NP Core Patient

Sets minimum expectations for identifying and locating individuals receiving healthcare in Nepal.

Canonical URL: http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-patient
Resource / type: Patient
Based on: http://hl7.org/fhir/StructureDefinition/Patient
Claim conformance: Put the canonical URL in meta.profile of each instance.

Required elements

“Always” means the element must be present in every instance. Otherwise it is required only when its parent element is present.

Element	Card.	When
`Patient.identifier` An identifier for this patient	1..*	Always
`Patient.identifier:healthId` Nepal Health ID	1..1	Always
`Patient.name` Patient name	1..*	Always
`Patient.communication.language` The language which can be used to communicate with the patient about his or her health	1..1	If parent present
`Patient.link.other` The other patient or related person resource that the link refers to	1..1	If parent present
`Patient.link.type` replaced-by \| replaces \| refer \| seealso	1..1	If parent present

Must-support elements

If your system has this data it SHALL send it, and receivers SHALL process it. Must-support does not by itself make an element mandatory.

Patient.extension:casteEthnicity
Patient.identifier:nationalId
Patient.identifier:healthId
Patient.identifier:citizenshipNumber
Patient.identifier:healthInsuranceId
Patient.identifier:passportNumber
Patient.identifier:ssfNumber
Patient.name
Patient.name.family
Patient.name.given
Patient.telecom
Patient.gender
Patient.birthDate
Patient.address

Identifier slices

Slice	Card.	system	Details
`nationalId`	0..1	http://donidcr.gov.np	type `NI` http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-national-id
`healthId`	1..1	http://fhir.digitalhealth.gov.np/core/NamingSystem/nepal-health-id	type `health-id` http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-health-id
`citizenshipNumber`	0..1	http://moha.gov.np	type `citizenship-number` http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-citizenship-id
`healthInsuranceId`	0..1	http://hib.gov.np	type `health-insurance-id` http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-health-insurance-id
`passportNumber`	0..1	http://nepalpassport.gov.np	type `PPN` http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-passport-id
`ssfNumber`	0..1	http://ssf.gov.np	type `ssf-number` http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-ssf-id

Terminology bindings

required: codes SHALL come from the value set · extensible: use the value set if a suitable code exists · preferred / example: guidance only.

Element	Strength	Value set
`Patient.language`	preferred	http://hl7.org/fhir/ValueSet/languages
`Patient.name.use`	required	http://hl7.org/fhir/ValueSet/name-use
`Patient.gender`	required	http://hl7.org/fhir/ValueSet/administrative-gender
`Patient.maritalStatus`	extensible	http://hl7.org/fhir/ValueSet/marital-status
`Patient.contact.relationship`	extensible	http://hl7.org/fhir/ValueSet/patient-contactrelationship
`Patient.contact.gender`	required	http://hl7.org/fhir/ValueSet/administrative-gender
`Patient.communication.language`	preferred	http://hl7.org/fhir/ValueSet/languages
`Patient.link.type`	required	http://hl7.org/fhir/ValueSet/link-type

Rules (invariants)

np-pat-1 Each name SHALL have a family name or a given name, or a Data Absent Reason extension, but not both. Evaluated per name, so an official name and a nickname are checked independently.

FHIRPath

(family.exists() or given.exists()) xor extension.where(url = 'http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

np-addr-1 The province, district, and localLevel extensions are Nepal-specific and SHALL only be present when country is "NP".

FHIRPath

(extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-province').exists() or extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-district').exists() or extension('http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-local-level').exists()) implies country = 'NP'

