NHDR Implementation Guide Release 1.0
0.1.0 - ci-build

NHDR Implementation Guide Release 1.0, published by NHDR. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/PROJ-PHILHEALTH-EA-NHDR/nhdr-fhir-ig-review-project-2/ and changes regularly. See the Directory of published versions

## Mapping of Konsulta Availment Slip to FHIR

View
Form

### Mapped Fields

Form Field | Use-Case Mapping / Target Element | Data Type | Cardinality | Notes
--- | --- | --- | --- | ---
To be filled out by the facility |  |  |  |
Consent Confirmation | Questionnaire.item.text | string | 0..1 |
HCI Name | Claim.provider | Reference(PH_Organization) | 1..1 |
► | Organization.name | string |  |
Case Number | Claim.encounter | Reference(PH_Encounter) | 0..* |
► | Encounter.identifier | identifier |  |
HCI Accreditation Number | Claim.provider | Reference(PH_Organization) | 1..1 |
► | Organization.Identifier | identifier |  | DOH fhudcode
Transaction Number | Claim.identifier | identifier | 0..1 |
PhilHealth Identification Number (PIN) | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.identifier | identifier |  | PhilHealth ID
Membership Category | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.MemberType | codeableConcept |  | ValueSet: MemberType
Patient Name (Last Name) | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.name.family | string |  |
Patient Name (First Name) | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.name.given | string |  |
Patient Name (Name Extension) | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.name.suffix | string |  |
Patient Name (Middle Name) | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.name.given | string |  |
Age | Claim.encounter | Reference(PH_Encounter) | 0..1 |
► | Encounter.ageYears | integer |  |
Contact Number | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.telecom.value | string |  |
Membership Type | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.type | codeableConcept |  | ValueSet: PatientType
Authorization Transaction Code | Claim.encounter | Reference(PH_Encounter) | 0..1 |
► | Encounter.appointment | Reference(PH_Appointment) |  |
► | Appointment.identifier | identifier |  |
Konsulta Services | Claim.item.productOrService | codeableConcept |  |
Performed? [check - x] | Questionnaire.item.text | string | 0..1 |
Date Performed | Claim.item.serviced[x] | date | 0..1 |
Performed by (Last Name) | Claim.careTeam.provider | ​Reference(PH_Practitioner) | 1..1 |
► | Practitioner.name.family | string |  |
Performed by (First Name) | Claim.careTeam.provider | ​Reference(PH_Practitioner) | 1..1 |
► | Practitioner.name.given | string |  |
Performed by (Name Extension) | Claim.careTeam.provider | ​Reference(PH_Practitioner) | 1..1 |
► | Practitioner.name.suffix | string |  |
Performed by (Middle Name) | Claim.careTeam.provider | ​Reference(PH_Practitioner) | 1..1 |
► | Practitioner.name.given | string |  |
To be filled out by the patient |  |  |  |
Have you received the above-mentioned essential service? [Y or N] | Questionnaire.item.text | string | 0..1 |
How satisfied are you with the services provided? | Questionnaire.item.text | string | 0..1 |
For your comment, suggestion or complaint | Questionnaire.item.text | string | 0..1 |
PhilHealth Identification Number of Patient | Claim.patient | ​Reference(PH_Patient) | 1..1 |
► | Patient.identifier | identifier |  | PhilHealth ID
Patient Name over Signature | Provenance.signature.who | ​Reference(PH_Patient) | 1..1 |
► | Patient.name | HumanName |  |
Patient Name over Signature | Provenance.signature.data | base64Binary | 0..1 |
Thumbmark Print | Provenance.signature.data | base64Binary | 0..1 |

### Mandatory Elements Not in the Form

Use-Case Mapping / Target Element | Data Type | Notes
--- | --- | ---
Claim.status | code |
Claim.type | CodeableConcept |
Claim.use | code |
Claim.created | dateTime |
Claim.priority | CodeableConcept |
Claim.careTeam.sequence | positiveInt |
Claim.insurance |  |
Claim.insurance.sequence | positiveInt |
Claim.insurance.focal | boolean |
Claim.insurance.coverage | ​Reference(PH_Coverage) |
Claim.item.sequence | positiveInt |
Provenance.signature.type | coding |
Provenance.target | Reference(Any) |
Provenance.recorded | instant |
Provenance.agent |  |
Provenance.agent.who | ​Reference(PH_Organization) |
Organization.name | string |
Provenance.signature.when | instant |
Questionnaire.status | code |
Questionnaire.item.linkId | string |
Questionnaire.item.type | code |
Encounter.status | code |
Encounter.class | coding |
Appointment.status | code |
Appointment.participant.status | code |
Coverage.status | code |
Coverage.beneficiary | ​Reference(PH_Patient) |
Coverage.payor | ​Reference(PH_RelatedPerson) |
Coverage.costToBeneficiary.value[x] | SimpleQuantity, Money |