Visit counts
  • Can be linked to DHIS2 datasets through mapping