Official examples

Patient/ExampleNPCorePatient

View in IG ↗

{
  "resourceType": "Patient",
  "id": "ExampleNPCorePatient",
  "meta": {
    "profile": [
      "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-patient"
    ]
  },
  "identifier": [
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "NI",
            "display": "National unique individual identifier"
          }
        ]
      },
      "system": "http://donidcr.gov.np",
      "value": "1234-5678-9012-3"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/np-core-identifier-type",
            "code": "health-id",
            "display": "Nepal Health ID"
          }
        ]
      },
      "system": "http://fhir.digitalhealth.gov.np/core/NamingSystem/nepal-health-id",
      "value": "10000000001"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/np-core-identifier-type",
            "code": "citizenship-number",
            "display": "Nepal Citizenship Certificate Number"
          }
        ]
      },
      "system": "http://moha.gov.np",
      "value": "12-34-56-78901"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/np-core-identifier-type",
            "code": "health-insurance-id",
            "display": "Nepal Health Insurance ID"
          }
        ]
      },
      "system": "http://hib.gov.np",
      "value": "HIB-000123456"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "PPN",
            "display": "Passport number"
          }
        ]
      },
      "system": "http://nepalpassport.gov.np",
      "value": "PA1234567"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/np-core-identifier-type",
            "code": "ssf-number",
            "display": "Nepal Social Security Fund Number"
          }
        ]
      },
      "system": "http://ssf.gov.np",
      "value": "1-01-01-00001234"
    }
  ],
  "active": true,
  "name": [
    {
      "use": "official",
      "family": "Shrestha",
      "given": [
        "Aarav"
      ]
    }
  ],
  "gender": "male",
  "birthDate": "1990-05-15",
  "_birthDate": {
    "extension": [
      {
        "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-bikram-sambat-date",
        "valueString": "2047-02-01"
      }
    ]
  },
  "address": [
    {
      "extension": [
        {
          "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-province",
          "valueCoding": {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/nepal-administrative-location",
            "code": "3",
            "display": "Bagmati Province"
          }
        },
        {
          "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-district",
          "valueCoding": {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/nepal-administrative-location",
            "code": "306",
            "display": "Kathmandu"
          }
        },
        {
          "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-local-level",
          "valueCoding": {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/nepal-administrative-location",
            "code": "30608",
            "display": "Kathmandu Metropolitan City"
          }
        }
      ],
      "use": "home",
      "type": "physical",
      "text": "Ward 10, Naxal, Kathmandu Metropolitan City, Kathmandu, Bagmati Province, Nepal",
      "line": [
        "Ward 10",
        "Naxal"
      ],
      "city": "Kathmandu Metropolitan City",
      "district": "Kathmandu",
      "state": "Bagmati Province",
      "postalCode": "44600",
      "country": "NP"
    }
  ]
}

Narrative (text) removed for readability.

Patient/ExampleNPCorePatientWithCasteEthnicity

View in IG ↗

{
  "resourceType": "Patient",
  "id": "ExampleNPCorePatientWithCasteEthnicity",
  "meta": {
    "profile": [
      "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-patient"
    ]
  },
  "extension": [
    {
      "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-caste-ethnicity",
      "valueCoding": {
        "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/nepal-caste-ethnicity",
        "code": "2",
        "display": "Janajati"
      }
    }
  ],
  "identifier": [
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "NI",
            "display": "National unique individual identifier"
          }
        ]
      },
      "system": "http://donidcr.gov.np",
      "value": "2345-6789-0123-4"
    },
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/np-core-identifier-type",
            "code": "health-id",
            "display": "Nepal Health ID"
          }
        ]
      },
      "system": "http://fhir.digitalhealth.gov.np/core/NamingSystem/nepal-health-id",
      "value": "10000000003"
    }
  ],
  "active": true,
  "name": [
    {
      "use": "official",
      "family": "Maharjan",
      "given": [
        "Anita"
      ]
    }
  ],
  "gender": "female",
  "birthDate": "1995-08-22",
  "address": [
    {
      "extension": [
        {
          "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-province",
          "valueCoding": {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/nepal-administrative-location",
            "code": "3",
            "display": "Bagmati Province"
          }
        },
        {
          "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-district",
          "valueCoding": {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/nepal-administrative-location",
            "code": "307",
            "display": "Bhaktapur"
          }
        },
        {
          "url": "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-local-level",
          "valueCoding": {
            "system": "http://fhir.digitalhealth.gov.np/core/CodeSystem/nepal-administrative-location",
            "code": "30701",
            "display": "Changunarayan Municipality"
          }
        }
      ],
      "use": "home",
      "type": "physical",
      "text": "Ward 1, Changunarayan Municipality, Bhaktapur, Bagmati Province, Nepal",
      "line": [
        "Ward 1"
      ],
      "city": "Changunarayan Municipality",
      "district": "Bhaktapur",
      "state": "Bagmati Province",
      "postalCode": "44700",
      "country": "NP"
    }
  ]
}

Narrative (text) removed for readability.